Altered balance control in thoracic adolescent idiopathic scoliosis during obstructed gait

Wu, Kuan‐Wen; Lu, Tung‐Wu; Lee, Wei-Chun; Ho, Yi-Hsun; Huang, Ting-Chun; Wang, Jyh-Horng; Wang, Ting‐Ming

doi:10.1371/journal.pone.0228752

Cited by 7 publications

(8 citation statements)

References 46 publications

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“…The severe deformation of body morphology resulting from scoliosis could influence the postural control. This three-dimensional spinal deformity often alters the orientations of the head, trunk, and pelvis in all anatomical planes, as well as resulting in vestibular and trunk muscle imbalance, and proprioceptive disorders, leading to a postural control problem 3 .…”

Section: Introductionmentioning

confidence: 99%

Postural control through force plate measurements in female AIS patients compared to their able-bodied peers

Piątek-Krzywicka

Borzucka

Kuczyński

2022

Sci Rep

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The present understanding of the mechanisms responsible for postural deficit in adolescent idiopathic scoliosis (AIS) is still insufficient. This is important because some authors see one of the causes of this disease in the impaired postural control. Moreover, there is a reciprocal link between the level of postural imbalance and the clinical picture of these people. Therefore, we compared the center-of-pressure (COP) indices of 24 patients with AIS to 48 controls (CON) during four 20-s quiet stance trials with eyes open (EO) or closed (EC) and on firm or foam surface. This included sway amplitude, speed, sample entropy and fractal dimension. AIS had poorer postural steadiness only in the most difficult trial. In the remaining trials, AIS did as well as CON, while presenting a greater COP entropy than CON. Thus, the factor that made both groups perform equally could be the increased sway irregularity in AIS, which is often linked to higher automaticity and lower attention involvement in balance control. After changing the surface from hard to foam, puzzling changes in sway fractality were revealed. The patients decreased the fractal dimension in the sagittal plane identically to the CON in the frontal plane. This may suggest some problems with the perception of body axes in patients and reveals a hitherto unknown cause of their balance deficit.

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Section: Introductionmentioning

confidence: 99%

Postural control through force plate measurements in female AIS patients compared to their able-bodied peers

Piątek-Krzywicka

Borzucka

Kuczyński

2022

Sci Rep

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“…When the trailing toe was above the obstacle (T5) with greater toe-obstacle clearance, the TCC group kept the position of the body’s COM more posteriorly relative to the COP, which effectively increased the posterior IA. However, the anterior RCIA did not increase correspondingly, which would require greater joint torques in the stance limb to provide support to the body for the smooth COM-COP movement, as well as for precise control of the swing foot 14 , 19 , 20 . The current results indicate that the older long-term TCC practitioners had the necessary muscle strength to maintain stability during the trailing-foot crossing without the need to increase the corresponding RCIA.…”

Section: Discussionmentioning

confidence: 88%

“…The body’s balance control during locomotion has been described by the motion of the body’s COM relative to the COP in various populations during dynamic activities 5 , 15 – 17 . Both the COM-COP inclination angle (IA), namely the angle formed by the COM-COP vector and the vertical vector, and the rate of change of IA (RCIA), i.e., the change of IA over a given short time interval, are sensitive indices for quantifying the actual COM-COP control 18 , 19 . Generally, the greater the IA, the greater the COM-COP vector deviates from the vertical, and the greater the effort (e.g., joint torque) needed to reduce or maintain the IA unless accompanied by an appropriate RCIA for dynamic balance, corresponding to the position and velocity control of the COM described by Pai and Patton 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

“…Both the COM-COP inclination angle (IA), namely the angle formed by the COM-COP vector and the vertical vector, and the rate of change of IA (RCIA), i.e., the change of IA over a given short time interval, are sensitive indices for quantifying the actual COM-COP control 18 , 19 . Generally, the greater the IA, the greater the COM-COP vector deviates from the vertical, and the greater the effort (e.g., joint torque) needed to reduce or maintain the IA unless accompanied by an appropriate RCIA for dynamic balance, corresponding to the position and velocity control of the COM described by Pai and Patton 19 , 20 . Increased toe-obstacle clearance during obstacle crossing demonstrated by older people reduces the risk of tripping 4 , 6 , 9 , 10 , 13 .…”

Section: Introductionmentioning

confidence: 99%

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Effects of long-term Tai-Chi Chuan practice on whole-body balance control during obstacle-crossing in the elderly

Kuo

Chen

et al. 2022

Sci Rep

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Older people are subject to an increased risk of falling compared to the young, especially during obstacle negotiation. This study aimed to quantify the effects of long-term Tai-Chi Chuan (TCC) practice on the balance control during obstacle-crossing in older people in terms of the inclination angles (IA) of the body’s centre of mass (COM) relative to the centre of pressure (COP), and the rate of change of IA (RCIA). Fifteen healthy older adults who had practised TCC for at least 13 years and 15 healthy controls without any experience in TCC performed obstacle-crossing in a gait laboratory. The TCC group showed significantly greater leading and trailing toe-obstacle clearances but smaller trailing stride lengths when compared to controls. In the sagittal plane, the TCC group showed significantly smaller average anterior IA when the COM was anterior to the COP but greater average posterior IA when the COM was posterior to the COP, with significantly smaller average and peak RCIA over the crossing cycle. Long-term TCC practitioners showed an obstacle-crossing technique for less risk of tripping and better balance control, as indicated respectively by significantly increased toe-obstacle clearances and more posterior COM position relative to the COP with smaller anterior IA and RCIA during leading crossing and greater posterior IA and frontal RCIA at trailing-toe crossing. These benefits appeared to be related to the main features of TCC movements that emphasized maintaining balance during single-leg support and keeping the body weight on the trailing limb during the slow weight-shifting of double-limb support.

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“…While the increased swing-side hiking and an anterior tilt of the pelvis increased the toe-obstacle clearance, they would also potentially affect the motions of the trunk and thus the body’s centre of mass (COM), leading to perturbations to whole-body posture and balance with increased risk of loss of balance, another major contributing factor to falls in older people ( Overstall et al, 1977 ; Blake et al, 1988 ; Campbell et al, 1990 ). This is especially critical for leading-limb crossing as the neuromechanical challenges for balance control are greater than trailing-limb crossing when the body moves away from the trailing stance limb ( Wu et al, 2020 ). Failure to recover balance would lead to falls once a trip or loss of balance occurs.…”

Section: Discussionmentioning

confidence: 99%

Synergistic multi-joint kinematic strategies to reduce tripping risks during obstacle-crossing in older long-term Tai-Chi Chuan practitioners

Huang

Kuo

et al. 2022

Front. Aging Neurosci.

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IntroductionLosing balance or tripping over obstacles is considered one of the most common causes of falls in the elderly. Tai-Chi Chuan (TCC) has been shown to improve muscle strength, inter-joint coordination and balance control in the elderly. This study aimed to determine whether older long-term TCC practitioners would show multi-joint kinematic strategies that would reduce the risk of tripping during obstacle-crossing compared to peers without TCC experience.MethodsThree-dimensional motions of the pelvis and lower extremities were measured using a motion capture system in fifteen older long-term TCC practitioners (TCC group) and 15 healthy controls without TCC experience during walking and crossing obstacles of three different heights. Crossing angles of the pelvis and lower limbs and toe-obstacle clearances were obtained and analyzed using two-way analyses of variance to study the between-subject (group) and within-subject (height) effects. A multi-link system approach was used to reveal the relationship between joint angular changes and toe-obstacle clearances.ResultsCompared to the controls, the TCC group showed increased leading and trailing toe-obstacle clearances (p < 0.05) with increased pelvic hiking and hip flexion but decreased hip adduction on the swing side and decreased knee flexion on the stance side during leading-limb crossing (p < 0.05), and increased pelvic hiking and anterior tilt but decreased hip adduction on the swing side, and decreased knee flexion on the stance side during trailing limb crossing (p < 0.05). All significant joint angular changes contributed to the increases in the toe-obstacle clearances.ConclusionThe current study identified the kinematic changes of the pelvis and the lower limb joints and revealed a specific synergistic multi-joint kinematic strategy to reduce tripping risks during obstacle-crossing in older long-term TCC practitioners as compared to non-TCC controls. The observed multi-joint kinematic strategies and the associated increases in toe-obstacle clearances appeared to be related to the training characteristics of TCC movements. Long-term TCC practice may be helpful for older people in reducing the risk of tripping and the subsequent loss of balance.

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Altered balance control in thoracic adolescent idiopathic scoliosis during obstructed gait

Cited by 7 publications

References 46 publications

Postural control through force plate measurements in female AIS patients compared to their able-bodied peers

Postural control through force plate measurements in female AIS patients compared to their able-bodied peers

Effects of long-term Tai-Chi Chuan practice on whole-body balance control during obstacle-crossing in the elderly

Synergistic multi-joint kinematic strategies to reduce tripping risks during obstacle-crossing in older long-term Tai-Chi Chuan practitioners

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