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Investigating Human Balance and Postural Control During Bilateral Stance on BOSU Balance Trainer

Abstract

Balance and postural control are essential for performing activities of daily living to minimize risks of fall and injury. A proven way to improve postural stability and the perception of the somatosensory system is to utilize devices such as the BOSU balance trainer, wobble board and seesaw platform. It was reported that performing unilateral stance on BOSU could stimulate and eventually improve human neuromuscular system in maintaining body balance. However, this posture is challenging and may not be suitable for individuals with sedentary lifestyle. Therefore, this study investigates the ability of human postural control while performing bilateral stance on BOSU. Increase in center of pressure measures e.g. sway area, sway velocity, and the range of excursion in both anterior–posterior and medial–lateral directions were observed when subjects stood on BOSU, as compared to when they stood on the flat ground (p < 0.01). This study also found that vision played an important role in challenging environment. Significant differences were found when subjects were standing on BOSU with eyes closed and eyes open (p < 0.01). Hence, it can be deduced that bilateral stance on BOSU can stimulate neuromuscular system to coordinate the lower extremity in order to mitigate the instability and to reduce the risk of fall. Individuals with sedentary lifestyle or impaired balance, or patients who are recovering from minor ankle or knee injury can perform bilateral stance on BOSU, instead of unilateral stance to improve their balance and postural control.

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References

  1. Stanek, J. M., Meyer, J., & Lynall, R. (2013). Single-limb-balance difficulty on 4 commonly used rehabilitation devices. Journal of Sports Rehabilitation, 22, 288–295.

    Article  Google Scholar 

  2. Ridder, R. D., Willems, T., Vanrenterghem, J., & Roosen, P. (2015). Influence of balance surface on ankle stabilizing muscle activity in subjects with chronic ankle instability. Journal of Rehabilitation Medicine, 47, 632–638.

    Article  Google Scholar 

  3. Ashton-Miller, J. A., Wojtys, E. M., Huston, L. J., & Fry-Welch, D. (2001). Can proprioception really be improved by exercise? Knee Surgery, Sports Traumatology, Arthroscopy, 9, 128–136.

    Article  Google Scholar 

  4. Balter, S. G. T., Stokroos, R. J., Akkermans, E., & Kingma, H. (2004). Habituation to galvanic vestibular stimulation for analysis of postural control abilities in gymnasts. Neuroscience Letters, 366, 71–75.

    Article  Google Scholar 

  5. Pappas, E., & Hagins, M. (2008). The effects of ‘‘raked’’ stages on standing posture in dancers. Journal of Dance Medicine and Science., 12, 54–58.

    Google Scholar 

  6. Redfern, M. S., et al. (2001). Biomechanics of slips. Ergonomics., 44(1138–116), 6.

    Google Scholar 

  7. Mezzarane, R. A., & Kohn, A. F. (2007). Control of upright stance over inclined surfaces. Experimental Brain Research, 180, 377–388.

    Article  Google Scholar 

  8. Niu, W., Chu, Z., Yao, J., Zhang, M., Fan, Y., & Zhao, Q. (2012). Effects of laterality, ankle inversion and stabilizers on the plantar pressure distribution during unipedal standing. Journal of Mechanics in Medicine and Biology, 12, 1250055.

    Article  Google Scholar 

  9. Maeda, Y., Tanaka, T., Nakajima, Y., & Shimizu, K. (2011). Analysis of postural adjustment responses to perturbation stimulus by surface tilts in the feet-together position. Journal of Medical and Biological Engineering, 31, 301–305.

    Article  Google Scholar 

  10. Niu, W., et al. (2015). Effect of ankle eversion, limb laterality and ankle stabilizers on transient postural stability during unipedal standing. Journal of Medical and Biological Engineering, 25, 69–75.

    Article  Google Scholar 

  11. Lubetzky-Vilnai, A., McCoy, S. W., Price, R., & Ciol, M. A. (2015). Young adults largely depend on vision for postural control when standing on a BOSU ball but not on foam. The Journal of Strength & Conditioning Research, 29(10), 2907–2918.

    Article  Google Scholar 

  12. Kean, C. O., Behm, D. G., & Young, W. B. (2006). Fixed foot balance training increases rectus femoris activation during landing and jump height in recreationally active women. Journal of Sports Science & Medicine, 5(1), 138–148.

    Google Scholar 

  13. Kioumourtzoglou, E., Derri, V., Mertzanidou, O., et al. (1997). Experience with perceptual and motor skills in rhythmic gymnasts. Perceptual and Motor Skills, 84(3), 1363–1372.

    Article  Google Scholar 

  14. Davlin, C. D. (2004). Dynamic balance in high level athletes. Perceptual and Motor Skills, 98(3), 1171–1176.

    Article  Google Scholar 

  15. Martinez-Amat, A., et al. (2010). Effects of 12-week proprioception training program on postural stability, gait and balance in older adults: A controlled clinical trial. Journal of Strength Conditioning Research, 24, 218–222.

    Article  Google Scholar 

  16. Romero-Franco, N., Martinez-Lopez, E., Lomas-Vega, R., Hita-Contreras, F., & Martinez-Amat, A. (2012). Effects of proprioceptive training program on core stability and center of gravity control in sprinters. Journal of Strength and Conditioning Research, 26, 2071–2077.

    Article  Google Scholar 

  17. Yaggie, J. A., & Campbell, B. M. (2006). Effects of balance training selected skills. Journal of Strength and Conditioning Research, 20(2), 422–428.

    Google Scholar 

  18. Cosio-Lima, L. M., Reynolds, K. L., Winter, C., Paolone, V., & Jones, M. T. (2003). Effects of physioball and conventional floor exercise on early phase adaptations in back and abdominal core stability and balance in women. Journal of Strength and Conditioning Research, 17, 721–725.

    Google Scholar 

  19. Schibek, J. S., Guskiewicz, K. M., Prentice, W. E., Mays, S., & Davis, J. M. (2001). The effect of core stabilization training on functional performance in swimming. Master’s thesis, University of North Carolina, Chapel Hill.

  20. Menayo, R., Encarnación, A., Gea, G. M., & Marcos, P. J. (2014). Sample entropy-based analysis of differential and traditional training effects on dynamic balance in healthy people. Journal of Motor Behavior, 46(2), 73–82.

    Article  Google Scholar 

  21. Aragão, F. A., Karamanidis, K., Vaz, M. A., & Arampatzis, A. (2011). Mini-trampoline exercise related to mechanisms of dynamic stability improves the ability to regain balance in elderly. Journal of Electromyography and Kinesiology, 21(3), 512–518.

    Article  Google Scholar 

  22. Guskiewicz, K. M. (2011). Regaining postural stability and balance. In W. Prentice (Ed.), Rehabilitation techniques for sports medicing and athletic training (5th ed., pp. 144–174). New York: McGraw Hill.

    Google Scholar 

  23. Zech, A., Hubscher, M., Vogt, L., Banzer, W., Hansel, F., & Pfeifer, K. (2010). Balance training for neuromuscular control and performance enhancement: A systematic review. Journal of Athletic Training, 45(4), 392–403.

    Article  Google Scholar 

  24. Rougier, P. R. (2008). What insights can be gained when analyzing the resultant centre of pressure trajectory? Clinical Neurophysiology, 38, 363–373.

    Article  Google Scholar 

  25. Murray, M. P., Seireg, A., & Sepic, S. B. (1975). Normal postural stability and steadiness: Quantitative assessment. Journal of Bone Joint Surgery., 57A(4), 510–516.

    Article  Google Scholar 

  26. Kingma, I., Toussaint, H. M., Commissaris, D. A., Hoozemans, M. J., & Ober, M. J. (1995). Optimizing the determination of the body center of mass. Journal of Biomechanics, 28, 1137–1142.

    Article  Google Scholar 

  27. Winter, D. A., Prince, F., Frank, J. S., Powell, C., & Zabjek, K. F. (1996). Unified theory regarding A/P and M/L balance in quiet standing. Journal of Neurophysiology, 75, 2334–2343.

    Google Scholar 

  28. Schubert, P., & Kirchner, M. (2014). Ellipse area calculations and their applicability in posturography. Gait Posture., 39(1), 518–522.

    Article  Google Scholar 

  29. Bronstein, A. M., Hood, J. D., Gresty, M. A., & Panagi, C. (1990). Visual control of balance in cerebellar and Parkinsonian Syndromes. Brain, 113, 767–779.

    Article  Google Scholar 

  30. Schinkel-Ivy, A., Inness, E. L., & Mansfield, A. (2016). Relationships between fear of falling, balance confidence, and control of balance, gait, and reactive stepping in individuals with sub-acute stroke. Gait and Posture, 43, 154–159.

    Article  Google Scholar 

  31. Paillard, T., & Noe, F. (2006). Effect of expertise and visual contribution on postural control in soccer. Scandinavian Journal of Medicine and Science in Sports, 16(5), 345–348.

    Article  Google Scholar 

  32. Paillard, T., Noe, F., Riviere, T., Marion, V., Montoya, R., & Dupui, P. (2006). Postural performance and strategy in the unipedal stance of soccer players at different levels of competition. Journal of Athletic Training, 41(2), 172–176.

    Google Scholar 

  33. Muehlbauer, T., Roth, R., Bopp, M., & Granacher, U. (2012). An exercise sequence for progression balance training. Journal of Strength and Conditioning Research., 26(2), 568–574.

    Article  Google Scholar 

  34. Raymakers, J. A., Samson, M. M., & Verhaar, H. J. J. (2005). The assessment of body sway and the choice of the stability parameter(s). Gait and Posture., 21, 48–58.

    Article  Google Scholar 

  35. Stambolieva, K., Diafas, V., Bachev, V., Christova, L., & Gatev, P. (2012). Postural stability of canoeing and kayaking young male athletes during quiet stance. European Journal of Applied Physiology, 112, 1807–1815.

    Article  Google Scholar 

  36. Harringe, M. L., Halvorsen, K., Renstrom, P., & Werner, S. (2008). Postural control measured as the center of pressure excursion in young female gymnasts. Gait and Posture., 28, 38–45.

    Article  Google Scholar 

  37. Vuillerme, et al. (2001). The effect of expertise in gymnastics on postural control. Neuroscience Letters, 303(2), 83–86.

    Article  Google Scholar 

  38. Gerbino, P. G., Griffin, E. D., & Zurakowski, D. (2007). Comparison of standing balance between female collegiate dancers and soccer players. Gait and Posture., 26(4), 501–507.

    Article  Google Scholar 

  39. Croft, J., Von Tscharner, V., & Zernicke, R. (2008). Movement variability and muscle activity relative to center of pressure during unipedal stance on solid and compliant surfaces. Motor Control, 12, 283–295.

    Article  Google Scholar 

  40. Rocchi, L., Chiari, L., & Cappello, A. (2004). Feature selection of stabilometric parameters based on principal component analysis. Medical & Biological Engineering & Computing, 42, 71–79.

    Article  Google Scholar 

  41. Baltich, J., von Tscharner, V., Zandiyeh, P., & Nigg, B. M. (2014). Quantification and reliability of center of pressure movement during balance tasks of varying difficulty. Gait & Posture, 40, 327–332.

    Article  Google Scholar 

  42. Richman, J., & Moorman, J. R. (2000). Physiological time-series analysis using approximate entropy and sample entropy. American Journal of Physiology—Heart and Circulatory Physiology., 278, H2039–H2049.

    Google Scholar 

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Correspondence to Darwin Gouwanda.

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Gouwanda, D., Gopalai, A.A. Investigating Human Balance and Postural Control During Bilateral Stance on BOSU Balance Trainer. J. Med. Biol. Eng. 37, 484–491 (2017). https://doi.org/10.1007/s40846-017-0282-9

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  • DOI: https://doi.org/10.1007/s40846-017-0282-9

Keywords

  • Dynamic balance
  • Force platform
  • Center of pressure