Michał Kuczyński

Attention Demand and Postural Control in Children with Hearing Deficit.

To elucidate the mechanisms responsible for deteriorated postural control in children with hearing deficit (CwHD), we measured center-of-pressure (COP) variability, mean velocity and entropy in bipedal quiet stance (feet together) with or without the concurrent cognitive task (reaction to visual stimulus) on hard or foam surface in 29 CwHD and a control group of 29 typically developing children (CON). The CwHD displayed an overall decreased postural performance as compared to the CON in the medial-lateral plane (p<0.05). Standing on foam pad revealed slower simple reaction time in the CwHD (p<0.05) while the results on hard surface were not different. The CwHD decreased (p<0.05) the amount of attention invested in posture during dual task which accounted for the need of more cognitive resources to handle two tasks simultaneously than controls. It was unmistakable that the intergroup differences emerged when the tasks performed were relatively novel and untrained: feet together, foam pad, and reaction time. All these tasks, while being very easy for the CON, made the CwHD deteriorate postural or cognitive performance. These results unravel the difficulty in reaching the consecutive developmental stages in the CwHD and call for specific therapeutic modalities that might facilitate this development.

Dual-task effect on postural control in high-level competitive dancers

Abstract We investigated balance in 33 competitive dancers (17 females, 16 males) and 22 controls (17 females, 5 males) (age 16–27 years) on a force plate in two conditions: single task (quiet stance) and dual task (with a concurrent mental task). Balance was evaluated using centre-of-pressure shift (sway) variability, mean speed, frequency, and sample entropy. The effect of the dual task in the medio-lateral plane was comparable in both groups, decreasing sway variability (P < 0.05) and increasing mean speed (P < 0.001), frequency, and sample entropy (P < 0.001), showing that the participants effectively increased the level of automaticity. In the antero-posterior plane, the dual task also increased sway frequency and sample entropy (P < 0.01) in dancers without affecting their standing performance. In contrast, postural control in non-dancers was vulnerable to reduced cognitive investment, which adversely interfered with baseline performance. There were very high correlations between sway sample entropy and frequency in each group, plane, and task (r = 0.92–0.98, P < 0.001), indicating that both parameters may measure the same characteristic of postural control and that higher sway frequency may play an important role in protecting stability in dual tasking. The postural control of dancers and non-dancers appears to be similar, although dancing seems to facilitate the increased level of automatic control in the antero-posterior plane.

Postural stability in young adults with down syndrome in challenging conditions

To evaluate postural control and performance in subjects with Down syndrome (SwDS), we measured postural sway (COP) in quiet stance in four 20-second tests: with eyes open or closed and on hard or foam surface. Ten SwDS and eleven healthy subjects participated, aged 29.8 (4.8) and 28.4 (3.9), respectively. The time-series recorded with the sampling rate of 100 Hz were used to evaluate postural performance (COP amplitude and mean velocity) and strategies (COP frequency, fractal dimension and entropy). There were no intergroup differences in the amplitude except the stance on foam pad with eyes open when SwDS had larger sway. The COP velocity and frequency were larger in SwDS than controls in all trials on foam pad. During stances on the foam pad SwDS increased fractal dimension showing higher complexity of their equilibrium system, while controls decreased sample entropy exhibiting more conscious control of posture in comparison to the stances on hard support surface. This indicated that each group used entirely different adjustments of postural strategies to the somatosensory challenge. It is proposed that the inferior postural control of SwDS results mainly from insufficient experience in dealing with unpredictable postural stimuli and deficit in motor learning.

Acute effects of cryotherapy on postural control

To investigate the acute effects of whole-body cryotherapy (WBC) on postural control, we measured postural sway (COP) in a quiet stance with eyes open in four consecutive 20-second tests: before and 1, 6 and 11min after the WBC. Twenty-four healthy young subjects aged 19.3±0.9 were exposed to WBC (-110°C) for 2min. The time series recorded with a sampling rate of 100Hz was used to evaluate postural performance (COP variability) and strategies (COP frequency and entropy). There were no differences between the pre- and post-WBC values of these measurements in the frontal plane; however, in the sagittal plane postural sway increased immediately after WBC (p<0.05) and remained elevated throughout the experiment. Deteriorated performance brought about lagged changes in postural strategies, including a decrease in frequency and entropy. These changes remained sustained until the end of the experiment. In conclusion, the WBC caused a drop in complexity, adaptability, and automaticity in postural control, which accounted for specific constraints imposed on the postural system due to cooling.

Changes in postural control between 13- and 19-year-old soccer players: is there a need for a specific therapy?

[Purpose] To investigate how increased training participation time and intensity affect postural control in young soccer players. [Subjects and Methods] Variability and mean velocity of sway were compared in U14 and U20 players during two-legged and one-legged quiet stances on a force plate with the player’s eyes open or closed. [Results] U20 players performed much better with vision, and eyes closure considerably deteriorated their performance. The increased reliance on vision in the older group most likely resulted from the longer exposure of the U20 players to strenuous exercise, overload, and cumulative residual effects of earlier contusions. [Conclusion] These specific postural deficits in apparently healthy soccer players were found only because of objective and sensitive posturographic tests. The results of this study suggest that such tests should be regularly performed to increase the efficiency and precision of motor control evaluation in athletes. The corresponding results may help therapists mitigate the indiscernible yet detrimental changes in postural control that predispose soccer players to injury and negatively affect their performance.

Attentional demands associated with augmented visual feedback during quiet standing

To investigate how additional visual feedback (VFB) affects postural stability we compared 20-sec center-of-pressure (COP) recordings in two conditions: without and with the VFB. Seven healthy adult subjects performed 10 trials lasting 20 seconds in each condition. Simultaneously, during all trials the simple auditory reaction time (RT) was measured. Based on the COP data, the following sway parameters were computed: standard deviation (SD), mean speed (MV), sample entropy (SE), and mean power frequency (MPF). The RT was higher in the VFB condition (p < 0.001) indicating that this condition was attention demanding. The VFB resulted in decreased SD and increased SE in both the medial-lateral (ML) and anterior-posterior (AP) planes (p < .001). These results account for the efficacy of the VFB in stabilizing posture and in producing more irregular COP signals which may be interpreted as higher automaticity and/or larger level of noise in postural control. The MPF was higher during VFB in both planes as was the MV in the AP plane only (p < 0.001). The latter data demonstrate higher activity of postural control system that was caused by the availability of the set-point on the screen and the resulting control error which facilitated and sped up postural control.

Repeated cryostimulation improves position sense and simple reaction time

[Purpose] Whole body cryotherapy has been shown to have many benefits, yet nothing is known if and how this modality can improve neuromuscular performance and retain those improvements. [Subjects and Methods] Joint position sense based on the bilateral knee joint matching test and simple reaction time was investigated in 25 young healthy adults who underwent an extended period of whole body cryostimulation. The measurements were taken at baseline and after 10, 20, and 30 whole body cryotherapy sessions, with three days elapsing after the last treatment, and comparing the results with 24 control subjects. [Results] Only when 20 sessions were completed did joint position sense and simple reaction time improve in the intervention group. After 30 sessions, the outcome was similar. Equal results were found at baseline and after 10 sessions in both groups, but the intervention group outstripped controls after 20 and 30 sessions in both joint position sense and simple reaction time. [Conclusion] These results indicate that the common standard of 10 sessions is insufficient, while approximately 20 sessions of whole body cryotherapy may efficiently enhance neuromuscular performance with an ability to sustain the effects for at least three days.

The Relationship Between Postural Control and Self-Reported Engagement in Physical Activity in Young and Older Age

Physical activity is known to have beneficial effects on a host of factors related to physical and mental health, and positively affects postural control. However, there is no agreement on which measures of postural control and to what extent they are dependent on the past and present physical activity in older adults. To answer this question we compared the postural performance in a 20-s quiet stance with eyes open on a Kistler force plate in 38 subjects, aged 60-92, who were formerly and are currently physically active (AA) with those who were always inactive (II) and those who were either formerly (AI) or are currently (IA) active. Results indicated that only current activity promoted better postural control while former activity was ineffective. Postural control in AA and IA was very similar and much better than in II and AI who, in contrast, displayed similarly deteriorated postural control.