The Effects of an Inclusive Badminton Program on Static Postural Control for Individuals with Intellectual and Developmental Disabilities.

The purpose of the study was to examine static postural control/balance in young adults with intellectual and developmental disabilities (IDD) and typically developing (TD) young adults before, during, and after an inclusive badminton intervention. Eight participants (four IDD-BADM and four TD-BADM) participated in a 12-week inclusive badminton intervention, with the other eight participants as matched controls (four IDD-CONTR and four TD-CONTR) (74.19 kg ± 9.8 kg, 171.96 cm ± 5.4 cm; 21.7 ± 1.8 years of age; nine females and seven males; eight with IDD and eight TD). The study followed a repeated measures design (pre, mid, post) before the intervention, at 6 weeks, and after 12 weeks. Static postural sway conditions included: bilateral stance eyes open (20 s), eyes closed (10 s), foam eyes open (20 s), foam eyes closed (10 s), and unilateral stance eyes open (10 s) and foam eyes open (10 s). Sway measurements included: average anterior/posterior (A/P) displacement (in), average medial/lateral (M/L) displacement (in), average 95% ellipsoid area (in2), and average velocity (ft/s). Significant time × group interactions were reported for average velocity (EO) (p = 0.030), average length (EO) (p = 0.030), 95% ellipsoid area (EO) (p = 0.049), and average A/P displacement (1LEO) (p = 0.036) for IDD-BADM. Significant time main effects were reported for average A/P displacement (FEO) (p = 0.040) for IDD groups. Significant time main effects were reported for average M/L displacement (EO) (p = 0.001), (EC) (p = 0.004), (FEO) (p = 0.005), (FEC) (p = 0.004), and average A/P displacement (EO) (p = 0.006) and (FEO) (p = 0.005) for TD groups. An inclusive badminton program indicated evidence of improved static postural control for those with IDD. However, no significant differences were reported for TD peers.

Physiological and Subjective Measures of Anxiety with Repeated Exposure to Virtual Construction Sites at Different Heights.

Background: Occupational workers at altitudes are more prone to falls, leading to catastrophic outcomes. Acrophobia, height-related anxiety, and affected executive functions lead to postural instabilities, causing falls. This study investigated the effects of repeated virtual height exposure and training on cognitive processing and height-related anxiety. Methods: Twenty-eight healthy volunteers (age 20.48 ± 1.26 years; mass 69.52 ± 13.78 kg) were recruited and tested in seven virtual environments (VE) [ground (G), 2-story altitude (A1), 2-story edge (E1), 4-story altitude (A2), 4-story edge (E2), 6-story altitude (A3), and 6-story edge (E3)] over three days. At each VE, participants identified occupational hazards present in the VE and completed an Attitude Towards Heights Questionnaire (ATHQ) and a modified State-Trait Anxiety Inventory Questionnaire (mSTAIQ). The number of hazards identified and the ATHQ and mSTAIQ scores were analyzed using a 7 (VE; G, A1, A2, A3, E1, E2, E3) x 3 (DAY; DAY 1, DAY 2, DAY 3) factorial repeated measures analysis of variance. Results: The participants identified the lowest number of hazards at A3 and E3 VEs and on DAY 1 compared to other VEs and DAYs. ATHQ scores were lowest at G, A1, and E1 VEs. Conclusion: Cognitive processing is negatively affected by virtual altitudes, while it improves with short-term training. The features of virtual reality, such as higher involvement, engagement, and reliability, make it a better training tool to be considered in ergonomic settings. The findings of this study will provide insights into cognitive dual-tasking at altitude and its challenges, which will aid in minimizing occupational falls.

Lower extremity joint kinematics of a simulated lateral ankle sprain after drop landings in participants with chronic ankle instability.

This study examined lower extremity joint kinematics in individuals with chronic ankle instability (CAI) and controls during unanticipated and anticipated single-leg drop landings onto a laterally inclined platform. Physically active adults with CAI 15 (n = 15) and controls (n = 15) performed an unanticipated and anticipated 30 cm single-leg drop landing onto a 20° laterally inclined platform. Three-dimensional ankle, knee and hip-joint kinematics were recorded 200 ms pre- to 200 post-landing and analysed with a 2 (group) × 2 (landing condition) SPM ANOVA (p < 0.05). Results revealed individuals with CAI displayed significantly greater ankle internal rotation post-landing across both landing conditions. Anticipated landings elicited significantly greater pre-landing ankle inversion and external rotation, knee abduction and hip adduction. Additionally, significantly less ankle inversion, knee and hip flexion, and knee adduction and hip abduction were present during post-landing of the anticipated landing. Greater ankle internal rotation during landing may contribute to the ankle 'giving way' in individuals with CAI. However, preparatory and reactive proximal-joint kinematics were similar in both groups during landing. This highlights the possible role of the knee and hip joints in assisting with ankle-joint stability during anticipated inversion perturbations.

Sensory Organization Test Conditions Influence Postural Strategy Rather than Footwear or Workload.

BACKGROUND: Postural strategies such as ankle, hip, or combined ankle-hip strategies are used to maintain optimal postural stability, which can be influenced by the footwear type and physiological workload. PURPOSE: This paper reports previously unreported postural strategy scores during the six conditions of the sensory organization test (SOT). METHODS: Fourteen healthy males (age: 23.6 ± 1.2 years; height: 181 ± 5.3 cm; mass: 89.2 ± 14.6 kg) were tested for postural strategy adopted during SOT in three types of occupational footwear (steel-toed work boot, tactical work boot, low-top work shoe) every 30 min during a 4-h simulated occupational workload. Postural strategy scores were analyzed using repeated measures analysis of variance at 0.05 alpha level. RESULTS: Significant differences among postural strategy scores were only evident between SOT conditions, and but not between footwear type or the workload. CONCLUSIONS: Findings indicate that occupational footwear and occupational workload did not cause a significant change in reliance on postural strategies. The significant changes in postural strategy scores were due to the availability of accurate and/or conflicting sensory feedback during SOT conditions. In SOT conditions where all three types of sensory feedback was available, the ankle strategy was predominantly adopted, while more reliance on hip strategy occurred in conditions with absent or conflicting sensory feedback.

Impact of Prolonged Exposure to a Slippery Surface on Postural Stability.

Falls are extremely common in occupational settings. Intrinsic factors such as overexertion and extrinsic factors such as the supporting surface are causative factors of falls. The impact of prolonged exposure to a slippery surface on postural stability has not been previously studied. The purpose of the study was to analyze the effect of extended exposure to a dry and a slippery surface on postural stability. Eighteen males (age: 21.17 ± 3.38 years; height: 1.77 ± 0.08 m; mass: 89.81 ± 14.23 kg) were recruited and subjected to one-hour walking on a dry surface and a slippery surface on two different days. Participants' balance was assessed using a force platform in stable and unstable conditions at 0, 30, and 60 min. Postural sway variables were analyzed using a 2 (surface) × 3 (time) repeated-measures ANOVA. Significant time main effects were observed in the stable condition with greater balance decrements at 30 and 60 min. Greater balance decrements were observed on the slippery surface compared to the dry surface in the unstable condition. The balance decrements can be attributed to overexertion due to the physiological workload of prolonged walking and to the potential gait modifications due to walking on the slippery surface.

Impact of Fat Grip Attachments on Muscular Strength and Neuromuscular Activation During Resistance Exercise.

ABSTRACT: Krings, BM, Shepherd, BD, Swain, JC, Turner, AJ, Chander, H, Waldman, HS, McAllister, MJ, Knight, AC, and Smith, JW. Impact of fat grip attachments on muscular strength and neuromuscular activation during resistance exercise. J Strength Cond Res 35(2S): S152-S157, 2021-The purpose of this study was to examine the acute effects of Fat Gripz (FG) on muscular activation and strength. Resistance trained men (n = 15; age = 22.4 ± 2.3 years; mass = 83.2 ± 11.1 kg) performed 2 experimental trials in a randomized order. Subjects completed 1 repetition maximum (1RM) testing with an Olympic barbell (OB) and with FG attached to an OB during the exercises of deadlift, bent-over row, upright row, concentration curl, and completed maximum repetitions of pull-ups until failure. Surface electromyography (EMG) was used to measure muscle activity from 8 upper extremity muscles (trapezius, medial deltoid, biceps brachii, triceps brachii, flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis, and extensor carpi ulnaris), while performing maximal voluntary isometric contractions during 1RM trials and while performing maximum number of pull-ups. When using the FG, 1RM strength was significantly decreased for each exercise, and the maximal number of pull-ups completed was significantly lower. Electromyography muscle activity was significantly increased in the forearm and shoulder muscles, but significantly decreased in the upper arm muscles with the use of FG during deadlift, bent-over row, and pull-ups. However, there were no differences for EMG activity for upright row and concentration curl. Differences in maximal strength, pull-up performance, and EMG activity with FG use may be due to the different muscle length positions. Although FG training may increase neuromuscular activation, decrements in muscular strength may result in prescribing low training loads that may not be ideal for building muscular strength.

Ankle kinematics, center of pressure progression, and lower extremity muscle activity during a side-cutting task in participants with and without chronic ankle instability.

This study assessed ankle kinematics, surface electromyography, and center-of-pressure (COP) progression relative to the medial border of the foot during a side-cutting task in individuals with and without chronic ankle instability (CAI). Thirty participants (CAI = 15; Controls = 15) performed a side-cutting task on a force platform while 3-dimentional ankle kinematics, COP position, and surface electromyography from the tibialis anterior, medial gastrocnemius, fibularis longus, fibularis brevis, vastus medialis, and semitendinosus were recorded on the testing leg. Ankle kinematics, root-mean-square muscle activity and COP position relative to the medial boarder of the foot were compared between CAI and healthy controls (p < 0.05). Significantly greater ankle internal rotation from 35-54% of the stance phase (p = 0.032) was found for the CAI group compared to controls. Furthermore, significantly greater tibialis anterior muscle activity from 86-94% of the stance phase (p = 0.022) and a more medial COP position from 81-100% (p < 0.05) and of the stance phase was also observed in the CAI group. Less lateral COP progression and increased tibialis anterior activation in the CAI group could reflect a protective movement strategy during anticipated side-cutting to avoid recurrent injury. However, greater ankle internal rotation during mid-stance highlights a potential 'giving way' mechanism in individuals with CAI.

Lower Limb Joint Kinetics During a Side-Cutting Task in Participants With or Without Chronic Ankle Instability.

CONTEXT: Individuals with chronic ankle instability (CAI) demonstrate altered lower limb movement dynamics during jump landings, which can contribute to recurrent injury. However, the literature examining lower limb movement dynamics during a side-cutting task in individuals with CAI is limited. OBJECTIVE: To assess lower limb joint kinetics and sagittal-plane joint stiffness during the stance phase of a side-cutting task in individuals with or without CAI. DESIGN: Cohort study. SETTING: Motion-capture laboratory. PATIENTS OR OTHER PARTICIPANTS: Fifteen physically active, young adults with CAI (7 men, 8 women; age = 21.3 ± 1.6 years, height = 171.0 ± 11.2 cm, mass = 73.4 ± 15.2 kg) and 15 healthy matched controls (7 men, 8 women; age = 21.5 ± 1.5 years, height = 169.9 ± 10.6 cm, mass = 75.5 ± 13.0 kg). INTERVENTION(S): Lower limb 3-dimensional kinematic and ground reaction force data were recorded while participants completed 3 successful trials of a side-cutting task. Net internal joint moments, in addition to sagittal-plane ankle-, knee-, and hip-joint stiffness, were computed from 3-dimensional kinematic and ground reaction force data during the stance phase of the side-cutting task and analyzed. MAIN OUTCOME MEASURE(S): Data from each participant's stance phase were normalized to 100% from initial foot contact (0%) to toe-off (100%) to compute means, standard deviations, and Cohen d effect sizes for all dependent variables. RESULTS: The CAI group exhibited a reduced ankle-eversion moment (39%-81% of stance phase) and knee-abduction moment (52%-75% of stance phase) and a greater ankle plantar-flexion moment (3%-16% of stance phase) than the control group (P range = .009-.049). Sagittal-plane hip-joint stiffness was greater in the CAI than in the control group (t28 = 1.978, P = .03). CONCLUSIONS: Our findings suggest that altered ankle-joint kinetics and increased hip-joint stiffness were associated when individuals with CAI performed a side-cutting task. These lower limb kinetic changes may contribute to an increased risk of recurrent lateral ankle sprains in people with CAI. Clinicians and practitioners can use these findings to develop rehabilitation programs for improving maladaptive movement mechanics in individuals with CAI.

Impact of occupational footwear and workload on postural stability in work safety.

BACKGROUND: The impact of occupational footwear and workload on postural stability has been studied previously to prevent fall-related workplace injuries. OBJECTIVE: The purpose of this study was to assess the impact of two types of occupational footwear [steel-toed (SB) and tactical (TB) work boots] on human balance, when exposed to physical workload. METHODS: Postural stability was evaluated in eighteen male participants in the following conditions: eyes open (EO), eyes closed (EC), eyes open unstable surface (EOU) and eyes closed unstable surface (ECU). Postural sway parameters were analyzed using a 2×3 repeated measures analysis of variance design [prior to (PRE) and twice post-workload (POST1 & POST2) separated by 10 minutes of rest]. RESULTS: Findings revealed that the use of SB resulted in greater postural stability, which could be attributed to the design characteristics of these footwear and that postural stability was negatively impacted immediately after the workload which could be attributed to the physical exertions during the workload. However, significant differences were limited to ECU with no visual and altered somatosensory feedback. CONCLUSION: Design features on occupational footwear can aid postural stability while physical exertional tasks can be detrimental. Findings can offer design and work-rest scheduling suggestions to improve work safety.

Virtual-Reality-Induced Visual Perturbations Impact Postural Control System Behavior.

BACKGROUND: Virtual reality (VR) is becoming a widespread tool in rehabilitation, especially for postural stability. However, the impact of using VR in a "moving wall paradigm" (visual perturbation), specifically without and with anticipation of the perturbation, is unknown. METHODS: Nineteen healthy subjects performed three trials of static balance testing on a force plate under three different conditions: baseline (no perturbation), unexpected VR perturbation, and expected VR perturbation. The statistical analysis consisted of a 1 × 3 repeated-measures ANOVA to test for differences in the center of pressure (COP) displacement, 95% ellipsoid area, and COP sway velocity. RESULTS: The expected perturbation rendered significantly lower (p < 0.05) COP displacements and 95% ellipsoid area compared to the unexpected condition. A significantly higher (p < 0.05) sway velocity was also observed in the expected condition compared to the unexpected condition. CONCLUSIONS: Postural stability was lowered during unexpected visual perturbations compared to both during baseline and during expected visual perturbations, suggesting that conflicting visual feedback induced postural instability due to compensatory postural responses. However, during expected visual perturbations, significantly lowered postural sway displacement and area were achieved by increasing the sway velocity, suggesting the occurrence of postural behavior due to anticipatory postural responses. Finally, the study also concluded that VR could be used to induce different postural responses by providing visual perturbations to the postural control system, which can subsequently be used as an effective and low-cost tool for postural stability training and rehabilitation.

Bilateral spatiotemporal postural control impairments are present in participants with chronic ankle instability.

OBJECTIVES: This study evaluated center-of-pressure (COP) and time-to-boundary (TTB) measures of postural control during a Lateral Step-Down Test in participants with chronic ankle instability (CAI). DESIGN: Cohort study. SETTING: Biomechanics laboratory. PARTICIPANTS: Physically active adults with CAI (n = 15) and matched controls (n = 15). MAIN OUTCOME MEASURES: Traditional COP and TTB measures of postural control were computed in the medial/lateral (ML) and anterior/posterior (AP) directions. RESULTS: No significant results were found for the traditional COP measures (p > 0.05). The CAI group exhibited a lower TTB ML absolute minimum on their affected limb compared to the matched limb of the control group (p < 0.001). Additionally, on average the CAI group displayed significantly lower TTB ML mean of minima (p = 0.004) and TTB standard deviation of minima in the ML (p < 0.001) and AP directions (p = 0.002) regardless of limb. CONCLUSIONS: Sensorimotor impairments associated with CAI negatively alter spatiotemporal postural control and may cause a maladaptive reorganization of centrally mediated motor control strategies that results in bilateral postural control deficits during the Lateral Step-Down Test. In addition, traditional COP measures did not reveal any postural control deficits suggesting that a spatiotemporal analysis should be used when assessing postural control in participants with CAI.

Neuromuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inversion perturbations during a single leg drop-landing.

While neuromuscular control deficits during inversion perturbations in chronic ankle instability (CAI) cohorts are well documented in the literature, anticipatory motor control strategies to inversion perturbations in CAI are largely unknown. The purpose of this study was to examine neuromuscular control and ankle kinematics in individuals with CAI (n = 15) and matched controls (n = 15) during unexpected and expected single leg drop-landings onto a tilted surface rotated 20° in the frontal plane. Muscle activity from 200 ms pre- to post-landing was recorded from the tibialis anterior (TA), medial gastrocnemius (MG), peroneus longus (PL) and peroneus brevis (PB). Mean muscle activity, co-contraction index (CCI), and peroneal latency was analyzed. Ankle inversion angle at initial contact, time to maximum inversion angle, maximum inversion angle and velocity were also assessed. Significantly longer PL latency, less time to maximum inversion and greater maximum inversion angle was found in CAI compared to controls. Regarding landing condition, significantly greater maximum inversion angle, less inversion at initial contact, longer PB latency, less TA activity and frontal plane CCI during the post-landing phase was found during the unexpected perturbation. Prolonged PL latency and altered ankle kinematics suggests reduced frontal plane ankle stabilization in CAI. However, similar motor control strategies were utilized in both groups during the ankle inversion perturbations.

Falls in Geriatric Populations and Hydrotherapy as an Intervention: A Brief Review.

Falls and fall-related injuries are a serious health concern in geriatric populations, especially with age-related deficits in postural control and during postural control challenging dual-task situations. Balance training has been reported to be beneficial in reducing falls. However, some of these exercises have their inherent physical challenges that prevent the elderly population from performing them effectively. Other concomitant age-related illness in the elderly pose further challenges in performing these exercises. Hence, the topic of finding alternative types of balance training that are effective and are performed in a safer environment is constantly researched. One such alternative is hydrotherapy that focuses on balance and postural perturbation-based exercises in water-based environments such as aquatic swimming pools or in dedicated hydrotherapy pools. Hydrotherapy for geriatric populations has been reported to be beneficial in improving balance, motor and cognitive tasks with improved motivation and positive attitude towards exercises. Additionally, hydrotherapy also has properties of buoyancy, resistance and temperature, which benefit biomechanical and physiological wellness and offers a safe environment to perform balance training. Hydrotherapy balance training need to be scaled and prescribed according to individual needs and can serve as an effective training and rehabilitation protocol in reducing falls in geriatric population.