Impact of lumbar delayed-onset muscle soreness on postural stability in standing postures.

BACKGROUND: Similar impact on proprioception has been observed in participants with lumbar delayed-onset muscle soreness (DOMS) and chronic low back pain (LBP), raising questions about the relevance of lumbar DOMS as a suitable pain model for LBP when assessing back pain-related postural stability changes. RESEARCH QUESTION: Does lumbar DOMS impact postural stability? METHODS: Twenty healthy adults participated in this experimental study and underwent a posturographic examination before and 24 to 36 h after a protocol designed to induce lumbar DOMS. Posturographic examination was assessed during quiet standing on both feet with eyes opened (EO), with eyes closed (EC), and on one-leg (OL) standing with eyes opened. Postural stability was assessed through center of pressure (COP) parameters (COP area, velocity, root mean square, mean power frequency) which were compared using repeated measure ANOVA. Moreover, pain, soreness and pressure pain threshold (PPT) on specific muscles were assessed. RESULTS: There was a significant main effect of the postural condition on all COP variables investigated. More specifically, each COP variable reached a significantly higher value in the OL stance condition than in both EO and EC bipedal conditions (all with p < 0.001). In addition, the COP velocity and the mean power frequency along the anteroposterior direction both reached a significantly higher value in EC than in EO (p < 0.001). In contrast, there was no significant main effect of the DOMS nor significant DOMS X postural condition interaction on any of the COP variables. There was a significant decrease in the PPT value for both the left and right erector spinae muscles, as well as the left biceps femoris. SIGNIFICANCE: Lumbar DOMS had no impact on postural stability, which contrasts findings in participants with clinical LBP. Although DOMS induces similar trunk sensorimotor adaptations to clinical LBP, it does not appear to trigger similar postural stability adaptations.

Can self-assessment and augmented feedback improve performance and learning retention in manual therapy: results from an experimental study.

BACKGROUND: The purpose of this study was to investigate how feedback and self-assessment strategies affect performance and retention of manual skills in a group of chiropractic students. METHODS: Seventy-five students participated in two spinal manipulation (SM) learning sessions using a force-sensing table. They were recruited between May and November 2022 during HVLA technical courses. Students were randomly assigned into three different groups: participants in group 1 received visual feedback, those in group 2 received visual feedback after self-assessment, and participants in group 3 (C) received no feedback. During the first session, participants started with one block of 3 familiarization trials, followed by two blocks of 6 SM HVLA (high velocity low amplitude) posterior-to-anterior thoracic SM trials, with 3 trials performed with a target force of 450 N and 3 others at 800 N. They received feedback according to their group during the first block, but no feedback was provided during the second block. All participants were invited to participate in a second session for the retention test and to perform a new set SM without any form of feedback. RESULTS: Results showed that visual feedback and visual feedback in addition to self-assessment did not improve short-term SM performance, nor did it improve performance at the one-week retention test. The group that received visual feedback and submitted to self-assessment increased the difference between the target force and the peak force applied, which can be considered a decrease in performance. CONCLUSION: No learning effects between the three groups of students exposed to different feedback and self-assessment learning strategies were highlighted in the present study. However, future research on innovative motor learning strategies could explore the role of external focus of attention, self-motivation and autonomy in SM performance training.

Acute effects of short-term stretching of the triceps surae on ankle mobility and gait initiation in patients with Parkinson's disease.

BACKGROUND: Ankle mobility is known to be of uttermost importance to generate propulsive forces and control balance during gait initiation. Impaired mobility of the postural chain occurs with normal ageing and is exacerbated in patients with Parkinson's disease. This study questions whether short-term stretching session applied to the triceps surae improves ankle mobility and, consequently, dynamical postural control in patients with Parkinson's disease performing gait initiation. METHOD: Nineteen patients with Parkinson's disease participated in this study and were randomly assigned to an "intervention group" or a "sham group". In the intervention group, patients were exposed to a 4 × 60 seconds triceps surae stretching. In the sham group, they were exposed to forearm stretching. Additionally, ten age-matched healthy elderly, who were not exposed to any stretching-treatment, were assigned to a "control group". Participants performed series of gait initiation on a force-plate before and after their treatment. FINDINGS: Ankle mobility was improved in the intervention group after triceps surae stretching. The forward velocity of the center-of-mass at heel-off and motor performance related-parameters (progression velocity, center-of-mass velocity at foot-contact and swing phase duration) were also improved in the intervention group, with large effect sizes (d ≥ 0.8). None of the stability parameters were modified by the treatments. INTERPRETATION: Short-term triceps surae stretching is an efficient method to increase ankle mobility and improve the capacity to generate forward propulsive forces in patients with Parkinson's disease. These findings are congruent with the "posturo-kinetics capacity" theory according to which dynamical postural control depends on postural chain mobility.

The role(s) of "Simultaneous Postural Adjustments" (SPA) during Single Step revealed with the Lissajous method.

Dynamical phenomena in the postural chain occur before, during and after the voluntary movement. These phenomena correspond to anticipatory (APA), simultaneous (SPA), and consecutive (CPA) postural adjustments, respectively. APA and, more recently, CPA, have been extensively investigated in the literature. SPA have surprisingly received much less attention. The aim of the present study was to examine the role(s) of SPA associated with a single step task (SST). Ten healthy young adults performed series of SST on a force-plate. A 2-DOF mechanical model was used to separate the dynamics of the swing leg and the dynamics of the rest of the body, corresponding to the focal and the postural component of the SST, respectively. The postural component was plotted against the focal one during SPA (from heel-off to foot-contact), and this plot was modelled as a Lissajous ellipse. Result showed that this ellipse systematically ran through the same three quadrants of the diagram. For each of these quadrants, the role of the postural component in regards to the focal one was interpreted according to the relative orientation of the postural and focal dynamics. Results thus showed that SPA ensured the following successive roles: counter-perturbation of swing leg dynamics following heel-off, propulsion of swing leg, counter-perturbation of swing leg dynamics again, and then braking swing leg movement. These new findings contribute to a better knowledge of postural adjustments properties, and may provide new insights for understanding balance troubles with aging and in neurological patients (e.g. people with Parkinson's disease).

Consecutive postural adjustments (CPAs): A kinetic analysis of variable velocity during a pointing task.

AIM: This paper examines the postural adjustments that occur after the end of a voluntary movement (consecutive postural adjustments, CPAs). Its aim is to reinforce the theory that CPAs are necessary to counterbalance the destabilizing effect of a voluntary movement. In addition, we compared the main features of CPAs with those of anticipatory postural adjustments (APAs) in order to gather evidence that could afford new insights into postural programming. METHODS: Nine healthy adults were invited to adopt a sitting position to perform nine pointing movements at decreasing velocities. The antero-posterior component of the reaction forces was measured. Upper limb kinematics were recorded and the kinetics calculated. The main features under study included linear impulses, peak amplitudes and duration of CPAs and APAs. RESULTS: Two main results emerged from our study: the impulse produced after the end of a focal movement (CPAIx) was negative, while the impulse produced before its end (*ASPIx) was positive; their absolute values were not significantly different; when movement velocity increased, CPA impulse and peak amplitude (pCPA) increased significantly, contrary to duration (dCPA). Furthermore, APA impulse, peak amplitude and duration were all increased. CONCLUSIONS: These findings on pointing movements strengthen the hypothesis that CPAs play a role of body stabilization and that the postural chain kinetics is programmed according to focal movement velocity. Evidence on CPA obtained from healthy subjects may contribute to the further specification of the differences associated with motor impairment.

Particular adaptations to potentially slippery surfaces: the effects of friction on consecutive postural adjustments (CPA).

This research deals with the postural adjustments that occur after the end of voluntary movement ("consecutive postural adjustments": CPAs). The influence of a potentially slippery surface on CPA characteristics was considered, with the aim of exploring more deeply the postural component of the task-movement. Seven male adults were asked to perform a single step, as quickly as possible, to their own footprint marked on the ground. A force plate measured the resultant reaction forces along the antero-posterior axis (R(x)) and the centre of pressure (COP) displacements along the antero-posterior and lateral axes (Xp and Yp). The velocity of the centre of gravity (COG) along the antero-posterior axis and the corresponding impulse (∫R(x)dt) were calculated; the peak velocity (termed "progression velocity": V(xG)) was measured. The required coefficient of friction (RCOF) along the progression axis (pµ(x)) was determined. Two materials, differing by their COF, were laid at foot contact (FC), providing a rough foot contact (RoFC), and a smooth foot contact (SmFC) considered to be potentially slippery. Two step lengths were also performed: a short step (SS) and a long step (LS). Finally, the subjects completed four series of ten steps each. These were preceded by preliminary trials, to allow them to acquire the necessary adaptation to experimental conditions. The antero-posterior force time course presented a positive phase, that included APAs ("anticipatory postural adjustments") and step execution (STEP), followed by a negative one, corresponding to CPAs. The backward impulse (CPI) was equal to the forward one (BPI), independently of friction and progression velocity. Moreover, V(xG) did not differ according to friction, but was faster when the step length was greater. Last CPA peak amplitudes (pCPA) were significantly greater and CPA durations (dCPA) shorter for RoFC and conversely for SmFC, contrary to APA. Finally, the results show a particular adaptation to the potentially slippery surface (SmFC). They suggest that adherence modulation at foot contact could be one of the rules for controlling COG displacement in single stepping. Consequently, the actual coefficient of friction value might be implemented in the motor programme at a higher level than the voluntary movement specific parameters.

The Consecutive Postural Adjustments (CPAs) that follow foot placement in single stepping.

This research deals with the postural adjustments that occur after the end of a voluntary movement ("Consecutive Postural Adjustments": CPAs). With the aim of more fully characterizing the postural component of motor tasks, they are compared with those occurring before movement onset ("anticipatory postural adjustments": APAs). Ten male adults were asked to perform a single step as quickly as possible to a target marked on the ground (STEP). A force plate measured the resultant reaction forces along the antero-posterior axis (Rx) and the Centre of Pressure (CoP) displacements along the antero-posterior and lateral axes (Xp and Yp). The velocity of the Centre of Gravity (COG) along the antero-posterior axis was calculated and the peak velocity (termed "progression velocity": VxG) was measured. Antero-posterior linear impulses (∫Rxdt) were also calculated. Two step lengths were considered: a short and a long one (SS and LS conditions). Each session consisted of ten steps. The antero-posterior force time course presented two phases: a positive one that included the APA and the STEP periods, then a negative one corresponding to CPA. The corresponding backward impulse (CPIx) was equal to the forward one (BPIx), which identifies CPA as a counter-perturbation, that is, a process by which the central nervous system controls and stops a forward impulse. CPA durations and peak amplitudes (dCPA and pCPA) were significantly greater than the corresponding APA values (dAPA and pAPA). Moreover, when the step length was greater, that is, when the progression velocity was faster, pCPAs, like pAPAs, increased, suggesting that CPAs and APAs are parts of the same motor program. In addition, CPA duration and time to peak amplitude do not vary with progression velocity, which could be explained by the movement braking constraints. Finally, CPA can be viewed as a means of achieving a new "static" postural equilibrium as soon as possible after foot contact, and to prevent the risk of falling. The outcome provides additional knowledge on how a stable posture is achieved at the end of a task movement, and is discussed from a postural control perspective.