Ground reaction forces better than center of pressure differentiate postural control between young female volleyball players and untrained peers.

A comprehensive explanation of the relationship between postural control and athletic performance requires compare body balance in athletes with their never training counterparts. To fill this gap in relation to volleyball, the aim of this study was to compare the balance of intermediate adolescent female players (VOL, n = 61) with inactive peers (CON, n = 57). The participants were investigated in normal quiet stance during 20 s trials on a Kistler force plate. The traditional spatial (amplitude and mean speed) and temporal (frequency and entropy) indices were computed for ground reaction forces (GRF) and center-of-pressure (COP) time-series. The spatial parameters of the both time-series did not discriminate the two groups. However, the temporal GRF parameters revealed much lower values in VOL than in CON (p < .0001). This leads to three important conclusions regarding posturography applications. First, GRF and COP provide different information regarding postural control. Second, measures based on GRF are more sensitive to changes in balance related to volleyball training and perhaps to similar training and sports activity regimens. And third, the indicators calculated based on these two time series can complement each other and thus enrich the insight into the relationship between balance and sports performance level.

Using Nonlinear Vibroartrographic Parameters for Age-Related Changes Assessment in Knee Arthrokinematics.

Changes in articular surfaces can be associated with the aging process and as such may lead to quantitative and qualitative impairment of joint motion. This study is aiming to evaluate the age-related quality of the knee joint arthrokinematic motion using nonlinear parameters of the vibroarthrographic (VAG) signal. To analyse the age-related quality of the patellofemoral joint (PFJ), motion vibroarthrography was used. The data that were subject to analysis represent 220 participants divided into five age groups. The VAG signals were acquired during flexion/extension knee motion and described with the following nonlinear parameters: recurrence rate (RR) and multi-scale entropy (MSE). RR and MSE decrease almost in a linear way with age (main effects of group p<0.001; means (SD): RR=0.101(0.057)−0.020(0.017); and MSE=20.9(8.56)−13.6(6.24)). The RR post-hoc analysis showed that there were statistically significant differences (p<0.01) in all comparisons with the exception of the 5th−6th life decade. For MSE, statistically significant differences (p<0.01) occurred for: 3rd−7th, 4th−7th, 5th−7th and 6th life decades. Our results imply that degenerative age-related changes are associated with lower repeatability, greater heterogeneity in state space dynamics, and greater regularity in the time domain of VAG signal. In comparison with linear VAG measures, our results provide additional information about the nature of changes of the vibration dynamics of PFJ motion with age.

Wavelet coherence as a measure of trunk stabilizer muscle activation in wheelchair fencers.

BACKGROUND: Intermuscular synchronization constitutes one of the key aspects of effective sport performance and activities of daily living. The aim of the study was to assess the synchronization of trunk stabilizer muscles in wheelchair fencers with the use of wavelet analysis. METHODS: Intermuscular synchronization and antagonistic EMG-EMG coherence were evaluated in the pairs of the right and the left latissimus dorsi/external oblique abdominal (LD/EOA) muscles. The study group consisted of 16 wheelchair fencers, members of the Polish Paralympic Team, divided into two categories of disability (A and B). Data analysis was carried out in three stages: (1) muscle activation recording using sEMG; (2) wavelet coherence analysis; and (3) coherence density analysis. RESULTS: In the Paralympic wheelchair fencers, regardless of their disability category, the muscles were activated at low frequency levels: 8-20 Hz for category A fencers, and 5-15 Hz for category B fencers. CONCLUSIONS: The results demonstrated a clear activity of the trunk muscles in the wheelchair fencers, including those with spinal cord injury, which can be explained as an outcome of their intense training. EMG signal processing application have great potential for performance improvement and diagnosis of wheelchair athletes.

Differences in static postural control between top level male volleyball players and non-athletes.

It is argued that elite athletes often demonstrate superior body balance. Despite the apparent significance of perfect balance ability in volleyball, little is known about the specific nature of postural control adjustments among first-rate volleyball competitors. This study compared postural performance and strategies in quiet stance between world vice-champions and young, healthy, physically active male subjects. The center-of-pressure (COP) signals recorded on a force plate were used to compute several measures of sway. In both axes of movement, athletes had lower COP range, but not its standard deviation and higher COP speed and frequency than controls. These findings indicate that postural regulation in athletes was more precise and less vulnerable to external disturbances which support optimal timing and precision of actions. Postural strategies in athletes standing quietly were similar to those exhibited by non-athletes performing dual tasks. It demonstrates a significant effect of sport practice on changes in postural control. In anterior-posterior axis, athletes displayed a much higher COP fractal dimension and surprisingly lower COP-COG frequency than controls. This accounts for their high capacity to use diversified postural strategies to maintain postural stability and significantly reduced the contribution of proprioception to save this function for carrying out more challenging posture-motor tasks.

Postural control in top-level female volleyball players.

BACKGROUND: The aim of this study was to compare the postural control of the Poland national women's volleyball team players with a control group of non-training young women. It was hypothesized that volleyball players use a specific balance control strategy due to the high motor requirements of their team sport. METHODS: Static postural sway variables were measured in 31 athletes and 31 non-training women. Participants were standing on a force plate with eyes open, and their center of pressure signals were recorded for the 20s with the sampling rate of 20 Hz in the medial-lateral (ML) and anterior-posterior (AP) planes. RESULTS: In both AP and ML planes, athletes had lower range and higher fractal dimension of the COP. They had also higher peak frequency than control group in the ML plane only. The remaining COP indices including variability, mean velocity and mean frequency did not display any intergroup differences. CONCLUSION: It can be assumed that due to the high motor requirements of their sport discipline Polish female volleyball players have developed a unique posture control. On the court they have to distribute their sensory resources optimally between balance control and actions resulting from the specifics of the volleyball game. There are no clearly defined criteria for optimal postural strategies for elite athletes, but they rather vary depending on a given sport. The results of our research confirm this claim. TRIAL REGISTRATION: The tests were previously approved by the Bioethical Commission of the Chamber of Physicians in Opole. (Resolution No. 151/13.12.2007). This study adheres to the CONSORT guidelines.

Flèche versus Lunge as the Optimal Footwork Technique in Fencing.

The objective of the study reported in this paper involved identifying the fencing attack (flèche versus lunge) that provides greater effectiveness in a real competition. Two hypotheses are presented in the study. The first hypothesis involves the greater effectiveness of the flèche with regard to bioelectric muscular tension, and the second hypothesis involves the reduction of movement time of the flèche. Therefore, analyses were conducted by the application of EMG (electromyography) signal, ground reaction forces, and parameters representing sensorimotor responses (RT-reaction time and MT-movement time). This study included six world-leading female épée fencers (mean age: 24.6 ± 6.2 years). Throughout the procedure, the subjects performed flèche and lunge touches at the command of the coach based on visual stimuli. The experimental results indicated the greater effectiveness of the flèche compared with the lunge with regard to increases in EMG values (p = 0.027) in the lateral and medial gastrocnemius muscles and decreases in the duration of the movement phase (p = 0.049) and vertical force of the rear leg (p = 0.028). In conclusion, higher levels of EMG and ground reaction forces were generated during the flèche compared with the lunge, which promotes an improvement in the explosive force and contributes to a reduction in the movement phase of the entire offensive action.

Analysis of patellofemoral arthrokinematic motion quality in open and closed kinetic chains using vibroarthrography.

BACKGROUND: Knee movements performed in open (OKC) and closed (CKC) kinetic chains generate various patterns of muscle activities and especially distinct contact stresses in the patellofemoral joint (PFJ). In contrast to these features, the arthrokinematic motion quality (AMQ) of the PFJ has not been compared between mentioned conditions. In this study we performed vibroarthrographic analysis of AMQ in movements performed in OKC and CKC, in healthy subjects and individuals with chondromalacia patellae, to assess which of the test conditions is more efficient in differentiation between healthy and deteriorated joints. Moreover, our analysis will broaden the knowledge related to behavior of normal and pathological synovial joints during motion with and without weight bearing. It is an essential issue, due to the recently observed significant interest in comparing potential benefits and limitations of CKC and OKC exercises as they relate to lower extremity rehabilitation. METHODS: 100 subjects (62 healthy controls and 38 subjects with PFJ chondromalacia) were enrolled. During repeated knee flexion/extension motions performed in OKC (in a sitting position) and CKC (sit-to-stand movements), the vibroarthrographic signals were collected using an accelerometer and described by variability (VMS), amplitude (R4), and spectral power in 50-250 Hz (P1) and 250-450 Hz (P2) bands. RESULTS: Significant differences in VMS [V], R4 [V], P1 [V2/Hz] and P2 [V2/Hz] between OKC and CKC were found (0.0001, 0.969. 0.800 0.041 vs 0.013, 3.973, 6.790, 0.768, respectively, P < 0.001). Moreover, in both analyzed load-related conditions the subjects with chondromalacia were characterized by significantly higher values of all parameters, when compared to controls (P < 0.001), with effect size values over 0.6. CONCLUSIONS: We showed that motion of the physiological, unloaded PFJ articular surfaces in OKC is nearly vibrationless, which corresponds with optimal AMQ of PFJ, while loaded movements in CKC are characterized by a higher vibroacoustic emission level. Moreover, chondral lesions should be considered as an increased friction-related, aggravating factor of AMQ, which is critical in CKC movements under load. Nonetheless, OKC and CKC conditions are characterized by large effect sizes, and provide an efficient test frame for differentiating physiological knees and joints with chondral lesions.

Intensity-Dependent Effects of a Six-Week Balance Exercise Program in Elderly Women.

The objective of this study was to gain a better understanding of the mechanisms underlying falls in the elderly. The results were based on a group of 28 women in a control group (CON) and 16 women in an experimental group (EXP), aged 60⁻70. Participants took part in the six-weeks Elderly Recreation Movement Program (ERMP) with the only difference that the EXP group practiced twice as often as the CON group. The measurement of variations in the index called limits of stability (LOS) was performed by application of Kistler force plate and the coactivation index (CI) was registered by means of sEMG. The results demonstrate the existence of statistically significant differences in terms of the principal outcome of the exercise time in the measurements of LOS (F(1.42) = 10.0, p = 0.003), and CI (F(1.42) = 10.5, p = 0.002). The effect of the program was associated with an increase the level of the maximum LOS, and a decrease of the CI level, especially in the experimental group. Hence, the implementation of an innovative ERMP exercise program results in the improvement of the physical capabilities of senior subjects.

Effect of six-week intervention program on postural stability measures and muscle coactivation in senior-aged women.

OBJECTIVE: The objective involved the analysis of the efficiency of the Program of Movement Recreation of Elderly People (PMREP) exercise program expressed in terms of the stabilography measures and coactivation of muscles in women in the age group of 60-70 years. The assumption that was assumed stems from theoretical implications that the adequate postural stability is manifested in the decrease of the body sways measured by means of a force plate. MATERIALS AND METHODS: The study involved a group of 60 females, all members of the active seniors' association. The subjects were in the age range from 60 to 70 years. The subjects were divided into 2 groups of equal size: control and experimental. Subjects in both groups participated in the rehabilitation exercises: experimental (n=16, PMREP - twice a week/60 minutes), control (n=27, PMREP - only once a week/60 minutes). RESULTS: The study demonstrated that the completion of a 6-week PMREP program resulted in a decrease in the variability and velocity as well as indicators representing center of pressure displacement measured in the feet for the exercises performed with closed eyes with subjects standing on a high foam pad located on a force plate (P=0.001). No significant changes in coactivation of the calf muscles were recorded in the subjects. CONCLUSION: The study concludes that a PMREP rehabilitation plan with an adequate program and frequency leads to an improvement of the vestibular system coupled with proprioception understood as an integrated process of sensor activation in the body. However, in regard to the coactivation of the muscles involved in maintaining postural stability, no significant differences have been observed.

Attentional demands associated with augmented visual feedback during quiet standing.

To investigate how additional visual feedback (VFB) affects postural stability we compared 20-sec center-of-pressure (COP) recordings in two conditions: without and with the VFB. Seven healthy adult subjects performed 10 trials lasting 20 seconds in each condition. Simultaneously, during all trials the simple auditory reaction time (RT) was measured. Based on the COP data, the following sway parameters were computed: standard deviation (SD), mean speed (MV), sample entropy (SE), and mean power frequency (MPF). The RT was higher in the VFB condition (p < 0.001) indicating that this condition was attention demanding. The VFB resulted in decreased SD and increased SE in both the medial-lateral (ML) and anterior-posterior (AP) planes (p < .001). These results account for the efficacy of the VFB in stabilizing posture and in producing more irregular COP signals which may be interpreted as higher automaticity and/or larger level of noise in postural control. The MPF was higher during VFB in both planes as was the MV in the AP plane only (p < 0.001). The latter data demonstrate higher activity of postural control system that was caused by the availability of the set-point on the screen and the resulting control error which facilitated and sped up postural control.

Analysis and multiclass classification of pathological knee joints using vibroarthrographic signals.

BACKGROUND AND OBJECTIVE: Vibroarthrography (VAG) is a method developed for sensitive and objective assessment of articular function. Although the VAG method is still in development, it shows high accuracy, sensitivity and specificity when comparing results obtained from controls and the non-specific, knee-related disorder group. However, the multiclass classification remains practically unknown. Therefore the aim of this study was to extend the VAG method classification to 5 classes, according to different disorders of the patellofemoral joint. METHODS: We assessed 121 knees of patients (95 knees with grade I-III chondromalacia patellae, 26 with osteoarthritis) and 66 knees from 33 healthy controls. The vibroarthrographic signals were collected during knee flexion/extension motion using an acceleration sensor. The genetic search algorithm was chosen to select the most relevant features of the VAG signal for classification. Four different algorithms were used for classification of selected features: logistic regression with automatic attribute selection (SimpleLogistic in Weka), multilayer perceptron with sigmoid activation function (MultilayerPerceptron), John Platt's sequential minimal optimization algorithm implementation of support vector classifier (SMO) and random forest tree (RandomForest). The generalization error of classification algorithms was evaluated by stratified 10-fold cross-validation. RESULTS: We obtained levels of accuracy and AUC metrics over 90%, more than 93% sensitivity and more than 84% specificity for the logistic regression-based method (SimpleLogistic) for a 2-class classification. For the 5-class method, we obtained 69% and 90% accuracy and AUC respectively, and sensitivity and specificity over 91% and 69%. CONCLUSIONS: The results of this study confirm the high usefulness of quantitative analysis of VAG signals based on classification techniques into normal and pathological knees and as a promising tool in classifying signals of various knee joint disorders and their stages.

Age-related impairment of quality of joint motion in vibroarthrographic signal analysis.

Aging is associated with degenerative changes in articular surfaces leading to quantitative and qualitative impairment of joint motion. Therefore, the aim of this study is to evaluate an age-related quality of the patellofemoral joint (PFJ) motion in the vibroarthrographic (VAG) signal analysis. Two hundred and twenty individuals were enrolled in this study and divided into five groups according to age. The VAG signals were collected during flexion/extension knee motion using an acceleration sensor and described using four parameters (VMS, P1, P2, and H). We observed that values of parameters VMS, P1, and P2 increase in accordance with the age, but H level decreases. The most significant differences were achieved between the youngest and the oldest participants' groups. Moreover, we show that parameters VMS, P1, and P2 positively correlate with age, contrary to negatively associated H parameter. Our results suggest that the impairment of joint motion is a result of age-related osteoarticular degenerative changes.

Postural stability in young adults with Down syndrome in challenging conditions.

To evaluate postural control and performance in subjects with Down syndrome (SwDS), we measured postural sway (COP) in quiet stance in four 20-second tests: with eyes open or closed and on hard or foam surface. Ten SwDS and eleven healthy subjects participated, aged 29.8 (4.8) and 28.4 (3.9), respectively. The time-series recorded with the sampling rate of 100 Hz were used to evaluate postural performance (COP amplitude and mean velocity) and strategies (COP frequency, fractal dimension and entropy). There were no intergroup differences in the amplitude except the stance on foam pad with eyes open when SwDS had larger sway. The COP velocity and frequency were larger in SwDS than controls in all trials on foam pad. During stances on the foam pad SwDS increased fractal dimension showing higher complexity of their equilibrium system, while controls decreased sample entropy exhibiting more conscious control of posture in comparison to the stances on hard support surface. This indicated that each group used entirely different adjustments of postural strategies to the somatosensory challenge. It is proposed that the inferior postural control of SwDS results mainly from insufficient experience in dealing with unpredictable postural stimuli and deficit in motor learning.

Vibroarthrography in the evaluation of musculoskeletal system - a pilot study.

BACKGROUND. Disorders of the articular surfaces are associated with impaired quality of joint motion and joint play. Crepitations are the hallmark clinical sign. This paper aims to present the possibilities of using vibroacoustic signal analysis in assessing the function of articular surfaces in the course of disorders of the knee and shoulder. MATERIAL AND METHODS. The study involved 30 people, 10 for each of the following disorders: patellar chondromalacia (Ch), meniscal tears (Mc), and degenerative changes of the glenohumeral joint (GH). A control group (K1-K3) was matched to each dysfunctional group. 6-second vibroacoustic signals (VAG) were recorded during motion in particular joints. The resulting time series were filtered (50-1000 Hz) and the following parameters were calculated: variance-mean-square (VMS), the mean of the four lowest and four highest values (R4) and the total spectral power density in the 50-250 Hz (P1) and 250-450 Hz (P2) ranges. RESULTS. Depending on the type of disorder, VAG signals in the dysfunctional groups were characterized by higher variability, amplitude and frequency than was the case in the control groups. This is reflected in the values of all parameters (VMS, R4, P1, P2), which were significantly higher in the Ch, Mc and GH groups compared to K1-K3. CONCLUSIONS. 1. Vibroarthrography can be a useful tool for accurate and objective assessment of the quality of joint motion. 2. The non-invasive nature of vibroarthrography allows the use of this method to monitor the effects of the treatment of joint structures.

Attention demand and postural control in children with hearing deficit.

To elucidate the mechanisms responsible for deteriorated postural control in children with hearing deficit (CwHD), we measured center-of-pressure (COP) variability, mean velocity and entropy in bipedal quiet stance (feet together) with or without the concurrent cognitive task (reaction to visual stimulus) on hard or foam surface in 29 CwHD and a control group of 29 typically developing children (CON). The CwHD displayed an overall decreased postural performance as compared to the CON in the medial-lateral plane (p<0.05). Standing on foam pad revealed slower simple reaction time in the CwHD (p<0.05) while the results on hard surface were not different. The CwHD decreased (p<0.05) the amount of attention invested in posture during dual task which accounted for the need of more cognitive resources to handle two tasks simultaneously than controls. It was unmistakable that the intergroup differences emerged when the tasks performed were relatively novel and untrained: feet together, foam pad, and reaction time. All these tasks, while being very easy for the CON, made the CwHD deteriorate postural or cognitive performance. These results unravel the difficulty in reaching the consecutive developmental stages in the CwHD and call for specific therapeutic modalities that might facilitate this development.