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Neste estudo foram avaliados os efeitos de restrições biomecânicas e de carga sobre a adaptação de respostas posturais automáticas (RPAs) a perturbações externas não-antecipadas. No Experimento 1 o objetivo foi avaliar o efeito do ângulo de orientação dos pés em RPAs causadas por perturbações de diferentes magnitudes. A perturbação foi gerada a partir da liberação inesperada de carga presa ao tronco do participante, levando à oscilação anterior do corpo. Foram avaliadas RPAs para cargas correspondendo a 5% e 10% do peso corporal do participante, comparando as seguintes orientações dos pés: paralelos, preferida (M = 10,46°), 15° e 30° para cada pé a partir da linha média do corpo. Os resultados mostraram que a perturbação com a carga 10% levou a maiores deslocamentos do centro de pressão e rotação das articulações, além de respostas musculares mais fortes e mais rápidas. Os pés orientados em 30° levaram ao maior deslocamento do centro de pressão em comparação com as outras angulações. A perturbação com a carga 5% levou a respostas similares para ambas as articulações, enquanto que com a carga 10% a amplitude de rotação das articulações foi maior com pés orientados em 30°. No Experimento 2, os objetivos foram avaliar o efeito de tentativas prévias com carga distinta, e a adaptação das respostas posturais em tentativas repetidas com mesma carga, em RPAs a uma perturbação não-antecipada. Foram empregadas três cargas para perturbação: 6%, 8% e 10% do peso corporal do participante. Este experimento foi realizado por meio da comparação de dois grupos: sequência alta-baixa, para o qual a ordem de aplicação das cargas se dava de forma decrescente; e sequência baixa-alta, para o qual a ordem de aplicação das cargas se dava de forma crescente. Os resultados mostraram que as respostas posturais foram graduadas de acordo com a magnitude da carga. O efeito de sequência de cargas foi observado na maior amplitude de deslocamento do centro de pressão para o grupo decrescente em relação ao crescente. A análise do centro de massa indicou adaptação intertentativas, com redução progressiva da amplitude de deslocamento entre a primeira e a última tentativa na carga de 10%. Esses resultados sugerem que respostas posturais reativas são produzidas levando em consideração não apenas feedback sensorial, mas também respostas posturais precedentes. Em uma análise global, os resultados deste estudo revelam a sensibilidade do sistema de controle postural a fatores contextuais, incluindo restrições biomecânicas e respostas a perturbações prévias, na geração de respostas posturais automáticas a uma perturbação da estabilidade do equilíbrio corporal / In this study we evaluated the effects of biomechanical constraints and load on the adaptation of automatic postural responses (APRs) to external perturbations of different magnitudes. The objective of Experiment 1 was to evaluate the effect of feet orientation angle in APRs caused by perturbations of different magnitudes. The perturbation was generated through unexpected load release attached to the participant\'s trunk, leading to forward body sway. APRs were evaluated for loads corresponding to 5% and 10% of participant\'s body weight, comparing the following feet orientations: parallel, preferred (M = 10.46°), 15° and 30° for each foot regarding the body midline. Results showed that APRs were sensitive to perturbation magnitude, with 10% load leading to higher center of pressure displacement and amplitude of leg joints rotation, in addition to stronger and faster muscle responses. Feet oriented at 30° led to higher center of pressure displacement compared to other angles. The 5% load led to similar responses for both the hip and ankle joints in the different orientations, while for the 10% load amplitude of legs joints rotation was higher for the feet oriented at 30° in comparison with the other orientation angles. In Experiment 2, we evaluate the effects of previous responses to a different perturbation load, and adaptation to the same load over repeated perturbations, on APRs to unanticipated perturbations. Three perturbation loads were employed: 6%, 8% and 10% of participant\'s body weight. The experiment was performed by comparing two groups: high-low sequence, with decreasing sequence of loads; and low-high sequence, with increasing sequence of loads. Results showed that postural responses were scaled according to load magnitude. The decreasing loads sequence led to higher amplitudes of center of pressure displacement in comparison to the increasing sequence. Analysis of center of mass indicated intertrials adaptation, with progressive reduction of amplitude displacement between the first and last trial in the 10% load. These results suggest that reactive postural responses are produced taking into consideration not only sensory feedback but also previous postural responses. Overall, results from this study reveal the sensitivity of the postural control system to contextual factors, including biomechanical constraints and responses to previous perturbations, in the generation of automatic postural responses to an unanticipated perturbation of balance stability.

Neste estudo foram avaliados os efeitos de restrições biomecânicas e de carga sobre a adaptação de respostas posturais automáticas (RPAs) a perturbações externas não-antecipadas. No Experimento 1 o objetivo foi avaliar o efeito do ângulo de orientação dos pés em RPAs causadas por perturbações de diferentes magnitudes. A perturbação foi gerada a partir da liberação inesperada de carga presa ao tronco do participante, levando à oscilação anterior do corpo. Foram avaliadas RPAs para cargas correspondendo a 5% e 10% do peso corporal do participante, comparando as seguintes orientações dos pés: paralelos, preferida (M = 10,46°), 15° e 30° para cada pé a partir da linha média do corpo. Os resultados mostraram que a perturbação com a carga 10% levou a maiores deslocamentos do centro de pressão e rotação das articulações, além de respostas musculares mais fortes e mais rápidas. Os pés orientados em 30° levaram ao maior deslocamento do centro de pressão em comparação com as outras angulações. A perturbação com a carga 5% levou a respostas similares para ambas as articulações, enquanto que com a carga 10% a amplitude de rotação das articulações foi maior com pés orientados em 30°. No Experimento 2, os objetivos foram avaliar o efeito de tentativas prévias com carga distinta, e a adaptação das respostas posturais em tentativas repetidas com mesma carga, em RPAs a uma perturbação não-antecipada. Foram empregadas três cargas para perturbação: 6%, 8% e 10% do peso corporal do participante. Este experimento foi realizado por meio da comparação de dois grupos: sequência alta-baixa, para o qual a ordem de aplicação das cargas se dava de forma decrescente; e sequência baixa-alta, para o qual a ordem de aplicação das cargas se dava de forma crescente. Os resultados mostraram que as respostas posturais foram graduadas de acordo com a magnitude da carga. O efeito de sequência de cargas foi observado na maior amplitude de deslocamento do centro de pressão para o grupo decrescente em relação ao crescente. A análise do centro de massa indicou adaptação intertentativas, com redução progressiva da amplitude de deslocamento entre a primeira e a última tentativa na carga de 10%. Esses resultados sugerem que respostas posturais reativas são produzidas levando em consideração não apenas feedback sensorial, mas também respostas posturais precedentes. Em uma análise global, os resultados deste estudo revelam a sensibilidade do sistema de controle postural a fatores contextuais, incluindo restrições biomecânicas e respostas a perturbações prévias, na geração de respostas posturais automáticas a uma perturbação da estabilidade do equilíbrio corporal / In this study we evaluated the effects of biomechanical constraints and load on the adaptation of automatic postural responses (APRs) to external perturbations of different magnitudes. The objective of Experiment 1 was to evaluate the effect of feet orientation angle in APRs caused by perturbations of different magnitudes. The perturbation was generated through unexpected load release attached to the participant\'s trunk, leading to forward body sway. APRs were evaluated for loads corresponding to 5% and 10% of participant\'s body weight, comparing the following feet orientations: parallel, preferred (M = 10.46°), 15° and 30° for each foot regarding the body midline. Results showed that APRs were sensitive to perturbation magnitude, with 10% load leading to higher center of pressure displacement and amplitude of leg joints rotation, in addition to stronger and faster muscle responses. Feet oriented at 30° led to higher center of pressure displacement compared to other angles. The 5% load led to similar responses for both the hip and ankle joints in the different orientations, while for the 10% load amplitude of legs joints rotation was higher for the feet oriented at 30° in comparison with the other orientation angles. In Experiment 2, we evaluate the effects of previous responses to a different perturbation load, and adaptation to the same load over repeated perturbations, on APRs to unanticipated perturbations. Three perturbation loads were employed: 6%, 8% and 10% of participant\'s body weight. The experiment was performed by comparing two groups: high-low sequence, with decreasing sequence of loads; and low-high sequence, with increasing sequence of loads. Results showed that postural responses were scaled according to load magnitude. The decreasing loads sequence led to higher amplitudes of center of pressure displacement in comparison to the increasing sequence. Analysis of center of mass indicated intertrials adaptation, with progressive reduction of amplitude displacement between the first and last trial in the 10% load. These results suggest that reactive postural responses are produced taking into consideration not only sensory feedback but also previous postural responses. Overall, results from this study reveal the sensitivity of the postural control system to contextual factors, including biomechanical constraints and responses to previous perturbations, in the generation of automatic postural responses to an unanticipated perturbation of balance stability.

The purpose of this study was to investigate the effects of Swiss ball training on (1) knee joint reposition sense (knee proprioception), (2) core muscle strength and (3) dynamic balance in sedentary collegiate students. In this thesis, two different participant groups and two different training methods were used. In order to evaluate the effect of Swiss ball training on knee proprioception and core strength, 3 days per week training was conducted throughout 10 weeks (Study 1). In order to evaluate the effect of Swiss ball training on dynamic balance, 2 days per week training was conducted throughout 10 weeks (Study 2). 60 sedentary university students participated in Study 1. 47 sedentary university students participated in Study 2. The results of the study indicated that Swiss ball training has significant effect on knee proprioception and core muscle strength. For dynamic balance, at the end of the 10-week Swiss ball training, in both groups (Swiss ball and control), dynamic balance scores were improved significantly. Therefore, effect of the Swiss ball training on dynamic balance could not be determined. As a conclusion, an instability training program using Swiss balls with body weight as resistance can provide prolonged improvements in joint proprioception and core strength which would contribute to general health and performance.

Submitted in partial compliance with the requirements for the Master of Technology: Chiropractic, Durban University of Technology, 2014. / Background: Poor balance is a risk factor for injury in adolescent sport including soccer. Despite the rapid growth in female adolescent soccer especially in South Africa, the association between balance and injury in this population has not been fully explored. This study aimed to determine the relationship between injury and balance. Static and dynamic balance was monitored as sway index (SI) and limits of stability direction control (LOSDC). Objectives: The objectives of this study were to determine the body mass index of adolescent female soccer players; to determine the prevalence of injury in adolescent female soccer players; to determine static balance as revealed by the sway index (SI); to determine dynamic stability as revealed by limits of stability direction control (LOSDC) and to correlate body mass index (BMI) to sway index and limits of stability. Method: Eighty adolescent female soccer players, between the ages of fourteen and eighteen, were recruited through convenience sampling from schools in the eThekwini district of KwaZulu-Natal. After obtaining informed consent and assent, participants completed questionnaires and were scheduled for the balance and BMI assessments. The objective data for each participant consisted of height, weight, Sway Index (SI) and Limits of Stability Direction Control (LOSDC) readings, measured using a stadiometer, electronic scale and Biodex Biosway Balance System (Biodex Medical Systems Inc., Shirley, New York) respectively. The subjective and objective data were analyzed using SPSS version 21.0 (SPSS Inc. Chicago, Ill, USA). Statistical tests included descriptive statistics using frequency and cross-tabulation. Inferential statistics using t-tests and Pearson’s correlations at a significance level of 0.05 was also incorporated. The testing of hypotheses was performed using Fisher’s Exact tests for nominal data and ordinal data. A p value of < 0.05 was considered as statistically significant. The statistical analysis also included Odds Ratio calculations. Results: The mean body mass index of the injured participants was 23.54±3.56 kg/m2 and the mean body mass index of the uninjured participants was 23.00±4.63. Only 27.5% of the participants sustained an injury. Injured participants performed poorly on average in the SI assessment involving their eyes open when standing on a soft surface. The results were similar for the LOSDC in the overall, right, left, backward-right and backward-left directions. However, there were no significant correlations calculated. Significant relationships existed between BMI and the SI assessments in the injured participants which involved standing on a firm surface with their eyes open (p = 0.05), their eyes closed when also standing on a firm surface (p = 0.05), their eyes open when standing on a soft surface (p = 0.02), and their eyes closed when standing on a soft surface (p = 0.04). A significant relationship also existed between BMI and LOS right direction control (p = 0.02). Conclusion: This research paper revealed that the body mass index as investigated in this study is similar to other studies involving female adolescents; soccer injury as investigated in this study is similar to other studies involving female adolescents; poor static and dynamic balance is not associated with injury in adolescent female soccer players and lastly, body mass index is linked to the balance of an individual.

After a stroke, gait and balance are often affected and an orthosis is typically required to facilitate postural control. This study has been conducted to examine how the Range of Motion in an Ankle-Foot-Orthosis (AFO) impacts on stroke patients’ dynamic balance. It was hypothesized that better dynamic balance would be recorded when individuals were wearing a flexible AFO. The tests that was used in this study were the Timed Up and Go test (TUG), and the Center of Pressure (CoP)/Center of Mass (CoM) inclination angle, both in Anterior-Posterior (AP) and Medio-Lateral (ML) planes. The three patients participating in this study were all users, or had been users of AFO’s, and during the study they were asked to wear a customized AFO with the possibility to change the settings to open, flexible and rigid ankle joints. The order was randomized within each patient. No clear pattern was observed across all patients, either in the TUG test or CoP/CoM inclination angles. Further studies are required to explore the impact that AFO flexibility has on dynamic balance in individuals who have had a stroke.

Bakgrund: Tio till tjugo procent av akuta skador på ligamenten kring fotleden resulterar ikronisk fotledsinstabilitet, vilket innebär en instabilitetskänsla, stukningstendens, smärta ochsvullnad i fotleden. Det är värdefullt att som fysioterapeut ha kunskap om vilkenrehabiliteringsmetod som förbättrar balans i syfte att öka stabiliteten i foten. Syfte: Sammanställa litteraturen och bedöma det vetenskapliga underlaget gällande effektenpå balansen hos individer med kronisk fotledsinstabilitet genom träning med balansbräda.Detta ställs upp i två sammanvägningar: balansbräda jämfört med styrketräning, ochbalansbräda jämfört med ingen behandling. Metod: En systematisk litteratursökning efter randomiserade kontrollerade studier utfördes idatabaserna PubMed, Uppsala universitetsbibliotek, samt Cochrane Library. Totaltinkluderades åtta studier med sammanlagt 286 deltagare. Samtliga studier kvalitetsgranskadesenligt PEDro-skalan, och GRADEstud användes för bedömning av det sammanvägdaresultatets tillförlitlighet. Resultat: Signifikant förbättring av balans kopplat till styrketräning samt balansträning medbalansbräda, men liten fördel för en kombination för de båda kopplat till statisk balans. Kvalitetsgranskning enligt PEDro visade på att sex studier hade en måttlig kvalité och tvåstudier hade hög kvalité. Utifrån evidensbedömningen anses det föreligga en lågtillförlitlighet till det vetenskapliga underlaget för styrketräning med motståndsband förfotleden samt balansträning med balansbräda. Konklusion: Både styrketräning för relevant muskulatur och balansträning med balansbrädaförbättrar balansen efter ett ≥4 veckor långt protokoll med ≥3 träningssessioner/vecka.Evidensen talar för att båda rehabiliteringsmetoder ger liknande utfall, men fler studierbehövs för att bekräfta resultatet då de sammanvägda resultaten har låg tillförlitlighet. / Background: Ten to twenty percent of acute ankle injuries result in chronic ankle instability,which results in instability in the foot, distorsion tendency, and pain and swelling around theankle. Thus it´s valuable for physiotherapists to have knowledge regarding whichrehabilitation methods yield the most positive effect on balance in order to increase stabilityin the foot. Purpose: To compile the literature and assess the evidence regarding the effects on balanceof people diagnosed with chronic ankle instability through rehabilitation with awobble-board. This is set up in two comparisons: wobble-board compared tostrength-training, and wobble-board compared to no treatment. Method: A systematic literature search for randomized controlled trials was done inPubMed, Uppsala University Library, and CochraneLibrary. A total of eight studies wereincluded in this review, with a total of 286 participants. Study quality was judged by using the PEDro-scale, and GRADEstud was used to assess the reliability of the combined results. Results: Significant improvement in balance related to resistance training and balancetraining with wobble-board, with a small advantage to training with a combination of the twowhen measuring static balance. Quality according to PEDro showed six studies of moderatequality and two studies of high quality. Grading of the evidence is deemed insufficient whenit comes to training with resistance bands and training with a wobble-board. Conclusion: Both strength-training for the relevant muscles and balance-training using thewobble-board improves the balance after a ≥4 week-long protocol with ≥3 sessions/week.The evidence shows that both methods give similar results, however further research isrequired to confirm the results because the reliability of the combined results was deemedinsufficient.

Bakgrund: Knäskador är vanligt förekommande bland yngre fysiskt aktiva personer. Ofta skadas flera strukturer samtidigt vilket medför att den mekaniska stabiliteten i knäleden försämras samt att den neuromuskulära funktionen i benet försämras, vilket påverkar den posturala kontrollen samt stabiliteten på knät. För att upptäcka instabilitet behövs mer utmanande och specifika test som Star Excursion Balance Test (SEBT). I dagsläget saknas studier gjorda med SEBT på en svensk population. Fysioterapeuter är beroende av tillförlitliga instrument för att kunna göra en korrekt bedömning. Syfte: Syftet med studien var att undersöka test-retest reliabiliteten för SEBT samt att undersöka samtidig validitet mellan SEBT och Unilateral Stance test (UST) för personer med knäproblematik.Syftet var dessutom att undersöka hur den posturala kontrollen var för personer i åldrarna 20-30 år med knäproblematik mätt med SEBT och UST. Metod: Studien var gjord med en icke experimentell design som var både deskriptiv och korrelerande. Alla tester gjordes vid ett tillfälle med 5 minuters vila mellan testerna. I studien ingick 30 personer med diagnostiserad alternativt självupplevd knäproblematik i åldern 20-30 år som studerade på Biomedicinskt centrum vid Uppsala Universitet. Resultat: Den posturala kontrollen för testpersonerna (n=30) var uppmätt till god både mätt med både SEBT och UST. Validiteten mellan SEBT och UST var låg r=0,3 (p=0,12). Test-retest reliabiliteten för SEBT var god r=0,74 (p=0.00013). Konklusion: SEBT har en god interbedömarreliabilitet. Korrelationen mellan UST och SEBT var låg. SEBT är ett test som är ett väldigt specifikt test där man behöver både material och tid för utförandet. Det behövs mer studier för att få fram om testet går att användas effektivt på allmänna kliniker som ett utvärderingsinstrument för postural kontroll. Keywords: Postural balance, Dynamic balance, Reliability, Validity, Star excursion balance test (SEBT), Unilateral stance test (UST), knee injury.

Estudos prévios têm indicado que o aumento da demanda de estabilidade manual induz maior estabilidade do equilíbrio corporal no controle das posturas quieta e perturbada. O presente estudo teve por objetivo avaliar o efeito da demanda de estabilidade imposta por uma tarefa manual sobre a regulação postural dinâmica em função da frequência de oscilação da base de suporte. Participaram desse estudo 20 estudantes universitários de ambos os sexos. A tarefa consistiu em manter um cilindro o mais estável possível sobre uma bandeja enquanto o equilíbrio em postura ereta era mantido em translações sinusoidais contínuas da plataforma móvel por 1 min., nas frequências de 0,4 Hz (baixa) ou 1 Hz (alta). A demanda de estabilidade manual foi manipulada por meio da disposição do cilindro. Na condição chamada de alta restrição (AR), o cilindro foi apoiado sobre sua face circular; na condição chamada de baixa restrição (BR), o cilindro foi apoiado sobre sua face plana. Os resultados mostraram que AR induziu menores amplitudes de oscilações de cabeça, centro de massa e bandeja na frequência de 0,4 Hz, porém não na frequência de 1 Hz. A análise das variáveis de coordenação revelou que na frequência de 0,4 Hz, AR levou a maiores valores de fase relativa entre as rotações cíclicas de tornozelo-quadril e tornozelo-ombro, como também na coordenação entre CM-plataforma e CP-plataforma. As análises mostraram que a condição de alta restrição também afetou o controle postural e manual na frequência de oscilação de 1 Hz, com aumento da amplitude de oscilação de CP e de rotações do ombro. Estes resultados sugerem que o controle postural dinâmico é regulado em diferentes parâmetros de maneira integrada e flexível, com interação recíproca entre os componentes da tarefa manual e postural, para atender à demanda de estabilidade imposta por uma tarefa posturomanual / Previous studies have indicated that increased steadiness constraints given by a manual task leads to gains of postural stability in quiet and perturbed standing. The aim of the present study was to evaluate the effects of manual task constraints on the regulation of dynamic postural control according to the frequency of sinusoidal translations of the base of support. Twenty university students performed a dual posturomanual task consisting of maintaining a cylinder on a handheld tray as stable as possible while maintaining the dynamic upright balance on a platform oscillating in sinusoidal translations at 0.4 Hz (low) or 1 Hz (high) frequencies during intervals of 1 min. The effects of manual task were studied through the manipulation of task constraint conditions set by positioning the cylinder supported on its round or flat side, corresponding respectively to high (HC) and low (LC) manual task constraints. Results showed that HC led to reduced oscillation amplitudes of the head, center of mass, and tray at 0.4 Hz, but not at 1 Hz. The coordination variables indicated that at 0.4 Hz, HC led to increased relative phase values between ankle-shoulder and hip-shoulder rotations, as also between center of mass-feet and center of pressure-feet oscillations in the slow oscillation frequency. Further analyses showed that the high manual task constraint also affected variables related to both postural and manual task components at 1 Hz, with increased center of pressure and shoulder rotation amplitudes of oscillation. These results suggest that dynamic postural control is regulated through different parameters in a flexible and integrated way in order to attend the stability demands imposed by a posturomanual task

Tyrimo objektas: Kineziterapijos ir kinezioteipavimo momentinis poveikis statinei ir dinaminei pusiausvyrai prieš priekinio kryžminio raiščio operaciją. Tyrimo tikslas: Nustatyti kineziterapijos ir kinezioteipavimo momentinį poveikį statinei bei dinaminei pusiausvyrai prieš priekinio kryžminio raiščio operaciją. Tyrimo uždaviniai: 1. Nustatyti kineziterapijos poveikį statinei ir dinaminei pusiausvyrai prieš priekinio kryžminio raiščio operaciją. 2. Nustatyti kinezioteipavimo momentinį poveikį statinei ir dinaminei pusiausvyrai taikant kineziterapiją prieš priekinio kryžminio raiščio operaciją. Tyrimo hipotezė: Manome, kad tiriamiesiems prieš priekinio kryžminio raiščio operaciją, taikyta kineziterapija pagerins statinę ir dinaminę pusiausvyrą. Be to, pusiausvyra stovint ant pažeistos kojos bus geresnė su kinezioteipu. Tyrimo rezultatai: Nustatėme, kad svyravimai Ax ir Ay ašyse, stovint ant pažeistos kojos, buvo statistiškai reikšmingai mažesni po kineziterapijos. Taip pat, po kineziterapijos pagerėjo pusiausvyra Ax ašyje stovint ant sveikos kojos. Pusiausvyra po šuolio stovint ant sveikos ir pažeistos kojos statistiškai reikšmingai pagerėjo po kineziterapijos Ay ašyje. Stovint ant pažeistos kojos su kinezioteipu, nustatėme statistiškai patikimą skirtumą tarp dinaminės pusiausvyros stovint ant pažeistos kojos be kinezioteipo ir su juo. Pusiausvyra pagerėjo Ax ir Ay ašyse. Išvados: 1. Po kineziterapijos pagerėjo statinė pusiausvyra pirmyn - atgal ir šonine kryptimis stovint ant... [toliau žr. visą tekstą] / Object of the study: The effect of physical therapy and instantaneous kinesio taping for static and dynamic balance before anterior cruciate ligament surgery. Aim of the study: To investigate effect of physical therapy and the instantaneous kinesio taping for static and dynamic balance before anterior cruciate ligament surgery. Goals of the study: 1. To investigate the effect of physical therapy for static and dynamic balance before anterior cruciate ligament surgery. 2. To investigate the instantaneous effect of kinesio taping for static and dynamic balance before anterior cruciate ligament surgery. Hypothesis of the study: We think that, static and dynamic balance will improve after physical therapy before anterior cruciate ligament surgery. Moreover, the balance of the injured limb will improve after instantaneous kinesio taping. Results of the study: We found that variations of standing on injured limb was significantly lower after physical therapy in Ax and Ay axis. Also, balance of healthy limb improved after physical therapy. Moreover, the balance after jump of injured and healthy leg improved in Ay axis after physical therapy. Dynamic balance improved with kinesio tape on injured limb before physical therapy. Conclusions: 1. Static balance forward - backward and side to side improved after physical therapy. Moreover, static balance standing on the injured limb improved side to side. Furthermore, dynamic side to side balance improved in both limbs after physical... [to full text]