Correlation between postural stability and fall risk in trans-femoral amputees due to muscle fatigue.

[Purpose] This study aimed to establish a connection between postural stability and falling in individuals with transfemoral amputation (TFA), particularly with muscle fatigue. [Participants and Methods] Fourteen participants were recruited. Muscle fatigue was induced using a sit-to-stand (STS) fatigue protocol. Pre-fatigue and post-fatigue assessments were conducted using the Biodex Balance System (BBS). [Result] The findings of the study revealed significant increases in the postural stability index between the pre-fatigue and post-fatigue conditions for the TFA group, particularly in the overall stability index (OSI) and anterior-posterior stability index (APSI) components. The mean postural stability index scores for the TFA group exhibited a percentage increase of 65.2% for OSI, 52.7% for APSI, and 50% for medial-lateral stability index (MLSI). Furthermore, the TFA fall risk index surged by 61.4%. Regarding the relationships observed, a significant correlation emerged between fall risk and both OSI and APSI. [Conclusion] These findings underscore the impact of muscle fatigue on postural stability and an increase in fall risk among TFA. By mitigating the effects of muscle fatigue, therapists can play an important role in reducing the risk of falls and promoting better postural stability in this population.

Assessing postural stability in flatfoot using a time-in-boundary method during single-leg standing.

Flatfoot, a foot deformity characterized by the collapse of the arch, significantly impacts an individual's balance and stability. This study explored postural adjustments and sway excursions in individuals with and without flatfoot using the Time-in-Boundary method. This method assessed relative stability by exploring various center of pressure radius thresholds during three trials of single-leg stance. We observed significant interactions in threshold levels (F = 4.37, p = 0.04) and normalized relative stable times (F = 7.64, p = 0.01), particularly in the initial trials. Initially, the flatfoot group showed marked decreases in stable times at 10 mm, 15 mm, and 20 mm thresholds, which expanded to 25 mm and 30 mm in subsequent trials. Despite a significant decrease in stability at the 30 mm threshold in early trials, participants exhibited improved stability control as trials progressed. This enhancement likely reflects a combination of a learning effect and an increased understanding of the task requirements, underscoring the adaptability of postural control systems to the biomechanical challenges posed by flatfoot. The Time-in-Boundary method has proven to be an effective tool for clinicians to assess postural control, playing a vital role in developing customized rehabilitation strategies for individuals with flatfoot.

Postural and spinal stability analysis for different floor sitting styles.

In contrast to Western countries, traditional floor-seating cultures are prevalent in Korea, Japan, the Middle East, and Africa, where sitting on the floor in static positions such as squatting, kneeling, or sitting cross-legged is common. Most studies on sitting posture have predominantly focused on chair sitting in Western cultures, resulting in a cultural bias. This study aimed to investigate the effects of different cushion types (floor and traditional cushions of 3-cm, 5-cm, and 8-cm thickness) and seating postures (cross-legged, mother's leg, and kneeling) on measures of postural stability, trunk muscle activity, rotational spinal stability, and subjective postural stability in an Asian population. Forty right-hand and right-foot-dominant volunteers who did not experience activity-limiting back pain in the past 12 months were recruited. Multivariate analyses of variance (MANOVA) and ANOVA with a repeated-measures design were employed to assess the within-subject effects of the cushion type and seating posture. An alpha value of 0.05 was set for statistical significance. The results of this study suggest that preventing lordosis posture, seating on the floor, and maintaining a kneeling posture may reduce the loss of balance and trunk muscle fatigue. These results emphasize the need for additional ergonomic studies that focus on the seating traditions of Asian cultures.

Lateral ligament reconstruction and additive medial ligament reconstruction in chronic ankle instability: a retrospective study.

Background: Ligamentous lesions of the ankle joint are common. Isolated medial ligament injuries are rare but are often associated with lateral ligament injuries, isolated medial ligament lesions are often overlooked. The present study aimed to evaluate the clinical and functional differences in the outcomes of isolated lateral and combined medial and lateral ligament reconstruction. The study is based on patient-reported outcome measurements and motion sensor technology to assess these outcomes. Objective: The purpose of this study was to compare the clinical and functional outcomes of isolated lateral and combined lateral and medial ankle ligament reconstruction. Methods: From December 2014 to August 2018, 111 patients underwent either isolated lateral ligament (LG) or medial and lateral ligament (MLG) reconstruction. Of the 104 patients meeting the inclusion criteria, 49 had LG and 55 had MLG reconstruction. Outcome measures included the Short Form-36 Health Survey SF-36, Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAMG), Tegner Activity Scale, the European Foot and Ankle Society (EFAS), American Orthopaedic Foot and Ancle Society (AOFAS) hindfoot score, and the Karlsson Peterson Score. Mobility and stability were assessed using the Ortheligent™ motion sensor for both healthy and treated ankles. Results: While there were no significant differences in outcome scores between the groups, overall scores improved after treatment (p >0.00). Notably LG showed improved movement, with better dorsal extension measured by the Sensor (p ÷ 0.02). The sensor's results correlated significantly with FAOS subscales for pain (p ÷0.05), stiffness (p ÷ 0.01), ADL (p ÷0.02), and sports (p >0.00). Conclusion: Postoperative results, regardless of LG or MLG, showed significant subjective well-being improvement. LG's advantages were highlighted by a significant improvement in dorsal extension, supported by correlated results from a portable motion sensor assessing ankle stability.

Different Factors Influencing Postural Stability during Transcutaneous Electrical Stimulation of the Cervical Spinal Cord.

Transcutaneous spinal cord stimulation (tSCS) is a promising noninvasive alternative to epidural stimulation. However, further studies are needed to clarify how tSCS affects postural control. The aim of this study was to investigate the effect of transcutaneous cervical spinal cord stimulation on postural stability in healthy participants via computerized stabilization. The center of pressure and the frequency spectrum of the statokinesiogram were assessed in 14 healthy volunteers under tSCS conditions with frequencies of 5 Hz or 30 Hz, subthreshold or suprathreshold stimulus strength, open or closed eyes, and hard or soft surfaces in various combinations. The results revealed that not all the changes in the center of the pressure oscillations reached statistical significance when the tSCS was used. However, tSCS at a frequency of 30 Hz with a suprathreshold stimulus strength improved postural stability. The use of subthreshold or suprathreshold tSCS at 5 Hz led to a shift of 60% of the signal power to the low-frequency range, indicating activation of the vestibular system. With tSCS at 30 Hz, the vestibular component remained dominant, but a decrease in the proportion of high-frequency oscillations was observed, which is associated with muscle proprioception. Thus, transcutaneous electrical stimulation of the cervical spinal cord may be an effective method for activating spinal cord neural networks capable of modulating postural control.

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.

Stair-Climbing Training with Interferential Electrotherapy Improves Knee Muscle Strength, Dynamic Postural Stability, Pain Score, and Physical Activity in Patients with Knee Osteoarthritis.

Background/Objective: This study aimed to compare the functional outcomes, such as knee muscle strength, dynamic postural stability, pain scores, and physical activity, in patients with knee osteoarthritis (OA) on stair climbing training with and without interferential electrotherapy (IFE) for 12 weeks. Methods: A total of 40 knee OA patients with Kellgren-Lawrence (K-L) grade ≤ 2 were enrolled (20 stair-climbing training with IFE vs. 20 stair-climbing training without IFE). The knee quadriceps and hamstring muscle strengths were measured using an isokinetic device. The dynamic postural stability was assessed using postural stabilometry. The pain score was evaluated using the visual analog scale (VAS). Physical activity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The WOMAC score was significantly different (p < 0.019) between stair-climbing training with and without IFE in patients with knee OA, while knee muscle strength, dynamic postural stability, or pain score were not (all p > 0.05). Conclusion: Stair-climbing training with IFE was more beneficial for physical activity recovery than stair-climbing training without IFE. Therefore, clinicians and therapists should be aware that stair climbing, which can be practiced in daily life for the management of patients with knee OA, and the addition of IFE may improve physical activity.

Characterizing the Longitudinal Impact of Backward Locomotor Treadmill Training on Walking and Balance Outcomes in Chronic Stroke Survivors: A Randomized Single Center Clinical Trial.

Background and Purpose: Walking and balance impairments after stroke are a global health concern, causing significant morbidity and mortality. However, effective strategies for achieving meaningful recovery in the chronic stages are limited. Backward locomotor treadmill training (BLTT) is a novel walking rehabilitation protocol that is safe, feasible, and likely beneficial in stroke survivors; however, its efficacy has not been tested. This single-center, randomized, assessor-blind clinical trial aims to test the preliminary efficacy of BLTT compared to forward locomotor treadmill training (FLTT) on walking speed, symmetry, and postural stability. Methods: Forty stroke survivors [BLTT (N=19), FLTT (N=21); mean age= 56.3 ± 8.6 years; 53% Female; 30% Non-Hispanic Black] with mild-moderate walking impairment were enrolled. Participants underwent nine 30-minute BLTT or FLTT sessions over three weeks. The primary outcome was the mean change in the 10-meter walk test (10 MWT) at 24 hours post-training (24 hr POST). Secondary outcome measures were changes in spatiotemporal walking symmetry and postural stability during quiet standing at 24 hr POST. Retention was explored at Days 30- and 90 POST. Results: We report clinically meaningful (≥ 0.16 m/s) improvements in overground walking speed at 24 hr POST, with retention up to Day 90 POST with BLTT and FLTT. However, contrary to our working hypothesis, no between-group differences in walking speed were observed. Nonetheless, we found that BLTT resulted in offline improvements in spatial symmetry and retention of subcomponents of the modified clinical test of sensory interaction on balance (mCTSIB), including the testing of proprio-vestibular integration up to Day 30 POST. Conclusion: Among chronic stroke patients with mild-moderate walking impairment, BLTT and FLTT both resulted in long-lasting and clinically meaningful improvement in walking speed. However, preliminary findings suggest that BLTT may better comprehensively target walking asymmetry and sensory systems processing and integration.

Assessment of Balance During a Single-Limb Stance Task in Healthy Adults: A Cross-Sectional Study.

Single-limb stance (SLS) is a demanding postural task, widely used for balance assessment in both research and clinical practice. Despite extensive data on elderly and clinical populations, less is known about younger and healthier adults. Our aim in this study was to assess balance during a SLS task among a cohort of healthy adults to determine whether there are age or sex group or testing condition differences in performances. In this cross-sectional study, we involved 120 participants aged 30-65 years and divided them into four age sub-groups with equal numbers of males and females in each. We assessed balance during a 45-s SLS task on a] the Delos Postural Proprioceptive System for both lower limbs in two conditions - open eyes (OE) and closed eyes (CE). We calculated stability (SI) and autonomy (AU) indices and used analysis of variance to determine that there was no significant effect of limb dominance or sex on balance parameters. However, there was a significant interaction effect between age group and testing condition for both SI and AU (p < .001 for both), with balance worsening as age increased only in the CE condition. These results highlight a pattern of balance decline with age when vision is eliminated from balance performance, underscoring the critical relationship between sensory input and postural control as people age.

Balance Board or Motion Capture? A Meta-Analysis Exploring the Effectiveness of Commercially Available Virtual Reality Exergaming in Enhancing Balance and Functional Mobility Among the Elderly.

Force platforms and motion capture are commonly used as feedback mechanisms in exergaming; nevertheless, their therapeutic effectiveness may vary. Therefore, the primary objective of this study was to evaluate the effectiveness of commercially available virtual reality (VR) exergaming systems on balance and functional mobility, with a supplementary analysis considering the administered dose of exergaming. The search was conducted in five databases. Commercially available exergaming platforms were classified into two categories: VR exergaming with a balance board (including Wii Balance Board) and motion capture (including Xbox Kinect). Two categories of control interventions (treatment as usual [TAU] and no treatment [NT]) were extracted. The meta-analysis was performed separately for static, dynamic, and proactive balance outcomes and for the aggregated results of all included outcomes with subgroup analysis of lower, moderate, and higher doses. In total, 28 studies with 1457 participants were included. Both exergaming systems were particularly effective in improving the single leg stance outcome. VR exergaming with motion capture was found to be more effective than TAU with a standardized mean difference (SMD) of 0.48 (P = 0.006) and NT (SMD = 0.86; P = 0.02). In conclusion, commercially available VR exergaming with a motion capture feedback mechanism has demonstrated effectiveness as an intervention for balance training when compared with NT. Specifically, high doses (above 134 minutes per week) appear to be more beneficial for healthy older adults. Moreover, the findings provide some weak evidence supporting the effectiveness of VR exergaming with a balance board for improving functional mobility, particularly when compared with NT.

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).

The impact of combined aerobic and resistance exercise on the prognosis of early Parkinson's disease patients.

BACKGROUND: Although literature suggests that exercise can improve symptoms in Parkinson's Disease (PD) patients, research on the effects of aerobic exercise and resistance training (AE&RT) in early-stage PD remains limited. Understanding the synergistic effects of these exercise modalities can provide valuable insights for optimizing exercise interventions for PD patients, particularly in the early stages of the disease, where interventions may have the greatest impact on long-term functional outcomes. OBJECTIVE: This study aimed to investigate the effects of a combined AE&RT program on motor function, postural stability, and cognitive processing speed in early stage PD patients. METHODS: A total of 236 participants with early-stage PD were assigned to either the Aerobic Exercise Group (AE group) (n= 112) or the AE&RT Group (n= 124) inthis controlled randomized trial. The study employed a one-year supervised exercise program, with the AE Group participating in aerobic activities and the AE&RT Group engaging in combined AE&RT. Outcome measures included symptom improvement, motor function, postural stability, cognitive processing speed, peak oxygen consumption, quality of life evaluation, and the incidence of adverse events. RESULTS: The AE&RT Group demonstrated greater improvements in tremor, muscle rigidity, gait instability, sleep problems, and hyposmia compared to the AE Group. Additionally, the combined exercise group exhibited better cognitive processing speed, as well as enhanced motor function and postural stability. Peak oxygen consumption was significantly higher in the AE&RT Group. However, the quality of life evaluation indicated a statistically higher quality of life in the AE Group. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION: The findings suggest that the integration of AE&RT in early-stage PD patients leads to more comprehensive improvements in motor symptoms, cognitive function, postural stability, and cardiovascular fitness compared to aerobic exercise alone. These results have important implications for developing tailored exercise interventions to enhance the physical and cognitive well-being of individuals with early-stage PD.

Comparative Effects of Fatiguing Exercise on Anticipatory and Compensatory Postural Adjustments between Trained and Untrained Individuals.

This study evaluates the effects of general fatiguing exercises on anticipatory postural adjustments (APAs), compensatory postural adjustments (CPAs), and standing stability between 18 individuals with comprehensive training experience (TR) and 18 untrained individuals (UT). Assessments were conducted before and after a 20-min fatiguing exercise using surface electromyography and a force platform during self-initiated perturbation and postural stability tests. Key findings include that, irrespective of fatigue, the APAs onsets in the TrA/IO (p = 0.004), LMF (PRE p = 0.003, POST p < 0.001), and ST (PRE p = 0.001, POST p = 0.006) muscles activated earlier in the TR group than in the UT group. Additionally, the APA co-contraction indices of the TrA/IO-LMF (PRE p = 0.011, POST p = 0.029), TrA/IO-ST (p = 0.014), and LMF-ST (PRE p = 0.002, POST p = 0.005) muscle pairs were higher in the TR group. After fatigue, the UT group significantly increased CPA co-contraction indices for the TrA/IO-LMF (p = 0.035) and LMF-ST (p = 0.005) muscle pairs. This research highlights the importance of comprehensive training in facilitating feedforward control strategies, particularly for individuals facing challenging postural conditions, such as fatigue or disturbances.

Assessing fall risk in osteoporosis patients: a comparative study of age-matched fallers and nonfallers.

This study aimed to investigate sway parameters and physical activity level of the age/gender-matched older adults with osteoporosis faller and nonfaller patients. By examining these factors, our objective was to understand how these faller and nonfaller groups with osteoporosis differed particularly in terms of balance capabilities and their impact on physical activity levels. We recruited 24 patients with osteoporosis: 12 who reported a fall within a year before recruitment (fallers) and 12 without falls (nonfallers). Given the close association between biochemical markers of musculoskeletal health such as serum calcium, parathyroid hormone (PTH), Vitamin D, and renal function, we compared these markers in both groups. As a result, elderly individuals with osteoporosis and with a history of falls within the preceding year indicated significantly higher sway velocity (P = 0.012*), sway area (P < 0.001*), and sway path length (P = 0.012*). Furthermore, fallers had significantly lower calcium (P = 0.02*) and Parathyroid hormone (PTH) (P = 0.02*), as well as higher Alkaline Phosphatase (ALP) (P = 0.02*) as compared to nonfallers despite similar vitamin D and creatinine levels. In conclusion, diminished biochemical factors in the osteoporosis faller group could possibly cause postural instability resulting in lower physical activity levels in the osteoporosis fall group and increasing the risk of falls.

Do Combined Oculomotor and Bimanual Coordination Exercises Instantly Stabilize Balance in Athletes?

Purpose: This study examined the immediate effects of oculomotor and bimanual coordination exercises, as well as a combination of the two, on stability of balance in athletes. Patients and Methods: Changes in center-of-gravity sway were measured in 30 college student athletes before and after the following three exercise conditions: 1) oculomotor exercises, 2) bimanual coordination exercises, and 3) a combination of oculomotor and bimanual coordination exercises (1+2). The order of these exercises was counterbalanced. Results: The combination of exercises (condition 3) reduced large swaying during balancing and immediately increased postural stability. Moreover, the oculomotor and bimanual coordination exercises (conditions 1 and 2) immediately reduced large sway during balancing when performed independently. Thus, the present study revealed that the combination of oculomotor and bimanual coordination exercises immediately reduced accidental swaying during balancing and also improved postural stability. Conclusion: This combination could be effective as an immediate balance adjustment method for athletes.

Moving together-benefits of a 12-week online dance training intervention on static and dynamic postural stability and gait speed in older women: an exploratory pre-post study.

Background: Physical inactivity negatively affects gait performance and postural stability in older adults resulting in a higher risk of fall accidents. Previous research has shown that in-person dance training improves various aspects of balance and lower-extremity function, however, little is known about the potential benefits of dance training delivered online on variables used for fall risk stratification in older adults. We aimed to explore the benefits of a 12-week online dance training intervention on static and dynamic postural stability and gait speed in older women. Methods: Forty-five older adults (44 women) were included in this exploratory pre-post study. The 12-week dance intervention consisted of two weekly 60-min classes in contemporary (improvisation) and salsa dance delivered online through Zoom video calls. Static and dynamic postural stability was assessed using the center of pressure (CoP) area and velocity (force platform), and the Mini Balance Evaluation Systems Test (Mini-BESTest), respectively. 10-m gait speed was measured using photo gates. Before and after comparisons were performed using paired sample t-tests. Results: Thirty-two older women completed the study. There were no significant changes for static postural stability assessed by CoP area or velocity (P ≥ 0.218, Cohen d ≤ 0.234). The Mini-BESTest total score was significantly improved at post-intervention (23.88 ± 3.01) compared to baseline (22.56 ± 1.41, P = 0.007, d = 0.52). 10-m gait speed was significantly faster at post-intervention (1.68 ± 0.25 m/s) compared to baseline (1.57 ± 0.22 m/s, P < 0.001, d = 0.737). Discussion: Although some caution is needed due to the uncontrolled study design, the results indicate that online dance training has a small effect on static postural stability but may be beneficial for gait speed and in particular dynamic postural control among older women. While the absolute increase in gait speed suggests limited clinical relevance, the change in Mini-BESTest score may reflect a clinically meaningful enhancement of dynamic postural control.

Investigation of the functional and biomechanical effect of instrument-assisted soft tissue mobilization technique in individuals with asymptomatic dynamic knee valgus - Randomized controlled trial.

Although there are studies showing that myofascial release will increase muscle force production, the contribution of its application alone to muscle force production has not been examined. Aim of the study is to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) on eccentric strength, frontal plane projection angle (FPPA), dynamic (DPS), and static postural stability (SPS), femoral internal rotation (FIR) angle in females with dynamic knee valgus (DKV). A total of 44 recreationally active females with asymptomatic DKV (age: 21,39 ± 1,79, body mass index: 20,09 ± 2,45) participated and were randomly assigned to either control group (CG) or IASTM group (IASTMG). Participants' eccentric contraction strength, FPPA, DPS, SPS, and FIR on the involved leg were measured pre- and post. IASTM application was applied to IASTMG for 6 weeks, twice a week, for 5 min, using Graston Technique® instruments on gluteus medius. CG received no intervention. In comparison of ECS difference values, change in IASTMG was found to be statistically significantly higher than CG (p = .004; p < .01). There was no statistical difference in comparison of FIR and FPPA values (respectively p = .213, p = .360; p < .05). In SPS and DPS evaluation, a statistically significant improvement was observed in favor of IASTMG in comparison of both intergroup and difference values (p < .05 for all). Strength gain without exercise can increase postural stability, but it isn't sufficient to correct faulty movement patterns. We recommend adding IASTM to injury prevention programs, but there is a need to investigate the effect of IASTM with technique correction feedback.

Postural Stability and Pedobarography After Reconstruction of Peroneus Brevis Tendon Split Lesion.

PURPOSE: Lesions of the peroneal tendons are frequently overseen after ankle sprain. The symptoms consist of stress-dependent pain that extends from the inframalleolar to the proximal part along the course of the peroneal tendons as well as ankle instability and soft-tissue swelling. In case of unsuccessful conservative treatment, surgical therapy is recommended. The aim of the study was to evaluate the clinical and functional outcome after open reconstruction of the peroneus brevis tendon. METHODS: 13 patients were included in this retrospective study. All of them received a single reconstruction of the peroneus brevis tendon in open technique. Postoperative results were evaluated with the AOFAS score, a functional and perdobargraphic analysis as well as measuring postural stability with the Biodex balance system. The participants were matched with a healthy control group according to age, sex and BMI. RESULTS: The results of the AOFAS score showed significantly convincing results in all subscores postoperatively. A bilateral comparison of the postural stability showed that the affected side had become functionally similar to the healthy side. No statistical significant difference was detected concerning both one-legged and two-legged standing with the control group. Pedobarographic results revealed no difference between the affected and contralateral side, as well as between the patients and the healthy control group. CONCLUSION: Open reconstruction of the peroneus brevis tendon leads to significant better postoperative results and can be recommended after unsuccessful conservative treatment as promising option.

Characterizing Longitudinal Alterations in Postural Control Following Lower Limb Injury in Professional Rugby Union Players.

Assessment of player's postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players' postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P < .05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P < .05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P < .05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase.

The effect of stroboscopic visual disruption on static stability measures in anterior cruciate ligament reconstructed individuals.

BACKGROUND: Those who undergo ACL reconstruction are at an increased risk of suffering a second ACL injury. A suggested rationale for the increased injury risk is sensory reweighting to the visual system to compensate for a lack of somatosensory information from the knee. Understanding this proposed visual reliance may help clinicians improve return to sport outcomes and reduce the risk of a subsequent ACL injury. METHODS: Thirteen ACL reconstructed individuals and thirteen matched controls completed two common static postural control assessments under three different visual conditions; eyes open, low visual disruption, and high visual disruption. Center of pressure data was collected for 30 s using force plates. Static postural stability was evaluated using the following: 1) root mean square distance, 2) mean velocity, 3) sway area, and 4) mean frequency. FINDINGS: No significant interactions between group and vision were observed. Significant differences between groups were observed for mean frequency in the double-limb stance (p < .05). Additionally, significant differences were observed for visual conditions in both double-limb (mean velocity; p < .05) and single-limb stances (root mean square distance, mean velocity, sway area, and mean frequency; p < .05). INTERPRETATION: The findings of the current study suggest that ACL reconstructed individuals, who are at least two years removed from surgery, do not rely on visual information to a greater extent than controls during static postural stability assessments. Stroboscopic glasses may be a cost-effective alternative for rehabilitation purposes compared to the traditional binary eyes open vs. eyes closed methods.