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Ece Acar, Tamer Çankaya and Serkan Öner

stability area and a lower sway area are the indicators of a stable balance. Trunk muscles have important functions in balance and mobility and give a stable ground for the extremities by providing postural support and stability to the spine ( Hodges et al., 2003 ; Hodges & Richardson, 1997 ; Suri, Kiely

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Jaclyn B. Caccese, Thomas A. Buckley and Thomas W. Kaminski

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass–center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

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Ming Fung Godfrey Lui, Hung Kay Daniel Chow, Wai Ming Kenny Wong and Wai Nam William Tsang

with the eyes open. The 15-cm thick foam pad was atop the force plate, and the subject’s total sway path and sway area were measured. Three trials were conducted for each participant 1 hr before and 1 hr after a dose of either the melatonin or the placebo. Fall risk was assessed using the short form of

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Yumeng Li, Melissa A. Mache and Teri A. Todd

common feature of ASD, 12 could result in activity avoidance. Most of the studies surrounding the postural stability have utilized traditional linear analyses of center of pressure (COP) and found that children with ASD demonstrated greater sway displacements, 13 , 14 sway areas, 8 , 9 SDs of sway

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Shin-Tsu Chang, Chih-Hung Ku, Ming-Fu Hsieh, Liang-Cheng Chen, Heng-Yi Chu, Cheng-Chiang Chang and Kao-Chung Tsai

Context:

The multifidus muscle plays a role in controlling lumbosacral position and postural sway. One of its attachment sites is the exact site of spina bifida occulta (SBO).

Objective:

To investigate the role of the muscle for postural control in SBO.

Design:

Cross-sectional cohort.

Participants:

Eighty subjects with SBO (38 in minor; 42 in major) and controls.

Interventions:

N/A.

Main Outcome Measures:

Subjects stood upright on a platform at 0° and on an inclined surface (10° and 20°) with feet in plantarflexion/dorsiflexion, together with eyes open and closed. The platform system measured posture to obtain sway area and sway mean for statistics.

Results:

Upon sway area/mean, the group differences of major/minor SBO vs. control were all significant. Sway means of minor SBO were lower than those of major SBO at corresponding inclined degrees.

Conclusions:

Subjects with SBO demonstrated increased sway as compared to controls.

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Matthew J. Leineweber, Dominik Wyss, Sophie-Krystale Dufour, Claire Gane, Karl Zabjek, Laurent J. Bouyer, Désirée B. Maltais, Julien I.A. Voisin and Jan Andrysek

This study evaluated the effects of intense physical exercise on postural stability of children with cerebral palsy (CP). Center of pressure (CoP) was measured in 9 typically developing (TD) children and 8 with CP before and after a maximal aerobic shuttle-run test (SRT) using a single force plate. Anteroposterior and mediolateral sway velocities, sway area, and sway regularity were calculated from the CoP data and compared between pre- and postexercise levels and between groups. Children with CP demonstrated significantly higher pre-SRT CoP velocities than TD children in the sagittal (18.6 ± 7.6 vs. 6.75 1.78 m/s) and frontal planes (15.4 ± 5.3 vs. 8.04 ± 1.51 m/s). Post-SRT, CoP velocities significantly increased for children with CP in the sagittal plane (27.0 ± 1.2 m/s), with near-significant increases in the frontal plane (25.0 ± 1.5m/s). Similarly, children with CP evidenced larger sway areas than the TD children both pre- and postexercise. The diminished postural stability in children with CP after short but intense physical exercise may have important implications including increased risk of falls and injury.

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Koichi Kaneda, Daisuke Sato, Hitoshi Wakabayashi, Atsuko Hanai and Takeo Nomura

This study compared the effects of 2 types of water exercise programs on balance ability in the elderly. Thirty healthy elderly persons (60.7 ± 4.1 yr) were randomly assigned to a deep-water-running exercise (DWRE, n = 15) group or a normal water exercise (NWE, n = 15) group. The participants completed a twice-weekly water exercise intervention for 12 wk. Exercise sessions comprised a 10-min warm-up on land, 20 min of water-walking exercise, 30 min of water exercise while separated into NWE and DWRE, a 10-min rest on land, and 10 min of recreation and relaxation in water. Postural-sway distance and tandem-walking time were decreased significantly in DWRE. Postural-sway area was decreased significantly in NWE. In both groups, simple reaction times were significantly decreased. The findings of this study show that a water exercise program including deep-water running is much better than normal water exercise for improving dynamic balance ability in the elderly.

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Jason P. Mihalik, Luv Kohli and Mary C. Whitton

Context:

Virtual reality environments may allow researchers to investigate functional balance performance without risks associated with testing in the real world.

Objective:

To investigate the effects of the mass of a head-mounted display (HMD) on balance performance.

Design:

Counterbalanced pretest-posttest.

Setting:

Virtual reality laboratory.

Participants:

20 healthy college students.

Intervention(s):

Balance Error Scoring System (BESS) with a tracker-only headband and again with tracker plus HMD was performed.

Main Outcome Measures:

BESS error scores, elliptical sway area, and center of pressure travel distance were recorded.

Results:

No effect of the HMD mass on balance performance was observed. A significant stance by surface interaction was present but was negated when the HMD conditions were included in the model.

Conclusions:

The mass of a HMD has not been proven to adversely affect balance performance. These data suggest the HMD mass is not a contraindication to the use of immersive virtual environments in future concussion research involving balance.

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Luis Mochizuki, Marcos Duarte, Alberto Carlos Amadio, Vladimir M. Zatsiorsky and Mark L. Latash

We investigated changes in postural sway and its fractions associated with manipulations of the dimensions of the support area. Nine healthy adults stood as quietly as possible, with their eyes open, on a force plate as well as on 5 boards with reduced support area. The center of pressure (COP) trajectory was computed and decomposed into rambling (Rm) and trembling (Tr) trajectories. Sway components were quantified using RMS (root mean square) value, average velocity, and sway area. During standing on the force plate, the RMS was larger for the anterior-posterior (AP) sway components than for the mediolateral (ML) components. During standing on boards with reduced support area, sway increased in both directions. The increase was more pronounced when standing on boards with a smaller support area. Changes in the larger dimension of the support area also affected sway, but not as much as changes in the smaller dimension. ML instability had larger effects on indices of sway compared to AP instability. The average velocity of Rm was larger while the average velocity of Tr was smaller in the AP direction vs. the ML direction. The findings can be interpreted within the hypothesis of an active search function of postural sway. During standing on boards with reduced support area, increased sway may by itself lead to loss of balance. The findings also corroborate the hypothesis of Duarte and Zatsiorsky that Rm and Tr reveal different postural control mechanisms.

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D. Clark Dickin and Jacqueline E. Heath

Whole body vibration (WBV) has been shown to improve force and power output as well as flexibility and speed, with improvements suggested to result from reduced electromechanical delays, improved rate of force development, and sensitivity of muscle spindles. Fixed frequency studies on postural control have been somewhat equivocal; however, individualized frequency protocols have shown promising results in other motor tasks. To assess this, 18 healthy young adults experienced three 4-minute WBV sessions with postural control assessed before vibration, after multiple exposures, and during recovery, with altered levels of sensory information available to the participants. Sway velocity, sway path length, and sway area were assessed in each environment. Study findings revealed that stability was impacted following WBV, with more challenging environments eliciting improvements persisting for 20 minutes. When the environment was less challenging, postural stability was impaired; however, the effects dissipated quickly (10-20 min). It was determined that exposure to individualized frequency WBV served to impair postural control when the challenge was low, but resulted in heightened stability when the overall challenge was high and vestibular information was needed for stability.