Analysis of Postural Control following Anterior Cruciate Ligament Reconstruction with Ipsilateral Peroneus Longus Tendon Graft

@#Introduction: Harvesting peroneus longus for ACL reconstruction is thought to create ankle instability which could add to postural instability from an ACL injury. This apprehension prevents its use as a graft of primary choice for many surgeons. To date, there is no evidence available describing changes in postural control after its use in ACL reconstruction. The purpose of the study was to analyse the changes in postural control in the form of static and dynamic body balance after ACL reconstruction with Peroneus Longus Tendon Graft and compare it with the unaffected limb at different time intervals. Materials and methods: Thirty-one participants with ACL injury were selected and subjected to an assessment of static and dynamic balance before and after ACL reconstruction using the HUMAC balance system. Outcome measures for Centre of Pressure (COP) assessment were average velocity, path length, stability score, and time on target. Comparison of scores was done pre-operatively as well as at three- and six-months post-reconstruction with Peroneus longus tendon graft. Results: Static balance of the affected limb showed significant improvement with a decrease in average velocity (F=4.522, p=0.026), path length (F=4.592: p=0.024) and improvement of stability score (F=8.283, p=0.001). Dynamic balance measured by the time on the target variable also showed significant improvement at six-month follow-up (F=10.497: p=0.000). There was no significant difference between the affected and non-affected limb when compared at the different time intervals. Conclusion: The static and dynamic balance, which is impaired after ACL injury, improves with ACL reconstruction with PLT autologous graft. Hence PLTG can be safely used as a graft for ACL reconstruction without affecting postural control and body balance.

Comparison of drop jump force-time profiles of team sport athletes and active controls

Abstract Aim: Lower-body non-contact injuries in team sport athletes (TSAs) are associated when absorbing force, during cutting and landing movements due to a lack of eccentric strength and decreased neuromuscular control leading to excessively higher joint forces. Thus, this project aimed to identify if TSAs had different acceleration and deceleration force profiles compared to a control group (non-TSA) when performing drop jumps (DJs). Methods: University TSAs (n = 15) and non-TSAs (n = 10) performed a series of DJs from a 39 cm box onto a force-plate. All data were normalized to the individual's body mass. Between-group differences in ground reaction force (GRF), rate of force development (RFD), and propulsive and breaking impulses were compared via t-tests and standardized differences. Results: TSAs had significantly, and meaningfully greater RFD than the non-TSAs (p < 0.01, Hedges' g (ES) = 1.24, 53%). While not statistically significant, the non-TSA group produced practically larger mean GRFs than TSAs (p = .09, ES = 0.72, 12.1%). No significant or meaningful between-group differences were detected for propulsive impulse (p = 0.08, ES = 0.41, 9.1%), braking impulse (p = 0.85, ES = 0.25, 4.6%), or impulse ratio (p = 0.35, ES = 0.21, 6.7%). Conclusions: This study shows the presence of significant RFD differences during the DJ in TSAs compared to non-TSAs. Furthermore, this investigation also showed there was no difference between TSA and students in GRF and impulse metrics. Implications from these findings suggest that TSAs can produce force rapidly, but deceleration metrics were not different from untrained students.

Avaliação do equilíbrio postural em idosos utilizando plataforma de força: uma revisão sistemática / Evaluation of postural balance in the elderly using force platform: a systematic review / Evaluación del equilibrio postural en ancianos utilizando plataforma de fuerza: una revisión sistemática

O objetivo desta revisão foi verificar de que forma estão sendo realizadas as pesquisas que investigam o equilíbrio de idosos, utilizando-se a plataforma de força. Foi realizada busca por artigos indexados nas bases de dados SCIELO, MEDLINE e BVS, no período de 2011 a 2016. Foram selecionados 34 estudos para análise; destes, 27 estudos avaliaram a posição bipodal (olhos abertos e fechados); 25 estudos utilizaram o tempo de 0-30 segundos; e o tratamento, quando realizado, foi de treinamento de força e de equilíbrio.

The aim of this study was to identify in which way the researches that investigate the balance of the elderly using the force platform are being carried out. We searched for articles indexed in the SCIELO, MEDLINE and VHL databases from 2011 to 2016. We selected 34 studies for analysis, of which 27 studies evaluated the bipodal position (open and closed eyes), 25 studies used time of 0-30 seconds and the treatment, when performed, was of strength and balance training.

El objetivo de esta revisión fue verificar de qué forma se están realizando las investigaciones que investigan el equilibrio de ancianos, utilizando la plataforma de fuerza. Se realizó búsqueda por artículos indexados en las bases de datos SCielo, MEDLINE y BVS, en el período de 2011 a 2016. Se seleccionaron 34 estudios para análisis; de estos, 27 estudios evaluaron la posición bipodal (ojos abiertos y cerrados), 25 estudios utilizaron el tiempo de 0 a 30 segundos, y el tratamiento, cuando fue realizado, fue de entrenamiento de fuerza y de equilibrio.

Positive correlation of postural balance evaluation by two different devices in community dwelling women / Correlação do desempenho do equilíbrio postural entre dois diferentes dispositivos em mulheres idosas

OBJECTIVE: To establish the convergent validity or relationship of the Balance Master® as balance assessment device by comparing its performance results with those obtained from the AccuSway Plus® force plate. METHOD: Cross-sectional observational study, without intervention, of 126 postmenopausal women (60.3 ± 3.2 years; body mass index = 27.6 ± 4.7 kg/m2). Two devices were used for the independent assessments of static balance: (a) Static postural balance assessment (posturography) was performed on a force platform (AccuSway Plus); (b) static evaluation was performed on the Balance Master®System. The variables studied in the two devices, were: (i) the Mean Velocity of the Center of Pressure Displacement in all directions (Vavg or Mean Firm), (ii) the Anteroposterior (Mean-Y) and (iii) the Mediolateral (Mean-X) Centers of Pressure Displacement. The Spearman correlation coefficient was calculated to measure the correlation of the variables of balance obtained with the two different devices. RESULTS: Significant correlations were obtained when the relationships between both variables were described by fitting multiple linear regression models. There was an association between the mean velocity of center of pressure displacement in both devices, with eyes open (r = 0.21) and eyes closed (r = 0.47). In the eyes open condition, Vavg increased, on average, 0.26 units, while Mean Firm increased 1.0 unit; in the Mean-Firm; in eyes closed condition, Vavg increased, on average, 1.27 units, while Mean-Firm increased by 1,0 unit. CONCLUSION: The devices investigated presented a significant correlation for the mean velocity calculated from the total displacement of the center of pressure in all directions.

OBJETIVO: Estabelecer a validade convergente ou relação do Balance Master® como dispositivo de avaliação do equilíbrio, comparando seus resultados de desempenho com os obtidos a partir da plataforma de força AccuSway Plus®. MÉTODO: Trata-se de um estudo observacional transversal, sem intervenção, de 126 mulheres na pós-menopausa (60,3 ± 3,2 anos; índice de massa corporal = 27,6 ± 4,7 kg/m2). A avaliação de equilíbrio postural estático (posturografia) para todos os voluntários foi realizada inicialmente em uma plataforma de força (AccuSway Plus); uma segunda avaliação estática foi realizada em um dispositivo de equilíbrio Balance Master® Sistem. As variáveis estudadas nos dois dispositivos, foram: velocidade média do deslocamento total do centro de pressão em todas as direções (Vavg e Média-Form); ântero-posterior (YSD and Mean-Y) e médio-lateral (XSD and X-Mean) do centro de pressão de deslocamento. O coeficiente de correlação de Spearman foram calculados para medir a correlação entre as variáveis de equilíbrio obtidas nos dois dispositivos diferentes. RESULTADOS: Foi encontrada uma correlação significativa entre as duas variáveis, e foi ajustado por um modelo de regressão linear. Houve uma associação entre a velocidade média de deslocamento do centro de pressão em ambos os dispositivos em ambas as condições, os olhos abertos (r = 0,21) e fechada (r = 0,47). Na condição de olhos abertos, os Vavg aumenta, em média, 0,26 unidades, com um aumento de uma unidade no Mean-Form; na condição de olhos fechados, Vavg aumenta, em média, 1,27 unidades, com um aumento de uma unidade no Mean-Form. CONCLUSÃO: Os dispositivos investigados apresentaram uma correlação significativa para a velocidade média calculada a partir do deslocamento total do centro de pressão em todas as direções.

La medición del control postural con estabilometría- una revisión documental / Measurment of Postural Control Through Stabilometry- a Literature Review

La estabilometría es el estudio del equilibrio que permite analizar el control postural y su relacion con la estabilidad en bípedo. Herramientas de alta tecnología se utilizan para medir la estabilidad en bípedo de forma cuantitativa con base en la posición del centro de gravedad de la persona determinado por la distribución de presiones plantares. Este artículo revisa el conocimiento científico sobre los conceptos en el trastorno de la estabilometría y la variedad de uso de estas herramientas en diferentes poblaciones y diagnósticos con base en artículos científicos encontrados en los últimos diez años en revistas indexadas. Se recomienda expandir el uso de las plataformas de fuerza que existen en Colombia a la estabilometría.

Stabilometry is the study of balance which permits the analysis of postural control as it relates to stability in standing. High tech tools are used to measure standing stability cuantitatively based on the position of the center of gravity of the person determined by his/ her distrubution of plantar pressures. This article reviews scientific knowlege regarding the concepts surrounding stabilomitry and the wide variety of uses of these tools in different populations and diagnoses based on scientific articles found in the last ten years in indexed journals. Expanding the use of the force plates that exist in Colombia to include stabilometry is recommended.

Revisão sobre posturografia baseada em plataforma de força para avaliação do equilíbrio / Revision of posturography based on force plate for balance evaluation

CONTEXTUALIZAÇÃO: A manutenção do equilíbrio e da orientação corporal em humanos é garantida pelo adequado funcionamento do sistema de controle postural. A investigação desse controle tem despertado interesse em profissionais de diversas áreas, tais como, Fisioterapia, Educação Física, Engenharia, Física, Medicina, Psicologia, entre outras. OBJETIVOS: Revisar os métodos de análise experimental de dados utilizados para investigação do controle postural em seres humanos e demonstrar o cálculo e rotinas de programação das principais medidas utilizadas na avaliação desse controle. CONCLUSÃO: Os procedimentos experimentais e as medidas utilizadas na avaliação do controle postural apresentados nesta revisão poderão auxiliar na padronização da investigação do controle postural.

BACKGROUND: The maintenance of balance and body orientation in humans is guaranteed by the adequate functioning of the postural control system. The investigation of this control has awakened the interest of professionals from several fields such as Physical Therapy, Physical Education, Engineering, Physics, Medicine, Psychology, and others. OBJECTIVES: The purposes of this study are to revise the methods of data analysis used to investigate the postural control in human beings and to demonstrate the computational algorithms of the main measures used in the postural control evaluation. CONCLUSION: The experimental procedures and measures used in postural control evaluation presented in this review can help in the standardization of postural control investigation.

Assessments of Balance Control Using Tetra-ataxiametric Posturography

OBJECTIVE: To assess and to compare the balance control between healthy old and young adults using clinical tests and tetra-ataxiametric posturography. METHOD: Eighteen healthy elderly adults over 60 years old and twenty one young individuals under 60 years old were recruited. All subjects had no neurological, cognitive and musculoskeletal problems, and were capable of standing and walking independently. The postural control capabilities of the subjects were assessed using the timed up and go test, Berg balance scale and a Tetrax(R) tetra-ataxiametric posturography (Tetrax, Ramat Gan, and Sunlight Medical, Tel-Aviv, Israel), which utilized two paired force plates measuring vertical pressure fluctuations over both heels and forefeet. Stability index, weight distribution index, synchronization index, and Fourier index were measured at six different head positions and at two positions with standing on pillows, and analyzed by independent t-test. RESULTS: The stability index was higher in the elderly subjects (p<0.05) than in young subjects, which indicated that the ability of balance control in the elderly subjects was poor. The abnormality of peripheral vestibular system, central nervous system and musculoskeletal system all affected the balance control in the elderly subjects, when standing on pillows or turning head to the up, down, right and left sides. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different between the elderly and young subjects. CONCLUSION: These findings suggest that elderly adults have more deficits in postural control than young subjects. Therefore changing environment around elderly adults and educating for prevention of falls were needed.