Smaller Cortisol Awakening Responses Are Associated with Greater Visual Dependence in Postural Control

There are known links between the hypothalamic–pituitary–adrenal (HPA) axis and systems responsible for regulating posture. Our aim was to explore directly, for the first time, whether an aspect of circadian HPA axis activity (the cortisol awakening response: CAR) was associated with greater visual dependency in postural control. For measurement of the CAR, electronically monitored saliva samples were collected by participants following morning awakening in their home environment. On the afternoons of the same days, postural sway was measured in the laboratory by exposing participants to static (control) and moving visual stimuli whilst standing still and upright on a force platform. Visual dependence was assessed as the increase in postural sway (path length) during exposure to the moving compared with the static condition. The 44 measurement days were derived from four days for each of eleven healthy participants (mean ± SD age: 51.18 ± 3.3 years). As expected, postural sway was greater when exposed to moving versus static cues. Mixed regression modelling showed that participants with smaller four day average CARs had greater deterioration in postural sway when presented with moving stimuli. These data are the first to document associations between the CAR and visual dependency in postural sway.

Download Full-text

Is Young Age a Limiting Factor When Training Balance? Effects of Child-Oriented Balance Training in Children and Adolescents

Pediatric Exercise Science ◽

10.1123/pes.2017-0061 ◽

2018 ◽

Vol 30 (1) ◽

pp. 176-184 ◽

Cited By ~ 12

Author(s):

Michael Wälchli ◽

Jan Ruffieux, ◽

Audrey Mouthon ◽

Martin Keller ◽

Wolfgang Taube

Keyword(s):

Postural Control ◽

Postural Sway ◽

Age Groups ◽

Balance Training ◽

Young Age ◽

Limiting Factor ◽

Training Outcomes ◽

Balance Exercises ◽

Explosive Force ◽

First Time

Purpose: Balance training (BT) studies in children reported conflicting results without evidence for improvements in children under the age of 8. The aim of this study therefore was to compare BT adaptations in children of different age groups to clarify whether young age prevents positive training outcomes. Methods: The effects of 5 weeks of child-oriented BT were tested in 77 (38 girls and 39 boys) participants of different age groups (6–7 y, 11–12 y, and 14–15 y) and compared with age-matched controls. Static and dynamic postural control, explosive strength, and jump height were assessed. Results: Across age groups, dynamic postural sway decreased (−18.7%; P = .012; ) and explosive force increased (8.6%; P = .040; ) in the intervention groups. Age-specific improvements were observed in dynamic postural sway, with greatest effects in the youngest group (−28.8%; P = .026; r = .61). Conclusion: In contrast to previous research using adult-oriented balance exercises, this study demonstrated for the first time that postural control can be trained from as early as the age of 6 years in children when using child-oriented BT. Therefore, the conception of the training seems to be essential in improving balance skills in young children.

Download Full-text

The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability

Prosthetics and Orthotics International ◽

10.1177/0309364615596068 ◽

2016 ◽

Vol 41 (1) ◽

pp. 58-64 ◽

Cited By ~ 4

Author(s):

Mohammad Hadadi ◽

Ismaeil Ebrahimi ◽

Mohammad Ebrahim Mousavi ◽

Gholamreza Aminian ◽

Ali Esteki ◽

...

Keyword(s):

Postural Control ◽

Postural Sway ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Foot And Ankle ◽

Balance Performance ◽

Balance Test ◽

Combined Mechanism ◽

Ankle Support ◽

Healthy Participants

Background:Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients.Objectives:The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients.Study design:Cross-sectional study.Methods:An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform.Results:The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support.Conclusion:The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals.Clinical relevanceApplication of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.

Download Full-text

Comparison of hypothalamo-pituitary-adrenal function in treatment resistant unipolar and bipolar depression

Translational Psychiatry ◽

10.1038/s41398-021-01343-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kalypso Markopoulou ◽

Susanne Fischer ◽

Andrew Papadopoulos ◽

Lucia Poon ◽

Lena J. Rane ◽

...

Keyword(s):

Hpa Axis ◽

Bipolar Depression ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

Total Cortisol ◽

The Awakening ◽

Resistant Depression ◽

Symptom Patterns ◽

Hpa Axis Activity ◽

First Time

AbstractAltered functioning of the hypothalamic-pituitary-adrenal (HPA) axis has been demonstrated in patients with treatment-resistant depression, although studies have often conflated patients with unipolar and bipolar depression. This is problematic given that the two groups often present with opposed neurovegetative symptom patterns. The aim of this study was to test, for the first time, whether post-awakening cortisol, a highly reliable, naturalistic measure of HPA functioning, could distinguish patients with clearly defined treatment-resistant unipolar (TRUD) and bipolar depression (TRBD). A total of 37 patients with TRUD, 17 patients with TRBD, and 47 healthy controls were recruited. Areas under the curve (AUC) with respect to the ground (g) and increase (i) of post-awakening cortisol concentrations (awakening, +15, +30, +45, +60, +90 min) were measured over two days. Patients with TRUD had higher total cortisol production in the morning hours compared to controls (AUCg, p = 0.01), while they did not differ in terms of the awakening response (AUCi, p = 0.28). By contrast, subjects with TRBD had lower total cortisol when compared to controls by trend (AUCg, p = 0.07), while they did not differ in the awakening response (AUCi, p = 0.15). A direct comparison of TRUD and TRBD revealed differences in the AUCg (p = 0.003) and AUCi (p = 0.03). This finding of comparatively elevated HPA axis activity in the morning in TRUD and attenuated HPA axis activity in TRBD attests to a fundamental biological distinction between unipolar and bipolar depression. It has implications for the understanding and treatment of bipolar depression and in differentiating the two types of depression.

Download Full-text