Relationship Between Executive Function Subdomains and Postural Balance in Community-Dwelling Older Adults.

BACKGROUND: Executive function (EF) deficits are a significant risk factor for falls among older adults (OAs). However, relationship between EF subdomains (shifting, updating, and inhibition), postural balance (PB), and fall risk in healthy OAs, remains poorly understood. OBJECTIVE: This study aimed to investigate the relationship between EF subdomains (shifting, updating, and inhibition) and PB, and to assess their impact on risk of falls in community-dwelling OAs. METHODS: A cross-sectional study involving 50 OAs aged over 60 years (average age of 72 years) was conducted. Participants underwent assessments of EF subdomains and PB using validated tests. A correlation analysis was employed to examine the relationships between EF and PB. RESULTS: The study revealed significant correlations between subdomains and PB. Mental set shifting (r = -.539; p < .001) and inhibition (r = -.395; p = .050) exhibited inverse relationships with PB. Stepwise multiple linear regression showed that Trail Making Test Part B was associated with the PB (R2 = .42, p < .001). CONCLUSION: These findings highlight the importance of assessing EF subdomains, particularly shifting and inhibition, to identify risk of falls. Trail Making Test Part B largely explains the variability of the PB. Integrating PB assessments and EF training, such as the Mini-BESTest, into routine care can be vital for fall prevention strategies. Significance/Implications: This knowledge underscores the need for cognitive training interventions focusing on shifting and inhibition to enhance PB and potentially reduce falls. Additionally, incorporation of EF assessment tools as Trail Making Test Part B and the Mini-BESTest into routine clinical practice for community-dwelling OAs is recommended to address fall prevention strategies.

Improved postural control in a patient having adult spinal deformity and previous thoraco-lumbar scoliosis surgery: a Chiropractic Biophysics® case report.

Background: There is evidence indicating patients with spinal deformity have impaired postural control and balance issues. Often, previous surgical intervention excludes the older patient from further invasive procedures leaving them with limited treatment options. The purpose of this case is to report on the clinically significant improvement in postural control as measured by force plate after a multimodal treatment program of Chiropractic Biophysics® (CBP®) posture rehabilitation as well as balance rehabilitation in an elderly patient with long-standing spinal deformity including thoracic hyperkyphosis and a T10-L4 Harrington rod instrumentation for thoracolumbar scoliosis. Case Description: A 69-year-old female presented with the main complaint of balance and gait impairment as well as back pain and headaches. Balance assessment on a force plate showed impaired balance, in the vestibular challenging condition (eyed closed; standing on foam). Radiography showed a forward stooped posture and surgical hardware. Treatment was directed at posture by CBP methods and balance rehabilitation by a whole-body vibration exercise program. Treatment progressed over a 10-month period. The patient experienced relief of back pains and headaches. There was a clinically significant improvement in posturography including a 102 cm reduction in center of pressure (COP) path length. There was an inch reduction in forward sagittal stoop. Conclusions: A non-surgical rehabilitation program demonstrated a clinically significant improvement in balance performance in an elderly female diagnosed with osteopenia, spinal deformity, and previous spine deformity surgery. This approach to improving postural stability is important and further investigations should be undertaken.

Temporal changes in postural control strategy through single-leg stance practice with active restriction of knee movement.

[Purpose] This study aimed to examine and verify temporal changes in lower limb joint action after 2 weeks of single-leg stance training under active restriction of knee movement. [Participants and Methods] The participants included 28 healthy adult females (mean age, 19.6 ± 1.0 years). A stabile meter was used to measure the center of pressure sway as an index of ankle joint action. In addition, a triaxial accelerometer was used to measure pelvic and knee sways as indices of hip and knee joint actions, respectively. We established two experimental groups: an active-restriction group and an unrestricted group. Measurements of lower limb joint actions were recorded thrice during single-leg stance exercises during the first session of practice, the third session 1 week later, and the sixth session 2 weeks later. [Results] Both groups exhibited shorter total trajectory lengths in sessions three and six than in the first session. The active restriction group showed less knee sway in later sessions, whereas the unrestricted group showed reduced pelvic sway in the third session. [Conclusion] Single-leg stance exercises with active restriction of knee movement may alter the strategy of lower limb joint action.

Effects of Cognitive Task During Unstable Walking on the Frontal Cerebral Blood Flow in Elderly Retirement Home Residents Leading an Independent Daily Life.

OBJECTIVES: This study aimed to examine the effects of cognitive tasks during walking with perturbation on the cerebral blood flow. METHODS: The subjects were a total of 20 persons, consisting of 12 healthy adults aged 21-47 years (adult group) and 8 retirement home residents aged 67-85 years who led an independent daily life and could walk independently (elderly group). Oxyhemoglobin was measured using wireless functional near-infrared spectroscopy (fNIRS). An analysis was conducted using the Wilcoxon rank sum test to compare the variation of oxyhemoglobin between walking with perturbation (WP) and walking with perturbation and cognitive tasks (WPC) in each group. In addition, we compared the variation of oxyhemoglobin between groups by analysis of covariance adjusting for the value of WP. RESULTS: In the adult group, the left and right oxyhemoglobin significantly increased under WPC (p=0.0122, 0.0015, respectively). On the other hand, in the elderly group, the right and left oxyhemoglobin did not significantly change under WPC. CONCLUSIONS: These results suggest that the effect of a cognitive task during unstable walking conditions differs between healthy adults and elderly persons, and that this may be important when considering postural control strategies, especially in the elderly.

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).

Exploring GVS as a display modality: signal amplitude and polarity, in various environments, impacts on posture, and with dual-tasking.

Galvanic Vestibular Stimulation (GVS) has been proposed as an alternative display modality to relay information without increasing demands on the visual or auditory sensory modalities of the wearer or in environments where those modalities cannot be used (e.g., covert night operations). We further investigated this concept with four experiments designed to test: (1) thresholds at which subjects could distinguish between different GVS current amplitudes and polarities, (2) thresholds at which different bipolar (i.e., sinusoidal waveform with current oscillating between left and right directions) current frequencies were distinguishable among room temperature, hot, cold, and windy environments, (3) effects of unipolar (i.e., sinusoidal waveform with current occurring in only the left or right direction) currents on balance performance, and (4) dual-task performance among frequency and polarity modulated GVS conditions during a concordant visual search task. Subjects reliably distinguished between current amplitudes that varied from a pedestal of ± 0.6 mA by a median of 0.03 mA (range of 0.02-0.32 mA) and between unipolar currents at a median amplitude of 0.55 mA (range of 0.32-0.83 mA). GVS frequency thresholds were robust to the environment conditions tested, with no statistical differences found. Sway and balance errors were increased with unipolar currents. GVS thresholds were not impacted by the dual-task paradigm, but the visual search scores were slightly elevated when congruently performing a polarity thresholding task. Overall findings continue to support GVS use as a display modality, but some limitations are noted, such as the use of unipolar currents under scenarios where postural control is important.

How bipedalism shapes humans' actions with hand tools.

The task for an embodied cognitive understanding of humans' actions with tools is to elucidate how the human body, as a whole, supports the perception of affordances and dexterous action with objects in relation to other objects. Here, we focus on the relationship between humans' actions with handheld tools and bipedal posture. Posture plays a pivotal role in shaping animals' perception and action dynamics. While humans stand and locomote bipedally, other primates predominantly employ quadrupedal postures and locomotion, relying on both hands and feet to support the body. Drawing upon evidence from evolutionary biology, developmental psychology and performance studies, we elucidate the influence of bipedalism on our actions with objects and on our proficiency in using tools. We use the metaphor of cascades to capture the dynamic, nonlinear transformations in morphology and behaviour associated with posture and the use of tools across evolutionary and developmental timescales. Recent work illustrates the promise of multifractal cascade analysis to reveal nonlinear, cross-scale interactions across the entire body in real-time, supporting the perception of affordances for actions with tools. Cascade analysis enriches our comprehension of real-time performance and facilitates exploration of the relationships among whole-body coordination, individual development, and evolutionary processes.This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

Electroencephalography microstate alterations reflect potential double-edged cognitive adaptation in Ménière's disease.

PURPOSE: To explore the microstate characteristics and underlying brain network activity of Ménière's disease (MD) patients based on high-density electroencephalography (EEG), elucidate the association between microstate dynamics and clinical manifestation, and explore the potential of EEG microstate features as future neurobiomarkers for MD. METHODS: Thirty-two patients diagnosed with MD and 29 healthy controls (HC) matched for demographic characteristics were included in the study. Dysfunction and subjective symptom severity were assessed by neuropsychological questionnaires, pure tone audiometry, and vestibular function tests. Resting-state EEG recordings were obtained using a 256-channel EEG system, and the electric field topographies were clustered into four dominant microstate classes (A, B, C, and D). The dynamic parameters of each microstate were analyzed and utilized as input for a support vector machine (SVM) classifier to identify significant microstate signatures associated with MD. The clinical significance was further explored through Spearman correlation analysis. RESULTS: MD patients exhibited an increased presence of microstate class C and a decreased frequency of transitions between microstate class A and B, as well as between class A and D. The transitions from microstate class A to C were also elevated. Further analysis revealed a positive correlation between equilibrium scores and the transitions from microstate class A to C under somatosensory challenging conditions. Conversely, transitions between class A and B were negatively correlated with vertigo symptoms. No significant correlations were detected between these characteristics and auditory test results or emotional scores. Utilizing the microstate features identified via sequential backward selection, the linear SVM classifier achieved a sensitivity of 86.21% and a specificity of 90.61% in distinguishing MD patients from HC. CONCLUSIONS: We identified several EEG microstate characteristics in MD patients that facilitate postural control yet exacerbate subjective symptoms, and effectively discriminate MD from HC. The microstate features may offer a new approach for optimizing cognitive compensation strategies and exploring potential neurobiological markers in MD.

Effects of Tai Chi training on functionality, dynamic balance, kinesiophobia, and quality of life in athletes with functional ankle instability.

This study investigated the effects of Tai Chi training on functionality, dynamic balance, kinesiophobia, and quality of life in athletes with Functional Ankle Instability (FAI). Forty-three athletes with FAI were randomly assigned to either a Tai Chi group (n = 21) or a control group (n = 22). The Tai Chi group followed a tailored exercise protocol addressing ankle instability through a three-phase progression, while the control group had no intervention but continued their usual activities. Measurements, including Cumberland Ankle Instability Tool (CAIT), Star Excursion Balance Test (SEBT), Tampa Scale for Kinesiophobia (TSK), Short Form-12 (SF-12), figure-8 hop test, and perceived treatment effect were assessed before and after the intervention. The Tai Chi group showed significant improvements in CAIT score and SEBT reach distance compared to the control group (p < 0.001). Tai Chi exercises also reduced TSK, improved figure-8 hop score, and enhanced the physical component of SF-12 (p < 0.005), with no significant effect on the mental component of SF-12 (p = 0.7). The findings imply that Tai Chi may be a valuable consideration for athletic trainers and sports medicine professionals working with athletes with FAI.

Influence of Visual Stimulus Changes in a Virtual Environment on Postural Control: Focusing on a Hallway Walking Simulation.

The purpose of this study was to clarify the effects of the standing center of gravity sway by providing visual stimulus information as if the subjects were walking in virtual reality (VR) and by monitoring conditions with different corridor widths. We included 25 healthy young individuals in our study. The center of gravity sway was measured during open- and closed-eye static standing using images of walking in corridors of different widths (780 and 1600 mm) presented on a VR and personal computer monitor (Monitor). The parameters measured for the center of gravity sway were swing path length (SPL), height of excursion (HoE), and width of excursion (WoE). The results showed that the SPL and HoE values were significantly greater in the VR group than those in the Monitor group. The greater center of gravity sway in the VR compared with the Monitor group can be attributed to the ability of the head-mounted VR display to cover the entire field of vision and its head-tracking function. There was no change in the center of gravity sway with respect to the corridor width, which may be because the width of the corridor alone did not provide sufficient visual stimulation to affect physical function. This research could lead to further studies which could impact the motivation of patients for rehabilitation therapies.

Different mechanisms of contextual inference govern associatively learned and sensory-evoked postural responses.

Human standing balance relies on the continuous monitoring and integration of sensory signals to infer our body's motion and orientation within the environment. However, when sensory information is no longer contextually relevant to balancing the body (e.g., when sensory and motor signals are incongruent), sensory-evoked balance responses are rapidly suppressed, much earlier than any conscious perception of changes in balance control. Here, we used a robotic balance simulator to assess whether associatively learned postural responses are similarly modulated by sensorimotor incongruence and contextual relevance to postural control. Twenty-nine participants in three groups were classically conditioned to generate postural responses to whole-body perturbations when presented with an initially neutral sound cue. During catch and extinction trials, participants received only the auditory stimulus but in different sensorimotor states corresponding to their group: 1) during normal active balance, 2) while immobilized, and 3) throughout periods where the computer subtly removed active control over balance. In the balancing and immobilized states, conditioned responses were either evoked or suppressed, respectively, according to the (in)ability to control movement. Following the immobilized state, conditioned responses were renewed when balance was restored, indicating that conditioning was retained but only expressed when contextually relevant. In contrast, conditioned responses persisted in the computer-controlled state even though there was no causal relationship between motor and sensory signals. These findings suggest that mechanisms responsible for sensory-evoked and conditioned postural responses do not share a single, central contextual inference and assessment of their relevance to postural control, and may instead operate in parallel.

Relationship among the COM Motion, the Lower Extremity and the Trunk during the Squat.

Squatting is a common motion in activities of daily living and is frequently used in training programs. Squatting requires a shift of the body in both vertical and anterior-posterior directions. Postural control during squatting is considered a mixed strategy; however, details and roles of the trunk and lower limb joints are unclear. The purpose of this study was to investigate the relationship among the kinematics of the lower limb, the trunk and the center of mass (COM) descent during squatting. Twenty-six healthy young adults performed repeated parallel squats. Lower limb joint and trunk angles and the COM were analyzed using a 3D motion analysis system. We evaluated the relationship between the kinematics and the squat depth by performing correlation analysis and multiple linear regression analysis. The ankle was the first to reach its maximum angle, and the remaining joints reached their maximum angles at the maximum squat depth. The knee joint motion and the squat depth were significantly correlated and there was a correlation between the hip and the ankle joint motion and the anteroposterior displacement of the COM during squatting. Multivariate linear regression analysis indicated that squat depth was predicted by both the knee and ankle motion and that anteroposterior displacement of the COM was predicted by the hip, ankle, and knee joint motion. The knees contributed to the vertical COM motion during squatting, while the hips contributed to the COM motion in the anteroposterior direction. On the other hand, the ankles contributed to COM motions in both the vertical and anteroposterior directions during squatting.

Motor adaptation to continuous lateral trunk support force during walking improves trunk postural control and walking in children with cerebral palsy: A pilot study.

PURPOSE: To determine whether the application of continuous lateral trunk support forces during walking would improve trunk postural control and improve gait performance in children with CP. MATERIALS AND METHODS: Nineteen children with spastic CP participated in this study (8 boys; mean age 10.6 ± 3.4 years old). Fourteen of them were tested in the following sessions: 1) walking on a treadmill without force for 1-min (baseline), 2) with lateral trunk support force for 7-min (adaptation), and 3) without force for 1-min (post-adaptation). Overground walking pre/post treadmill walking. Five of them were tested using a similar protocol but without trunk support force (i.e., control). RESULTS: Participants from the experimental group showed enhancement in gait phase dependent muscle activation of rectus abdominis in late adaptation period compared to baseline (P = 0.005), which was retained during the post-adaptation period (P = 0.036), reduced variability of the peak trunk oblique angle during the late post-adaptation period (P = 0.023), and increased overground walking speed after treadmill walking (P = 0.032). Participants from the control group showed modest changes in kinematics and EMG during treadmill and overground walking performance. These results suggest that applying continuous lateral trunk support during walking is likely to induce learning of improved trunk postural control in children with CP, which may partially transfer to overground walking, although we do not have a firm conclusion due to the small sample size in the control group.

Noninstrumented Clinical Assessment of Static Postural Stability in Chronic Ankle Instability: A Systematic Review and Meta-Analysis.

CONTEXT: Several clinical tests are available to assess static postural stability in individuals with chronic ankle instability (CAI); however, it is unclear which test should be used. OBJECTIVE: To determine which noninstrumented clinical tests should be used to detect static postural stability deficits in individuals with CAI. EVIDENCE ACQUISITION: We searched 4 databases from their inception to February 2023, and included studies comparing static postural stability in individuals with CAI and healthy controls using noninstrumented assessments. Two reviewers independently extracted study characteristics, participant information, static postural stability assessment methods, and results. We calculated the pooled standardized mean difference (SMD) and 95% confidence interval using a random effects meta-analysis and assessed the certainty of the evidence. EVIDENCE SYNTHESIS: Fourteen cross-sectional studies (293 participants with CAI and 284 healthy controls) were included. The meta-analysis showed no significant differences between the CAI and healthy groups in the double-leg stance condition of the Balance Error Scoring System (BESS) (SMD, -0.03; low-certainty evidence). Significant group differences were found in the BESS single-leg stance (SLS) on firm and foam surfaces (SLS firm: SMD, 0.47, very low-certainty evidence; SLS foam: SMD, 0.80, very low-certainty evidence), the tandem stance (TS) on firm and foam surfaces (TS firm: SMD, 0.39, low-certainty evidence; TS foam: SMD, 0.76, low-certainty evidence), and the total BESS in the foam conditions (SMD, 1.12, very low certainty evidence). Significant differences were also found between the CAI and healthy groups in the foot-lift (SMD, 1.24; very low certainty evidence) and time-in-balance tests (SMD, -0.94; very low certainty evidence). CONCLUSIONS: Due to the large magnitude of the differences, the SLS foam, TS foam, and the total BESS in the foam conditions, as well as the foot-lift test or time-in-balance test, may be the most appropriate to clinically identify static postural stability impairment in individuals with CAI.

12-week melatonin supplementation improved dynamic postural stability and walking performance in persons living with multiple sclerosis: A randomized controlled trial.

BACKGROUND: Persons with multiple sclerosis (PwMS) suffer from sleep disturbances, fatigue and pain, which can be due, at least in part, to decreased levels of endogenous melatonin. These disorders could exacerbate postural instability, gait disorders and fall risk. Acute effects of exogenous melatonin on MS-related physical disorders have been studied but its long-term effects on these parameters have not been explored yet in PwMS. This study aimed to determine the impact of chronic melatonin intake on dynamic postural stability, walking performance and fall risk in PwMS. METHODS: This randomized placebo-controlled study included 27 PwMS who were assigned to either melatonin group (MG, n=15) or placebo group (PG, n=12) (3mg/night for 12 weeks). Dynamic postural balance (force platform), walking performance (locometer) and fall risk (Four Square Step Test) were evaluated pre- (T0) and post-intervention (T1). Sleep quality (Pittsburgh Sleep Quality Index (PSQI)), fatigue perception (Fatigue Severity Scale (FSS)), neuropathic pain (Neuropathic Pain Questionnaire 4 (DN4)) and quality of life (the International Multiple Sclerosis (MS)) quality of life questionnaire) were also assessed at T0 and T1. RESULTS: The center of pressure mean velocity decreased in MG compared with PG (22.98%, p=0.028) in the frontal plane. In MG, stride length and walking speed increased (18.09%, p=0.036; 9.65%, p=0.025, respectively) comparatively with PG. The PSQI (55.89%, p<0.001), FSS (32.38%, p=0.003) and DN4 (32.41%, p=0.035) scores decreased in MG compared with PG. CONCLUSION: Chronic melatonin ingestion can be recommended for managing MS-related gait disorders and dynamic postural imbalance. It had also anti-fatigue and analgesic effects as well as benefits on sleep quality in PwMS. CLINICAL REGISTRATION: This study was prospectively recorded in the Pan African Clinical Trial Registry database (PACTR202007465309582) (https://pactr.samrc.ac.za/.).

The effects of six weeks of combined balance and plyometric training on postural control performance in elite badminton players: A pilot randomized, controlled study.

Background/Objectives: The athletic performance in badminton players largely depends on the capability of dynamic postural control to quickly restore balance when performing high-paced movements (e.g., frequent single-leg jumps). Our aim was to examine the effects of a novel intervention that combines balance training on an unstable surface and plyometric training on the performance of restoring balance after jumping, as well as related postural control in elite badminton players. Methods: Sixteen elite male badminton players were randomly allocated to either a combined balance and plyometric training group (CT, n = 8) or a plyometric training group (PT, n = 8). The CT group participated in a six-week training program, which included three training sessions per week. Each session comprised 40 min of plyometric exercises and 20 min of balance training. The PT group underwent plyometric training using the identical protocol as that of the CT group. All participants underwent identical technical training in badminton throughout the duration of the study. At baseline and immediately after the intervention, participants completed a single-leg jumping test. The capacity to restore balance was evaluated using the time to stabilization (TTS) after landing; and the related center of pressure (COP) fluctuations were also recorded. The effect of intervention was examined by two-way repeated-measures of ANOVA. Results: The primary two-way repeated-measures ANOVA models showed no significant interactions between group and time on either the time to stability in the dominant leg (D-TTS) or the time to stability in the non-dominant leg (N-TTS) (p > 0.70). Significant main effects of time, group, and their interactions on dominant legs of the anterior-posterior displacement difference (D-COPAP) (time: p = 0.001; group: p = 0.001; interaction: p = 0.014), non-dominant legs of the anterior-posterior displacement difference (N-COPAP) (time: p < 0.001; group: p = 0.003; interaction: p = 0.021) and non-dominant legs of the medial-lateral displacement difference (N-COPML) (time: p < 0.001; group: p < 0.001; interaction: p = 0.026), that is, compared to baseline of both groups and post PT, the COP metrics were significantly reduced after CT. Secondarily, within the CT and PT group, after the intervention, the N-TTS (CT: p = 0.001, post: 0.58 ± 0.87; PT: p = 0.03, post: 0.71 ± 0.11) was significantly decreased compared to baseline (CT pre: 0.76 ± 0.16; PT pre: 0.88 ± 0.13). Conclusion: This pilot study demonstrated that, compared to PT-only, the 6-week CT which combines balance training induced comparable improvements in the capacity to restoring balance after landing from a single-leg jump, and significantly improved the postural control performance as measured by COP metrics.

Effects of Robotic Postural Stand Training with Epidural Stimulation on Sitting Postural Control in Individuals with Spinal Cord Injury: A Pilot Study.

(1) Background. High-level spinal cord injury (SCI) disrupts trunk control, leading to an impaired performance of upright postural tasks in sitting and standing. We previously showed that a novel robotic postural stand training with spinal cord epidural stimulation targeted at facilitating standing (Stand-scES) largely improved standing trunk control in individuals with high-level motor complete SCI. Here, we aimed at assessing the effects of robotic postural stand training with Stand-scES on sitting postural control in the same population. (2) Methods. Individuals with cervical (n = 5) or high-thoracic (n = 1) motor complete SCI underwent approximately 80 sessions (1 h/day; 5 days/week) of robotic postural stand training with Stand-scES, which was performed with free hands (i.e., without using handlebars) and included periods of standing with steady trunk control, self-initiated trunk and arm movements, and trunk perturbations. Sitting postural control was assessed on a standard therapy mat, with and without scES targeted at facilitating sitting (Sit-scES), before and after robotic postural stand training. Independent sit time and trunk center of mass (CM) displacement were assessed during a 5 min time window to evaluate steady sitting control. Self-initiated antero-posterior and medial-lateral trunk movements were also attempted from a sitting position, with the goal of covering the largest distance in the respective cardinal directions. Finally, the four Neuromuscular Recovery Scale items focused on sitting trunk control (Sit, Sit-up, Trunk extension in sitting, Reverse sit-up) were assessed. (3) Results. In summary, neither statistically significant differences nor large Effect Size were promoted by robotic postural stand training for the sitting outcomes considered for analysis. (4) Conclusions. The findings of the present study, together with previous observations, may suggest that robotic postural stand training with Stand-scES promoted trunk motor learning that was posture- and/or task-specific and, by itself, was not sufficient to significantly impact sitting postural control.

Exploring the Effects of Sensorimotor Training and Relaxation Therapy on Postural Control, Balance, Sleep, and Stress in Sedentary Young Adults: Rationale, Design, and Methodology.

Postural control (PC) and sleep are critical in several aspects of health. Poor sleep negatively influences PC and balance, which is necessary for performing various tasks, from reaching to mobility. Moreover, sleep disturbances and consequent PC and balance deterioration are associated with job accidents, traffic accidents, falls, and injuries. Healthy adults who have inadequate sleep show a decline in optimal functioning, even in the absence of medical illnesses. This suggests that getting enough sleep, both in duration and quality, is essential to maintain optimal health. Moreover, inadequate sleep has also been observed to have a bidirectional relationship with stress levels. However, there is insufficient evidence regarding the impact of non-pharmacological treatments to improve PC, sleep, and stress in the sedentary young adult (YA) population. This article describes the protocol for a study to investigate the effects of sensorimotor training and relaxation therapy on various static and dynamic PC tests, balance measures, and subjective and objective indices of sleep and stress among sedentary YAs with impaired sleep quality. The protocol is also designed to evaluate the effect of these therapies on fatigue, salivary cortisol levels, anxiety, and depression. Methods for assessing the sleep architecture, static and dynamic PC, balance, and stress are described along with the methods of scoring with the primary goal of providing a standardized set of assessment and scoring procedures according to the latest guidelines and gold-standard techniques and measures that can be used reliably at different laboratories. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Postural control assessment Basic Protocol 2: Balance assessment Basic Protocol 3: Sleep architecture assessment Basic Protocol 4: Salivary cortisol analysis.

Age-based stereotype threat effects on dynamic balance in healthy older adults.

Introduction: Stereotype threat can lead older adults to perceive their experiences in a biased manner, giving rise to interfering thoughts and negative emotions that generate stress and anxiety. Negative beliefs about aging may serve as an additional factor that increases the need for attentional demand, potentially resulting in a performance level below their actual capabilities. In the present study, we asked whether negative aging stereotypes influence a dynamic balance task and explored the means to counteract them in healthy elderly participants. Methods: The performance of balance was compared in two groups of participants aged 65 to 75 years (n = 22) under stereotype threat or reduced-threat situation. Balance abilities were tested under dynamic conditions, requiring participants to maintain balance on a moving platform and using a gradient of difficulty (with eyes open or closed, without or with foam). Postural performance was evaluated by means of posturographic evaluation of the center of pressure displacement and motion analysis. Additionally, we investigated the effects of stereotype threat on a preferred walking speed task and on the Timed Up and Go (TUG) test. Results: Participants under stereotype threat showed poorer balance, particularly in challenging conditions (eyes closed, on foam), with less effective body segments stabilization. Their postural stabilization on foam was worse compared to a solid surface. Conversely, those in the reduced threat condition maintained better body segment stabilization across all conditions, indicating consistent postural control regardless of the presence of foam. Stereotype threat did not affect preferred walking speed or the time to complete the "Time Up and Go" test. Discussion-conclusion: This study provides the first description of age-based stereotype threat effects on a dynamic balance task and how to counteract them in healthy older adults. We suggest that the decrease in postural performance observed in participants exposed to stereotype threat can be attributed to a split in attentional focus between negative intrusive thoughts and the attention needed for maintaining balance. These findings open new perspectives on how to overcome negative expectations when evaluating and training physical abilities, thereby contributing to fall prevention among older adults.