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.

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.