The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial.

This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.

Time Course Effects of Different Intensities of Running Exercise on Cognitive and Motor Performances in Individuals With Intellectual Disability.

This study explored the acute effects of different running intensities on cognitive and motor performances in individuals with intellectual disability (ID). An ID group (age, M = 15.25 years, SD = 2.76) and a control group without ID (age, M = 15.11 years, SD = 1.54) performed visual simple and choice reaction times, auditory simple reaction time, and finger tapping tests before and after running at low or moderate intensity (30% and 60% of heart rate reserve [HRR], respectively). Visual simple reaction time values decreased (p < .001) after both intensities at all time points with higher (p = .007) extend after the 60% HRR intensity for both groups. After both intensities, the VCRT decreased (p < .001) in the ID group at all time points compared with preexercise (Pre-EX) while, in the control group, these values decreased (p < .001) only immediately (IM-EX) and after 10 min (Post-10) of exercise cessation. Compared withs Pre-EX, in the ID group, the auditory simple reaction time values decreased (p < .001) at all time points after the 30% HHR intensity whereas, after the 60% HRR, these values decreased only at IM-EX (p < .001), Post-10 (p = .001) and Post-20 (p < .001). In the control group, auditory simple reaction time values decreased (p = .002) only after the 30% HRR intensity at IM-EX. The finger tapping test increased at IM-EX (p < .001) and at Post-20 (p = .001) compared to Pre-EX in both groups only after the 30% HHR intensity and for the dominant hand. The effect of physical exercise on cognitive performances in individuals with ID seems to depend on the cognitive test type as well as the exercise intensity.

Does piriformis muscle syndrome impair postural balance? A case control study.

BACKGROUND AND PURPOSE: While patients with musculoskeletal disorders reported postural balance impairments, it is unknown whether patients with piriformis muscle syndrome (PMS) may exhibit postural balance disorders compared to controls. The aim was to compare postural balance in patients with PMS to controls in static and dynamic conditions. MATERIAL AND METHODS: Twelve patients with PMS and twelve controls were enrolled. Static postural balance was assessed by calculating the symmetry index (SI) in the unipedal posture. To measure vision contribution, the Romberg index (RI) was computed. Dynamic postural balance was evaluated with the Timed up and go test (TUGT). Besides, inter-limb strength asymmetry (SA), pain and the short form-36 (SF-36) were assessed. RESULTS: The PMS group (PMSG) exhibited significant (p < 0.001) higher SI in eyes opened (EO) and eyes closed (EC) conditions compared to the control group (CG). Besides, PMSG had significant higher RI (p < 0.05), TUGT scores (p < 0.001), SA values (p < 0.05), pain intensity (p < 0.001), and worse SF-36 scores on all physical health (p < 0.05) and psychological health (only in vitality and mental health [p < 0.05]), compared to CG. CONCLUSION: Our data revealed impaired static and dynamic postural balance, and reduced quality of life in PMSG compared to CG. Postural balance impairments could explain the poor quality of life, which are likely due to the higher SA and higher pain intensity. Clinicians and physiotherapists should consider postural balance disorders while designing rehabilitation programs in these patients.

Relationship Between Postural Stability and Proprioception, Pain, Quadriceps Strength, and Muscle Tightness in Athletes With Patellar Tendinopathy.

BACKGROUND: Athletes with patellar tendinopathy (PT) have postural stability deficits; however, the underlying mechanisms and factors responsible remain unknown. The effect on postural stability in PT of decreased quadriceps strength, altered proprioception, lower-limb muscle tightness, and knee pain, which explain postural stability deficiency in other populations, is uninvestigated. HYPOTHESIS: Proprioceptive acuity, muscle tightness, quadriceps strength, and pain predict postural stability in athletes with PT. STUDY DESIGN: Cross-sectional comparative study. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 43 athletes with PT and 43 healthy athletes were enrolled. Static and dynamic postural stability, proprioceptive acuity, muscle tightness, quadriceps strength, and pain were evaluated using a force platform, Y-balance test (YBT), a weight discrimination protocol, a goniometer, an isometric dynamometer, and a valid questionnaire, respectively. RESULTS: Athletes with PT had significantly worse static and dynamic postural stability in the affected limb (AL) compared with the nonaffected limb (NAL) (P < 0.01) and the control group (P < 0.01). Athletes suffering from PT revealed lower quadriceps strength (P < 0.01), proprioceptive acuity (P = 0.02), and higher muscle tightness in the AL compared with the NAL and controls. Quadriceps weakness of the AL and pain in athletes with PT explained the variance of dynamic postural stability impairment. CONCLUSION: Athletes with PT have postural stability deficiency compared with healthy peers. Our results demonstrate that quadriceps muscle weakness and pain are the factors that explain postural stability impairment. CLINICAL RELEVANCE: These results can assist clinicians in the design of therapeutic balance rehabilitation programs by acting not only on pain relief but also on quadriceps strengthening through resistance training to avoid subsequent injuries in athletes with PT.

Core stability is associated with dynamic postural balance in soccer players experiencing groin pain without time-loss.

Objectives: The study sought to evaluate possible relationships between dynamic postural balance and pain, core stability, and hip range of motion in soccer players who were experiencing groin pain (GP). Furthermore, the study aimed to compare these measurements in symptomatic and asymptomatic players. Methods: The study included 42 male soccer players experiencing GP and an equal number of asymptomatic players. Dynamic postural balance, pain, hip range of motion and trunk endurance were measured. Results: The GP group revealed reduced dynamic balance performance (p < 0.01-0.001) in injured and non-injured limbs compared to control group. Further, players experiencing GP demonstrated lower hip range of motion in internal (p < 0.05) and total rotations (p < 0.01) in the injured limb, and lower trunk endurance (p < 0.001) compared to their asymptomatic peers. In general, core stability was associated (r = 0.13-0.61, p < 0.05-0.001) with the poor dynamic balance performance in the GP group while standing on injured and non-injured limbs. No significant correlations between dynamic postural balance, pain and hip range of motion were observed. Conclusion: Poor core endurance was found to be associated with dynamic balance disorders in soccer players experiencing GP. This information can aid in the development of targeted strategies to enhance dynamic postural balance in these players.

Iron Deficiency Anemia Is Associated with Proprioceptive Deficit in Adult Women: a Cross-Sectional Case-Control Study.

Proprioception is essential to several conscious and unconscious sensations and automatic control of movement in daily life activities. Iron deficiency anemia (IDA) may alter proprioception as it could induce fatigue, and affect neural processes such as myelination, and neurotransmitters synthesis and degradation. This study aimed to explore the effect of IDA on proprioception in adult women. Thirty adult women with IDA and 30 controls participated in this study. The weight discrimination test was performed to assess proprioceptive acuity. Attentional capacity and fatigue were evaluated, too. Women with IDA had a significantly (P < 0.001) lower ability to discriminate weights compared to controls in the two difficult increments, and for the second easy weight (P < 0.01). For the heaviest weight, no significant difference was found. Attentional capacity and fatigue values were significantly (P < 0.001) higher in patients with IDA compared to controls. Moreover, moderate positive correlations between the representative proprioceptive acuity values and Hb (r = 0.68) and ferritin (r = 0.69) concentrations were found. Moderate negative correlations were found between the proprioceptive acuity values and general (r = - 0.52), physical (r = - 0.65) and mental (r = - 0.46) fatigue scores, and attentional capacity (r = - 0.52). Women with IDA had impaired proprioception compared to their healthy peers. This impairment may be related to neurological deficits due to the disruption of iron bioavailability in IDA. In addition, fatigue resulting from IDA due to the poor muscle oxygenation could also explain the proprioceptive acuity decrease in women suffering from IDA.

Reference values of postural balance in preschoolers: Age and gender differences for 4-5 years old Tunisian children.

BACKGROUND: Preschool age is a critical stage of postural balance development. Posturography normative data during this age are crucial for surveillance of postural balance and for the timely diagnosis of any dysfunction. The aim of this study was to provide normative data, specific to Tunisian preschoolers, according to age and gender, and to examine gender- and age-related differences in postural balance. RESEARCH QUESTION: Are there postural balance gender- and age-related differences in Tunisian preschoolers? METHODS: The study included 410 (205 boys and 205 girls) preschool children aged between 4- and 5-year-old selected within a large geographic area of Tunisia. Postural balance was assessed using a stabilometric platform under 4 sensory conditions. The mean center of pressure velocity (CoP-V) parameter was selected for analysis. Differences between gender and age groups were analysed using the Mann-Whitney U. Normative data were expressed in percentiles. RESULTS: Significant gender effect was found in conditions where sensory inputs are most challenged with a significantly smaller mean CoP-V in girls compared to boys (p < 0.05). Moreover, 5-year-old children had significantly better postural balance than 4-year-old ones in almost all conditions (p < 0.05). SIGNIFICANCE: The normative data established for Tunisian preschoolers provide useful comparative data for pediatricians, teachers and coaches for the early evaluation and monitoring of postural balance during this age. Gender and age-related differences should be considered in this population.

Athletes with unilateral patellar tendinopathy have increased subsequent lower extremity musculoskeletal injury risk.

This study aimed to investigate static and dynamic postural balance inter-limb asymmetries in athletes with unilateral patellar tendinopathy (UPT) and estimate subsequent lower extremity musculoskeletal injury risk compared to controls. Twenty-eight athletes with UPT were recruited. Twenty-eight healthy athletes served as controls. Static postural balance inter-limb asymmetry (symmetry index: SI) was assessed based on differences in the mean centre of pressure (CoP) velocity (CoPv) values between the affected leg (AL) and non-affected leg (NAL) for the UPT group, and the dominant leg (DL) and non-dominant leg (NDL) for controls. Outcome variables were dynamic postural balance, assessed with inter-limb asymmetry using the Y Balance Test (YBT), and injury risk. In static balance, SI values were significantly (P<0.001) higher in the UPT group compared to controls. In dynamic balance, normalized inter-limb asymmetry values were also significantly higher in athletes with UPT compared to controls in anterior (P<0.001), posteromedial (P<0.001) and posterolateral (P<0.01) directions, and in the composite score (P<0.001). Furthermore, the incidence of sustaining a non-contact lower extremity injury during the follow-up period (10 months) was significantly higher (P<0.05) in the UPT group compared to controls. Athletes with UPT had postural balance inter-limb asymmetries. Moreover, they had increased subsequent lower extremity musculoskeletal injury risk compared to controls. Since most athletes with UPT continue to train and compete, adequate training and rehabilitation programmes should be implemented to prevent potential subsequent injury occurrence.

Patellar tendinopathy impairs postural control in athletes: A case-control study.

OBJECTIVE: To compare postural control performance between athletes with and without patellar tendinopathy (PT). DESIGN: Case-control study. PARTICIPANTS: Fifty-eight athletes, 29 with PT (PT group: PTG) and 29 healthy ones (control group: CG). MAIN OUTCOME MEASURES: Static and dynamic postural control were assessed with a force platform and the Y-Balance Test (Y-BT), respectively. Quadriceps strength of both limbs was evaluated using an isometric dynamometer. RESULTS: The PTG exhibited significantly (p < 0.05) higher centre of pressure (CoP) values than the CG on the foam surface, and significantly lower (p < 0.001) anterior, posteromedial and posterolateral normalized reach distances, and composite score in dynamic postural control on the injured limb (IL) compared to non-injured limb (NIL) and dominant limb (DL) of the CG. The quadriceps muscle strength was significantly lower on the IL compared to the NIL (p < 0.01) and DL (p < 0.05) of the CG. CONCLUSION: Athletes suffering from PT exhibited worse static and dynamic postural control compared to healthy peers. As players with PT frequently continue training despite their tendon pain, physiotherapists and clinicians should incorporate balance rehabilitation programs in the treatment of these players, not only to prevent further potential injuries but also to enhance sport performance.

Postural balance asymmetry and subsequent noncontact lower extremity musculoskeletal injuries among Tunisian soccer players with groin pain: A prospective case control study.

BACKGROUND: Recent studies reported postural balance disorders in patients and soccer players with groin pain (GP) compared to controls. Since postural balance asymmetry identified after an initial injury contributes for subsequent injuries, identification of this asymmetry in soccer players with GP may highlight the risk of sustaining subsequent noncontact lower extremity musculoskeletal injuries in these players. Therefore, the aims of this study were to (i) examine static and dynamic unipedal postural balance asymmetry in soccer players with GP compared to healthy ones, and (ii) quantify the risk of subsequent noncontact lower extremity injuries in these players. RESEARCH QUESTION: Do soccer players with GP exhibit higher static and dynamic unipedal postural balance asymmetry, and higher risk of sustaining subsequent injuries compared to controls? METHODS: In this prospective case control study, 27 soccer players with non-time loss GP (GP group: GPG), and 27 healthy ones (control group: CG) were enrolled. Static and dynamic unipedal postural balance asymmetry were evaluated with a force platform using symmetry index (SI), and Y-balance test (Y-BT), respectively. Additionally, subsequent noncontact lower extremity musculoskeletal injuries were tracked for 10 months. RESULTS: The GPG revealed higher (p < 0.01) SI in eyes closed condition, higher (p < 0.001) side-to-side asymmetry in anterior, posteromedial and posterolateral reach distances and in composite Y-BT score compared to CG. They showed lower (p < 0.001) composite score for injured limb and higher (p < 0.001) side-to-side asymmetry in posteromedial reach distance compared to the cut-off values of 89.6 % and 4 cm, respectively. Moreover, GPG exhibited higher odds (OR= 7.48; 95 % CI = 2.15, 26.00; p < 0.01) of sustaining subsequent injuries compared to CG. SIGNIFICANCE: The Y-BT should be instituted into existing pre-participation physical examinations to screen for soccer players with non-time loss GP at an elevated risk of sustaining subsequent injuries. This could help coaches and clinicians make valid return to play decisions.

Postural balance impairment in Tunisian second division soccer players with groin pain: A case-control study.

OBJECTIVE: To compare postural balance outcomes between soccer players with and without groin pain (GP). DESIGN: Case-control study. SETTING: Laboratory. PARTICIPANTS: Fifty-four soccer players, 27 with GP (GP group: GPG) and 27 healthy ones (control group: CG). MAIN OUTCOME MEASURES: Static and dynamic postural balance were assessed with a force platform and Y-balance test (Y-BT), respectively. Hip abduction, internal rotation (IR), external rotation (ER) and total rotation (TR) of both limbs were evaluated. RESULTS: The GPG exhibited significant higher centre of pressure values in the bipedal posture only on the foam surface in eyes opened and closed compared to controls. Besides, they had lower anterior, posteromedial and posterolateral reach distances and composite Y-BT score on the injured limb (IL) compared to non-injured limb (NIL) and dominant-limb (DL) of the CG. Moreover, they showed lower abduction, IR, ER, and TR on the IL compared to NIL and DL. CONCLUSIONS: Dynamic unipedal postural balance disorder could be one of the limiting factors of performance in soccer players with non-time loss GP. Hence, postural balance data in these players could enable sport coaches and physical therapists to better understand the mechanisms contributing for performance decrease.

Iron deficiency anemia induces postural control disorders in young women.

BACKGROUND: Due to menstruation and restrictive dietary practices, women are at a particular risk of iron deficiency anemia (IDA). This hematologic manifestation could impair postural control as it induces fatigue, muscle weakness, cognitive and neurological functions alteration. AIM: This study aimed to investigate IDA effects on postural control in young women in comparison to healthy counterparts. MATERIAL AND METHODS: Twenty-four young women with IDA and twenty-four controls participated in this study. Center of pressure (CoP) excursions, in the bipedal and semi-tandem postures on the firm and foam surfaces in the eyes opened (EO) and closed (EC), were recorded, and Romberg index was calculated to evaluate postural control. Besides physical performance, attentional capacity, fatigue, and heart and respiratory rates were assessed. RESULTS: Young women with IDA had significantly higher CoP velocity (CoPv) values in the bipedal posture in both vision and surface conditions (EO [firm: P < 0.001 and foam: P < 0.01]; EC: P < 0.001), as well as in the semi-tandem posture (EO [firm: P < 0.01 and foam: P < 0.001]; EC: P < 0.001) compared to controls indicating that they had worse postural control than their peers. In addition, values of the respiratory rate (P < 0.001), attentional capacity (P < 0.001), physical performance (P < 0.001), fatigue (P < 0.001), and Romberg index on the foam surface in both postures (P < 0.05) were significantly higher in young women with IDA compared to controls. CONCLUSIONS: Physical performance, fatigue, tachypnea and attentional capacity resulting from IDA may explain postural control disorder in young women.