Tyrimo problema: Apie 2,5 mln. žmonių visame pasaulyje serga išsėtine skleroze. Lietuva priklauso didelio sergamumo išsėtine skleroze zonai (Kizlaitienė, 2008). Vienas iš pagrindinių simptomų, pasireiškiančių ankstyvoje šios ligos stadijoje, yra pusiausvyros sutrikimas (Prosperini et al., 2010; Cameron et al., 2008; Martin, Phillips, 2006). Darbo aktualumas: Kinezioteipas yra lengvai prieinama ir neivazinė priemonė, galinti pagerinti sergančiųjų išsėtine skleroze statinę ir dinaminę pusiausvyrą, gyvenimo kokybę, sumažinti griuvimų riziką. Tyrimo hipotezė: Kinezioteipas, užklijuotas ant dvilypio ir priekinio blauzdos raumens, gali pagerinti sergančiųjų išsėtine skleroze statinę ir dinaminę pusiausvyrą. Tyrimo tikslas: Nustatyti kinezioteipo poveikį sergančiųjų išsėtine skleroze statinei ir dinaminei pusiausvyrai. Tyrimo uždaviniai: 1. Įvertinti tiriamųjų statinę ir dinaminę pusiausvyrą su kinezioteipu, užklijuotu ant dvilypio ir priekinio blauzdos raumens funkcine korekcine technika. 2. Įvertinti tiriamųjų statinę ir dinaminę pusiausvyrą su kinezioteipu, užklijuotu placebo ant keturgalvio raumens. 3. Įvertinti skirtingų kinezioteipavimo technikų efektyvumą tiriamųjų statinei ir dinaminei pusiausvyrai. Tyrimo metodai: Tyrimas atliktas Lietuvos Sveikatos Mokslų Universiteto Reabilitacijos Klinikoje, 2014 kovo 21 – 28 dienomis, jame dalyvavo 48 darbingi asmenys, sergantys išsėtine skleroze. Atliktas aklas vienpusis tyrimas, tiriamieji atsitiktiniu atrankos būdu suskirstyti į... [toliau žr. visą tekstą] / Abaut 2,5 million people suffer from multiple sclerosis. Lithuania belongs to a zone of high rate of people suffering from this desease (Klizaitienė, 2008). On of the main symptoms, appearing in the early stage of this desease is imbalance (Prosperini et al., 2010; Cameron et al., 2008; Martin & Phillips, 2006). Relevance of the topic: Kinesio Tape is a available and non-invasive means which can improve static balance, quality of life and reduce coincidental risk of falls for those who have multiple sclerosis. Hypothesis: Kinesio Tape sticked to gastrocnemius and tibialis anterior muscle can improve the postural stability of those who have multiple sclerosis. The aim of the research: To establish the effect of the Kinesio Tape of those who suffer from multiple sclerosis and to estimate the postural stability. The task of the research: 1. Estimate the static and dynamic posture with Kinesio Tape sticked on the gastrocnemius and tibialis anterior muscle with the help of functional correctional technique. 2. Estimate the static and dynamic posture with Kinesio Tape sticked on the quadriceps muscle with the placebo technique. 3. Estimate the efficiency of Kinesio Tape on postural stability of those who were in the research. Methods of the research: The study was conducted in Lithuanian University of Health Sciences, in Rehabilitation clinic in March 21th – 28th. There were 48 patients with Multiple Sclerosis participating in the study. The patients were randomized into two... [to full text]

Dizziness and balance problems are common symptoms at all ages. The aims were; to evaluate rehabilitation, static, dynamic balance and recovery in acute unilateral vestibular loss (AUVL), to evaluate the treatment of benign paroxysmal positional vertigo (BPPV) with assessment of static and dynamic balance and to evaluate the prevalence of dizziness and BPPV in a population of 75-year-olds. Study 1: Twenty-seven patients (51years) with AUVL were included and the recovery was followed regarding vestibular function, dizziness, and sick-leave. The recovery was rapid, with disappearance of spontaneous nystagmus and rapid return to work. Study II: Forty two patents (51 years) with AUVL were included and compared with a reference group. Static and dynamic balance were assessed after six months. Significant instability was found both in static and dynamic balance compared to a reference group. Study III: Seventeen patients (52 years) with severe BPPV (> 3 months) were treated with Semonts´s manouver and/or Brandt-Daroff exercises. The recovery was evaluated by Dix-Hallpike test, subjective dizziness, unsteadiness and balance tests, after 1, 6 and 12 months. Semont´s maneouver resolved dizziness but the long term follow up showed impaired balance. Study IV: A large cohort (675) of elderly was assessed regarding dizziness and BPPV. Side lying test and balance tests were applied. A high prevalence of dizziness (36%) and BPPV (11%) was found. Conclusions: Patients with AUVL and BPPV have despite good symptomatic relief, still impaired static and dynamic balance at long term follow up. BPPV in elderly is common and should be examined since it can be treated.

1 Abstract Title: Dynamic competitive balance in European football leagues Objectives The quality of objective of this master thesis is the analysis of dynamic competitive balance of ten European football leagues. Namely the English league, the German league, the Dutch league, the Greek league, the Romanian league, the Czech league, the Danish league, the Polish league, the Cyprian league, the and the Bulgarian league and their comparison. Methods: Dynamic competitive balance showed by the Lorenz curve of the number of league champions during the period under review. Results: The results show comparison of dynamic competitive balance in top European leagues. Further refute or confirm the established assumption of same trend in the designated groups divided by market value and competitive format. Key words: Football, competition, dynamic balance, Lorenz curve, league market value, competitive format

Made available in DSpace on 2014-06-11T19:22:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-12-13Bitstream added on 2014-06-13T19:08:24Z : No. of bitstreams: 1 caetano_mjd_me_rcla.pdf: 817407 bytes, checksum: f99f3e12cec3f7e3ecd3ea982d13c044 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Andar é essencial para o desempenho das funções diárias. No entanto, as alterações morfofuncionais decorrentes do processo de envelhecimento podem comprometer o equilíbrio durante o andar e gerar instabilidade. Este comprometimento é ainda mais acentuado em idosos com doença de Parkinson devido aos distúrbios motores ocasionados pela doença. Neste contexto, os objetivos do presente estudo foram: 1) analisar as características espaço-temporais e os ângulos articulares de indivíduos idosos neurologicamente sadios e com doença de Parkinson idiopática andando livremente e em condições de restrição na largura e na altura da superfície de suporte; 2) relacionar estes parâmetros com as pontuações nas escalas de H&Y e UPDRS (apenas para os pacientes) e com a incidência de queda recente (1 ano) e pontuações na Escala de Equilíbrio Funcional de Berg (para ambos os grupos). Participaram 16 idosos distribuídos em dois grupos: oito idosos neurologicamente sadios e oito com doença de Parkinson idiopática. As características espaço-temporais e os ângulos articulares andando livremente e em condições de restrição na largura e na altura da superfície de suporte foram investigados por meio de ferramenta cinemática. Pacientes com doença de Parkinson apresentaram valores médios significativamente menores que os idosos neurologicamente sadios em relação à duração da fase de balanço e ao comprimento e velocidade da passada e maiores para a duração do duplo suporte devido à hipocinesia, à dificuldade no controle do equilíbrio e ao próprio relacionamento entre as variáveis. As restrições impostas pela superfície de suporte geraram alterações nas características espaço-temporais e angulares do andar dos idosos de ambos os grupos, devido à necessidade de adotar uma estratégia cautelosa que facilite o controle da locomoção, garantindo estabilidade, e ao medo de cair imposto pelas demandas da tarefa,... / Walking is crucial for the performance of daily living activities. However, morpho and functional changes due to the aging process can compromise the balance during walking and generate instability. It is more pronounced in elderly patients with Parkinson’s disease due to the motor signs/symptoms of the disease. In this context, the aims of this study were: 1) to analyze the spatial and temporal parameters and joint angles of healthy elderly and with Parkinson’s disease during free walking and under width and height constraints of the support surface; 2) to correlate these parameters with the scores in H&Y scale and UPDRS (only for patients) and with the occurrence of recent fall (1 year) and the scores in the Berg Functional Balance Scale (for both groups). Sixteen elderly were distributed in two groups: 8 healthy elderly and 8 idiopathic Parkinson’s disease patients. Both the spatial and temporal parameters of gait and joint angles were investigated by means of kinematics tools during free walking and under width and height constraints of the support surface. Parkinson’s disease patients showed significantly lower mean values than healthy elderly for swing phase duration, stride length and stride velocity, and higher double support duration due to the hipokinesia, the difficulty in balance control, and the relationship among the gait variables. The support surface constraints changed the gait spatial and temporal parameters and joint angles in both groups due to the necessity to perform a cautious walking strategy that can facilitate the locomotor control, preventing instability, and the fear of falling enforced by the task demands, specially when width and height constraints were associated. The scores in H&Y and UPDRS were not correlated to the gait parameters of the Parkinson’s disease patients probably because the scales did not reflect the gait performance of patients under medication. There were a relationship among the gait .

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-25T18:06:07Z No. of bitstreams: 1 Roberta Delasta Lazzari.pdf: 2200811 bytes, checksum: 37290c6b343d6e2ca53090aceb0d4682 (MD5) / Made available in DSpace on 2016-05-25T18:06:07Z (GMT). No. of bitstreams: 1 Roberta Delasta Lazzari.pdf: 2200811 bytes, checksum: 37290c6b343d6e2ca53090aceb0d4682 (MD5) Previous issue date: 2015-02-26 / Purpose: To investigate the effects of transcranial direct current stimulation in the primary motor cortex, associated with mobility training with virtual reality on the static and functional balance of children with cerebral palsy (CP). Materials and Methods: The population sample that was part of this project consisted of 24 children with CP between 4 and 12 years old. The children were divided randomly into two groups (control group: mobility training with virtual reality and use transcranial stimulation placebo; Experimental Group: mobility training using virtual reality and transcranial stimulation active) and evaluated at four different times (pre -intervention, immediately after the first session, after the intervention and one month after intervention). The static balance was evaluated by force platform in four conditions: feet flat on the platform with open eyes, feet on the platform with eyes closed, feet in the open foam eyes, feet foam eyes closed for 30 seconds each. The Functional Balance was measured by Pediatric Balance Scale(PBS) and Timed Up and Go(TUG). Results: The analysis of the immediate effect of treatment with transcranial Direct Current Stimulation (tDCS) only sway velocity showed a significant interaction. In the analysis of the effects of the training area, Center of Pressure (COP) speed and frequency presented significatia interaction as well as the EEP and TUG Conclusion: It is suggested that tDCS interferes with the static and functional balance of children with CP. / Objetivo: Verificar os efeitos da estimulação transcraniana por corrente contínua no córtex motor primário, associada ao treino mobilidade com realidade virtual sobre o equilíbrio estático e funcional de crianças com paralisia cerebral (PC). Materiais e Métodos: A amostra populacional que fez parte deste projeto foi composta de 24 crianças com PC entre 4 e 12 anos de idade. As crianças foram alocadas aleatoriamente em dois grupos (Grupo Controle: treino de mobilidade com uso de realidade virtual e estimulação transcraniana placebo; Grupo Experimental: treino de mobilidade com o uso de realidade virtual e estimulação transcraniana ativa) e avaliadas em quatro momentos distintos (pré-intervenção,imediatamente após a primeira sessão, pós-intervenção e um mês após as intervenções). O equilíbrio estático foi avaliado através da plataforma de força em quatro condições: pés apoiados na plataforma com olhos abertos, pés na plataforma com olhos fechados, pés na espuma olhos abertos, pés espuma olhos fechados, por 30 segundos cada. O Equilíbrio Funcional foi medido por meio da Escala de Equilíbrio Pediátrica (EEP) e Timed Up and Go (TUG). Resultados: Na Análise do Efeito imediato do tratamento com Estimulação Transcraniana por Corrente Contínua(ETCC) somente a velocidade de oscilação apresentou interação significativa. Já na análise dos efeitos do Treinamento a área, velocidade e frequência do Centro de Pressão (CoP) apresentaram interação significatia, bem como o EEP e TUG Conclusão: Sugere-se que a ETCC interfere sobre o equilíbrio estático e funcional de crianças com PC.

<p>У тези су анализиране карактеристичне компензационе стратегије, за<br />које је уочено да их човек често примењује. На основу анализе су<br />дефинисане предности и мане сваке од стратегија. Након тога је<br />приказан систем за приоритетизацију задатака, ради истраживања<br />могућности симултане реализације више задатака. Да би се омогућило<br />укључивање различитих задатака и ограничења развијен је формални<br />начин њиховог записивања. Посебна пажња је дата ограничењима која<br />настају као последица контакта са околином. Развијена је методологија<br />којом се утврђује да ли неки од постојећих контаката може бити<br />раскинут а да жељени покрет буде изводив, као и да ли је ради<br />реализације намераваног покрета потребно успоставити нови контакт.<br />Укључивањем ограничења у систем за приоритетизацију је добијена<br />методологија за модификацију покрета у присуству ограничења.</p> / <p>U tezi su analizirane karakteristične kompenzacione strategije, za<br />koje je uočeno da ih čovek često primenjuje. Na osnovu analize su<br />definisane prednosti i mane svake od strategija. Nakon toga je<br />prikazan sistem za prioritetizaciju zadataka, radi istraživanja<br />mogućnosti simultane realizacije više zadataka. Da bi se omogućilo<br />uključivanje različitih zadataka i ograničenja razvijen je formalni<br />način njihovog zapisivanja. Posebna pažnja je data ograničenjima koja<br />nastaju kao posledica kontakta sa okolinom. Razvijena je metodologija<br />kojom se utvrđuje da li neki od postojećih kontakata može biti<br />raskinut a da željeni pokret bude izvodiv, kao i da li je radi<br />realizacije nameravanog pokreta potrebno uspostaviti novi kontakt.<br />Uključivanjem ograničenja u sistem za prioritetizaciju je dobijena<br />metodologija za modifikaciju pokreta u prisustvu ograničenja.</p> / <p>The thesis analyzes the characteristic compensation strategies, which are<br />observed to be often applied by men. Based on the analysis benefits and<br />disadvantages each of the strategies are defined. After that, the task<br />prioritization framework is shown, which enables simultaneous realiztation of<br />multiple tasks. In order to include different tasks and constraints in the<br />framework, the formal way of their notation is developed. Special attention is<br />given to the constraints that arise as a consequence of contacts with the<br />environment. Methodology for determining whether some of the existing<br />contacts can be broken, but that the desired movement is feasible, and<br />whether is it necessary to establish a new contact for the realization of the<br />intended movement. By including the constraints in the task prioritization<br />framework, methodology for modification of the movement in the presence of<br />constraints is obtained.</p>

The central integration of sensory information provided by various afferent receptors is required to control human movement. Although the function of individual afferent receptors is known, the complexity and interactivity of afferent information remains unclear, especially in scenarios which involve the reduction of information provided by one or more afferent receptors. Reduced plantar sensitivity is commonly associated with postural instability, which occurs in ageing, peripheral neuropathies, and other neurological disorders like Parkinson's disease. Although there has been a great advance in understanding afferent inputs during recent years, the role of afferent information in controlling movement is still unclear. Therefore, the aim of the present thesis is to investigate the effects of reduced plantar sensitivity on quasi-static and dynamic balance control, as well as muscle reflexes. The current thesis is comprised of five experiments. Two experiments were designed as preliminary investigations, while the remaining three experiments addressed the main questions of this thesis. The first experiment investigated a basic question about subjective foot sensitivity (vibration perception) measured in two different body positions: standing and sitting. Results of Experiment I showed no differences of vibration perception between both measured conditions. Therefore, comparing data from plantar sensitivity vibration tests performed during sitting and during standing (e.g. balance) is feasible. In Experiment II, the role of afferent information from plantar mechanoreceptors on quasi-static balance was investigated using two different cooling procedures: a permanently cooling thermal platform and conventional ice pads. COP total excursions, plantar temperatures, and scores of a Visual Analogue Scale (VAS) regarding subjective pain were analyzed. Experiment II demonstrated that constant and controllable cooling via the thermal platform is the superior approach with respect to subjective pain (VAS) and to reach and maintain the desired temperature throughout the trials. Furthermore, only cooling via the thermal platform induced postural instability, revealed by increased COP values. This instability was expected due to reduced plantar input, indicating no compensation by other sensory systems. Experiment III focused on the inter- and intraday- reliability of dynamic balance responses using the Posturomed device. Generally good relative and absolute reliability were found for COP excursions. This outcome was fundamental to proceed with dynamic balance measurements using the same setup. Subsequently, effects of reduced plantar cutaneous inputs via cooling on anticipatory and compensatory balance responses (unexpected perturbations) were explored in Experiment IV. COP and EMG data were used to analyze anticipatory and compensatory balance responses. No differences in COP or EMG parameters were found for the anticipatory responses after hyper-thermia, while decreased values for compensatory balance responses were observed in response to cooling. This was interpreted as a kind of overcompensatory behavior of the central nervous system (CNS) due to more cautious behavior induced after plantar cooling. Finally, the question regarding the interaction between afferent receptors arose in Experiment V, in which the effects of reduced plantar temperatures on the Achilles tendon stretch reflex and plantar flexion were examined. Short latency responses and maximal force of plantar flexion were analyzed. Cooling resulted in decreased amplitudes of short latencies, as well as in delays in time to maximal force of plantar flexion. These findings suggest that plantar inputs participate complementarily in the Achilles stretch reflex. Collectively, the current thesis contributes to understanding how plantar receptors are involved in movement control; not only do they seem to work as independent contributors, but they also appear to interact with other afferent receptors. Furthermore, an important outcome is that the reduced plantar inputs seem to induce different alterations in the organization of CNS inputs and outputs, according to different balance tasks: quasi-static responses, anticipatory responses, and compensatory responses. For the future, the use of other methods like microneurography and electroencephalography could be helpful to gain even more understanding of afferent interactions during the control of movements. Similar protocols may also be implemented in other populations, such as elderly people or patients suffering from neurological disorders, who exhibit continued decline or degeneration of sensory receptors. / Die zentrale Integration von sensorischen Informationen, die aus verschiedenen afferenten Rezeptoren zur Verfügung gestellt werden, ist erforderlich, um die menschliche Bewegung zu steuern. Obwohl die Funktion der einzelnen afferenten Rezeptoren bekannt ist, bleibt die Komplexität und Interaktivität von afferenten Information unklar, insbesondere in Szenarien, in denen die Verminderung von Informationen aus einem oder mehreren afferenten Rezeptoren eintritt. Reduzierte plantare Sensibilität wird häufig im Zusammenhang mit Haltungsinstabilität verbunden. Dies tritt häufig während des Alterns ein, bei peripheren Neuropathien und anderen neurologischen Erkrankungen, wie etwa bei der Parkinson-Krankheit. Obwohl es in den vergangen Jahren große Entwicklungen was das Verständnis afferenter Inputs gab, ist die Rolle afferenter Information bei der Bewegungskontrolle immer noch unklar. Daher ist das Ziel der vorliegenden Dissertation, den Einfluss der Beeinträchtigung der plantaren Sensibilität auf das quasi-statische und dynamische Gleichgewicht, sowie auf den Reflex der Achillessehne, zu untersuchen. Die vorliegende Dissertation ist dazu aus fünf Untersuchungen aufgebaut. Zwei Untersuchungen werden als Voruntersuchungen präsentiert, während die übrigen drei Untersuchungen auf die Kernfragen dieser Doktorarbeit gerichtet sind. Die erste Untersuchung beschäftigt sich mit der grundlegenden Fragestellung bzgl. der subjektiven Fußsensibilität (Vibrationswahrnehmung), die in zwei verschiedenen Körperpositionen gemessen wurde: Im Stehen und im Sitzen. Ergebnisse aus Untersuchung I zeigten keine Unterschiede der Vibrationswahrnehmung zwischen den beiden Körperpositionen. Daher ist es möglich, Vergleiche zwischen Daten aus plantaren Vibrationswahrnehmungstests während des Sitzens und des Stehens (z.B. bei Gleichgewichtstests) durchzuführen. In Untersuchung II wurde die Rolle afferenter Informationen plantarer Mechanorezeptoren auf das quasi-statische Gleichgewicht mittels zwei unterschiedlicher Abkühlverfahren untersucht: eine permanente Abkühlung durch eine thermische Plattform und konventionelle Eis-Pads. Es wurden der COP Gesamtweg, plantar Temperaturen und eine visuelle Analogskala (VAS) in Bezug auf subjektive Schmerzen analysiert. Untersuchung II hat gezeigt, dass eine konstante und steuerbare Abkühlung über die thermische Plattform der überlegene Ansatz in Bezug auf subjektiven Schmerz (VAS) und bzgl. des Erreichens und Erhaltens einer gewünschten Temperatur innerhalb der Messungen ist. Weiterhin wurde nur durch die Abkühlung mittels thermischer Plattform eine posturale Instabilität induziert, evident durch erhöhte COP Gesamtwege. Diese Instabilität wurde aufgrund der Beeinträchtigung der plantaren Sensibilität erwartet, was auf eine fehlende Kompensation durch andere Sinnessysteme hinzuweisen scheint. In Untersuchung III lag der Fokus auf der inter- und intra-Tag-Reliabilität dynamischer Gleichgewichtsantworten mittels des Posturomed-Trainingsgerätes. Im Allgemeinen wurden eine gute relative und absolute Reliabilität der COP Gesamtwege ermittelt. Dieses Ergebnis war von grundlegender Bedeutung, um die Nutzung des gleichen Setups für die folgenden dynamischen Gleichgewichtsmessungen (Untersuchung IV) zu ermöglichen. Anschließend wurden die Effekte einer Beeinträchtigung der plantaren Sensibilität mittels Abkühlung auf antizipatorische und kompensatorische Antworten des dynamischen Gleichgewichts (anhand unerwarteter Störungen des Gleichgewichts) in Untersuchung IV erforscht. COP und EMG Daten wurden verwendet, um die antizipatorischen und kompensatorischen Antworten des Gleichgewichts zu analysieren. Nach der Abkühlung wurden bzgl. antizipatorischer Antworten keine Unterschiede in den COP und EMG Parametern gefunden. Im Hinblick auf kompensatorische Antworten zeigten sich reduzierte COP und EMG als Reaktion auf die Abkühlung. Dies wurde wie folgt interpretiert: aufgrund eines vorsichtigen Verhaltens, ausgelöst durch die verminderten sensorischen Inputs infolge der Abkühlung, kam es zu einer Art „Überkompensierungsverhalten“ des zentralen Nervensystems (ZNS). Schließlich stellte sich die Frage der Interaktion afferenter Rezeptoren in Untersuchung V, in welcher die Effekte reduzierter plantarer Temperaturen auf den Achillessehnen-Dehnungsreflex und die Plantarflexion untersucht wurden. Kurze Latenz Antworten (short latency responses) und die maximale Kraft der Plantarflexion wurden dabei analysiert. Die Abkühlung führte zu einer verminderten Amplitude der short latency responses sowie zu Verzögerungen der Zeit bis zur maximalen Kraft der Plantarflexion. Diese Ergebnisse deuten darauf hin, dass plantare Inputs in komplementärer Weise am Achillessehnen-Dehnungsreflex beteiligt sind. Zusammenfassend lässt sich aussagen, dass die vorliegende Arbeit zum Verständnis beiträgt, wie plantare Rezeptoren an der Bewegungssteuerung beteiligt sind. Es scheint, dass diese nicht nur in unabhängiger Form zur Bewegungssteuerung beitragen, sondern dabei auch mit anderen afferenten Rezeptoren interagieren. Darüber hinaus ist ein wichtiges Resultat, dass die reduzierten plantaren Inputs scheinbar verschiedene Änderungen in der Organisation von Ein- und Ausgängen im ZNS induzieren. Dies erfolgt anhand unterschiedlicher Anforderungen an das Gleichgewicht: quasi-statische Antworten, antizipatorische Antworten und kompensatorischen Antworten. Für die Zukunft könnte die Implementierung anderer Methoden, wie Mikroneurographie und Elektroenzephalographie, hilfreich sein, um noch mehr Verständnis bezüglich afferenter Interaktionen während der Kontrolle von Bewegungen erlangen zu können. Ähnliche Protokolle könnten auch in anderen Populationen durchgeführt werden, wie ältere Menschen oder Patienten mit neurologischen Erkrankungen, die einen kontinuierlichen Rückgang oder Degenerationen sensorischer Rezeptoren zeigen.

Goal The goal of our pilot study was to evaluate the effect of short-term home based sensomotoric Training program (six weeks) in healthy adults on dynamic postural stability. We used the SOT at baseline and post the training program to evaluate the effect. Methodology The number of participants in this experiment was 10 healthy students, the number of males was 8 and 2 females, they were all between the age of 23 and 40 (mean 29.5 and ± S.D = 5.1 years). The sensory organization test was conducted at baseline and post the home based sensomotoric training program by using the dynamic posturography SMART Balance Master System (NeuroCom). The somatosensory (SOM), visual (VIS), vestibular (VEST), preference (PREF) and composite equilibrium outcome measures of the sensory organization test were evaluated. Results The VIS sensory system has significantly improved also the VEST sensory system with p-value < 0.05. The SOM sensory system had no significant improvement also the PREF sensory system with p-value > 0.05, while the overall composite equilibrium had a significant improvement with p-value > 0.05. Conclusion According to our findings the short-term home based sensomotoric training program has a positive effect in terms of improving the overall dynamic balance in healthy adults. Keywords Dynamic...

The Posturomed device is used as a scientific tool to quantify human dynamic balance ability due to unexpected perturbations, and as a training device. Consequently, the question arises whether such measurements are compromised by learning effects. Therefore, this study aimed to analyze inter- and intra-day reliability of dynamic balance responses using the Posturomed. Thirty healthy young subjects participated (24.3±3.2 years). The Posturomed was equipped with a triggering mechanism to enable unexpected, horizontal platform perturbations. A force platform was used to quantify Center of Pressure (COP) excursions for two time intervals: interval 1 (0–70 ms post perturbation) and interval 2 (71–260 ms post perturbation). Dynamic balance tests were performed in single leg stances in medio-lateral and anterior-posterior perturbation directions. Inter- and intra-day reliability were assessed descriptively using Bland-Altman plots and inferentially using tests for systematic error and intra-class-correlations. With regard to the mean COP excursions for every subject and all intervals, some cases revealed significant differences between measurement sessions, however, none were considered relevant. Furthermore, intra class correlation coefficients reflected high magnitudes, which leads to the assumption of good relative reliability. However, analyzing inter- and intra-day reliability using Bland-Altman plots revealed one exception: intra-day comparisons for the anterior-posterior direction in interval 2, which points towards possible learning effects. In summary, results reflected good overall reliability with the exception of certain intra-day comparisons in the anterior-posterior perturbation direction, which could indicate learning effects in those particular conditions.

Background Anticipatory and compensatory balance responses are used by the central nervous system (CNS) to preserve balance, hence they significantly contribute to the understanding of physiological mechanisms of postural control. It is well established that various sensory systems contribute to the regulation of balance. However, it is still unclear which role each individual sensory system (e.g. plantar mechanoreceptors) plays in balance regulation. This becomes also evident in various patient populations, for instance in diabetics with reduced plantar sensitivity. To investigate these sensory mechanisms, approaches like hypothermia to deliberately reduce plantar afferent input have been applied. But there are some limitations regarding hypothermic procedures in previous studies: Not only plantar aspects of the feet might be affected and maintaining the hypothermic effect during data collection. Therefore, the aim of the present study was to induce a permanent and controlled plantar hypothermia and to examine its effects on anticipatory and compensatory balance responses. We hypothesized deteriorations in anticipatory and compensatory balance responses as increased center of pressure excursions (COP) and electromyographic activity (EMG) in response to the hypothermic plantar procedure. 52 healthy and young subjects (23.6 ± 3.0 years) performed balance tests (unexpected perturbations). Subjects’ foot soles were exposed to three temperatures while standing upright: 25, 12 and 0 °C. COP and EMG were analyzed during two intervals of anticipatory and one interval of compensatory balance responses (intervals 0, 1 and 2, respectively). Results Similar plantar temperatures confirmed the successful implementation of the thermal platform. No significant COP and EMG differences were found for the anticipatory responses (intervals 0 and 1) under the hyperthermia procedure. Parameters in interval 2 showed generally decreased values in response to cooling. Conclusion No changes in anticipatory responses were found possibly due to sensory compensation processes of other intact afferents. Decreased compensatory responses may be interpreted as the additional balance threat, creating a more cautious behavior causing the CNS to generate a kind of over-compensatory behavior. Contrary to the expectations, there were different anticipatory and compensatory responses after reduced plantar inputs, thereby, revealing alterations in the organization of CNS inputs and outputs according to different task difficulties.