Kim, Seo-hyun
(Department of Physical Therapy, The Graduate School, Yonsei University)
,
Lee, Kyung-eun
(Department of Physical Therapy, The Graduate School, Yonsei University)
,
Lim, One-bin
(Department of Physical Therapy, College of Health Science, Yonsei University)
,
Yi, Chung-hwi
(Department of Physical Therapy, College of Health Science, Yonsei University)
Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, ...
Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a co-contraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing.
Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a co-contraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing.
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문제 정의
No study has yet explored the effect of somatosensory feedback on ankle muscle co-contraction. Thus, the aim of this study was to compare the effects of feedback-free, AFOs and vibration on postural sway and muscle co-contraction with different sensory conditions. We hypothesized that augmented somatosensory feedback (AFOs and vibration) would reduce postural sway (the AREA and VEL parameters) and affect the co-contraction index (CI) during static standing.
가설 설정
Thus, the aim of this study was to compare the effects of feedback-free, AFOs and vibration on postural sway and muscle co-contraction with different sensory conditions. We hypothesized that augmented somatosensory feedback (AFOs and vibration) would reduce postural sway (the AREA and VEL parameters) and affect the co-contraction index (CI) during static standing.
제안 방법
They were instructed to try not to sway during measurements taken over 60 s during all tests. Each subject was then asked to perform postural tasks with two sensory conditions: Eyes opened (EO), or eyes closed, and head tilted back (ECHB). Under the EO condition, the subjects stared at a stationary sign on paper placed 2 m from the front of the platform.
Figure 2. Post-hoc comparisons of the effects of the three feedback conditions (control, AFOs, and vibration) on the (A) AREA, (B) VEL, and (C) CI values during static standing. AREA, the mean sway area of the 95% confidence ellipse; VEL, the mean velocity of the center of pressure displacements; CI, cocontraction index; AFOs, ankle-foot orthoses.
However, few studies have explored postural muscle co-contraction during augmented somatosensory feedback. Therefore, the aim of this study was to investigate whether postural sway (AREA and VEL) and CI changed during three feedback conditions delivered to subjects in two sensory conditions. The result suggested that AFOs not only improve postural control but also reduce postural muscle co-contraction.
대상 데이터
Fifteen young age subjects (11 males, 4 females; mean age: 22.9 ± 1.7 years, height: 169.5 ± 6.8 cm, weight: 68.1 ± 10.6 kg) participated in the study.
데이터처리
Three feedback conditions were tested in each sensory condition: 1) control, no AFOs or vibration (Figure 1A), 2) AFOs, Wearing the AFOs on both lower legs (Figure 1B), 3) Vibration, vibrators on both Achilles tendon (Figure 1C). The tests were performed in random order using a randomization sequence created by Microsoft Excel (Microsoft Corp., Roselle, IL, USA). The subjects sat for 60 seconds (rest periods) between each test.
성능/효과
In three feedback conditions (control, AFOs, and vibration), significant main effects on AREA (F = 1.004, p = 0.002) and VEL (F = 2.380, p < 0.001) were apparent (Table 2).
Our results suggest that AFOs of the somatosensory feedbacks improve postural sway and reduce ankle muscle co-contraction Such feedback stimulates muscle mechanoreceptors to enhance somatosensory awareness, rather than inducing excessive muscle contractions, and it is particularly sensitive to changes in body movements and position. Therefore, static balance training using flexible AFOs would effectively improve postural control while preventing excessive ankle muscle cocontraction during static standing.
Significant main effects of the two sensory conditions (EO and ECHB) on AREA (F = 0.680, p = 0.005) and VEL (F = 1.061, p < 0.001) were apparent (Table 2).
002) (Table 2). The AFOs significantly decreased the CI compared to the control condition (p = 0.004), but the effects of AFOs and vibration did not differ significantly (p = 0.133). The effect of vibration did not differ significantly from that of the control condition (p = 0.
후속연구
Third, we did not explore dynamic balance, which is critical in daily life. Further research should explore postural muscle co-contraction with dynamic balance.
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