Relationship between the level of mental fatigue induced by a prolonged cognitive task and the degree of balance disturbance.

This study investigated the effects of mental fatigue (MF) induced by a 90-min AX-continuous performance test (AX-CPT) on balance control by addressing the issue of the heterogeneity of individuals' responses. Twenty healthy young active participants were recruited. They had to carry out two balance tasks (sway as little as possible on a stable support with the eyes open and closed) when standing on a force platform before and after performing a 90-min AX-CPT. The NASA-TLX test was used to assess the subjective manifestations of MF. Objective cognitive performance was measured using results from the AX-CPT. Inter-individual differences in behavioral deterioration due to MF were analyzed with a hierarchical cluster analysis, which categorizes participants' behaviors into subgroups with similar characteristics. The cluster analysis revealed that the achievement of the AX-CPT induced various levels of MF and balance impairments within the whole sample. A significant relationship between the level of MF and the degree of balance disturbance was observed only when participants stood with the eyes open, thus suggesting that inter-individual differences in vulnerability to MF could stem from differences between subjects in the level of engagement of visual attention and/or from differences in field dependency for balance control. These findings show that the completion of the same prolonged demanding cognitive task induces a strong heterogeneity in subjects' responses, with marked individual differences in MF vulnerability that affect balance control differently according to the sensory context.

Balance control is impaired by mental fatigue due to the fulfilment of a continuous cognitive task or by the watching of a documentary.

The aim of the present study was to evaluate the effects of mental fatigue (MF) induced by a 90-min continuous demanding cognitive task on balance control. Twenty healthy young participants were recruited. They had to perform three postural tasks (on a stable support with eyes open, with eyes closed and on a wobble board) while standing on a force platform before and after watching a documentary in a control condition or carrying out a prolonged continuous demanding cognitive task (AX-continuous performance test-AX-CPT) in a MF condition. Results showed that performing the AX-CPT generated MF since participants felt a higher subjective workload from the NASA Task Load Index after the AX-CPT than after viewing the documentary. Both the AX-CPT and the viewing of the documentary impaired balance control, mainly by affecting postural regulatory mechanisms which evolved towards a less automatic and less complex regulation mode with an increased participation of cognitive resources. MF generated by the AX-CPT affected balance control by compromising the attentional processing, while the deleterious influence of watching a documentary on postural control could stem from an adverse effect of prolonged sitting on balance control during subsequent standing.

Correction to: Voluntary and electrically-induced muscle fatigue differently affect postural control mechanisms in unipedal stance.

In the metadata of the original publication of the article.

Ski Boots Do Not Impair Standing Balance by Restricting Ankle-Joint Mobility.

OBJECTIVE: This study was undertaken in order to provide new insight into sensorimotor control of posture when wearing high-shaft (HS) boots as ski boots. BACKGROUND: Previous studies into the effects of HS boots on postural control have produced controversial results. Some studies reported postural control impairments with ski boots in bipedal postural tasks due to ankle movement restrictions without quantifying the actual restrictive effect of these boots and specifying the adaptations of the postural control system. METHOD: Eighteen young healthy subjects took part in the experiment. Bilateral postural control was assessed on stable and unstable surfaces, while standing barefoot or wearing ski boots. Center of pressure (COP) parameters, ankle, knee, and hip joints movements were calculated and EMG activity from main postural muscles was recorded. RESULTS: Ski boots did not restrict the amplitude of ankle angular movements and largely impacted COP parameters and EMG activity on stable ground. In conditions of mediolateral instability, COP data illustrated an enhanced postural control in the frontal plane when wearing ski boots. CONCLUSIONS: Ski boots do not affect bipedal postural balance by restricting the ankle angular motions but induce complex adaptations of the postural control system which combine factors of a mechanical, motor, and sensorial nature. They impede postural control mainly when standing on stable ground without producing similar deleterious effects on unstable surfaces. APPLICATION: Our results show that HS boots as ski boots can improve lateral balance on unstable surfaces, which can contribute to prevent fall risk and ankle sprain.

Optimization of the Effects of Physical Activity on Plantar Sensation and Postural Control With Barefoot Exercises in Institutionalized Older Adults: A Pilot Study.

Increasing somatosensory information from the foot by exercising barefoot can potentially optimize the effectiveness of physical exercise interventions on falls prevention in the older adults. This pilot study was then undertaken to explore the effects of increased somatosensory information from the foot by exercising barefoot on balance, gait, and plantar cutaneous sensitivity in institutionalized older adults involved in multimodal exercise intervention. Participants were assigned to three groups: a control group which did not perform any physical exercise and two groups in which they were involved in a multimodal exercise program performed barefoot or shod. Postural, gait, and plantar cutaneous sensitivity parameters were collected. The results showed that the exercise program produced larger effects on balance and plantar cutaneous sensitivity when exercises were performed barefoot, without any noticeable effect on gait. Hence, barefoot exercising could be a relevant means to optimize the fall-prevention exercise programs in institutionalized older adults.

Fatigue does not conjointly alter postural and cognitive performance when standing in a shooting position under dual-task conditions.

This study investigated the effects of fatigue on balance control and cognitive performance in a standing shooting position. Nineteen soldiers were asked to stand while holding a rifle (single task - ST). They also had to perform this postural task while simultaneously completing a cognitive task (dual task - DT). Both the ST and DT were performed in pre- and post-fatigue conditions. In pre-fatigue, participants achieved better balance control in the DT than in the ST, thus suggesting that the increased cognitive activity associated with the DT improves balance control by shifting the attentional focus away from a highly automatised activity. In post-fatigue, balance control was degraded in both the ST and DT, while reaction time was enhanced in the first minutes following the fatiguing exercise without affecting the accuracy of response in the cognitive task, which highlights the relative independent effects of fatigue on balance control and cognitive performance.

Warm-up Optimizes Postural Control but Requires Some Minutes of Recovery.

Paillard, T, Kadri, MA, Nouar, MB, and Noé, F. Warm-up optimizes postural control but requires some minutes of recovery. J Strength Cond Res 32(10): 2725-2729, 2018-The aim was to compare monopedal postural control between the dominant leg (D-Leg) and the nondominant leg (ND-Leg) in pre- and post-warm-up conditions. Thirty healthy male sports science students were evaluated before and after a warm-up exercise (12 minutes of pedaling with an incremental effort on a cycle ergometer with a controlled workload). Monopodal postural control was assessed for the D- and ND-Legs before and immediately, 2, 5, 10, and 15 minutes after the warm-up exercise, using a force platform and calculating the displacement velocity of the center of foot pressure on the mediolateral (COPML velocity) and anteroposterior (COPAP velocity) axes. No significant difference was observed between the D-Leg and ND-Leg for both COPML and COPAP velocity in all the periods. In comparison with pre-warm-up, COPML decreased after 15-minute and 10-minute recovery periods for the D-Leg and the ND-Leg, respectively (p < 0.05), whereas COPAP decreased after 10-minute and 15-minute recovery periods (p < 0.001; p < 0.01, respectively) for the D-Leg, and after a 10-minute recovery period for the ND-Leg (p < 0.001). The warm-up optimized monopedal postural control but did not make it possible to distinguish a difference between the D-Leg and the ND-Leg. Some minutes of recovery are required between the end of the whole-body warm-up exercise and the beginning of the postural test to optimize postural control. The optimal duration of recovery turns out to be about 10-15 minutes.

Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

PURPOSE: To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. METHODS: 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. RESULTS: After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. CONCLUSION: The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

The difficulty of postural tasks amplifies the effects of fatigue on postural stability.

PURPOSE: It was supposed that the difficulty of postural tasks accentuates the effects of fatigue on postural stability. The aim of this work was to compare the effects of fatiguing running on three different postural conditions presenting different levels of difficulty: a standing still position with the eyes open (EO condition), a standing still position with the eyes closed (EC condition) and a shooting position with the eyes open (SP condition). The SP condition required a rifle to be held horizontally with the arms and a standing posture with the non-dominant foot ahead of the dominant foot. METHODS: Thirty-two male soldiers 32.2 ± 3.8 years old completed a maximal incremental protocol on a treadmill by running until they reached a state of fatigue. The three postural conditions were evaluated in a randomized order before and after the fatiguing exercise with the use of a force platform which recorded the displacements of the centre of foot pressure. RESULTS: Following the fatiguing running exercise, postural stability was affected to a greater extent in the SP condition than in the EO condition and the EC condition. CONCLUSION: The requirements of the SP condition modify the entire postural organization and this challenges balance control to a greater extent than when in EO and EC standing still positions, following fatiguing exercise. The difficulty of postural tasks thus amplifies the effects of fatigue on postural stability.

Does the time of day differently impact the effects of an exercise program on postural control in older subjects? A pilot study.

BACKGROUND: The time of day that people exercise can potentially influence the efficiency of exercises for fall prevention in older adults. The present pilot study was conducted to explore the feasibility and effects of morning versus afternoon exercising on postural control in institutionalized older adults. METHODS: Nine older adults completed a 3-month multimodal exercise program in its entirety (14 participants were recruited at the beginning and were initially randomly separated into two groups). One group exercised in the morning (ME; n = 4) and the other in the afternoon (AE; n = 5). Postural control was assessed with a force platform at pre and post-intervention at the following times: 8 a.m., 11 a.m., 2 p.m. and 5 p.m. RESULTS: Postural control significantly improved only in the AE group post-intervention. Improvements in postural control in the AE group were mainly observed in the morning. CONCLUSIONS: The afternoon would be the best period to implement exercise sessions dedicated to improve postural control in older subjects with benefits mainly observed in the morning. Further studies are needed with a larger sample in order to confirm these results.

Local exercise based on voluntary contractions produces greater warm-up effects on balance control than electro-induced contractions.

On the one hand, while general (involving the whole body) warm-up exercises have been extensively used to optimize motor and postural performance, the effect of a local (involving a particular muscular group) warm-up has not yet been addressed. On the other hand, voluntary (VOL) and electro-induced (EI) contractions produce different physiological effects likely to differently affect motor and postural performance. The aim was to analyze and compare the effects of two local warm-up modalities, voluntary and electro-induced (VOL or EI warm-up) on balance control. Balance control was evaluated with a force platform (recording the displacement of the centre of foot pressure - COP) in 27 healthy young subjects before (PRE), immediately after (POST), 5 min after (POST5), and 10 min after (POST10) either warm-up. Each warm-up included 6 sets of 5 contractions at 10% of maximal voluntary contraction of the quadriceps femoris. The results showed that the VOL warm-up improved balance control at POST, POST5 and POST10 while the EI warm-up improved it only at POST10. In addition, balance control was significantly better after the VOL warm-up than after the EI warm-up at POST5 and POST10. A short and local VOL warm-up improved balance control immediately after its completion and for, at least, ten minutes, while the EI warm-up required some minutes of recovery before producing its improving effects.

Can Compression Garments Reduce Inter-Limb Balance Asymmetries?

Sensory cues provided by compression garments (CG) can improve movement accuracy and potentially reduce inter-limb balance asymmetries and the associated risk of injury. The aim of this study was to analyze the effects of CG wearing on inter-limb balance asymmetries. The hypothesis was that CG would reduce inter-limb balance asymmetries, especially in subjects with high level of asymmetries. Twenty-five sportsmen were recruited. They had to stand as motionless as possible in a one-leg stance in two postural tasks (stable and unstable), while wearing CG or not. Asymmetry indexes were calculated from center of foot pressure parameters. The effects of CG wearing were analyzed according to participants' baseline level of asymmetry (i.e., without wearing CG) with correlation analyses. A qualitative analysis was also performed after a dichotomization procedure to check for a specific influence of CG on the dominant and non-dominant leg. Inter-limb balance asymmetries were reduced with CG in participants with high levels of asymmetries at baseline. However, asymmetries were increased with CG in participants with low levels of asymmetries at baseline. The dominant leg was more affected by this negative effect. CG wearing could reduce inter-limb balance asymmetries and the related injury risk in subjects with high levels of inter-limb balance asymmetries at baseline. Nevertheless, CG should not be used in individuals with low baseline balance asymmetries since it can increase asymmetries in these subjects, likely by confusing and overloading the sensorimotor processing on the dominant leg.

Warm-Up Improves Balance Control Differently in the Dominant and Non-Dominant Leg in Young Sportsmen According to Their Experience in Asymmetric or Symmetric Sports.

The aim of this study was to investigate the acute effects of a warm-up on balance control and inter-limb balance asymmetries by analyzing the influence of the nature of the sport practiced by participants. Twelve sportspeople were recruited. They had to stand on a force plate for 30 s in a one-leg stance on their dominant (used to perform skilled movements) and non-dominant leg (used to support the body) before and 2, 5, 10, 15 and 20 min after a 10 min warm-up exercise performed at moderate intensity on a cycle ergometer. The center of foot pressure displacements was recorded. Statistical analysis was performed by considering one group of all participants and with two subgroups according to the symmetrical or asymmetrical nature of the sport they practiced. The warm-up exercise improved acute balance control only on the dominant leg after a 20 min rest without significantly reducing inter-limb balance asymmetries. This effect was more characteristic of participants with experience in asymmetric sports. These results confirm previous findings of the greater sensitivity of the dominant leg to the physiological state and reveal that between-leg differences in balance control appear mainly in subjects with experience in asymmetric sports in a specific physiological condition (post-warm-up state).

Effect of the application of somatosensory and excitomotor electrical stimulation during quiet upright standing balance.

Somatosensory (which activates sensory neurons only) and excitomotor (which activates both motoneurons and sensory neurons) electrical stimulations applied on the musculature of the lower-limb are likely to facilitate and disturb balance control respectively. The aim of this study was to compare the possible balance control modifications induced by somatosensory (SS) and excitomotor (EX) electrical stimulations applied on the quadriceps femoris in quiet standing condition. Kinetics and kinematics parameters were recorded with a force platform (displacements of center of foot pressure) and a 3D analysis system (hip, knee and ankle angles) respectively during a postural task. Twenty healthy young male participants carried out a monopedal postural task (i.e., unilateral stance) in three conditions: SS stimulation (1ms; 10Hz; 7±2 mA i.e., twice the intensity corresponding to the sensory threshold), EX stimulation (400 µs; 50 Hz; 20 ± 5 mA i.e., twice the intensity corresponding to the motor threshold), and a control (CONT) condition without stimulation. The results showed no significant differences between the three conditions except for the knee' angle which was higher in the EX condition (167.3±11.6 vs 164.3±5.8 and 163.9±8) (p < 0.005) than in the two other conditions (SS stimulation and CONT). This means that the EX stimulation induced a postural position change (i.e., a slight knee extension) during the monopedal postural task without altering balance control. Overall, on the basis of the stimulation parameters used in the present work, neither the SS stimulation, nor the EX stimulation facilitated or disturbed postural balance.

The optimal exploitation of sensory electrical stimulation for regulating postural balance depends on participants' intrinsic balance abilities.

BACKGROUND: The sensory electrical stimulation applied to the postural muscles provides additional sensory information that improves postural balance but this improvement seems to be highly subject-dependent. RESEARCH QUESTION: The first aim was to analyse the effects of sensory electrical stimulation on postural balance and the second aim was to analyse these effects depending on intrinsic postural balance abilities of subjects. METHODS: Twenty healthy young male participants completed a monopedal postural task with sensory electrical stimulation (1 ms; 10 Hz; 7 ± 2 mA i.e., twice the intensity corresponding to the sensory threshold) and without sensory electrical stimulation. Pearson's product-moment correlations were performed on centre of pressure parameters to assess whether the participant's balance abilities at baseline were related to the beneficial effects of sensory electrical stimulation. RESULTS: The results showed positive correlations for all the variables measured (i.e., with r2 from 0.32 to 0.35). Evidence suggests that subjects' abilities to take advantage from electrically induced additional afferents depended on participants' intrinsic balance abilities. In fact, subjects who exhibited the worst postural balance at baseline (i.e. without stimulation) benefited more from the effects of sensory electrical stimulation than subjects who displayed the best postural balance at baseline. SIGNIFICANCE: In physically impaired subjects, as part of functional rehabilitation, sensory electrical stimulation would be particularly interesting in order to limit their risk of falling.

The tightening parameters of the vibratory devices modify their disturbing postural effects.

The purpose was to specify the impact of two different forces exerted by vibratory devices on the Achilles tendon on postural balance. The postural balance of 13 participants was evaluated on a force platform in two 40 s bipedal stance conditions with closed eyes. Tendon vibrations (80 Hz) were triggered 10 s after the beginning of the postural evaluation and applied during 20 s. Two levels of the force exerted by the vibrators were calibrated using load cells to control the tightening parameters of the vibrators: a strong tightening (ST) condition at 45 N and a light tightening (LT) condition at 5 N. The soleus electromyographic (EMG) activity and the spatio-temporal parameters of displacement of the centre of foot pressure (COP) were analysed. To analyse the effects of the introduction, the adaptation and the end of the stimulation, non-parametric tests were used. The results indicated that the soleus EMG activity increased only in the ST condition. However, during the vibration the anteroposterior COP position was significantly more in a backward position in the LT condition. At the end of the vibration, COP parameters increased more in the LT condition than the ST condition. This study demonstrated that the effects of the vibration depended on the force exerted by the devices on the tendons. The ST increased the vibration effects on EMG activity through greater stimulating effects compared to the LT. However, the ST could also increase the ankle joint stiffness and/or somaesthetic sensory information, which attenuated the COP backward shift.

Does monopedal postural balance differ between the dominant leg and the non-dominant leg? A review.

The interlimb postural comparison i.e., between the dominant leg and the non-dominant leg has been studied by numerous authors but their results are contradictory and do not lead to a consensus. Some studies showed no difference of postural balance between the dominant and the non-dominant leg whereas other studies concluded that the dominant and non-dominant leg exhibit different postural balance in healthy subjects and athletes. The aim was to analyse all these studies in order to identify the different factors that could facilitate or prevent the appearance of a postural difference between the dominant and non-dominant leg by means of a narrative review. Environmental and experimental conditions (e.g., difficulty and specificity of postural tasks; physiological state, expertise level and moment of season/period over career of subjects/athletes evaluated and nature of sport/physical activity practiced; techniques and methods used for measuring postural balance) in which postural balance is evaluated and intrinsic/individual factors (e.g., morphology, strength/power muscle, proprioception, hemispheric laterality) could influence the results. Thus, the influence of limb dominance on monopedal postural balance would probably be context-dependent. Mechanistic explanations are proposed to explain how each factor could act on the relationship between limb dominance and postural balance. However many mechanisms have not yet been explained and all the factors have not been identified, which suggests that further exploratory research is needed in order to understand this relationship.

Effects of Compression Garments on Balance Control in Young Healthy Active Subjects: A Hierarchical Cluster Analysis.

There is controversy about the influence of compression garments on balance control. A positive influence was reported in elderly and injured individuals, whereas no beneficial effects were observed in young healthy active subjects, which is likely due to the large inter-individual differences in these subjects. Hence, this study investigated the acute effects of compression garments on balance control in young healthy active subjects by addressing the issue of heterogeneity of individuals' responses to the wearing of compression garments. Thirteen young, healthy, active subjects were recruited. They stood on a force plate which recorded the center of foot pressure displacements in a monopedal stance with the eyes closed and on a wobble board with the eyes open, while wearing compression garments or not. Statistics were first calculated with the data from the whole sample. A hierarchical cluster analysis was also performed in order to categorize the participants' behaviors into subgroups with similar characteristics. The whole group analysis showed that there were no significant effects attributed to compression garments. The clustering analysis identified distinct and homogeneous subgroups of participants. Only participants who swayed the more at baseline benefited from the wearing of compression garments to improve their balance control. These participants might have either a gravity-dependent preferred sensorimotor strategy with an exploratory postural behavior or poorer balance/proprioceptive abilities. Since poor balance control is a predictor of sports injury risk, wearing compression garments during sports practice could be viewed as a potential prevention strategy for individuals at risk.

Wearing compression garments differently affects monopodal postural balance in high-level athletes.

This study investigated the acute effects of compression garments (CG) on balance control in elite athletes. 15 male professional handball players were recruited. They had to stand as motionless as possible in a monopedal stance on a force plate with the eyes closed and on a wobble board with the eyes open, while wearing CG or not. Centre of foot pressure mean velocity and surface area were calculated. Statistics were first calculated with the data from the whole sample. A hierarchical cluster analysis was also performed in order to categorize the participants' behaviours into subgroups with similar characteristics. The whole group analysis showed that there were no significant effects attributed to CG. The clustering analysis identified two distinct and homogeneous subgroups of participants. Only athletes with the best balance abilities at baseline could benefit from CG wearing to improve their balance control. These athletes, who swayed less and were more sensitive to somatosensory manipulation due to CG wearing, seem to control balance by adopting a support-dependent preferred sensorimotor tactic. Our findings suggest that amongst high-level athletes, the ability to benefit from CG wearing to improve balance control seems to depend on participants' intrinsic balance skills and/or preferred sensorimotor tactics.

The influence of wearing ski-boots with different rigidity characteristics on postural control.

External supports that reduce ankle joint mobility such as ski-boots can impair postural control of healthy participants. Although this disruptive effect has been attributed to the rigidity of the external supports, the results remained controversial and no study has been conducted in order to evaluate the influence of ski-boots rigidity. Hence, the question about the influence of ankle support rigidity on postural control remains open. This study was therefore undertaken in order to investigate the effect of ski-boots rigidity on postural control. Ten healthy active participants were recruited. The wearing of soft and rigid ski-boots was compared to barefoot while standing on a seesaw generating mediolateral and anteroposterior instability. Centre of pressure displacements were sampled with a force platform. The surface electromyographic activity of the main muscles from the leg, thigh and trunk was recorded. A motion analysis system was also used to calculate the ankle, knee and hip angles. The results did not reveal any negative influence of ski-boot rigidity on postural control but rather suggest a less active postural control with the rigid ski-boots which offered a higher mechanical contribution.