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Purpose: Investigate the feasibility of a non-invasive method to evaluate the physical and cognitive repercussions of long-lasting post-concussion effects in professional combat sports athletes. To help athletes return to professional combat, there is a need for unbiased objective tools and techniques used as a prognostic method of recovery after Sport Related Concussion (SRC).Methods: Six mild Traumatic Brain Injury (mTBI) athletes, age 20 ÷ 43 yr (1 female, 5 males) and 7 not concussed (NC) participants (amateur), age 24 ÷ 38 yr (3 females, 4 males), were tested Inspired/expired gas concentration, Cerebral changes in oxygenated hemoglobin (Δ[HbO2]) and deoxygenated hemoglobin (Δ[HHb]) were measured using near infrared spectroscopy (NIRS) with a 3-step protocol: rest before maximal oxygen uptake (VO2max) test, hypercapnia, and recovery after VO2max test. The brain oxygenation and respiratory parameters of both sample sets were calculated using a non-parametric test (Mann-Whitney U test). Aerobic fitness outcome was quantified through mean average using the Bruce test. Participants performed Fitt's test using a laptop and analysis of medio-lateral and anterior-posterior range of oscillation was carried out via a force platform Romberg test.Results: mTBI group showed statistically significant differences in saturated hemoglobin Δ[HbO2] (p < 0.001) during rest and recovery phase after maximal incremental exercise, in medio-lateral sway eyes open (p = 0.008, NC 25.35 ± 4.11 mm and mTBI 17.65 ± 4.79 mm). VO2max revealed no significant differences between the two groups: NC 47.47 ± 4.91 mTBI 49.58 ± 5.19 ml/kg/min−1. The 2 groups didn't differ for maximum power output (NC 220 ± 34, mTBI 255 ± 50 W). End-tidal fractional concentration of O2 (FetO2 NC15.20 ± 0.41, mTBI 16.09 ± 0.68) throughout hypercapnia, saturated blood hemoglobin (Δ[HbO2]) revealed significant differences with the mTBI group. No differences emerged from Fitt's test.Conclusions: It emerges that NIRS is able to reveal differences in long time outcomes of mTBI. The medio-lateral variations cannot be considered as a marker of long-term damage in athletes specifically trained for balance.

The role of attentional focusing in motor tasks has been highlighted frequently. The “internal–external” dimension has emerged, but also the spatial distance between body and attended location. In two experiments, an extended attentional focus paradigm was introduced to investigate distality effects of attentional foci on balance performance. First, the distality of the coordinates of the point of focus was varied between a proximal and distal position on an artificial tool attached to the body. Second, the distance of the displayed effect on the wall was varied between a 2.5 and 5 m condition. Subjects were instructed to focus on controlling either a proximal or distal spot on a tool attached to their head, represented by two laser pointers. Subsequently, they needed to visually track their own body-movement effect of one of the laser pointers at a wall while completing various single leg stance tasks. Center of pressure (COP) sway was analyzed using a linear method (classic sway variables) as well as a non-linear method (multiscale entropy). In addition, laser trajectories were videotaped and served as additional performance outcome measure. Experiment 1 revealed differences in balance performance under proximal compared to distal attentional focus conditions. Moreover, experiment 2 yielded differences in balance-related sway measures and laser data between the 2.5 and 5 m condition of the visually observable movement effect. In conclusion, varying the distality of the point of focus between proximal and distal impacted balance performance. However, this effect was not consistent across all balance tasks. Relevantly, the distality of the movement effect shows a significant effect on balance plus laser performance with advantages in more distal conditions. This research emphasizes the importance of the spatial distality of movement effects for human behavior.

The role of attentional focusing in motor tasks has been highlighted frequently. The "internal–external" dimension has emerged, but also the spatial distance between body and attended location. In two experiments, an extended attentional focus paradigm was introduced to investigate distality effects of attentional foci on balance performance. First, the distality of the coordinates of the point of focus was varied between a proximal and distal position on an artificial tool attached to the body. Second, the distance of the displayed effect on the wall was varied between a 2.5 and 5 m condition. Subjects were instructed to focus on controlling either a proximal or distal spot on a tool attached to their head, represented by two laser pointers. Subsequently, they needed to visually track their own body-movement effect of one of the laser pointers at a wall while completing various single leg stance tasks. Center of pressure (COP) sway was analyzed using a linear method (classic sway variables) as well as a non-linear method (multiscale entropy). In addition, laser trajectories were videotaped and served as additional performance outcome measure. Experiment 1 revealed differences in balance performance under proximal compared to distal attentional focus conditions. Moreover, experiment 2 yielded differences in balance-related sway measures and laser data between the 2.5 and 5 m condition of the visually observable movement effect. In conclusion, varying the distality of the point of focus between proximal and distal impacted balance performance. However, this effect was not consistent across all balance tasks. Relevantly, the distality of the movement effect shows a significant effect on balance plus laser performance with advantages in more distal conditions. This research emphasizes the importance of the spatial distality of movement effects for human behavior. [ABSTRACT FROM AUTHOR]

With the progress of technologies of recent years, methods have become available that use wearable sensors and ambulatory systems to measure aspects of - particular axial - motor function. As Parkinson's disease ( PD) can be considered a model disorder for motor impairment, a significant number of studies have already been performed with these patients using such techniques. In general, motion sensors such as accelerometers and gyroscopes are used, in combination with lightweight electronics that do not interfere with normal human motion. A fundamental advantage in comparison with usual clinical assessment is that these sensors allow a more quantitative, objective, and reliable evaluation of symptoms; they have also significant advantages compared to in-lab technologies (e.g., optoelectronic motion capture) as they allow long-term monitoring under real-life conditions. In addition, based on recent findings particularly from studies using functional imaging, we learned that non-motor symptoms, specifically cognitive aspects, may be at least indirectly assessable. It is hypothesized that ambulatory quantitative assessment strategies will allow users, clinicians, and scientists in the future to gain more quantitative, unobtrusive, and everyday relevant data out of their clinical evaluation and can also be designed as pervasive (everywhere) and intensive (anytime) tools for ambulatory assessment and even rehabilitation of motor and (partly) non-motor symptoms in PD. [ABSTRACT FROM AUTHOR]

Introduction: The attribution of balance or gait disorders to psychogenic origin can be exceedingly challenging, as clinical tests involving distraction maneuvers are prone to subjective bias. We tested the value of biomechanical balance analysis to identify psychogenic balance and gait (PBG) disorders. Methods: We quantified and compared the effects of distraction maneuvers on balance based on four stance conditions (eyes open, EO; eyes closed, EC; EO on foam, EOF; and EC on foam; ECF) in subjects with suspected PBG (n=12), subjects with balance and gait disorder due to multiple sclerosis (MS; n=12) and healthy controls (n=12). We measured trunk inclination in transverse plane (°)2 and the corresponding body angular velocity (°/s). Distractibility of postural stability was analysed using ANOVA with repeated measures. Results: In evident contrast to the MS group and healthy controls, the PBG group showed increased values of (°)2 and (°/s) and significant distractibility in all four stance conditions. Conclusions: Biomechanical balance analysis can help clinicians to get objective, quantified results of distraction maneuvers and confirm a positive diagnosis of PBG disorders. Large prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Mechanisms of balance control are investigated on computerized posturography data on vertical two-legged and uncomfortable one-legged stance measured on healthy subjects. Oscillations of the centre of mass in the course of 30 s standing and the corresponding trajectories for a step forward off the force platform have been computed. Spectral analysis of the time series revealed three main harmonics for the studied postures. When a volunteer was balancing standing on one leg, all the harmonics were shifted towards the high frequencies and the sway amplitude was twice increased in comparison with comfortable two-legged vertical stance. Decomposition of the sway trajectories into the rambling and trembling components has been carried out. It was shown that in the course of the one-legged stance the balance control strategy includes 'scanning' of the larger area with bigger sway amplitudes in the vicinity of the stable state as compared to two-legged stance. A mathematical model of the body as a multi-link system is considered. Mass and inertia of each body segment and torques in joints are taken into consideration. The calculated own and forced frequencies of the model correspond to the spectral analysis of the posturography data. One-legged stance is proposed as an excellent tool for revealing the balance problems. It is shown that investigation of the oscillations and trajectories of the centre of mass for the step forward off the force platform is perspective for medical diagnostics to distinguish between the spine and joint pathologies. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to determine if Swaystar (University Hospital, Basel), a device that measures trunk sway, could be used in the office to detect abnormalities in patients who had vestibular abnormalities. Design: Prospective study design. Setting: Patients were referred to our tertiary and quaternary care dizziness clinic. Methods: We measured total sway amplitudes using Swaystar during tandem walking of 18 patients referred sequentially who were identified as abnormal by caloric testing. These patients were compared with age- and sex-matched subjects from our normative Swaystar databank. Main Outcome Measures: We measured total sway amplitude in pitch and roll planes with Swaystar during tandem walking testing with eyes open and eyes closed. Results: Patients with caloric abnormalities had significantly higher total sway than the age- and sex-matched normals from our normative databank. Conclusions: Swaystar is sensitive to measuring increased sway amplitude in patients with balance system deficits (as documented by caloric abnormalities) whether the patient is unstable in the pitch plane, roll plane, or both. [ABSTRACT FROM AUTHOR]

Purpose: Investigate the feasibility of a non-invasive method to evaluate the physical and cognitive repercussions of long-lasting post-concussion effects in professional combat sports athletes. To help athletes return to professional combat, there is a need for unbiased objective tools and techniques used as a prognostic method of recovery after Sport Related Concussion (SRC). Methods: Six mild Traumatic Brain Injury (mTBI) athletes, age 20 ÷ 43 yr (1 female, 5 males) and 7 not concussed (NC) participants (amateur), age 24 ÷ 38 yr (3 females, 4 males), were tested Inspired/expired gas concentration, Cerebral changes in oxygenated hemoglobin (Δ[HbO 2 ]) and deoxygenated hemoglobin (Δ[HHb]) were measured using near infrared spectroscopy (NIRS) with a 3-step protocol: rest before maximal oxygen uptake (VO 2 max) test, hypercapnia, and recovery after VO 2 max test. The brain oxygenation and respiratory parameters of both sample sets were calculated using a non-parametric test (Mann-Whitney U test). Aerobic fitness outcome was quantified through mean average using the Bruce test. Participants performed Fitt's test using a laptop and analysis of medio-lateral and anterior-posterior range of oscillation was carried out via a force platform Romberg test. Results: mTBI group showed statistically significant differences in saturated hemoglobin Δ[HbO 2 ] ( p < 0.001) during rest and recovery phase after maximal incremental exercise, in medio-lateral sway eyes open ( p = 0.008, NC 25.35 ± 4.11 mm and mTBI 17.65 ± 4.79 mm). VO 2 max revealed no significant differences between the two groups: NC 47.47 ± 4.91 mTBI 49.58 ± 5.19 ml/kg/min -1 . The 2 groups didn't differ for maximum power output (NC 220 ± 34, mTBI 255 ± 50 W). End-tidal fractional concentration of O 2 (FetO 2 NC15.20 ± 0.41, mTBI 16.09 ± 0.68) throughout hypercapnia, saturated blood hemoglobin (Δ[HbO 2 ]) revealed significant differences with the mTBI group. No differences emerged from Fitt's test. Conclusions: It emerges that NIRS is able to reveal differences in long time outcomes of mTBI. The medio-lateral variations cannot be considered as a marker of long-term damage in athletes specifically trained for balance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tiberini, D'Antona and Cicchella.)