Effect of active foot positioning on the outcome of a balance training program (original) (raw)

Balance Training Improves Function and Postural Control in Those with Chronic Ankle Instability

Medicine & Science in Sports & Exercise, 2008

Purpose: The purpose of this randomized controlled trial was to determine the effect of a 4-wk balance training program on static and dynamic postural control and self-reported functional outcomes in those with chronic ankle instability (CAI). Methods: Thirty-one young adults with self-reported CAI were randomly assigned to an intervention group (six males and 10 females) or a control group (six males and nine females). The intervention consisted of a 4-wk supervised balance training program that emphasized dynamic stabilization in single-limb stance. Main outcome measures included the following: self-reported disability on the Foot and Ankle Disability Index (FADI) and the FADI Sport scales; summary center of pressure (COP) excursion measures including area of a 95% confidence ellipse, velocity, range, and SD; time-to-boundary (TTB) measures of postural control in single-limb stance including the absolute minimum TTB, mean of TTB minima, and SD of TTB minima in the anteroposterior and mediolateral directions with eyes open and closed; and reach distance in the anterior, posteromedial, and posterolateral directions of the Star Excursion Balance Test (SEBT). Results: The balance training group had significant improvements in the FADI and the FADI Sport scores, in the magnitude and the variability of TTB measures with eyes closed, and in reach distances with the posteromedial and the posterolateral directions of the SEBT. Only one of the summary COP-based measures significantly changed after balance training. Conclusions: Four weeks of balance training significantly improved self-reported function, static postural control as detected by TTB measures, and dynamic postural control as assessed with the SEBT. TTB measures were more sensitive at detecting improvements in static postural control compared with summary COP-based measures.

Effect of different balance training programs on postural control in chronic ankle instability: a randomized controlled trial

2018

Background: Chronic ankle instability (CAI) is a common sequence of ankle sprain. Conservative treatment of CAI is currently accepted as a primary mean of managing the condition and preventing of recurrence. Objectives: The purpose of the current study was to evaluate the effect of Weight-bearing Exercise for Better Balance (WEBB) program and unilateral balance training exercises on postural control in females with CAI. Methods: Thirty-five females with CAI participated in this study. The participants' mean values of age, body mass, height, and body mass index were 21.76 ± 1.96 y, 64.82 ± 9.37 kg, 161.85 ± 7.24 cm, and 24.76 ± 3.76 kg/m², respectively. They were randomly assigned into three groups: experimental group A (n = 13) who received WEBB program, experimental group B (n = 12) who received unilateral balance training, and control group C (n = 10) using statistical random tables. Balance parameters were measured for all participants via Biodex Balance System (BBS) before and after four weeks of balance training. They included overall stability index (OASI), antero-posterior stability index (APSI), and medio-lateral stability index (MLSI). Results: There was a significant improvement in the post testing mean values of OASI and APSI, compared with the pre testing values in both experimental groups (A and B). There was no significant difference between the pre and post testing mean values of MLSI in the experimental group (A). Conclusions: Both WEBB program and unilateral balance training have positive effects on postural control in females with CAI.

What we know so far about postural balance training: An exploratory scoping review of nomenclature and related issues

Journal of Bodywork & Movement Therapies, 2020

Different terms are used to refer to postural balance training, but the ontological debate involving the concepts to pursue nomenclature consensus is unusual. Objective: The goal of this study was to analyze how often the terms balance, neuromuscular, proprioceptive, functional and sensorimotor training/exercise are used in the literature, and to propose a conceptual critical appraisal to determine the most appropriate terminology to address postural balance exercises. Methods: A literature search was conducted in the Scopus electronic database. Eligibility criteria: papers with the selected expressions on the title or keywords, published in English, were included. Results: The most used term was balance training (471 of 1105 included papers). Europe, followed by Asia and North America, had the highest number of publications. In the 21st century, the number of publications increased considerably. However, the terms have conceptual differences and controversies regarding its use. Conclusion: Despite a large variety of exercise types and divergences, balance training seems to be the most suitable term, given it refers to postural equilibrium exercises.

Do fallers and nonfallers equally benefit from balance specific exercise program? A pilot study

BioMed research international, 2013

The purpose of the study was to determine the sample size that would allow broad generalizability of the results. To investigate the differences in the responsiveness of fallers and nonfallers to a multicomponent functional balance specific program, 23 participating subjects (70.1 ± 6.6 years) were divided into nonfallers group (13) and fallers group (10). The components of the balance specific program were (1) changing of the center of gravity (CoG) in the vertical direction, (2) shifting of the CoG to the border of stability, (3) rotation of the head and body about the vertical axis, (4) standing and walking on soft surface, and (5) walking over obstacles or on a narrow path. At the end of eight months of the training program, there was no significant difference between the two groups regarding postural sway. The total center of pressure path length was used as the principal outcome measure for the sample size calculation. Based on these results the a priori sample size calculatio...

Effect of ankle proprioceptive training on static body balance

J. Phys. Ther. Sci., 2015

[Purpose] This study aimed to investigate the effect of ankle proprioceptive training on static body balance. [Subjects and Methods] In this randomized-controlled, single-blind study, 59 university students (35 females , 24 males) were randomized into study (n=29) and control (n=30) groups. The study group received a foot and ankle proprioceptive exercise program including stretching, strengthening (plantar and dorsi-flexors, invertor and evertor muscles), and balance board exercises, each with 10 repetitions per session, 5 days a week, for a total of 10 sessions. The control group did not receive any intervention. Static body balance was evaluated by a kines-thetic ability trainer, which showed the balance index scores under both single foot and both feet conditions. This evaluation was repeated at the end of two weeks for both groups. [Results] Outcome measures of the groups were similar at the baseline. Balance index scores of both groups improved at the end of two weeks, and the study group had significantly lower index scores than those of the control group, indicating better balance. [Conclusion] Ankle proprioceptive training had positive effects on static body balance parameters in healthy individuals, and it is worth investigating the effects of this type of training in patients with balance disorders.

Clinical Study Do Fallers and Nonfallers Equally Benefit from Balance Specific Exercise Program? A Pilot Study

2013

Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The purpose of the study was to determine the sample size that would allow broad generalizability of the results. To investigate the differences in the responsiveness of fallers and nonfallers to amulticomponent functional balance specific program, 23 participating subjects (70.1 ± 6.6 years) were divided into nonfallers group (13) and fallers group (10). The components of the balance specific program were (1) changing of the center of gravity (CoG) in the vertical direction, (2) shifting of the CoG to the border of stability, (3) rotation of the head and body about the vertical axis, (4) standing and walking on soft surface, and (5) walking over obstacles or on a narrow path. At the end of eight months of the training program, there was no significant difference between the two groups regarding postural sway. The total cen...

Effect of Balance Training on Postural Analysis of Patients suffering from Balance Disorders: A Preliminary Report

Journal of Postgraduate Medicine, Education and Research

Introduction: Postural stability assessment is an important task that has found widespread medical and therapeutic applications. Typically, balance measurement systems are used for this purpose. The quantitative score of postural balance is very important in determining improvement of the patients suffering from balance disorder. Postural stability of humans is highly dependent on the position of centre of pressure of the body. The analysis of sway of a human body can be successfully done by studying oscillations of its centre of pressure. The distribution of foot pressure over different regions namely medial-lateral and anteriorposterior, governs the balance of the posture in both directions. Objective: The aim of this study is to assess quantitative changes in the postural stability of patients suffering from balance disorders after providing them biofeedback based balance training. Materials and methods: We used Force Sensing Resistors (FSRs) to sense the magnitude of forces acting at various points of both the feet. The centre of pressure is determined using the positions of various force points and magnitude of the force acting on them. The higher capability of the body to remain at that position implies higher postural stability and a lower power of sway. The force sensors produce signal proportional to the magnitude of the foot pressure. This signal after being collected by the Data Acquisition Board is fed to the system for calculating the centre of pressure and drawing a real time graph. Different algorithms are used to determine its mean position and compare the stability. The repeated analysis shows the amount of change in patient's postural behaviour, before and after the training. Results: Until the publication of this research work, analysis of the data of 4 patients was performed. Post intervention trials resulted in higher scores of their postural performance. Hence, favourable results were obtained showing improvement in postural stability of the patients. Conclusion: Wider variety of ataxia patients can be chosen to perform this assessment. The system is capable of determining jpmer reSeArCH ArTICLe

Effects of pronated and supinated foot postures on static and dynamic postural stability

Journal of athletic training, 2005

Context: The foot is the most distal segment in the lower extremity chain and represents a relatively small base of support on which the body maintains balance (particularly in single-leg stance). Although it seems reasonable that even minor biomechanical alterations in the support surface may influence postural-control strategies, the implications of a hypermobile or hypomobile foot on balance have received little attention to date.Objective: To determine if supinated and pronated foot types influence measures of static and dynamic balance.Design: Participants were assigned to 1 of 3 groups depending on foot type, as defined by navicular-drop measures: pronated (≥10 mm), neutral (5–9 mm), or supinated (≤4 mm). Measures of static and dynamic balance were obtained for each participant and compared across groups.Setting: Sports medicine and athletic training research laboratory.Patients or Other Participants: Sixteen individuals with pronated (navicular drop = 13.0 ± 3.7 mm), neutral (navicular drop = 6.2 ± 1.1 mm), or supinated (navicular drop = 2.2 ± 1.7 mm) foot postures volunteered to participate in the study.Main Outcome Measure(s): We used the Chattecx Balance System to measure center of balance, stability index, and postural sway during static single-limb stance under eyes-open and eyes-closed conditions. Center of balance was defined as the point on the foot at which the body weight was equally distributed between the medial-lateral and anterior-posterior quadrants and was recorded in centimeters. Stability index was defined as the mean deviation in sway around the center of balance. Postural sway was expressed as the maximum sway distance recorded (cm) in the medial-lateral and anterior-posterior directions. The Star Excursion Balance Test was used to measure dynamic balance, which was reported as the reach distance (cm) in each of the 8 directions tested. The average of 3 trials of each measure was calculated and normalized to the subject's height.Results: We found no difference in center of balance or postural sway as a function of foot type. The stability index was greater in pronators than in supinators, but neither group was different from those with neutral foot types. Dynamic reach differed among groups but only in some directions. Generally, pronators reached farther in the anterior and anterior medial directions and supinators reached farther in the posterior and posterio-lateral directions. In the lateral direction, supinators reached farther than pronators but not farther than neutrals.Conclusions: Our results suggest that postural stability is affected by foot type under both static and dynamic conditions. These differences appear to be related to structural differences as opposed to differences in peripheral input. These effects should be considered when clinicians use such balance measures to assess injury deficits and recovery.

Effect of foot position on balance ability in single-leg stance with and without visual feedback

Journal of Biomechanics, 2016

The purpose of this study was to determine the natural foot position and to quantify the effect of foot position on balance performance during single-leg stance. Forty healthy subjects participated in this study (age, 18 to 32 years; 24 female). Subjects were asked to perform single-leg balance trials on a balance force plate in their self-selected and four predetermined foot positions with their eyes open and closed. Sway distance, area and velocity were computed for each trial. There was significant interactions between visual conditions and foot position for all sway parameters (P o.001). With the eyes closed, sway parameters were greatest for the self-selected foot position compared to the other foot positions (P o.005). No differences in sway parameters between foot positions were detected for the eyes-open condition. Sway distance, area and velocity were 94%, 400% and 89% greater, respectively, for the eyesclosed than the eyes-open condition. Self-selected foot placement did not produce the most stable single-leg stance. The results of this study indicate that foot position is not important for protocols for assessing balance or for rehabilitation exercises using eyes-open conditions and that assessment protocols and rehabilitation exercises should clearly specify the foot position when using eyes-closed protocols.