Assessment of Static and Dynamic Balance in Swimmers

Background: Swimming can be defined as an activity in which a person practices a regulated Olympic sport in order to move as fast as possible through the water due to the propulsive forces generated by arm, leg, and body movements overcoming the resistance of water. Swimming is performed in either a supine or prone position with a bilaterally-symmetric motion and is influenced by buoyancy. In other words, it is nearly unaffected by gravity and requires the same muscle exertion of both the right and left extremities. Balance is considered to be an important component of motor performance tasks. It is controlled by the central nervous system with the help of input from the visual, tactile, proprioceptive and vestibular systems (5) Balance can be defined as a condition during which the body's center-of-gravity (COG) is maintained within its base of support (BOS). Methodology: In this study, 50 Competitive swimmers were included. 36 Male and 14 Female, with a mean age, height and weight of 22.68 years, 175.56 cm and 70.94 kg respectively. Each had a swimming career more than 5 years, Training at least 5 days a week for 2 hours or more with an average of 10.12 years, 5.54 days a week for 2.68 hour training sessions. Static Balance was assessed using Balance Error Scoring System where the subjects were asked to stand with their eyes closed for 20 seconds in 6 Different Positions and the number of errors made were noted. Dynamic Balance was assessed using Star Excursion Balance Test were, a Star was marked on the ground to have 8 directions. The subject stood in the center of the star and had to reach as far as they could in each direction. This distance from the middle to the point of contact of their toe was noted and relative distance was calculated using Limb Length. The Results of both the test was compared with the normal data present. Result: The result of the test done to evaluate static balance; BESS showed that out of 50 participants 19 had superior balance, 18 had above average balance and 13 had broadly normal balance and the errors on the firm surface and soft surface had a mean and standard deviation of 2 ± 1.12 and 4.1±1.31 respectively. On the other hand, the test done to evaluate dynamic balance; SEBT showed that in each direction on an average the swimmer could reach 119.21±8.39 % relative distance in each direction. Conclusion: Different tests were conducted in the study to understand if competitive swimmers are somehow weak in terms of static and dynamic balance. The entire study is based on the effectiveness of maintaining and enhancing the static and dynamic stability among the swimmers. This study concludes that competitive swimmers have Superior Static and Dynamic Balance because of strong core muscles used to keep their body streamlined during swimming and good flexibility and neuromuscular feedback. Key words: Balance, Swimmers, Star Excursion Balance test (SEBT), Balance Error Scoring System (BESS).

ANÁLISE DAS CONDICIONANTES DE LESÕES ESPORTIVAS NA PRÁTICA DO VOLEIBOL FEMININO EM ATLETAS JOVENS

O voleibol é uma das modalidades esportivas mais praticadas no mundo. Acompanhado desta prática, está presente o risco de lesões musculoesqueléticas, especialmente nos membros inferiores. Tais lesões podem ser causadas por fatores intrínsecos ou extrínsecos. A proposta deste estudo, foi analisar as condicionantes intrínsecas estruturais, estáticas e dinâmicas das principais lesões esportivas envolvidas na prática junto a atletas de voleibol e a necessidade de propor ações preventivas de Fisioterapia Esportiva. Trata-se de um estudo observacional do tipo transversal, realizado com 34 atletas do sexo feminino, idade de 12,74 ± 1,16 anos, praticantes de voleibol há no mínimo um ano. Foi aplicado um questionário referente a informações antropométricas e queixas referente a dor e lesões das atletas, plantigrafia e os seguintes testes funcionais: Step Down Test, Star Excursion Balance Test, Balance Error Scoring System. A frequência de treinos era de 2 à 3 vezes por semana, tempo de prática ficou entre 1 a 4 anos envolvendo 85,3% das atletas. Em relação ao índice do arco plantar a maioria apresentou normal. O valgismo de joelho prevaleceu em grande parte das avaliadas. O segmento corporal com mais queixa de dor foi o joelho e lesões o tornozelo. O período de treinamento teve mais lesões do que em competição. Em relação aos achados da avaliação, é considerada necessária a adoção de medidas de prevenção, evitando agravos musculoesqueléticos nas praticantes de voleibol.

Comparison of Concussion Sideline Screening Measures Across Varying Exertion Levels Within Simulated Games

Context: Currently, there is no gold standard to evaluate the effect of varying game-like exertion states on Sport Concussion Assessment Tool 3rd Edition (SCAT-3) outcomes. Baseline assessments may occur before, during, or after physical activity, while postinjury evaluations predominantly occur following physical activity. Thus, clinicians may be comparing postinjury evaluations completed following exertion to baseline evaluations completed following varying levels of rest or exertion, which may not be a valid method for clinical decision making. Objective: To determine the effect of various physical exertion levels on sideline concussion assessment outcomes and reliability. Design: Within-subjects, repeated measures. Setting: Field. Participants: Physically active participants (N = 36) who regularly participate in basketball activity. Intervention: Subjects participated in 2 simulated basketball games, completing a symptom checklist, Standardized Assessment of Concussion, and Balance Error Scoring System before game play, during halftime, and at the completion of each simulated game. Pulse rate was assessed as a proxy of physical exertion. Main Outcome Measures: Total symptom, Standardized Assessment of Concussion, and Balance Error Scoring System scores. Results: Physical exertion did not significantly predict symptom, Standardized Assessment of Concussion, or Balance Error Scoring System scores, although a trend toward higher symptom scores was observed for females (ß = 0.03, P = .09). All assessments had poor to moderate reliability across sessions (.15 < interclass correlation coefficient [2,1] < .60). Conclusion: Low- to moderate-intensity physical activity did not have a significant effect on clinical concussion sideline assessments; however, the low test–retest reliability observed prevents strong conclusions on these relationships. The poor overall reliability does not allow for clear recommendations for what state of baseline physical exertion (ie, rested or exerted) provides optimal data to make postinjury clinical decisions, although baseline concussion assessments completed at rest have the most valid and conservative normative values for injury comparison.

The Comparison Between Instrumented and Observer-Rated Measures of the Modified Balance Error Scoring System: A Critically Appraised Topic

Clinical Scenario: Postural control deficits are one of the most common impairments associated with sport-related concussion. The Modified Balance Error Scoring System (mBESS) is one of the current standard clinical measures for assessing these deficits; however, it is dependent upon observer-rated measurements. Advancements in inertial measurement units (IMUs) lend themselves to be a viable option in objectifying postural control assessments, such as the mBESS. Clinical Question: Are IMU-based measures of the mBESS more effective than observer-rated measures of the mBESS in identifying patients with sport-related concussion? Summary of Key Findings: Following a systematic search, three studies were included. One study compared observer-rated measures of the Balance Error Scoring System and mBESS to instrumented measures of both tests and determined that the instrumented mBESS had the highest diagnostic accuracy. The results of the second study determined that IMU-based measures were successful in both classifying group and identifying task errors. The final study found that using IMUs increased sensitivity of the mBESS, specifically the double-limb stance, to group classification. Clinical Bottom Line: Instrumentation of the mBESS using IMUs provides more objective and sensitive measures of postural control in patients with SRC. Strength of Recommendation: Due to the consistent, good-quality evidence used to answer this critically appraised topic, the grade of A is recommended by the Strength of Recommendation Taxonomy.

Balance performance in sedentary and active healthy young individuals – a cross-sectional study

Background and Study aim. Balance ability has a fundamental role in many activities of daily living, as well in athletic activities. The Balance Error Scoring System is a valid and reliable test used to evaluate postural balance. The aim of this study was to assess the postural balance in active and sedentary healthy young individuals. Material and Methods. A cross-sectional study was carried out to evaluate the balance performance in forty-four healthy young individuals (mean age 21.69±4.87 years), based on their physical activity level. Balance was assessed using the Balance Error Scoring System (BESS), and the total number of errors was scored, for the non-dominant limb (the left leg for both groups). The errors were counted for each of the six situations (double leg stance, single leg stance and tandem stance, on hard and soft surface). Results. Group 1 consisted of twenty-two active subjects (mean age 21.18±2.32 years, 59.09% females), with a BESS score of 9.87±1.6. The sedentary group (group 2), with twenty-two young subjects (mean age 22.22±6.61 years, 59.09% females), scored a significantly higher BESS score for the sedentary group (15.48±2.24) (p<0.001). No gender differences were recorded. Conclusions. Physically active young people have a better postural balance than do the sedentary ones, as scored with the BESS.

Balance Error Scoring System Reliability and Validity When Performed With Ice Skates

In equipment-heavy sports, there is a growing need to evaluate players in the condition in which they participate. However, the psychometric properties of the Balance Error Scoring System (BESS) while wearing skates remains unknown. Seventy-four adolescent male hockey players completed the BESS with and without skates. A subset was reevaluated at the conclusion of the season. The BESS while wearing skates resulted in a mean of 15 more total errors than the traditional administration (t73 = 14.94, p < .001; ES = 1.95) and demonstrated low test-retest reliability. The BESS should be administered in the traditional manner (without skates).