Age related differences in whole body and body part angular momentum in the frontal plane during walking.

The contribution of body part angular momentum (BPAM) to whole body angular momentum (WBAM) in the frontal plane during walking differs across age groups. We investigated age related differences in BPAM and WBAM during walking. We used marker coordinate data from a publicly available database for 54 individuals aged 20-30 years and 78 aged 60-70 years. Angular momentum in the frontal plane was calculated as the sum of the translational component and the rotational component for each segment. The angular momentum of each segment was categorized into five BPAM: right and left lower limbs (foot, shank, and thigh), right and left arms (hand, forearm, and upper arm), and torso (head, thorax, and pelvis). BPAM at WBAM peak frames during stride cycles was compared between older and younger adults. The peak WBAM, angular momentum of the stance-and swing side upper limbs, and torso in older adults was significantly larger than that in younger adults, with increases of 74.6% in the stance-side upper limb, 127.5% in the swing-side upper limb, and 30.9% in the torso. These results suggest that interventions aimed at improving torso control could decrease the amplitude of WBAM in the frontal plane in older adults.

Dynamic ensemble balance in direct- and indirect-pathway striatal projection neurons underlying decision-related action selection.

The posterior dorsal striatum (pDS) plays an essential role in sensory-guided decision-making. However, it remains unclear how the antagonizing direct- and indirect-pathway striatal projection neurons (dSPNs and iSPNs) work in concert to support action selection. Here, we employed deep-brain two-photon imaging to investigate pathway-specific single-neuron and population representations during an auditory-guided decision-making task. We found that the majority of pDS projection neurons predominantly encode choice information. Both dSPNs and iSPNs comprise divergent subpopulations of comparable sizes representing competing choices, rendering a multi-ensemble balance between the two pathways. Intriguingly, such ensemble balance displays a dynamic shift during the decision period: dSPNs show a significantly stronger preference for the contraversive choice than iSPNs. This dynamic shift is further manifested in the inter-neuronal coactivity and population trajectory divergence. Our results support a balance-shift model as a neuronal population mechanism coordinating the direct and indirect striatal pathways for eliciting selected actions during decision-making.

Dynamic Balance and Muscle Activity in Lifesavers: A Study on Intrinsic and Extrinsic Foot Muscles.

Activities on sandy soil are known to contribute to improved leg strength and balance. Lifesavers (LSs) have shown that sandy soil activity promotes intrinsic foot muscle development and improves balance. LS improves leg strength and balance through activities on sandy soil. However, the effect of foot muscle development on the actual muscle activity of LS remains unclear. We aimed to evaluate the effect of foot muscle development on muscle activity in lifeguards on a sandy beach compared with the corresponding in healthy participants. Fifteen LSs and 15 healthy adults underwent a Y-balance test to assess dynamic balance and surface electromyography to measure muscle activity. The LSs exhibited a significantly higher percentage of maximum voluntary contraction values in the tibialis anterior muscle in all directions than the healthy adults. The LSs showed increased peroneus longus and abductor hallucis muscle activity in the posterolateral and posteromedial directions, suggesting their involvement in contralateral postural control during dynamic balance. These findings suggest that engaging in barefoot activities on sandy soil enhances foot muscle activity and improves dynamic balance in LSs.

The effect of kinesio taping on joint range of motion and balance in total knee replacement patients.

We adopted a within-subjects quasi-experimental approach to assess the impact of kinesio taping (KT) on joint range of motion (ROM), static balance, and dynamic balance. The research subjects were 15 patients who had, within the previous 3 weeks, undergone total knee replacement (TKR) by an orthopedic surgeon in 2022. We measured the ROM, static balance, and dynamic balance of the knee joint before and after applying KT. We then compared the pre- and post-tape measurements to assess the effects of KT on joint function and balance. The ROM of the knee joint was measured using a goniometer in the supine position before the KT application. The static and dynamic balance were assessed using a balance assessment device by measuring the sway area and length of the center of gravity during the measurement period. The effects of KT on the ROM and static and dynamic balance of the knee joint were investigated. The differences in joint ROM and static and dynamic balance between pre- and post-KT applications were analyzed using a paired-sample t-test. This study found that the ROM of the knee joint was significantly increased after applying KT. For static and dynamic balance, both the sway area and length of the center of gravity decreased after applying KT, indicating a significant improvement in static and dynamic balance. KT, when combined with standard physiotherapy, can be a useful therapeutic approach for TKR patients, effectively enhancing joint ROM and balance function.

Dynamic balance and gait impairments in Parkinson's disease: novel cholinergic patterns.

The cholinergic system has been implicated in postural deficits, in particular falls, in Parkinson's disease (PD). Falls and freezing of gait typically occur during dynamic and challenging balance and gait conditions, such as when initiating gait, experiencing postural perturbations, or making turns. However, the precise cholinergic neural substrate underlying dynamic postural and gait changes remains poorly understood. The aim of this study was to investigate whether brain vesicular acetylcholine transporter binding, as measured with [18F]-fluoroethoxybenzovesamicol binding PET, correlates with dynamic gait and balance impairments in 125 patients with PD (mean age 66.89 ± 7.71 years) using the abbreviated balance evaluation systems test total and its four functional domain sub-scores (anticipatory postural control, reactive postural control, dynamic gait, and sensory integration). Whole brain false discovery-corrected (P < 0.05) correlations for total abbreviated balance evaluation systems test scores included the following bilateral or asymmetric hemispheric regions: gyrus rectus, orbitofrontal cortex, anterior part of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, cingulum, frontotemporal opercula, insula, fimbria, right temporal pole, mesiotemporal, parietal and visual cortices, caudate nucleus, lateral and medial geniculate bodies, thalamus, lingual gyrus, cerebellar hemisphere lobule VI, left cerebellar crus I, superior cerebellar peduncles, flocculus, and nodulus. No significant correlations were found for the putamen or anteroventral putamen. The four domain-specific sub-scores demonstrated overlapping cholinergic topography in the metathalamus, fimbria, thalamus proper, and prefrontal cortices but also showed distinct topographic variations. For example, reactive postural control functions involved the right flocculus but not the upper brainstem regions. The anterior cingulum associated with reactive postural control whereas the posterior cingulum correlated with anticipatory control. The spatial extent of associated cholinergic system changes were least for dynamic gait and sensory orientation functional domains compared to the anticipatory and reactive postural control functions. We conclude that specific aspects of dynamic balance and gait deficits in PD associate with overlapping but also distinct patterns of cerebral cholinergic system changes in numerous brain regions. Our study also presents novel evidence of cholinergic topography involved in dynamic balance and gait in PD that have not been typically associated with mobility disturbances, such as the right anterior temporal pole, right anterior part of the dorsomedial prefrontal cortex, gyrus rectus, fimbria, lingual gyrus, flocculus, nodulus, and right cerebellar hemisphere lobules VI and left crus I.

Timed Up-and-Go Test and Sit-to-Stand Test in Community-Dwelling Older Person: Inter and Intraobserver Reliability Among Turkish Nurses.

BACKGROUND: A decrease in dynamic balance and muscle strength related to ageing is associated with a decreased quality of life, reduced life expectancy and increased risk of falls. Timed stand-up test (TUG) is one of the most used clinical tests for the evaluation of dynamic balance and sit-to-stand test (STS). Although these tests are reported to be reliable in pathological conditions in different populations and different countries, there is a gap in the evaluation of the reliability of the tests by nurses in the older persons living in Turkish society. OBJECTIVE: The present study aimed to investigate the inter- and intra-observer reliability of the timed up-and-go test (TUG) and sit-to-stand test (STS) performed by nurses in Turkish community-dwelling older persons. METHODS: A total of 97 community-dwelling older persons participated in this study. To determine the interobserver reliability of the TUG and STS tests, all tests were performed at an interval of 30 min by two nurses. To determine the intra-observer reliability of the tests, each measurement was repeated 1 week after the first measurement by another nurse. RESULTS: Excellent intra-observer reliability was found for the TUG (intraclass correlation coefficient [ICC] = 0.962) and STS tests (ICC = 0.996), with a total range of 0.943-0.997. Excellent interobserver reliability was found for the TUG (ICC = 0.995) and STS (ICC = 0.996) tests. The coefficient of variant values for the tests was < 15%. CONCLUSION: Our results demonstrated that the TUG and STS tests can be reliably used by nurses in community-dwelling older persons. IMPLICATIONS FOR PRACTICE: This study is important in terms of determining the risk of falling among older persons aged 60 and over in Turkey, preventing hospitalisations due to falls and developing nursing policies that promote the safety of older persons individuals.

Enhancing Dynamic Balance and Postural Stability in Stroke Patients: The Impact of Immersive Virtual Reality Training.

Introduction Stroke is a major neurological event resulting from reduced or blocked blood flow to the brain, leading to significant morbidity. Immediate medical attention is essential to minimize brain damage and improve outcomes since it leads to many clinical deficits like locomotor impairment, instability in postural control, tonic alterations of the affected musculature, and an array of neurological dysfunctions if left unnoticed. Immersive virtual reality (VR) has emerged as a novel therapeutic tool in stroke rehabilitation, offering engaging and realistic environments for therapy. This study aims to evaluate the effectiveness of immersive VR training combined with functional gait exercises in improving dynamic balance and postural stability in stroke patients, compared to VR training alone. Methods This comparative study included 30 subjects from Madha Medical College and Hospital, Chennai, Tamil Nadu, India, divided into two groups. Group A (n=15) received immersive VR combined with functional gait exercises, while Group B (n=15) received immersive VR alone. Subjects were aged 40-60 years with stable blood pressure and a stroke duration of two weeks to six months. The study spanned 12 weeks, with 30-minute sessions on alternate days. Dynamic balance and postural stability were assessed using the Functional Gait Assessment (FGA) and Falls Efficacy Scale (FES). Pre-test and post-test scores were evaluated using parametric tests. Results Post-test mean values showed significant improvements in both groups. Group A demonstrated greater effectiveness, with lower FES scores (mean 36.66 ± 11.12) than Group B (mean 46.66 ± 9.75). FGA scores were higher in Group A (mean 28.00 ± 0.925) compared to Group B (mean 26.06 ± 1.66). Significant differences were observed in pre-test and post-test values within each group, supporting the hypothesis that combined VR and gait exercises offer superior rehabilitation outcomes. Conclusions Immersive VR combined with functional gait exercises significantly improves dynamic balance and postural stability in stroke patients compared to VR alone. This integrated approach can enhance motor function recovery, increase independence, and improve the quality of life. VR's capability to simulate real-life activities and provide immediate feedback allows for personalized rehabilitation programs. Further research is required to validate these findings and optimize VR-based rehabilitation protocols.

Lower-Quarter Y-Balance Test Differs by Age: Younger Athletes May Not Be Generalized to High School-Aged Counterparts.

Background: Given rising youth sport participation, 8 to 10-year-olds increasingly display comparable lower-extremity injury incidence to 11 to 17-year-olds and require effective return to sport criteria. One such criterion which quantifies dynamic stability is the Y-Balance Test (YBT), though it has not been validated in children under age 11. Hypothesis/Purpose: The purpose of this study was to examine the performance of 8 to 10-year-old patients on the YBT after lower-extremity injury and determine how these results compare to larger samples of age-grouped athletes within the validated 11 to 17-year-old range. It was hypothesized that 8 to 10-year-olds would display different normalized YBT distances compared to 11 to 17-year-olds. Study Design: Cross-sectional Study. Methods: Patients (N=1093) aged 8 to 17 who presented to a pediatric sports medicine practice with a lower-extremity injury and completed the YBT between December 2015-May 2021 were included. Anterior, posteromedial, and posterolateral YBT scores were collected at return-to-sport for affected and unaffected limbs. Scores were normalized to limb length, and composite scores were created. Between-limb differences were calculated in groups of ages 8-10, 11-12, 13-14, and 15-17. Groups were also evaluated for differences by sex. Results: A rise in performance was observed in unaffected limb anterior reach from ages 8 to 10 years to 11 to 12 years followed by a subsequent significant decrease at older ages (p<0.001). Affected limb anterior reach differed between the youngest group and two oldest groups (p=0.004). Anterior and composite difference were significantly different between the oldest three groups (p=0.014 anterior; p=0.024 composite). No differences were observed between sexes in 8 to 10-year-olds, though 11 to 12-year-old females reached further during all eight distances. In the older three groups, males generally displayed greater between-limb differences. Conclusion: YBT scores, specifically anterior reach, demonstrated inconsistency by age and sex across a large adolescent cohort. Existing return-to-sport standards should not be used with younger athletes, and individual validation is required. Level of Evidence: Level III.

Effects of neuromuscular training on dynamic balance ability in athletes: A systematic review and meta-analysis.

Objectives: This study aimed to quantitatively analyze the effects of neuromuscular training (NMT) on dynamic balance in healthy athletes through a systematic review and meta-analysis of randomized controlled trials. Methods: Searches on six databases for randomized controlled trials examining the impact of NMT on athletes' balance ability. The search period extended from the inception of the database to March 16, 2024, languages are limited to Chinese and English. Review Manager 5.1 was used for literature quality assessment and data analysis. Stata 15.0 software was used for assessing publication bias, employing the clipping method, and conducting sensitivity analysis. The Grading of recommendations assessment development and evaluation (GRADE) was used to assess the certainty of evidence. Effect size (ES) was used to evaluate the impact effect of the results. Results: (1) Meta-analysis: A total of 7 papers met the inclusion criteria, and the meta-analysis indicated that NMT had a positive impact on the dynamic balance ability of the right (SMD = 0.74) and left (SMD = 0.70) lower limb of athletes, and a statistically significant difference was observed (p < 0.01). Subgroup analysis revealed that NMT did not have a positive effect (p > 0.05) on the right anterior (SMD = 0.35); However, it had a positive effect (p < 0.05) on the right posteromedial (SMD = 1.22), right posterolateral (SMD = 0.82), right composite score (SMD = 0.79), left anterior (SMD = 0.38), left posteromedial (SMD = 1.19), left posterolateral (SMD = 0.57) and left composite score (SMD = 0.86). (2) Reporting bias: Funnel plot indicated evidence of publication bias, but there was no significant asymmetry in the funnel plot after trimming and filling. The results were not reversed, indicating the robustness of the combined results. (3) Sensitivity analysis: The results of the sensitivity analysis suggest that the data in this meta-analysis are relatively stable and credible. (4) Grading the evidence: Based on GRADE scale the certainty of evidence from the included studies was determined to be moderate. Conclusion: Neuromuscular training can enhance the dynamic balance ability of athletes on both the left and right sides. Therefore, neuromuscular training is an effective method for enhancing the unilateral dynamic balance ability of athletes.

Transcranial Direct-Current Stimulation Over the Primary Motor Cortex and Cerebellum Improves Balance and Shooting Accuracy in Elite Ice Hockey Players.

PURPOSE: To investigate the effects of transcranial direct-current stimulation (tDCS) applied over the primary motor cortex (M1) and cerebellum on balance control and shooting accuracy in elite ice hockey players. METHODS: Twenty-one elite ice hockey players underwent anodal tDCS over the M1 (a-tDCSM1), anodal tDCS over the cerebellum (a-tDCSCB), concurrent dual-site anodal tDCS over the M1 and the cerebellum (a-tDCSM1+CB), and sham stimulation (tDCSSHAM). Before and after receiving tDCS (2 mA for 15 min), participants completed an ice hockey shooting-accuracy test, Pro-Kin balance test (includes stance test and proprioceptive assessment), and Y-balance test in randomized order. RESULTS: For static balance performance, the ellipse area in the 2-legged stance with eyes open and the 1-legged stance with the dominant leg significantly improved following a-tDCSM1, a-tDCSCB, and concurrent dual-site a-tDCSM1+CB, compared with tDCSSHAM (all P < .05, Cohen d = 0.64-1.06). In dynamic balance performance, the average trace error of the proprioceptive assessment and the composite score of the Y-balance test with the dominant leg significantly improved following a-tDCSM1 and concurrent dual-site a-tDCSM1+CB (all P < .05, Cohen d = 0.77-1.00). For the ice hockey shooting-accuracy test, shooting-accuracy while standing on the unstable platform significantly increased following a-tDCSM1 (P = .010, Cohen d = 0.81) and a-tDCSCB (P = .010, Cohen d = 0.92) compared with tDCSSHAM. CONCLUSION: tDCS could potentially be a valuable tool in enhancing static and dynamic balance and shooting accuracy on unstable platforms in elite ice hockey players.

Ultrasonographic Achilles Tendon Measurements and Static and Dynamic Balance in Prediabetes.

Background and Objectives: There is a lack of studies examining balance problems and Achilles tendon thickness in prediabetes despite their common occurrence in diabetes mellitus. The aim of this study was to evaluate Achilles tendon size and static and dynamic balance, as well as the role of the Achilles tendon in balance, in prediabetic patients. Materials and Methods: A total of 96 participants were divided into three groups: (1) the control group, consisting of participants without diabetes mellitus; (2) the prediabetes group; and (3) the diabetes mellitus group. Ultrasonographic measurements of Achilles tendon sizes (thickness, width and area) were performed. Dynamic balance was assessed using the Berg Balance Scale, and static balance (the Fall and Stability Indices) was assessed using a Tetrax device. The Self-Leeds Assessment of Neuropathic Symptoms and Signs was utilized to identify neuropathic pain. Results: In the prediabetes group, the median dynamic balance scores [54.0 (51.0-56.0)] were lower than those of the control group [55.0 (54.0-56.0)] but higher than those of the patients with diabetes mellitus [52.50 (49.0-54.25)]; however, this difference did not reach statistical significance. The ultrasonographic measurements of the Achilles tendon size were similar among the three groups. On the other hand, in the prediabetes group, a positive correlation was observed between the bilateral Achilles tendon anterior-posterior thickness and Fall Index score (p = 0.045), while a negative correlation was found between the left Achilles tendon anterior-posterior thickness and the Berg Balance Score (p = 0.045). Conclusions: In prediabetes, neither Achilles tendon size nor static or dynamic balance appears to be significantly affected. However, in prediabetic patients, increased Achilles tendon thickness appears to be associated with increased risk of falls and decreased balance.

The reliability and validity of the Lie­To­Sit­To­Stand­To­Walk transfer test in total knee arthroplasty.

BACKGROUND: Total knee arthroplasty (TKA) is the standard procedure for treating end-stage knee osteoarthritis. Nevertheless, some residual issues can persist, leading to various problems, including pain, compromised strength, impaired proprioception, postural instability, dynamic balance issues, and gait deficiencies. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) implements a multi-faceted methodology to evaluate basic transfer abilities. The purpose of this study is to investigate the validity, reliability, and minimal clinically important difference of the LSSWT in TKA patients. METHODS: Twenty-two patients with TKA were enrolled in this study. The patients were administered the LSSWT, the Timed Up and Go Test (TUG), and the Hospital for Special Surgery (HSS) knee score. Patients rested between the tests for an hour to prevent fatigue. RESULTS: The mean age was 68.1 ± 2.59 years and the mean HSS Knee Score was 85.43 ± 3.47 of the patients. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values were 0.88, 1.21, and 3.33 respectively. The Spearman correlation coefficient of the LSSWT with the TUG was 0.63. CONCLUSIONS: The LSSWT displays excellent reliability and high validity in assessing fall risk, complex dynamic balance, and mobility required for daily activities in patients post-TKA. The low MCID value (3.33) indicates its sensitivity and ability to identify minor changes in a patient's status over time or in response to rehabilitation applications. Therefore, it is recommended to use the LSSWT when evaluating fall risk, dynamic balance, and mobility for community living, discharge planning, or facility admission.

Influence of protocol variables on outcomes of the star excursion balance test group (SEBT, mSEBT, YBT-LQ) in healthy individuals: a systematic review.

Background: The "SEBT group," which includes the Star Excursion Balance Test (SEBT), its modified version (mSEBT), and the Lower Quarter Y-Balance Test (YBT-LQ), is used to assess the limits of stability. Interestingly, the testing protocol allows users a considerable degree of flexibility, which can affect the obtained results. Therefore, the objective of this systematic review was to analyze the impact of different protocol variants within the "SEBT group" on outcomes. Methods: Data were acquired by searching 4 databases (MEDLINE, ScienceDirect, Wiley, Springer Link) focusing on studies published in English in peer-reviewed journals, empirical in nature, conducted on healthy individuals, and examining the effects of various protocol variants on test outcomes. Study quality was assessed with the NHLBI quality assessment tool for pre-post studies with no control group. Results: The calculation method based on the maximum repetition yields statistically significantly higher results compared to other calculation methods. Allowing unrestricted arm movements during the test results in statistically significantly higher scores compared to the procedure that restricts arm movements. The impact of a warm-up, wearing footwear during testing, and using a dedicated kit remains ambiguous. To obtain reliable results, 4-6 familiarization trials are necessary, though fewer may suffice for athletes experienced in performing the test. Conclusion: This systematic review highlights the significant impact of the calculation method and arm movement restrictions on the outcomes of the "SEBT group." The effects of wearing footwear during testing, warm-up, and using a dedicated test kit remain unclear. The required number of familiarization repetitions may varies depending on biological maturity level of the person being tested. Future research should develop a warm-up protocol tailored to the needs of the "SEBT group," and investigate the impact of heel elevation during testing on outcomes. Systematic review registration: The protocol for this systematic review was prospectively registered in the OSF Registries (https://doi.org/10.17605/OSF.IO/JSKH2).

Evaluating plantar biomechanics while descending a single step with different heights.

Objective: This study aims to investigate the plantar biomechanics of healthy young males as they descend a single transition step from varying heights. Methods: Thirty healthy young males participated the experiment using the F-scan insole plantar pressure system in which participants made single transition steps descent from four step heights (5, 15, 25, and 35 cm), leading with their dominant or non-dominant foot. Plantar pressure data were collected for 5 s during the period between landing touchdown and standing on the ground. Landing at each step height was repeated three times, with a five-minute rest between different height trials. Results: At 5 cm and 15 cm steps, participants demonstrated a rearfoot landing strategy on both sides. However, forefoot contact was observed at heights of 25 cm and 35 cm. Parameters related to center of plantar pressure (COP) of the leading foot were significantly larger compared to the trailing foot (P < 0.001), increased with higher step heights. Vertical ground reaction forces for the biped, leading and trailing feet decreased with increasing step height (all P < 0.05). The leading foot had a higher proportion of overall and forefoot loads, and a lower proportion of rearfoot load compared to the trailing foot (P < 0.001). The overall load on the dominant side was lower than that on the non-dominant side for both the leading and trailing feet (P < 0.001). For the trailing foot, forefoot load on the dominant side was lower than that on the non-dominant side, however, the opposite result appeared in rearfoot load (P < 0.001). Upon the leading foot landing, forefoot load exceeded the rearfoot load for the dominant (P < 0.001) and non-dominant sides (P < 0.001). Upon the trailing foot landing, forefoot load was lower than the rearfoot load for the dominant (P < 0.001) and non-dominant sides (P = 0.019). Conclusion: When the characteristics of biomechanical stability are compromised by step height, landing foot, and footedness factors - due to altered foot landing strategies, changing COP, or uneven force distribution - ability to control motion efficiently and respond adaptively to the forces experienced during movement is challenged, increasing the likelihood of loss of dynamic balance, with a consequent increased risk of ankle sprains and falls.

Accounting for climate transition risk in banks' capital requirements.

This paper uses a stylized simulation model to assess the potential impact of climate transition risk on banks' balance sheets in a climate-stress-testing (i.e. short-run) framework. We show that a moderate to high transition risk increases overall bank losses only relatively modestly if the baseline is a stressed macroeconomic scenario. However, even in a benign macroeconomic scenario, if high-carbon assets are at least 13% riskier than comparable assets a fire sale mechanism could amplify an initially contained shock into a systemic crisis, resulting in significant losses for the EU banking sector. We show that transition risks are concentrated, and find that an additional capital buffer of 0.9% risk-weighted assets on average would be sufficient to protect the system.

Biomechanical and Physiological Variables in Dynamic and Functional Balance Control during Single-Leg Loading in Individuals with Chronic Ankle Instability: A Scoping Review.

BACKGROUND: This scoping review summarizes the tasks and outcomes in dynamic and functional balance assessments of individuals with chronic ankle instability, focusing on the physiological and biomechanical characteristics. METHOD: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and MEDLINE databases in September 2023 and revised in April 2024. Studies evaluating dynamic and functional balance in chronic ankle instability using clinical tests, as well as biomechanical and physiological outcomes, were included. RESULTS: Out of 536 publications, 31 met the screening criteria. A history of ankle sprain was the main focus of the inclusion criteria (28 articles, 90%). The star excursion balance test, emphasizing maximum reach distance, was the most common quantitative task (12 articles, 66%). Physiological data mainly came from electromyography studies (7 articles, 23%), while biomechanical variables were often assessed through center of pressure studies using force plates (17 articles, 55%). CONCLUSIONS: The preferred quantitative clinical assessment was the star excursion balance test, focusing on normalized reach outcomes. Qualitative functional balance assessments emphasize landing activities and center of pressure displacement. Electromyography is commonly used to analyze the tibialis anterior and peroneus longus muscles. However, there is a lack of qualitative data on dynamic balance control, including morphological characteristics and the center of mass adaptation.

Comparing reach distance between the Y-Balance Test-Lower Quarter and Star Excursion Balance Test: Are practitioners using the correct protocol?

OBJECTIVES: To compare reach distances between the YBT-LQ and SEBT using the correct protocols as outlined by the developers. This will provide an accurate insight on the actual magnitude differences in reach distance between the movement screen tests and will safeguard practitioners on the subsequent use of these outcomes to inform clinical decision making. DESIGN: Observational. SETTING: Laboratory. PARTICIPANTS: Participants included sixteen healthy female subjects from the university and amateur sports teams. MAIN OUTCOME: Reach distances in the anterior direction (ANT), posterior medial (PM) and posterior lateral (PL) between participants on the YBT-LQ and SEBT. RESULTS: The principal findings highlighted that a statistically significantly greater reach distance on the left and right side for the YBT-LQ compared to the SEBT in the ANT, PM, and PL directions (p < 0.0005). CONCLUSION: The results of this study suggest that the YBT-LQ and SEBT are not comparable tests due to the differences in reach distance and methodological differences. Therefore, previous, and future research using the YBT-LQ and SEBT cannot be used interchangeably. Not following developed guidelines questions the applicability of the findings of reach distance scores to infer on performance and assessment of injury risk.

Effect of Progressive Balance Control Strategies on Chronic Ankle Instability in Middle-Aged Obese Women.

INTRODUCTION: Chronic ankle instability (CAI) is a disease characterized by persistent feelings of instability in the ankle joint and a propensity for recurrent ankle sprains. It is often caused by ligamentous laxity or neuromuscular deficits. Middle-aged obese females represent a demographic subset at increased risk for CAI due to factors such as reduced proprioception and increased loading on the ankle joint. The gaps in the current evidence suggest that more research is needed on middle-aged obese females, who are particularly vulnerable to CAI due to physiological changes associated with poor balance. OBJECTIVES: This study aims to determine the effect of progressive balance control strategies on CAI in middle-aged obese women. METHOD: In this experimental study, 72 patients with CAI in middle-aged women were selected randomly using a simple random sampling method. Females aged 35-45 with a body mass index (BMI) greater than 27 kg/m2 and a history of ankle sprains greater than one and having residual symptoms. The experimental group (Group B) received progressive balance control strategies, and the conventional group (Group A) received conventional balance exercises. Foot and ankle ability measure (FAAM) scale, push-and-release test (PART), single-leg stance test (SLST), evaluations, and star excursion balance test (SEBT) were used for pre- and posttreatment. RESULTS: The experimental group post-intervention for static balance, dynamic balance, and postural control tests showed extremely significant improvement with a p-value of <0.0001. Between groups A and B, the dynamic balance was considered very significant, with a p-value of 0.0001. In the single-leg stance test, Group B's result was significantly greater than that of Group A's (63.4 + 16.1 and 63.4 + 16.1). PART results indicate that Group B is more significant than Group A (0.76 and 0.51, respectively). CONCLUSIONS: The study concluded that progressive balance control strategy training is effective in middle-aged obese women with CAI.

Flow and performance: a quantitative study of elicitation modeling in a piano performance perspective.

Introduction: Flow, defined as a heightened state of consciousness characterized by intense concentration during an activity, is influenced primarily by the perceived challenge and the dynamic equilibrium of skills. This investigation focuses on the patterns of flow state attainment and its elicitation mechanisms within the context of piano performance among Chinese music college students. Methods: Our study establishes a framework for accessing flow, utilizing quantitative data from music ontology to gauge the level of challenge and the level of music acquisition to assess skills. Additionally, we integrate external factors such as music culture heterogeneity and demographic variables to elucidate the causes and moderating effects of flow on piano performance. Results: The findings reveal a positive correlation between flow and performance, with the model of challenge and skill induction partially explaining these results. Notably, melodic Shannon Entropy emerges as a potential indicator of challenge, suggesting its relevance in future studies on flow. Discussion: This research provides multidimensional insights into the interplay between performance and flow in piano performance, guiding future investigations to explore the musical quantitative perspective more deeply.

Effects of Rehabilitative Exercise and Neuromuscular Electrical Stimulation on Muscle Morphology and Dynamic Balance in Individuals with Chronic Ankle Instability.

Background and Objectives: Muscle atrophy caused by chronic ankle instability (CAI) can incur muscle weakness, altered movement patterns, and increased risk of injury. Previous studies have investigated the effects of rehabilitative exercises and neuromuscular electrical stimulation (NMES) on characteristics in CAI individuals, but few studies have examined their effects on foot and ankle muscle morphology. This study aimed to determine the effects of rehabilitative exercises and NMES on muscle morphology and dynamic balance in individuals with CAI. Materials and Methods: Participants with CAI (n = 47) were randomly divided into control (CG), rehabilitative exercise (REG), NMES (NG), and rehabilitative exercise and NMES combined (RNG) groups. The six-week intervention program consisting of rehabilitative exercises and NMES was applied to groups excluding CG. Muscle morphology and dynamic balance were evaluated using a portable wireless diagnostic ultrasound device and dynamic balance tests. For statistical analysis, an effect size with 95% confidence interval was calculated to assess mean differences according to intervention. Results: After six weeks, significant increases in morphology and dynamic balance were observed for all muscles except flexor hallucis longus (p > 0.05) in the intervention groups except for CG. However, no significant changes were observed in the CG (p > 0.05). Conclusions: These findings suggest that intervention programs may help prevent muscle atrophy and improve balance in CAI individuals.