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The postural system requires the sensory systems to maintain postural control (PC). Blind subjects use the somatosensory system to keep PC whereas sighted subjects use the visual system. So what happens to PC when challenging the sensory systems? We analyzed the center of pressure (COP) in ten blind and 10 sighted subjects under conditions: eyes open/closed (interference of visual system) and on firm/foam surfaces (interference of somatosensory system). We found that under the condition of eyes open on a firm surface, the blind subjects relied on the somatosensory system, whereas sighted subjects relied on the visual system. However, when eyes closed and on foam surface, similar behavior was found in both groups for all COP variables. In general blind subjects use their somatosensory system as the main sensory input to maintain PC.

Introduction: low back pain (LBP) is characterized by pain in the region between the last costal arches and the gluteal fold. It can occur due to several intrinsic and extrinsic factors, and it has a very high prevalence in adulthood, causing several problems which directly influence the quality of life. Neurosensory Postural Therapy (NPT) is a technique which uses manual neural stimulation to adjust muscle tone. Objective: The aim of the present study was to verify the effects of NPT on pain, mobility, flexibility, functionality, cardiac variability and body oscillation. Methodology: Seven women over 20 years old were recruited, which were evaluated before and after the technique, which consisted of pressure on the upper and lower roots of the sciatic nerve at 3 points for 60 seconds. Results: The mean pain score was 2.71 ± 1.38 and 1.35 ± 1.18, with a value of p = 0.02. For the Schöber test we obtained a mean of 21.93 ± 1.36 and 22.34 ± 1.30 cm in the pre- and post-test with p=0.01. No statistical difference was found in the Rolland Morris questionnaire. The electromyography obtained statistical difference in the analysis of the gluteus medius with p=0.02. Significant results (p=0.0001) were found in the lateral evaluation by the stabilometry and the HF/LF ratio showed difference with p=0.03 in the pretest and after 30 days. Conclusion: The technique of NPT has benefits in the parameters studies, demonstration being a fast technique with period of efficiency.

Background Children with Down syndrome have poorer functional and sensory skills compared to children with typical development. Virtual reality (VR) training could help improve these skills. Moreover, transcranial direct current stimulation (tDCS) has achieved promising results in terms of enhancing the effects of physical and sensory therapy by modulating cortical excitability. Methods/design Two investigations are proposed: (1) an observational study with a convenience sample consisting of children with Down syndrome (group 1—cognitive age of 6 to 12 years according to the Wechsler Abbreviated Scale of Intelligence) and children with typical development 6 to 12 years of age (group 2). Both groups will undergo evaluations on a single day involving a three-dimensional analysis of upper limb movements, an analysis of muscle activity of the biceps and brachial triceps muscles and an analysis of visuospatial and cognitive-motor variables. (2) Analysis of clinical intervention: a pilot study and clinical trial will be conducted involving individuals with Down syndrome (cognitive age of 6 to 12 years according to the Wechsler Abbreviated Scale of Intelligence). The sample will be defined after conducting a pilot study with the same methodology as that to be used in the main study. The participants will be randomly allocated to two groups: An experimental group submitted to anodal tDCS combined with a VR game and a manual motor task and a control group submitted to sham tDCS combined with a VR game and a manual motor task. The training protocol will involve 10 sessions of active or sham tDCS during memory and motor task games. Three 20-min sessions will be held per week for a total of 10 sessions. Evaluations will be performed on three different occasions: pre-intervention, post-intervention (after 10 sessions) and follow-up (1 month after the intervention). Evaluations will consist of analyses of electroencephalographic signals, electromyographic signals of the biceps and triceps brachii, and the three-dimensional reconstruction of the reaching movement. The results will be analyzed statistically with the significance level set at 5% (p ≤ 0.05). Discussion The optimization of the results obtained with virtual reality training is believed to be related to the interactive experience with a wide range of activities and scenarios involving multiple sensory channels and the creation of exercises, the intensity of which can be adjusted to the needs of children. Therefore, the proposed study aims to complement the literature with further information on tDCS and VR training considering different variables to provide the scientific community with clinical data on this combination of interventions. Trial registration Brazilian Clinical Trials Registry (REBEC) protocol number RBR-43pk59 registered on 2019 March 27 https://ensaiosclinicos.gov.br/rg/RBR-43pk59 and Human Research Ethics Committee number 3.608.521 approved on 2019 September 30. Protocol version 2021 October 20. Any changes to the protocol will be reported to the committees and approved. Informed consent will be obtained from all participants by the clinical research coordinator and principal investigator.

The present study assessed the effects of anodal transcranial direct current stimulation (tDCS) combined with treadmill training on spatiotemporal and kinematic variables in stroke survivors using gait speed as the primary outcome. A randomized, sham-controlled, triple-blind, study was conducted involving 28 patients with hemiparesis allocated to two groups. The experimental group was submitted to treadmill training combined with anodal tDCS over the primary motor cortex (M1) of the damaged hemisphere. The control group was submitted to treadmill training combined with sham tDCS. Stimulation was administered (2 mA, 20 min) five times a week for two weeks during treadmill training. No significant differences (p > 0.05) in spatiotemporal variables were found in the intra-group and inter-group analyses. However, the experimental group demonstrated improvements in kinematic variables of the knee and ankle (p < 0.05) and these results were maintained one month after the end of the intervention. The inter-group analysis revealed significant differences (p < 0.05) with regard to the pelvis, hip and knee. Anodal tDCS over M1 of the damaged hemisphere combined with treadmill training did not affect spatiotemporal variables, but promoted improvements in kinematic variables of the pelvis, hip, knee and ankle and results were maintained one month after treatment.

Background: Children with Down Syndrome have poorer functional and sensory skills compared to children with typical development. Virtual reality training could help improve these skills. Moreover, transcranial direct current stimulation has achieved promising results in terms of enhancing the effects of physical and sensory therapy by modulating cortical excitability. Methods/design The sample will be defined after conducting a pilot study with the same methodology as that to be used in the main study. The study will involve individuals with Down Syndrome with a cognitive age of six to 12 years according to the Wechsler Abbreviated Intelligence Scale. Will be randomly allocated into two groups: Group 1 AtDCS combined with a virtual reality game and a manual motor task. Group 2 sham AtDCS with a virtual reality game and a manual motor task. The training protocol will involve 10 sessions of AtDCS during memory and motor task games. Three 20-minute sessions will be held per week for a total of 10 sessions. Evaluations will be performed on three different occasions: pre-intervention, post-intervention (after session 10) and follow-up (one month after the proposed training). The evaluations will consist of an analysis of electroencephalographic signals, electromyographic signals of the biceps and triceps brachii and the three-dimensional reconstruction of the reaching movement. The results will be analyzed statistically, with the significance level set at 5% (p ≤ 0.05). Discussion: The optimization of the results obtained is believed to be related to interactive training with a wide range of activities and scenarios involving multiple sensory channels and the creation of exercises, the intensity of which can be adjusted to the needs of individuals. Therefore, the proposed study aims to complement the literature with further information and different variables to provide the scientific community with clinical data on this combination of interventions. Trial Registration: REBEC protocol number RBR-43pk59 registered on 2019/03/27 and Human Ethics Committee number 3.608.521 approved on 2019/09/30.

To maintain the balance, the postural system needs to integrate the three main sensorial systems: visual, vestibular, and somatosensory to keep postural control within the limits of stabilization. Damage of one of these systems, in this case, the vision, will have a great disturbance on the postural control influencing the behavior of the balance, resulting in falls. The aim of this study protocol for a randomized, controlled clinical trial is to analyze the effects of transcranial direct current stimulation (tDCS) combined with proprioceptive exercises on postural control in individuals with congenital and acquired blindness. In this randomized, controlled, double-blind, clinical trial, male, and female individuals with blindness between 18 and 55 years of age will participate in this study divided into three phases: 1—Determine differences in postural control and gait between individuals with congenital and acquired blindness with and without the use of a guide stick when wearing shoes and when barefoot; 2—A pilot study to analyze the effects a bilateral cerebellar anodal tDCS on postural on postural control and gait; and 3—A treatment protocol will be conducted in which the participants will be allocated to four groups: G1—active tDCS + dynamic proprioceptive exercises; G2—sham tDCS + dynamic proprioceptive exercises; G3—active tDCS + static proprioceptive exercises; and G4—sham tDCS + static proprioceptive exercises. Evaluations will involve a camera system for three-dimensional gait analysis, a force plate, and electromyography. Dynamic stability will be determined using the Timed Up and Go test and static stability will be analyzed with the aid of the force plate. The viability of this study will allow the determination of differences in postural control between individuals with congenital and acquired blindness, the analysis of the effect of tDCS on postural control, and the establishment of a rehabilitation protocol.

Team handball is a complex intermittent sport game, which requires several motor abilities and effective postural control. Objective evaluation of stabilometric variables may be interesting to assess and improve functional parameters by postural control management. The purpose of the study was to evaluate the effects of a small additional thickness placed under the great toe (TUGT) on the Centre of Pressure (CoP) parameters in elite women handball players. Fourteen elite women handball players voluntarily participated in this study. Two conditions were compared: TUGT 0 (control) and TUGT 0.8 mm; four variables were computed from the CoP displacements. A paired T‐test was performed for each variable. This study concludes that a low focal additional thickness placed under both great toes has an effect on the CoP measures used to assess postural control during an unperturbed stance. These results suggest that a low TUGT could contribute to a change in balance ability, and may be of clinical interest. This brings new perspectives in the management of athletes to prevent injury risk and optimize performance.

The world’s population is aging at a faster pace than it has ever before. This demographic tendency is directly linked to lower fertility rates and a steep reduction in mortality, especially in the western world. The aging process is progressive and dynamic; and involves biochemical, morphological, and functional alterations that progressively modify the organism, making it more susceptible to the deleterious effects of intrinsic and extrinsic factors, and insults that will eventually culminate in death. After the sixth decade of life, one of the main alterations that occurs, is the degradation of the neurological system and the development of neurovascular diseases and cerebral vascular dysfunction due to decreased cerebral blood flow and abnormal brain metabolism; which consequently elevate the risk of dementia related diseases. Some studies have demonstrated the positive effects of photobiomodulation in the human brain. But in the elderly, research on cerebral circulation is very scarce. We observed through Doppler ultrasonography that transcranial low level light therapy with an LED device (light-emitting diode device—627 nm, 70 mW/cm2, 10 J/cm2, for a total of 2 minutes) applied to in the frontal and parietal encephalic regions in elderly individuals, twice a week for 4 weeks, increased blood flow velocity in the middle and basilar cerebral arteries. Likewise, there was a reduction in PI and RI in the three arteries analyzed. We suggest that PBM with transcranial LED irradiation could be used as a prophylactic therapy in the elderly population, who are commonly affected by vascular and cognitive alterations derived from the aging process.

Background Photobiomodulation using low-level laser therapy (LLLT) has been tested as a new technique to optimize recovery of patients with traumatic brain injury (TBI). The aim of this study is to evaluate inhibitory attentional control after 18 sessions of active LLLT and compare with the placebo group (sham LLLT). Our exploratory analysis will evaluate the efficacy of the active LLLT on verbal and visuospatial episodic memory, executive functions (working memory, verbal and visuospatial fluency, attentional processes), and anxiety and depressive symptoms compared to the sham group. Methods/Design A randomized double-blinded trial will be made in 36 patients with moderate and severe TBI. The active LLLT will use an optical device composed of LEDs emitting 632 nm of radiation at the site with full potency of 830 mW. The cranial region with an area of 400 cm2 will be irradiated for 30 min, giving a total dose per session of 3.74 J/cm2. The sham LLLT group contains only an LED device with power

Introduction. This study evaluated the effects of foot reflexotherapy on pain and postural balance in elderly individuals with low back pain. Design. Randomized, controlled pilot study. Participants (n=20) were randomly assigned to 2 groups: individuals submitted to conventional foot massage (control group) or foot reflexotherapy (RT, intervention group) for a period of 5 weeks. Questionnaires on pain and disability (visual analogue scale [VAS] and Roland-Morris Disability Questionnaire [RMDQ]), heart rate variability, and orthostatic balance and baropodometric analysis were assessed at two intervals: before and after intervention. Results. RT group showed statistically significant differences when compared to control group in the following parameters: decrease in VAS scores for pain throughout the study, decrease in parasympathetic activity, and improvement in RMDQ scores. The two groups did not statistically differ in either orthostatic balance or baropodometric analyses. Conclusion. This study demonstrated that foot reflexotherapy induced analgesia but did not affect postural balance in elderly individuals with low back pain.

During aging processes, there is a range of functional changes, where we can highlight the disease related to the central nervous system, such as Alzheimer disease and others forms of dementia. This study investigated the effects of transcranial light emitting diode (LED) on cerebral blood flow in healthy elderly women analyzed by transcranial Doppler ultrasound (TCD) of the right and left middle cerebral artery and basilar artery. Twenty-five noninstitutionalized elderly women (mean age 72 years old), with a cognitive status >24, were assessed using transcranial Doppler ultrasound on two separate occasions: pre-irradiation and post-transcranial LED therapy (TCLT). Prior to this, they answered two questionnaires: the perceived stress scale and the general health questionnaire. TCLT (627 nm, 70 mW/cm2, 10 J/cm2) was performed at four points of the frontal and parietal region for 30 s each, totaling 120 s two times per week for 4 weeks. Paired t-test results showed that there was a significant improvement after TCLT with increase in the systolic and diastolic velocity of the left middle cerebral artery (25 and 30 %, respectively) and basilar artery (up to 17 and 25 %), as well as a decrease in the pulsatility index and resistance index values of the three cerebral arteries analyzed (p

Excessive Aβ deposition in the brain is associated with the formation of senile plaques, and their diffuse distribution is related to Alzheimer’s disease. Thirty rats (EG) were irradiated with light-emitting diode (photobiomodulation (PBM)) in the frontal region of the skull after being inoculated with the Aβ toxin in the hippocampus; 30 rats were used as the control group (CG). The analysis was conducted at 7, 14, and 21 days after irradiation. We observed a decreased in Aβ deposits in treated animals compared with animals in the CG. The behavioral and motor assessment revealed that the EG group covered a larger ground distance and explored the open field than the CG group on days 14 and 21 (p

Made available in DSpace on 2018-11-26T16:27:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-02-01 Objective: To determine the immediate effect of a Basic Body Awareness Therapy (BAT) session on measures of heart rate variability (HRV) in healthy young people. Methods: 13 healthy young subjects of both genders, who showed no illnesses related to the autonomic nervous system (ANS) underwent an ANS evaluation before and after conducting a session of BAT. The assessment of ANS activity was conducted through the HR with the aid of Nerve-Express (R) software. The BAT session lasted for 50 min and was performed by one investigator (blinded to the assessment procedures). Results: After BAT session significant improvement was found in the sympathetic and parasympathetic modulation (p < 0.05), and the general estimate of heart rate variability (p < 0.04). Conclusion: BAT was found to be an effective, easy to apply and inexpensive therapeutic technique, able to change ANS in order to improve HR which may suggest better health conditions for participating individuals. (C) 2015 Elsevier Ltd. All rights reserved. Univ Estadual Paulista, Inst Biosci, PhD Student Sci Motr, BR-19060900 Rio Claro, SP, Brazil Univ Estadual Paulista, Dept Post Grad Program Phys Therapy, BR-19060900 Presidente Prudente, Brazil Salgado Inst Integral Hlth, Sch Postural & Manual Therapy, BR-86055240 Londrina, PR, Brazil Nove Julho Univ, Rehabil Sci Master & Doctoral Degree Program, UNINOVE, BR-01504000 Sao Paulo, SP, Brazil Univ Estadual Paulista, Inst Biosci, PhD Student Sci Motr, BR-19060900 Rio Claro, SP, Brazil Univ Estadual Paulista, Dept Post Grad Program Phys Therapy, BR-19060900 Presidente Prudente, Brazil

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The Transcranial LED Therapy (TCLT) is a modality of low-level energy therapy based on the principle of photons delivered in a non-invasive manner for the rehabilitation of some neurological conditions such as psychological disorders, traumatic brain injuries, and neurodegenerative diseases among others. Because the phototherapy approach has attracted interest in the scientific medical field we discuss the action of TCLT at the cellular level in this review. Cytochrome c oxidase is the main target of TCLT for therapeutic effects by enhancing cerebral blood flow. This enzyme boosts cell respiration and energy production, which induces cell proliferation and reduces apoptosis in Alzheimer and Parkinson’s diseases. Thus, TCLT is a safe, non-invasive, and low cost alternative treatment compared to other treatment modalities for clinical neurological disorders.

BACKGROUND AND OBJECTIVE Poor back endurance is a predictor of low back pain. Few studies have investigated back muscle fatigue in older people. The purpose of this study was to compare the back muscle fatigue by endurance time and perceived effort between young and older adults during dynamic exercise. METHOD Sixteen older and 16 young adults, all healthy, participated in this study. The subjects performed a fatiguing trunk extension-flexion exercise on a Roman chair until exhaustion. Endurance time and perceived muscle fatigue (Borg CR-10 scale) were used as fatigue criteria. RESULTS The older adults were significantly (T _{(30)} = -2,073; p = 0.039) more resistant to back muscle fatigue (time in mean 133 ± 52 s) than the young adults (mean 97 ± 27 s). In general, both groups had the same perception of high-level fatigue during the exercise bout (T _{(29)} = 1.73; p=0.092). CONCLUSION The older adults presented better back endurance than young adults during a dynamic trunk extension exercise. These results have implications for back endurance in the primary prevention of low back pain in both young and older adults.

Muscle fatigue can influence the various mechanisms that regulate balance. Few studies have investigated the effects of trunk extensor muscle fatigue on postural control. The purpose of this study was to evaluate the impact of trunk extensor fatigue during a one-leg balance test in young and elderly adults, as well as to determine the time necessary to recover posture control after fatigue. A total of 36 subjects (18 elderly and 18 young adults) participated in the study. Subjects were tested on a force platform to assess the postural control parameters associated with center of pressure (COP) movements, before and after a fatiguing trunk extension-flexion exercise on a roman chair carried out to exhaustion. Post-fatigue effects and postural control recovery were investigated at different times in minutes (MIN): immediately post-fatigue (postIME), after 5 (rec5MIN), 10 (rec10MIN), and 20 min (rec20MIN). Elderly subjects had greater sway (P

Balance impairs with aging and may cause mobility limitations and functional decline. We aimed to evaluate postural balance and PADL in physically independent older adults with different levels of exercise capacity. One hundred fifty seven physically independent individuals, aged 60 years or older were evaluated. Postural balance assessment was performed during one-legged stance test using a force-platform and maximum exercise capacity with the incremental shuttle walking test (ISWT). PADL was assessed subjectively by the modified Baecke questionnaire and objectively using a pedometer. Based on the performance achieved in the ISWT, according to the percentage of the predicted value, the older adults were separated into 3 groups: low performance group (LP group, ISWT80% predicted, n = 32, 19 women), normal performance group (NP group, 80 ≤ ISWT ≤ 100% predicted, n = 30, 22 women) and high performance group (HP group, ISWT100% predicted, n = 95, 67 women). The HP group showed better postural balance when compared to LP groups (p0.001) and also higher levels of PADL measured with pedometer (p0.001). There was a modest correlation (r = 0.45) between exercise capacity and PADL in the LP group and a weak correlation between exercise capacity and balance (r = -28) in the HP group. Physically independent older adults with more preserved exercise capacity have better postural balance and higher levels of PADL in comparison to those older adults who show a poorer condition in terms of exercise capacity.

Introduction: Sensory information from vestibular, visual, proprioception, and feet contribute on postural control. Plantar afferent contribution comes from the tactile and nociceptive cues of the plantar sole. Nociceptive capacity of plantar irritating stimulus (NCPIS) is one of the foot problems that induce nociception. Objective: Was to determine the postural impact of sensory input flow modifications induced by foam in people with and without nociceptive plantar irritating stimuli in different ages (children, adolescents, and adults). Method: 120 participants with (NP) and X without (Ct) NCPIS in different age group were evaluated (20 subjects in each age group and conditions). Postural balance assessment was performed during two-legged stance test using a force platform. Postural recoding was performed with eyes open in two conditions: on a hard surface and on a foam surface. The postural balance parameter analyzed was center of pressure area and variance of speed. Results: Area and variance of speed in control group increased, whereas decreased in NP subjects. No differences were observed for mean speed. In the Ct group, nociceptor and mechanoreceptor afferent sensations on foam induced postural variation with more oscillations (area and speed). Conclusion: NCPIS influenced postural control, and this foam neutralization of afferent nociception induced a new sensory organization. Foam surface imitated afferent plantar sensory information, induced postural variation as measured by CoP parameters with increasing postural control in subjects without NCIPS and decreasing postural control in subjects with NCPIS.