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Introduction: Chronic Ankle Instability (CAI) is a musculoskeletal condition that evolves from acute ankle sprains, and its underlying mechanisms have yet to reach a consensus. Mounting evidence suggests that neuroplastic changes in the brain following ankle injuries play a pivotal role in the development of CAI. Balance deficits are a significant risk factor associated with CAI, yet there is a scarcity of evidence regarding the sensorimotor cortical plasticity related to balance control in affected individuals. This study aims to evaluate the differences in cortical activity and balance abilities between patients with CAI and uninjured individuals during a single-leg stance, as well as the correlation between these factors, in order to elucidate the neurophysiological alterations in balance control among patients with CAI. Methods: The study enrolled 24 patients with CAI and 24 uninjured participants. During single-leg stance, cortical activity was measured using a functional near-infrared spectroscopy (fNIRS) system, which included assessments of the pre-motor cortex (PMC), supplementary motor area (SMA), primary motor cortex (M1), and primary somatosensory cortex (S1). Concurrently, balance parameters were tested utilizing a three-dimensional force platform. Results: Independent sample t-tests revealed that, compared with the uninjured individuals, the patients with CAI exhibited a significant increase in the changes of oxyhemoglobin concentration (ΔHbO) during single-leg stance within the left S1 at Channel 5 (t = 2.101, p = 0.041, Cohen's d = 0.607), left M1 at Channel 6 (t = 2.363, p = 0.022, Cohen's d = 0.682), right M1 at Channel 15 (t = 2.273, p = 0.029, Cohen's d = 0.656), and right PMC/SMA at Channel 11 (t = 2.467, p = 0.018, Cohen's d = 0.712). Additionally, the center of pressure root mean square (COP-RMS) in the mediolateral (ML) direction was significantly greater (t = 2.630, p = 0.012, Cohen's d = 0.759) in the patients with CAI. Furthermore, a moderate positive correlation was found between ML direction COP-RMS and ΔHbO2 in the M1 (r = 0.436; p = 0.033) and PMC/SMA (r = 0.488, p = 0.016), as well as between anteroposterior (AP) direction COP-RMS and ΔHbO in the M1 (r = 0.483, p = 0.017). Conclusion: Patients with CAI demonstrate increased cortical activation in the bilateral M1, ipsilateral PMC/SMA, and contralateral S1. This suggests that patients with CAI may require additional brain resources to maintain balance during single-leg stance, representing a compensatory mechanism to uphold task performance amidst diminished lateral balance ability in the ankle joint. [ABSTRACT FROM AUTHOR]

The single-leg stance test is included in the FUNfitness (FF) screening for Special Olympic athletes to determine if balance education and/or referrals are needed. There are limited data regarding the use of the single-leg stance test for people with intellectual disabilities. Data were collected for this prospective study as part of the FF screens during the 2018 Special Olympics summer games. Each athlete completed the SLS test on the right (R) and left (L) lower extremity (LE), with eyes opened (SLS-EO) and closed (SLS-EC), and asked if they had fallen in the past year. A total of 178 athletes completed the test. Data analysis revealed a weak relationship between falls and SLS-EO (R LE rs = −0.170 and L LE rs = −0.185) and SLS-EC (R LE rs = −0.169 and L LE rs = −0.187), all of which were significant (p<.05). Sensitivity and specificity of the SLS-EO were low for both the R LE (74.5% and 42.2%, respectively) and L LE (74.5% and 42.7%, respectively). Sensitivity rose slightly with SLS-EC (R LE = 80.9% and L LE = 89.1%), while specificity decreased (R LE = 22.9% and L LE = 25.2%). The positive predictive values for SLS-EO and SLS-EC ranged from 27.3% to 31.8%. The SLS test demonstrated poor accuracy in identifying fallers in SO athletes with area under the curve values ranging from 0.610 to 0.623. These results indicate that the SLS test, or cutoff scores used, may not be the most appropriate for this population. [ABSTRACT FROM AUTHOR]

Auditory stimulation activates brain areas associated with higher cognitive processes, like the prefrontal cortex (PFC), and plays a role in postural control regulation. However, the effects of specific frequency stimuli on upright posture maintenance and PFC activation patterns remain unknown. Therefore, the study aims at filling this gap. Twenty healthy adults performed static double- and single-leg stance tasks of 60s each under four auditory conditions: 500, 1000, 1500, and 2000Hz, binaurally delivered through headphones, and in quiet condition. Functional near-infrared spectroscopy was used to measure PFC activation through changes in oxygenated hemoglobin concentration, while an inertial sensor (sealed at the L5 vertebra level) quantified postural sway parameters. Perceived discomfort and pleasantness were rated through a 0-100 visual analogue scale (VAS). Results showed that in both motor tasks, different PFC activation patterns were displayed at the different auditory frequencies and the postural performance worsened with auditory stimuli, compared to quiet conditions. VAS results showed that higher frequencies were considered more discomfortable than lower ones. Present data prove that specific sound frequencies play a significant role in cognitive resources recruitment and in the regulation of postural control. Furthermore, it supports the importance of exploring the relationship among tones, cortical activity, and posture, also considering possible applications with neurological populations and people with hearing dysfunctions. [ABSTRACT FROM AUTHOR]

Auditory stimulation activates brain areas associated with higher cognitive processes, like the prefrontal cortex (PFC), and plays a role in postural control regulation. However, the effects of specific frequency stimuli on upright posture maintenance and PFC activation patterns remain unknown. Therefore, the study aims at filling this gap. Twenty healthy adults performed static double- and single-leg stance tasks of 60s each under four auditory conditions: 500, 1000, 1500, and 2000 Hz, binaurally delivered through headphones, and in quiet condition. Functional near-infrared spectroscopy was used to measure PFC activation through changes in oxygenated hemoglobin concentration, while an inertial sensor (sealed at the L5 vertebra level) quantified postural sway parameters. Perceived discomfort and pleasantness were rated through a 0–100 visual analogue scale (VAS). Results showed that in both motor tasks, different PFC activation patterns were displayed at the different auditory frequencies and the postural performance worsened with auditory stimuli, compared to quiet conditions. VAS results showed that higher frequencies were considered more discomfortable than lower ones. Present data prove that specific sound frequencies play a significant role in cognitive resources recruitment and in the regulation of postural control. Furthermore, it supports the importance of exploring the relationship among tones, cortical activity, and posture, also considering possible applications with neurological populations and people with hearing dysfunctions.

This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study's findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training. [ABSTRACT FROM AUTHOR]

This study investigates gait symmetry and single-leg stance balance of professional yoga instructors versus age-matched typically developed controls using inertial measurement unit (IMU)-based evaluation. We recruited twenty-five yoga instructors and twenty-five healthy control subjects to conduct the walking experiments and single-leg stance tests. Kinematic data were measured by attaching IMUs to the lower limbs and trunk. We assessed the asymmetry of swing phases during the normal-walk and tandem-walk tests with eyes open and closed, respectively. The subjects subsequently conducted four single-leg stance tests, including a single-leg stance on both legs with eyes open and closed. Two balance indexes regarding the angular velocities of the waist and chest were defined to assess postural stability. The gait asymmetry indexes of yoga instructors were significantly lower than those of the typically developed controls. Similarly, the yoga instructors had better body balance in all four single-leg stance tests. This study’s findings suggest that yoga improves gait asymmetry and balance ability in healthy adults. In the future, further intervention studies could be conducted to confirm the effect of yoga training.

With the loss of a lower limb, amputees lack the active muscle empowered control of the ankle that is important for balance control. We examined single-leg stance on prosthesis vs. sound limb balancing on narrow ridges in transtibial amputees. When balancing on the prosthetic limb, the lateral displacement of the center of pressure was reduced and was compensated by an increase in counter-rotation. We show that single-leg stance on a prosthetic limb can be compared to balancing on a narrow ridge. Standing on a prosthetic limb involves the same balance mechanisms as balancing on narrow ridges of 40-mm to 20-mm width. Yet, the ability to balance on a narrow ridge with the sound limb was only a weak predictor for an amputee's ability to stand on the prosthetic limb. Balancing in single-leg stance on a prosthetic limb is not a common activity. The ability to compensate with the sound limb may therefore be functionally more important than the ability to stay in dynamic balance on the prosthetic limb. [ABSTRACT FROM AUTHOR]

Background An anterior cruciate ligament injury may lead to deteriorations in postural stability. The goal of this study was to evaluate postural stability during the transition from double-leg stance to single-leg stance of both legs in anterior cruciate ligament injured subjects and non-injured control subjects with a standardized methodology. Methods Fifteen control subjects and 15 anterior cruciate ligament injured subjects (time after injury: mean (SD) = 1.4 (0.7) months) participated in the study. Both groups were similar for age, gender, height, weight and body mass index. Spatiotemporal center of pressure outcomes of both legs of each subject were measured during the transition from double-leg stance to single-leg stance in eyes open and eyes closed conditions. Movement speed was standardized. Findings The center of pressure displacement after a new stability point was reached during the single-leg stance phase was significantly increased in the anterior cruciate ligament injured group compared to the control group in the eyes closed condition ( P < .001). No significant different postural stability outcomes were found between both legs within both groups ( P > .05). No significant differences were found during the transition itself ( P > .05). Interpretation The anterior cruciate ligament injured group showed postural stability deficits during the single-leg stance phase compared to the non-injured control group in the eyes closed condition. Using the non-injured leg as a normal reference when evaluating postural stability of the injured leg may lead to misinterpretations, as no significant differences were found between the injured and non-injured leg of the anterior cruciate ligament injured group. [ABSTRACT FROM AUTHOR]

Background Balance deteriorates with age and fall related injuries are often linked to long-term disability and loss of independence in older adults. This study focuses on the task of establishing single leg stance, which requires the ability to shift the center of mass onto the supporting leg. Methods Fifteen younger adults and eight older adults participated in the study. Subjects performed a step with self-selected step length onto the force plate to establish a single leg stance (SLS) on their dominant leg. The first four seconds of SLS were analyzed to investigate age related temporal dependencies of sway area, sway velocity, anterior–posterior sway, and medio-lateral sway. Findings Younger adults show a rapid decrease of sway area, anterior–posterior sway, medio-lateral sway, and sway velocity within the first fours seconds while older adults show elevated initial values in anterior–posterior sway and sway velocity and less decrease over time. Interpretation Older adults have not only diminished initial sway, but also less ability to control sway during the initial phase of single leg stance. The early phase of single leg stance is rather dynamic in older adults compared to younger adults who maintain their balance after three seconds with small adjustments. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To document the effects of repeated testing on the single-leg stance balance task. Design: Single cohort repeated measures. Setting: Laboratory in an educational institution. Subjects: Thirty-two healthy males and females. Outcome measure: The number of errors (deviations from the required posture) during each 20-s trial summed over the eight conditions recorded on six occasions. Results: There was a statistically significant (p=.0013) decrease in the number of errors recorded over the six sessions, from 26.8 (95% CI: 23.1–30.5) to 19.7 (95% CI: 16.3–23.1). Linear regression confirmed a systematic decrease of 1.5 errors per session on average (95% CI: 1.0–1.9; p<.0001). Conclusion: The decreased number of errors (increased performance) with repeated testing alerts clinicians to the need for care when using this test protocol to measure rehabilitation interventions. [Copyright &y& Elsevier]