Protocols Targeting Afferent Pathways via Neuromuscular Electrical Stimulation for the Plantar Flexors: A Systematic Review.

This systematic review documents the protocol characteristics of studies that used neuromuscular electrical stimulation protocols (NMES) on the plantar flexors [through triceps surae (TS) or tibial nerve (TN) stimulation] to stimulate afferent pathways. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, was registered to PROSPERO (ID: CRD42022345194) and was funded by the Greek General Secretariat for Research and Technology (ERA-NET NEURON JTC 2020). Included were original research articles on healthy adults, with NMES interventions applied on TN or TS or both. Four databases (Cochrane Library, PubMed, Scopus, and Web of Science) were systematically searched, in addition to a manual search using the citations of included studies. Quality assessment was conducted on 32 eligible studies by estimating the risk of bias with the checklist of the Effective Public Health Practice Project Quality Assessment Tool. Eighty-seven protocols were analyzed, with descriptive statistics. Compared to TS, TN stimulation has been reported in a wider range of frequencies (5-100, vs. 20-200 Hz) and normalization methods for the contraction intensity. The pulse duration ranged from 0.2 to 1 ms for both TS and TN protocols. It is concluded that with increasing popularity of NMES protocols in intervention and rehabilitation, future studies may use a wider range of stimulation attributes, to stimulate motor neurons via afferent pathways, but, on the other hand, additional studies may explore new protocols, targeting for more optimal effectiveness. Furthermore, future studies should consider methodological issues, such as stimulation efficacy (e.g., positioning over the motor point) and reporting of level of discomfort during the application of NMES protocols to reduce the inherent variability of the results.

Electromyographic responses to unexpected Achilles tendon vibration-induced perturbations during standing in young and older people.

This study aimed to investigate age-related differences in electromyographic (EMG) responses to unexpected Achilles tendon vibration (ATV) perturbations while standing blindfold. ATV with variable and random duration (12-15 s) and rest periods (20-24 s) was applied on 18 young and 16 older volunteers. The anterior/posterior center of pressure (CoP) and the soleus (SOL) and tibialis anterior (TA) EMG were analyzed for 1 s before and 8 s after the ATV onset and offset. ATV induced a posterior shift of CoP in both groups, with more pronounced shift in the older group. During ATV onset, the older group demonstrated less SOL and more TA EMG increase compared to the young group. During the first 0.5 s of ATV offset, SOL EMG was decreased in both age groups, while TA showed a burst of EMG activity that was greater in the older group. No difference in the latencies of EMG peaks or valleys was observed between the groups. It is concluded that ATV induces greater posterior CoP shift in older adults, and they adopt a recovery strategy, characterized by a decreased SOL activation and an increased TA activation. These differences are possibly attributed to the increased fear of falling, decreased limits of stability and reduced capacity of older people to reweight their sensory inflow when proprioception is distorted.

Kinetic and Kinematic Changes in Vertical Jump in Prepubescent Girls After 10 Weeks of Plyometric Training.

PURPOSE: To examine the effect of a 10-week plyometric training (PT) on the kinematic and kinetic properties of prepubescent girls during squat jump, countermovement jump, and drop jumps. METHODS: Twenty-four untrained girls (aged 9-11 y) were assigned to a training group (TG) and a control group. The TG followed twice a week PT for 10 weeks. Squat jump, countermovement jump, and drop jumps performed from heights of 20, 35, and 50 cm were tested before and after PT. Jump height, kinematic, and kinetic parameters were evaluated using a motion analysis system and a force plate. RESULTS: Jumping height in all jump types increased significantly after PT for the TG (P < .001). After training, the TG presented increased power (P < .001) and knee angular velocity (P < .001), higher knee flexion at the deepest point during the braking phase (P < .001), longer contact time (P < .001), and unchanged stiffness and reaction strength index (P > .05). No differences were observed in the control group (P > .05). CONCLUSION: These findings indicate that a 10-week PT positively affected jumping performance in prepubescent girls who improved their drop jump performance after training not by adopting a stiff/bouncing jumping style of short contact time and increased stiffness, but a compliant/absorbing style of prolonged contact time.

Effect of Drop Height on Vertical Jumping Performance in Pre-, Circa-, and Post-Pubertal Boys and Girls.

PURPOSE: To examine the effect of drop height on vertical jumping performance in children with respect to sex and maturity status. METHODS: Thirty-seven pre-pubertal, 71 circa-pubertal, and 69 post-pubertal boys and girls performed, in a randomized order, 2 squat jumps, 2 countermovement jumps, and 2 drop jumps (DJ) from heights of 20, 30, 40, 50, 60, and 70 cm. The trial with the best jump height in each test was used for analysis. RESULTS: No significant sex × maturity status × jump type interaction for jump height was observed. However, on average, the children jumped higher in the countermovement jump than in squat jump and DJs (+1.2 and +1.6 cm, P < .001, respectively), with no significant differences between DJs and squat jumps or between DJs when increasing drop heights. Regarding DJs, 59.3% of the participants jumped higher from drop heights of 20 to 40 cm. CONCLUSIONS: Children, independent of sex and maturity status, performed best in the countermovement jump, and no performance gain was obtained by dropping from heights of 20 to 70 cm. During maturation, the use of drop heights between 20 and 40 cm may be considered in plyometric training, but the optimum height must be obtained individually.

Exercise-induced fatigue in young people: advances and future perspectives.

PURPOSE: In recent decades, the interest for exercise-induced fatigue in youth has substantially increased, and the effects of growth on the peripheral (muscular) and central (neural) mechanisms underpinning differences in neuromuscular fatigue between healthy children and adults have been described more extensively. The purpose of this review is to retrieve, report, and analyse the findings of studies comparing neuromuscular fatigue between children and adults. Objective measures of the evaluation of the physiological mechanisms are discussed. METHOD: Major databases (PubMed, Ovid, Scopus and Web of Science) were systematically searched and limited to English language from inception to September 2017. RESULT: Collectively, the analyzed studies indicate that children experience less muscular and potentially more neural fatigue than adults. However, there are still many unknown aspects of fatigue regarding neural (supraspinal and spinal) and peripheral mechanisms that should be more thoroughly examined in children. CONCLUSION: Suitable methods, such as transcranial magnetic stimulation, transcranial electrical stimulation, functional magnetic resonance imaging, near-infrared spectroscopy, tendon vibration, H-reflex, and ultrasound are recommended in the research field of fatigue in youth. By designing studies that test the fatigue effects in movements that replicate daily activities, new knowledge will be acquired. The linkage and interaction between physiological, cognitive, and psychological aspects of human performance remain to be resolved in young people. This can only be successful if research is based on a foundation of basic research focused on the mechanisms of fatigue while measuring all three above aspects.

The acute effects of an intense stretch-shortening cycle fatigue protocol on the neuromechanical parameters of lower limbs in men and prepubescent boys.

The study examined the differences between boys and adults after an intense stretch-shortening cycle fatigue protocol on neuromechanical parameters of the lower limb. Thirteen boys (9-11 years old) and 13 adult men (22-28 years old) were tested for maximal isometric voluntary knee extension torque and drop jump (DJ) performance from 30 cm before and immediately after a fatigue protocol, consisted of 10 × 10 maximum effort vertical jumps. Three-dimensional kinematics, kinetics and electromyographic (EMG) parameters of the lower extremities muscles were recorded during DJs before and after the fatigue test. The results indicated that reduction in maximal isometric torque and jumping performance was significantly higher in adults compared to boys. Vertical ground reaction forces, contact time and maximum knee flexion increased in a greater extend in adults than in boys. In addition, preactivation, EMG agonist activity, knee joint stiffness and stretch reflex decreased more in adults than in boys at all the examined phases of jumping tasks. It is concluded that employed fatigue protocol induced acute reduction in performance and altered motor control during jumping in both age groups. However, the differences in the level of fatigue between the 2 groups could be attributed to neuromuscular, mechanical and kinematic parameters observed between groups.

Muscle Twitch Torque During Two Different in Volume Isometric Exercise Protocols: Fatigue Effects on Postactivation Potentiation.

Xenofondos, A, Bassa, E, Vrabas, IS, Kotzamanidis, C, and Patikas, D. Muscle twitch torque during two different in volume isometric exercise protocols: fatigue effects on postactivation potentiation. J Strength Cond Res 32(2): 578-586, 2018-The purpose of this study was to quantify the effect of the contraction duration of 2 isometric exercise protocols on the postactivation potentiation of 14 well-trained men (age: 22.6 ± 2.8 years, height: 180.3 ± 5.9 cm, and body mass: 72.3 ± 37.9 kg). The protocols consisted of 4 × 6 maximal plantar flexions, of 3-second (P3) or 6-second (P6) duration, performed in random order, with a 2-minute and 15-second intervals between the sets and repetitions, respectively. The torque during maximal isometric voluntary contraction (MIVC), the peak twitch torque (TT), and the rate of torque development (RTD) after each MIVC were analyzed for the first and the last trial of each set, the average of all trials of each set, and the trials within each set that had the highest peak TT. The MIVC had an overall greater reduction during P6 compared with P3 (P3: -4.6 ± 2.3 vs. P6: -16.0 ± 1.9%). P6 showed higher potentiation in TT during the initial repetitions of the first 2 sets (p < 0.05) in contrast to the P3, which revealed a lower potentiation but for a longer period along the exercise session. However, both protocols had on average the same potential for potentiation (P3: 81.6 ± 6.1 vs. P6: 79.8 ± 6.3%). The twitch RTD presented no systematic difference between the 2 protocols (p > 0.05). These data demonstrate the dependence of the TT potentiation on the conditioning stimulus and verify the cumulative effect of potentiation, suggesting the implementation of longer contractions to achieve maximal but temporal TT potentiation and shorter contractions for less variable but prolonged potentiation.

Soleus H-reflex modulation during balance recovery after forward falling.

INTRODUCTION: Our purpose was to examine the Hoffmann reflex (H-reflex) during balance recovery after a simulated forward fall from 2 different inclination angles. METHODS: The soleus H-reflex of 15 healthy adults was measured in 2 different leaning positions (exerting a horizontal force at 15% and 30% of body weight, respectively), with no release (Int0) and at 2 different intervals (Int1, Int2) after the release (∼45 and ∼65 ms, respectively). RESULTS: During Int2, the H-reflex, which was evoked before the onset of the soleus electromyography, was significantly higher than the H-reflex induced 20 ms earlier (Int1). No significant difference was observed between Int0 and Int1 and between the 2 leaning positions. CONCLUSIONS: These findings indicate that Ia afferent input is facilitated before muscle activation during forward falling. This could be important for the timely activation and increased rate of force development required during this task. Muscle Nerve 54: 952-958, 2016.

Effect of Combined Sensorimotor-Resistance Training on Strength, Balance, and Jumping Performance of Soccer Players.

The purpose of the study was to investigate the effects of resistance training (RT) and sensorimotor training combined with RT (SM-RT) on balance, 1 repetition maximum (RM), rate of force development (RFD), and squat jump (SJ) height. Twenty amateur soccer players were equally divided into 2 groups assigned as SM-RT group (age: 22 ± 1.7 years, body mass: 79.9 ± 6.3 kg, body height: 1.81 ± 0.06 m) and RT group (age: 21.3 ± 1.3 years, body mass: 77.4 ± 9.3 kg, body height: 1.78 ± 0.04 m). Both groups were trained over a 6-week period with 2 session units per week. SM-RT group performed sensorimotor training (balance on balance board) followed by a high-intensity RT at 8-5RM leg press. The RT group performed the resistance program only. Both groups showed significantly increased 1RM leg press strength, RFD, SJ height, and balance abilities (p ≤ 0.05), whereas no significant between-group differences were observed in any of the outcome variables (p > 0.05). It was concluded that SM-RT was not superior compared with RT for both balance and strength enhancement. These findings have implications in time management during training for soccer players.

Post-activation potentiation: The neural effects of post-activation depression.

INTRODUCTION: Our knowledge of the neurophysiology of post-activation potentiation (PAP) is limited. The purpose of this study was to examine the effect of PAP on twitch torque and H-reflex amplitude after a 10-s maximal voluntary contraction (MVC). METHODS: PAP measurements were assessed with the plantarflexors in a relaxed state and during a tonic contraction at 10% MVC. RESULTS: The H-reflex/maximum M-wave ratio (H/M) decreased significantly (P<0.05) and returned to baseline levels after 1 min. The decrement in H/M was depressed when the plantarflexors were active at 10% MVC, and the depression was more obvious in the lateral gastrocnemius than in the soleus muscle. CONCLUSIONS: The inhibition induced immediately after contraction could be attributed to post-activation depression. We conclude that PAP after a 10-s MVC cannot be attributed to increased motor neuron excitability through the reflex pathway as assessed by the H-reflex technique.

The post-activation potentiation effect on squat jump performance: age and sex effect.

This study examined the post-activation potentiation (PAP) effects on squat jump (SJ) performance and on peak rate of force development (RFDpeak) in preadolescent (10-12 y), adolescents (14-15 y) and adults (20-25 y) males and females. All participants performed a SJ with and without prior conditioning stimulus (PAP and control protocol, respectively), consisting of 3 × 3-second maximal isometric squats. Jump height and RFDpeak of the vertical ground reaction force during SJ were assessed before, and at 20 seconds and at 4 minutes following the conditioning stimulus. The results revealed a different pattern of age-effect on SJ performance within males and females. The RFDpeak significantly increased as a factor of age in both males and females (P < .05). Increase in SJ performance after conditioning stimulus occurred only in men (P < .05), with no effects in teen-males, boys, and female groups. There was a significant PAP effect on RFDpeak in both adult groups (P < .05) and teen-males, with no effects in children. In conclusion, the PAP effects on SJ performance and RFDpeak are age- and sex-dependent; that is PAP appears as a viable method for acutely enhancing SJ performance in men but not in pediatric population.

Acute effects of static and dynamic stretching on balance, agility, reaction time and movement time.

The purpose of this study was to compare the acute effects of three different stretching protocols on balance, agility, reaction time and movement time of the upper limbs. Participants were thirty one female high school athletes (age = 17.3 ± 0.5 yr.). All participants performed one of the following protocols on different days: (a) 3 min jogging followed by 7 min static stretching (SS), (b) 3 min jogging followed by 7 min dynamic stretching (DS), and (c) 3 min jogging followed by 7 min of rest (NS). After the protocols participants performed the following tests: dynamic balance, 505 agility test, reaction time (time between a sound stimulus and release of a button) and movement time (movement of the upper extremity over a 0.5 m distance). The order of stretching protocols and performance tests were counterbalanced to avoid carryover effects. Repeated measures analysis of variance revealed significant main effects for all variables except reaction time. The DS protocol compared to SS performed significantly better in balance, agility and movement time. Additionally, the DS protocol compared to NS performed significantly better in agility. According to the results of the study, a DS protocol is more appropriate than SS for activities that require balance, rapid change of running direction (agility) and movement time of the upper extremities. Key pointsStatic stretching has a negative effect on balance and agility performance compared to dynamic stretching.There was no effect of the stretching protocols on reaction time.Dynamic stretching was more effective than static stretching for increasing movement time of the upper extremities.

The Effect of Fatigue on Electromyographic Characteristics during Obstacle Crossing of Different Heights in Young Adults.

The aim of this study was to investigate the effect of fatigue on electromyographic (EMG) parameters of healthy young adults during obstacle crossing of two different heights. Twelve untrained male adults (23 ± 5 years of age) were fatigued running on a treadmill with increasing speed and inclination and walked over an obstacle with a height set at 10% and 20% of each individual's lower limb length. Maximal plantar flexor torque and EMG of the medial gastrocnemius, soleus, and tibialis anterior muscles of the trailing limb were assessed during obstacle crossing. Data were captured before, immediately after and 5 minutes after a fatigue session. Fatigue induced significant reduction on the plantar flexor torque output immediately after and 5 minutes after exhaustion. After fatigue gait speed was not affected, the minimum distance between the obstacle and the trailing or leading foot remained unchanged, and the trailing foot contacted the ground closer to the obstacle immediately after fatigue. Regarding the EMG, medial gastrocnemius became after fatigue more active during swing phase when increasing the obstacle height, whereas this was not the case before or 5 minutes after fatigue. No other significant difference was observed for any of the examined muscles. It is concluded that the assessed fatigue protocol induced only minimal changes in the EMG activity of the examined muscles during obstacle crossing. Therefore, it is suggested that the neuromuscular system of healthy young individuals is able to respond to the decreased force capacity after fatigue during obstacle crossing of heights up to the 20% of the limb length. Key PointsExhaustion after running on a treadmill induces significant reduction in plantar flexion strength and changes in the positioning of the feet relative to the obstacle during obstacle crossing.EMG activity of the calf muscles of the trailing limb does not change significantly after fatigue during the stance phaseDuring swing phase, medial gastrocnemius EMG activity of the trailing limb increases after fatigue when obstacle height increases.These minor changes in EMG after fatigue, reveals that untrained, healthy, young subjects may compensate the deficit in muscular force due to fatigue when performing obstacle crossing.

Biomechanical comparison in different jumping tasks between untrained boys and men.

This study examines the biomechanical differences during different vertical jump tasks in 12 prepubescent and 12 adult males. The sagittal knee kinematics, vertical ground reaction force (vGRF) and electromyographic (EMG) activity of 5 lower extremity muscles were recorded. Compared with boys, men presented higher peak vGRF during the propulsive phase in all examined jumps, but lower values during the braking phase, even when related to body mass. Normalized EMG agonist activity in all phases was higher in men (p < .05), while antagonist coactivation was enhanced in boys (p < .05). The knee joint was on average 9 degrees more flexed at touchdown in men during drop jump tasks, but boys exhibited 12 degrees and 17 degrees higher knee flexion at the deepest point when performing drop jump from 20 and 40 cm, respectively. In conclusion, the performance deficit observed in boys in all jump types is a reflection of their immature technique, which could be partly attributed to the less efficient stiffness regulation and activation of their neuromuscular system.

The post-activation potentiation effect on sprint performance after combined resistance/sprint training in junior basketball players.

The aim of this study was to examine the effect of a 10-week combined resistance/sprint training programme in the post-activation potentiation of sprint performance before, between and after resistance training sets. Twenty-six junior basketball players were randomly divided into a control and a combined training group. The combined training group performed a combined training programme consisting of 5 sets at 5-8 RM (Repetition Maximum) half-squats with sprints performed between each set. Post-activation potentiation was considered as the increase in sprint velocity in trials executed between and after the resistance sets compared with the sprint trial performed before the resistance sets of the respective first and last training session. For sprint evaluation the running distances 0-10 and 0-30 m were selected. The intervention increased both strength and sprint performance. No post-activation potentiation effect was observed during the first training session in either group. Post-activation potentiation appeared in the combined training group during the last training session of the intervention in both 0-10 and 0-30 m sprint. This study illustrates that post-activation potentiation effect on sprint performance in junior basketball players, who did not previously follow systematic resistance training, emerges after a 10-week resistance/sprint combined training programme.

Construct validity of gymnastics-specific assessment on the neuromuscular function of shoulder flexor and extensor muscles.

The present study examined the construct validity of gymnastics-specific measurements of the shoulder flexor and extensor neuromuscular function. Fifteen male gymnasts and 18 male physical education (PE) students participated voluntarily. The electromyogram (EMG) of 3 flexor and 3 extensor shoulder muscles was assessed during isometric (45, 90, and 135º) and isokinetic (concentric and eccentric 60, 180, and 300º/s) shoulder flexion/extension. Peak torque (PT) and neuromuscular function in terms of neuromuscular efficiency (NME, i.e. torque to EMG ratio) and antagonist/agonist coactivation index were evaluated. The construct validity of the measurements was supported by the ability to discriminate between gymnasts and physical education (PE) students, taking into consideration the shoulders' neuromuscular function parameters (37%-57% of the variability explained). After accounting for the limitations of the study, these findings may assist gymnastics coaches and researchers to develop and evaluate more effective training methods for athletes related to shoulder joint physiological characteristics and level of expertise.

Postactivation Potentiation and the Asynchronous Action of Muscular and Neural Responses.

PURPOSE: This study examined the underlying mechanisms of postactivation potentiation and the time course of muscular- and neural-related variables. METHODS: Fourteen trained males executed 4 sets of six 6-second maximum isometric conditioning plantar flexions, with 15 seconds and 2 minutes of interval between the contractions and sets, respectively. Peak twitch torque (TT), rate of torque development, time to peak torque, half relaxation time, and the neural-related variables of H-reflex and electromyogram, normalized to the maximum M-wave (H/M and RMS/M, respectively), were evaluated, as well as the level of the voluntary activation, assessed by the twitch interpolation technique. All neural-related variables were analyzed for the trial within each set when TT was maximal and for the trial within each set when the neural-related variable itself was maximal. RESULTS: Compared with the baseline measures, TT and rate of torque development significantly increased in all sets (P < .001), whereas time to peak torque and half relaxation time significantly decreased in sets 1 to 4 and 2 to 4, respectively (P < .001). However, H/M and the RMS/M did not change for the repetition of each set for which the TT was maximal (P > .05). Interestingly, the within-set maximum H/M ratio of the lateral gastrocnemius muscle revealed a significant increase in all sets (P < .05), compared with the baseline measures. CONCLUSION: One set of 4 contractions with 6-second duration is sufficient to cause postactivation potentiation for most participants, whereas peak TT augmentation does not coincide with changes in the examined neural-related variables. Further experiments should consider the time lag on their maximal values and their inherent between-participants variability.

The effect of dropping height on jumping performance in trained and untrained prepubertal boys and girls.

Plyometric training in children, including different types of jumps, has become common practice during the last few years in different sports, although there is limited information about the adaptability of children with respect to different loads and the differences in performance between various jump types. The purpose of this study was to examine the effect of gender and training background on the optimal drop jump height of 9- to 11-year-old children. Sixty prepubertal (untrained and track and field athletes, boys and girls, equally distributed in each group [n = 15]), performed the following in random order: 3 squat jumps, 3 countermovement jumps (CMJs) and 3 drop jumps from heights of 10, 20, 30, 40, and 50 cm. The trial with the best performance in jump height of each test was used for further analysis. The jump type significantly affected the jump height. The jump height during the CMJ was the highest among all other jump types, resulting in advanced performance for both trained and untrained prepubertal boys and girls. However, increasing the dropping height did not change the jumping height or contact time during the drop jump. This possibly indicates an inability of prepubertal children to use their stored elastic energy to increase jumping height during drop jumps, irrespective of their gender or training status. This indicates that children, independent of gender and training status, have no performance gain during drop jumps from heights up to 50 cm, and therefore, it is recommended that only low drop jump heights be included in plyometric training to limit the probability of sustaining injuries.

Temporal modulation of H-reflex in young and older people: Acute effects during Achilles tendon vibration while standing.

PURPOSE: Examining how timely is sensory input processed and regulated after a perturbation while standing, is a key element to understand postural control, especially in people with balance deficits, such as older adults. In this study, we investigated the age-related temporal modulations in spinal excitability, by measuring the soleus H-reflex within the first 250 ms after switching on (V-ON) and off (V-OFF) a pair of vibrators, placed over the Achilles tendons. METHODS: Twenty young (25.1 ± 5.1 yrs) and 16 older (71.8 ± 6.1 yrs) adults stood blindfolded, while 12-15 s periods of Achilles tendon vibration (ATV) were applied with 20-24 s intervals. Anterior/posterior center of pressure and electromyographic (EMG) responses [soleus (SOL) and tibialis anterior (TA)] were assessed whereas SOL H-reflex normalized to maximum M-wave (H/Mmax) and SOL EMG (H/SOL) were evaluated before ATV (Pre) and at 50, 100, 150, 200 and 250 ms after the V-ON and V-OFF. RESULTS: Only in young adults the TA/SOL EMG ratio decreased 100 (p = 0.032) and 150 ms (p < 0.001) after V-ON and the H/Mmax and H/SOL decreased 150-250 ms after V-ON (p < 0.001). At 50-250 ms after V-OFF, H/Mmax was reduced compared to Pre values (p < 0.001), with no differences between the age groups (p > 0.05). H/SOL was decreased for the young adults (p < 0.001) and remained reduced at least for the first 250 ms after V-OFF. At 150 ms after V-OFF, SOL/Mmax was decreased only for the older adults (p < 0.001), whereas TA/SOL EMG gradually increased for both groups (p < 0.001). CONCLUSION: When ATV is introduced while standing, the spinal excitability of older people is reduced later and to a lesser extent compared to young adults. Their limited capacity to down-regulate the "noisy" sensory input generated by ATV gives further evidence of a possible mechanism for their inefficient postural control.

Resilience of visually guided weight shifting to a proprioceptive perturbation depends on the complexity of the guidance stimulus.

BACKGROUND: Whole-body tracking of visual motion cues is used in balance training to improve weight shifting ability in old age and sports. RESEARCH QUESTION: How tracking of a complex (pink noise) and a periodic visual target motion during anteroposterior weight shifting affects postural and muscle responses to unilateral hip vibration. METHODS: Twenty-six participants performed 160 anteroposterior weight shifting cycles while tracking the vertical motion of a visual target, concurrently receiving Center of Pressure (CoP) feedback. They were randomly divided to groups; (a) the Constant group tracked a visual target motion constructed by 3 sinusoids of different amplitude, and (b) the Pink group tracked a complex visual target motion constructed by a pink noise generation process. Between the 60th and the 120th cycle, vibration was applied to the right gluteus medius, introducing a sideways CoP deviation. CoP displacement and electromyographic (EMG) responses of soleus, tibialis anterior and peroneus longus were recorded and summarized in blocks of 3 cycles. RESULTS: Sideways CoP deviation induced at the onset/offset of unilateral hip vibration was smaller for the Pink than the Constant group. The Pink group demonstrated greater tibialis anterior and peroneus longus EMG activity around the most anterior sway peak while soleus EMG was similar for the two groups. Both groups successfully coupled weight shifting amplitude to the target motion, but the Pink group tracked the target motion with a greater delay compared to the Constant group. SIGNIFICANCE: Whole body tracking of complex visual motions evokes perception-based action and increases ankle muscle co-activation making sway more resilient to a proprioceptive perturbation induced by unilateral hip vibration. Complex visual guidance motions should be considered when designing balance rehabilitation regimes, aiming at improving weight shifting ability and dynamic balance control.