EMG-Triggered Pedaling Training on Muscle Activation, Gait, and Motor Function for Stroke Patients

This study aimed to determine the effects of electromyography (EMG)-triggered pedaling training to improve motor functions in the lower extremities, muscle activation, gait, postural balance, and activities of daily living in stroke patients. Subjects were randomly allocated to two groups: the EMG-triggered pedaling training group (EMG-PTG, n = 21) and the traditional pedaling training group (TPTG, n = 20). Both groups trained five times per week for four weeks, with 50 min per session. Lower extremity motor function was assessed using the Fugl–Meyer Assessment (FMA). Muscle activation of the four muscles of the lower extremities was assessed using eight-channel electromyography, while gait ability was assessed using GaitRite. Postural balance was assessed using the Berg balance scale (BBS), the timed up and go (TUG), and functional reach tests (FRT). Daily activities were assessed using the Modified Barthel Index (MBI). For lower extremity motor function, gait ability, balance ability, and activities of daily living, the EMG-PTG showed significant improvement compared to TPTG (p < 0.05). These results suggest that EMG-triggered pedaling training effectively improves lower extremity motor function, muscle activation, gait, postural balance, and activities of daily living in stroke patients.

Influence of Physically Active or Sedentary Lifestyle on Postural Control of Community-dwelling Old Adults

Objectives: The maintenance of the postural balance is fundamental for the daily living activities, as well as for the practice of physical exercise. However, the aging process and sedentary behavior (i.e., large sitting time) lead to changes biological systems, impairing postural balance with consequent increased falls risk. On the other hand, physical activity practice is a protective factor against these trends. The aim of this study is to investigate the influence of physical activity profile and sedentary behavior on postural control in community-dwelling old adults.Methods: This is a cross-sectional study including 208 community-dwelling old adults, which were stratified as sufficiently or insufficiently physically active and with or without sedentary behavior. Then, they were grouped as follow: G1 (sufficiently physically active and without sedentary behavior), G2 (insufficiently physically active, but without sedentary behavior), G3 (sufficiently physically active, but with sedentary behavior), and G4 (insufficiently physically active and with sedentary behavior).Results: Stabilometric parameters (sway area, total length of center of pressure [CoP] trajectory, and the mean velocity of CP displacement) were obtained to evaluate the postural control. There was significant difference between G1 and G4 on mean velocity of CoP displacement (p < 0.05).Conclusions: The coexistence of sedentary behavior and insufficient physically active profile seem to impact negatively on postural control.

Relación entre la estabilidad del core y el equilibrio postural en las habilidades biomotoras de los jóvenes atletas de baloncesto: una revisión sistemática (Relationship between Core Stability and Postural Balance on the Biomotor Capabilities of Young B

El baloncesto requiere exigencias físicas variadas, caracterizadas por esfuerzos intermitentes y situaciones de desequilibrio. Core Stability (EC) y Postural Balance (EP) son temas asociados como un factor significativo en la prevención de lesiones y dolor. Sin embargo, los resultados de los estudios en relación con las habilidades biomotoras son contrastantes, lo que indica que no hay efectos sobre el rendimiento deportivo en el contexto de alto rendimiento, pero es necesario profundizar las investigaciones sobre esta relación en la población adolescente.El objetivo del estudio fue verificar la relación entre la EC y la EP sobre las habilidades biomotoras en practicantes de baloncesto adolescentes. Utilizando la estrategia PICO, se realizaron búsquedas en las bases de datos PubMed y Scielo, buscando estudios experimentales con intervención de ejercicios EC / EP y pruebas de rendimiento atlético. Los resultados apuntan pocos estudios con efectos positivos sobre el rendimiento deportivo de los jóvenes atletas de baloncesto, pero no fue posible identificar pruebas sólidas de la influencia positiva del entrenamiento de EC / EP en las habilidades biomotoras de los adolescentes practicantes de baloncesto. Es necesario realizar más investigaciones sobre la influencia en los indicadores de rendimiento deportivo. Abstract. Basketball demands varied physical demands, characterized by intermittent efforts and situations of imbalance. Core Stability (EC) and Postural Balance (EP) are themes that have been associated as a significant factor in the prevention of injuries and pain. However, the results of studies in relation to biomotor skills are contrasting, indicating that there are no effects on athletic performance in the context of high performance, but investigations on this relationship in the adolescent population need to be further investigated. The aim of the study was to verify the relationship between EC and PE on biomotor skills in adolescent basketball players. Using the PICOS strategy, searches were performed in the PubMed and Scielo databases, looking for experimental studies with EC / EP exercise intervention and athletic performance test. The results point to studies with positive effects on the athletic performance of young basketball athletes, however few among them used a specific additional intervention. There is a need for further investigation regarding the influence on athletic performance indicators.

ANALYSIS OF POSTURAL BALANCE IN CHILDREN WHO PRACTICE AND THOSE WHO DO NOT PRACTICE SPORTS ACTIVITIES

ABSTRACT Introduction: Postural balance is essential for activities of daily living and sports performance in all life phases, but it remains unknown whether the regular practice of sports activities can improve postural balance in children. Objective: To evaluate postural balance in children who practice and those who do not practice regular sports activities. Methods: The sample consisted of 60 children (7-13 years of age) divided into two groups: participants in sports activities (n = 30) and non-participants in sports activities (n = 30). The level of physical activity was assessed by applying the Physical Activity Questionnaire for Children (PAQ-C) and static postural balance was assessed on the BIOMEC400-412 strength platform in bipedal and unipedal support. Results: No significant difference was observed between the groups in age, height or body mass index (p > 0.05). However, the groups showed a significant difference (p < 0.001) in the level of physical activity. The practicing sports group was characterized as active and the non-practicing group as sedentary. The practicing sports group had better postural balance in both bipedal and unipedal support compared to the non-practicing group (p < 0.05). Conclusion: The practice of regular sports activities improves postural balance in children from 7 to 13 years of age. Level of evidence II; Diagnostic study - Investigating a diagnostic test.

Objective and Subjective Evaluation of a Passive Exoskeleton for Upper Limbs

The aim of this study was to evaluate the Hapo ms, a passive upper limbs exoskeleton developed to assist workers for tasks with arms in front of the body. Twelve participants had to perform a static task, a manual handling task and a load carrying task two times: with and without the exoskeleton. In all cases subjective (perceived effort in arm and back areas, comfort) and objective (muscular activity, postural balance) criteria were evaluated. Results have shown a decrease in anterior deltoid (-12 to -18% depending of the task) and in biceps brachii (-19% to -33% depending of the task) muscular activity. No significant difference was pointed out in back muscle and postural balance was not significantly perturbed due to the wear of the exoskeleton. Finally, perceived effort reduction was observed during the three tasks (except in back area for task 1). To conclude, the Hapo ms seems well adapted to assist upper arms during tasks with arms in front of the body.

Menopausal Symptoms, Postural Balance, and Functional Mobility in Middle-Aged Postmenopausal Women

The aim of the present study was to determine the associations between the severity of the menopausal symptoms and postural balance and functional mobility in middle-aged postmenopausal women. A cross-sectional study was performed (171 participants, 57.18 ± 4.68 years). Severity of the menopausal symptoms (on the Menopause Rating Scale), postural balance (stabilometric platform) with eyes open and closed, and functional mobility (timed up and go test) were determined. A multivariate linear regression was performed, with body mass index, waist to hip ratio, age and fall history as possible confounders. Our findings showed that a greater severity of the menopausal symptoms at a psychological level was associated, under both eyes open and closed conditions, with worse postural control assessed by the length of the stabilogram (adjusted R2 = 0.093 and 0.91, respectively), the anteroposterior center of pressure displacements (adjusted R2 = 0.051 and 0.031, respectively) and the center of pressure velocity (adjusted R2 = 0.065 for both conditions). Older age was related to greater mediolateral displacements of the center of pressure with eyes open and closed (adjusted R2 = 0.45 and 0.58, respectively). There were no associations between the menopausal symptoms’ severity and functional mobility. We can conclude that a greater severity of psychological menopausal symptoms was independently associated with worse postural balance in middle-aged postmenopausal women.

CHARACTERISTICS OF EQUILIBRIUM FUNCTION AND THE SENSORY ORGANIZATION OF POSTURAL BALANCE IN WOMEN 85-95 YEARS OLD

Цель работы - установить возрастные особенности показателей эффективности функции равновесия и сенсорной организации постурального баланса у женщин 85-95 лет. Были обследованы 68 женщин 85-95 лет (средний возраст - 89,3±3 года), которых разделили на две возрастные группы: 1-я - 37 женщин 85-89 лет (средний возраст - 86,9±1,6 года); 2-я - 31 женщина 90-95 лет (средний возраст - 92,1±1,4 года). Для оценки компонентов постурального баланса использовали компьютерный динамический постурографический (стабилометрический) комплекс «Smart Equitest Balance Manager». Проводили Sensory Organization Test (SOT). Сравнительная оценка показателей Equilibrium Score во всех функциональных пробах SOT, включая показатель Com posite of all Equilibrium Scores, не выявила статистически значимых различий между группами обследованных женщин. Сенсорный анализ также не выявил возрастных изменений соматосенсорной, зрительной и вестибулярной информации в контроле над балансом. При этом показатель сенсорного предпочтения (Ratio for Sensory Analysis-Patient Preference) был выше у женщин 90-95 лет (p=0,007). У женщин после 89 лет не наблюдали возрастных изменений сенсорной организации постурального контроля, эффективности подержания статического и статодинамического баланса, включая снижение общей производительности баланса, а также адаптационных возможностей их функции равновесия. При этом у женщин-долгожителей сохраняется эффективность процесса сенсорной интеграции для поддержания постурального баланса и чувства пространственной ориентации, что можно рассматривать как предиктор активного долголетия. Кроме этого, у женщин-долгожителей сохраняется способность пространственной и временной организации контроля постурального равновесия, а также степени и порядка набора задействованных мышц для снижения дисбаланса. Полученные результаты позволили обозначить параметры SOT, которые можно учитывать при прогнозировании постуральных изменений и продолжительности жизни у женщин в старческом возрасте. The purpose of this work is to establish the age-related indicators’ characteristics of the effectiveness of the balance function and the postural balance sensory organization in women 85-95 years old. We examined 68 women aged 85-95 years [mean age (M±SD) 89,3±3 years]. The first age group included 37 women whose calendar age ranged from 85 to 89 years (mean age 86,9±1,6 years). The second age group included 31 women of 90-95 years (mean age: 92,1±1,4). To assess the components of the postural balance, a computer-based dynamic posturographic complex «Smart Equitest Balance Manager» was used. The Sensory Organization Test (SOT) was performed. Comparative assessment of the Equilibrium Score indicators in all SOT functional tests, including the Composite of all equilibrium scores, did not reveal statistically significant differences between the examined groups of women. The sensory analysis did not reveal age-related changes in somatosensory, visual and vestibular information in the control over balance, either. At the same time, the indicator of sensory preference (Ratio for sensory analysis-patient Preference) was higher in women 90-95 years old (p=0,007). In women after 89 years of age, there are no age-related changes in the sensory organization of postural control or the effectiveness of maintaining static and static-dynamic balance. No decrease in overall balance performance, as well as the adaptive capabilities of their balance function, was noticed. At the same time, long-lived women retain the effectiveness of the sensory integration process to maintain postural balance and a sense of spatial orientation, which can be considered a predictor of active longevity. In addition, centenarians retain the ability of spatial and temporal organization of postural equilibrium control, as well as the degree and order of the muscles involved to reduce the imbalance recruitment. The results obtained made it possible to designate SOT parameters that can be taken into account when predicting postural changes and life expectancy in women in old age.

Development and Validity of a Serious Game (VirtualTer) for Postural Balance Rehabilitation in Older Adults

Background Physiological changes resulting from aging can impair postural balance. Exergames have been used to treat balance disorders, enabling sensory-motor training due to their content, and with targeted goals and purposes beyond entertainment. Aim The aim of this investigation was to describe the development of a serious game, VirtualTer, and to test content validity. Methods A Brazilian group from the Federal University of Rio Grande do Norte developed a serious game called VirtualTer for postural balance rehabilitation in older adults. In game navigation, the avatar needed to save the environment from catching harmful energy that destroys nature. The avatar performs stationary walking, lateral reaching, and climbing up and down steps to capture the energies. Content validity was determined using content matter experts by the Delphi method. Eleven content matter experts played the game and expressed their opinions using the assessment instruments: VirtualTer Dimensions (VD) and System Usability Scale (SUS). Results VirtualTer was designed with regard to variability in practice, since the game was constructed under three levels and offers continuous and terminal feedback. The participants needed to achieve at least 70% of the total score to advance to the next phase. The limits of stability for lateral reach test were right 23.2 ± 4.77 cm and left 22.9 ± 4.86 cm, which was applied in the game. The content validity index of the VD was 0.8, and Cronbach’s alpha coefficient was 0.924. The content matter experts reported the game as having a 67.73 satisfaction with the SUS. Conclusion This game has good usability, low-cost investment, and supports access to innovative and valid technology for rehabilitation in countries with little investment in technology for health.