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11 pages, 750 KiB  
Article
Wobble Board Performance: A Practical and Useful Quantification in Balance Assessment
by Philip X. Fuchs, Andrea Fusco, Tzyy-Yuang Shiang, Cristina Cortis and Herbert Wagner
Appl. Sci. 2024, 14(14), 6113; https://doi.org/10.3390/app14146113 - 13 Jul 2024
Viewed by 1145
Abstract
Balance is integral in ankle injury prevention and therapy, especially in high-risk sports like volleyball. For balance assessment, the recommended wobble board (WB) performance (i.e., time at equilibrium) has never been compared with the gold standard. The objective was to investigate the relationships [...] Read more.
Balance is integral in ankle injury prevention and therapy, especially in high-risk sports like volleyball. For balance assessment, the recommended wobble board (WB) performance (i.e., time at equilibrium) has never been compared with the gold standard. The objective was to investigate the relationships of force-plate-derived center of pressure (CoP) with WB performance and the accuracy of WB-derived CoP estimates. Twelve high-level volleyball players completed six unipedal standing trials on a computerized WB. WB tilt angles and CoP were obtained simultaneously via tri-axis accelerometers on the WB (200 Hz) and a force plate (1000 Hz), respectively. WB performance, polynomial-transformed CoP estimates, and CoP fractal sway, sway area, and mean sway velocity were assessed via Pearson and concordance correlation, root mean square errors, and dependent t-tests. WB performance was related with CoP sway and sway area (|rlinear| = 0.714–0.842, |rnonlinear| = 0.833–0.910, p < 0.01). The strongest concordance (0.878–0.893, p < 0.001) and smallest errors (6.5–10.7%) were reported for anterior–posterior sway and sway area. Moderate to excellent relationships between the WB performance and force plate CoP variables supported the usefulness of WB performance and estimates (especially sway area) in balance assessment. Furthermore, this study presents recommendations for future analyses and modeling approaches to reflect the complexity of postural control. Full article
(This article belongs to the Special Issue Sports Medicine: Latest Advances and Prospects)
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<p>Correlation coefficients r between wobble board (WB) performance and force-plate-derived center of pressure variables during different measurement sessions.</p>
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<p>Scatterplots of wobble board (WB) performance and force-plate-derived center of pressure variables (i.e., anterior–posterior sway, mediolateral sway, sway area, and mean sway velocity) with correlation results expressing linear relationship (grey straight line; r<sub>lin</sub>) and nonlinear relationship via polynomial least square fit (black dotted curve; r<sub>non</sub>) as well as the polynomial regression equation.</p>
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14 pages, 2097 KiB  
Article
Do Hand Exercises Influence Physiological Hand Tremor? An Observational Cohort Study on Healthy Young Adults
by Olga Papale, Francesca Di Rocco, Emanuel Festino, Viviana Gammino, Cristina Cortis and Andrea Fusco
Appl. Sci. 2024, 14(11), 4467; https://doi.org/10.3390/app14114467 - 23 May 2024
Viewed by 1772
Abstract
Physiological hand tremors appear to be one of the most common types of tremors that occur during the lifespan. Activities most prominently affected by hand tremors are those involving the movement of small muscles, such as fine motor skills, which in turn could [...] Read more.
Physiological hand tremors appear to be one of the most common types of tremors that occur during the lifespan. Activities most prominently affected by hand tremors are those involving the movement of small muscles, such as fine motor skills, which in turn could be influenced by several factors, including lateral dominance. The difference in skills due to lateral dominance is defined as inter-limb imbalance or inter-limb asymmetry. When this asymmetry is attributed to the tremor and the difference in tremor between the limbs, it could be defined as the inter-limb asymmetry of tremors. This study aimed to evaluate the acute effects of wobble-board hand exercise training on the inter-limb asymmetry of tremors. Thirty-two (eighteen males and fourteen females) participants (age: 25.2 ± 2.6 years, weight: 63.9 ± 10.5 kg, height: 1.66 ± 0.8 m, and BMI: 22.8 ± 2.3 kg/m2) were involved in the study. Before (PRE) and after (POST) the wobble-board hand exercises, postural hand tremor was evaluated using a tri-axial accelerometer fixed under the palm. Recordings were taken for 15 s. One-way Analysis of Variance (ANOVA) was used to examine the effects of hand exercises on inter-limb (dominant vs. non-dominant) asymmetry of tremor in testing time (PRE vs. POST) in relation to sex (male vs. female). The statistical significance was set at p < 0.05. Significant differences were found in physiological hand tremors between limbs (dominant vs. non-dominant) in the PRE evaluation (p = 0.03) independently from sex while no differences were found in the POST evaluation. A significant difference emerged in the PRE evaluation for males (p = 0.04) and females (p = 0.03) in relation to the testing time and preferred hand. This difference was no longer present in the POST evaluation. In conclusion, wobble-board hand exercises could represent an effective strategy to reduce inter-limb asymmetry. These results emphasize the importance of task-specific training to maximize the reduction in inter-limb asymmetry of tremors following wobble-board hand exercises. Full article
(This article belongs to the Special Issue Applied Biomechanics and Motion Analysis)
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<p>Timeline of the experimental procedures.</p>
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<p>Tri-axial accelerometer attached to the hand using the customized elastic belt (<b>a</b>). Starting (<b>b</b>) and recording (<b>c</b>) positions of the hand during physiological hand tremor measurement.</p>
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<p>Standard upper-limb wobble-board hand exercise position with the working limb placed at 90° on the wobble board and the contralateral one resting on the same side (<b>a</b>) with the monitor at eye level 2 m away (<b>b</b>).</p>
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<p>Means and standard deviations of the acceleration during tremor before (PRE) and after (POST) the wobble-board hand exercise for dominant and non-dominant limbs. * Significant differences between dominant and non-dominant limbs.</p>
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<p>Means and standard deviations of the acceleration during tremor before (PRE) and after (POST) the wobble-board hand exercises in male and female participants. * Significant differences between male and female participants.</p>
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<p>Means and standard deviations of the acceleration during tremor before (PRE) and after (POST) the wobble-board hand exercises in male and female participants for dominant and non-dominant limbs. * Significant differences between dominant and non-dominant limbs for males and females, respectively.</p>
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11 pages, 1022 KiB  
Article
Could Mini-Trampoline Training Be Considered as a New Strategy to Reduce Asymmetries?
by Marianna De Maio, Francesca Di Rocco, Olga Papale, Emanuel Festino, Andrea Fusco and Cristina Cortis
Appl. Sci. 2023, 13(5), 3193; https://doi.org/10.3390/app13053193 - 2 Mar 2023
Cited by 2 | Viewed by 2264
Abstract
Inter-limb asymmetry is defined as the performance imbalance of a limb with respect to the other one. Studies demonstrated how plyometric training could minimize inter-limb imbalance by reducing asymmetries and the relative risk of musculoskeletal injuries. Among the different plyometric training modalities, SuperJump [...] Read more.
Inter-limb asymmetry is defined as the performance imbalance of a limb with respect to the other one. Studies demonstrated how plyometric training could minimize inter-limb imbalance by reducing asymmetries and the relative risk of musculoskeletal injuries. Among the different plyometric training modalities, SuperJump® represented a reliable method. This study aimed to evaluate the acute effects of SuperJump® training on dynamic balance Unilateral Asymmetry and Bilateral Asymmetry Indexes. Thirty-seven subjects were randomly allocated in two groups: SuperJump® (N = 20) and Control (N = 17). The SuperJump® group participated in the SuperJump® session, whereas the Control group did not receive any workout session. Before (PRE) and after (POST) the SuperJump® session, both groups performed the Wobble Board balance test. A significant difference (p < 0.003) between the SuperJump® in POST and Control groups in PRE intervention for dominant leg was found. No significant differences (p > 0.05) emerged between groups in testing time on Bilateral Asymmetry Index. Significant differences (p = 0.005) between PRE and POST in the SuperJump® group and an 18.9% Unilateral Asymmetry Index threshold reduction for the subjects were found. A strong relationship (R2 = 0.79) between delta (∆) change Unilateral Asymmetry Index and Unilateral Asymmetry Index baseline parameters was tested. Lastly, no significant differences (p > 0.05) in Unilateral Asymmetry Indexes between the Bilateral Asymmetry equal and change categories in the SuperJump® group was found. In conclusion, SuperJump® training played a key role in reducing Unilateral Asymmetry Index. Full article
(This article belongs to the Section Applied Biosciences and Bioengineering)
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<p>Flow chart of the recruitment and selection process of the subjects included in the study.</p>
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<p>Means and standard deviations of Unilateral Asymmetry Index between SuperJump<sup>®</sup> (SJG) and Control (CON) groups before (PRE) and after (POST) the training session. * significantly differences for SuperJump<sup>®</sup> group between testing time.</p>
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<p>Delta change between before (PRE) and after (POST) the exercise testing values for Unilateral Asymmetry Index (R<sup>2</sup> = 0.79, <span class="html-italic">p</span> &lt; 0.0001).</p>
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<p>Means and standard deviations of Unilateral Asymmetry Index between the Bilateral Asymmetry equal and change categories.</p>
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10 pages, 1338 KiB  
Protocol
The Effect of a Combined Exercise Program on Postural Control and Fine Motor Skills in Parkinson’s Disease: Study Design
by Marianna De Maio, Loriana Castellani, Lucia Cugusi, Cristina Cortis and Andrea Fusco
Int. J. Environ. Res. Public Health 2022, 19(22), 15216; https://doi.org/10.3390/ijerph192215216 - 18 Nov 2022
Viewed by 2756
Abstract
Parkinson’s disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim [...] Read more.
Parkinson’s disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim to evaluate the effect a of postural and fine motor skills training program in older adults with PD. PD individuals, with mild to moderate stage PD, aged between 65 to 80 years, will be voluntary selected from the Nursing Home Residences and Rehabilitation Centers. Subsequently, they will be randomly assigned to intervention group (PD) to receive a combined training program (postural control and fine motor skills exercises) or to the Control group (CON) to receive a stretching program. Before (PRE) and after (POST) a 12-week program both groups will perform wobble board (WB) and grooved pegboard (GPT) tests. Different performances between groups will be expected: (1) no significant differences between PD and CON group for WB and GPT test values before the beginning of the training intervention (PRE); (2) significantly better WB and GPT test values in PD subjects after the training intervention (POST) when compared to the base values (PRE); and (3) no significant differences in WB and GPT test values in CON subjects after the training intervention (POST) when compared to the base values (PRE). The findings of the present study protocol could be used for future studies investigating clinical populations, such as PD, and the effects of different rehabilitative interventions aiming to improve postural control and fine motor skills performances assessed by WB and GPT tests. Full article
(This article belongs to the Special Issue Feature Papers in Sport, Performance and Physical Fitness)
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<p>Standard lower limb Wobble Board test position.</p>
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<p>Standard upper limb Wobble Board test position.</p>
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<p>Standard Grooved Pegboard test position.</p>
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10 pages, 715 KiB  
Article
Influence of Rehabilitation Aid with Biofeedback on the Rehabilitation Process during Remote Home-Based Rehabilitation
by Mariana Zadrapova, Eva Mrázková, Miroslav Janura, Michal Strycek and Martin Cerny
Int. J. Environ. Res. Public Health 2022, 19(15), 9069; https://doi.org/10.3390/ijerph19159069 - 25 Jul 2022
Cited by 1 | Viewed by 1853
Abstract
Ensuring the regularity and correctness of rehabilitation exercises in the home environment is a prerequisite for successful treatment. This clinical study compares balance therapy in the home environment on a conventional balance mat and an instrumented wobble board, with biofeedback supported by a [...] Read more.
Ensuring the regularity and correctness of rehabilitation exercises in the home environment is a prerequisite for successful treatment. This clinical study compares balance therapy in the home environment on a conventional balance mat and an instrumented wobble board, with biofeedback supported by a rehabilitation scheme realized as web-based software that controls the course of rehabilitation remotely. The study included 55 patients with knee injuries. The control group consisted of 25 patients (12 females and 13 males, mean age 39 ± 12 years) and the study group of 30 patients (19 females and 11 males, mean age 40 ± 12 years). Treatment effects were compared using the ICS Balance Platform measurement system. Measurements showed significant differences in the change in ICS Balance platform parameters representing the dynamic stability of the patients. The dynamic stability improved more with the instrumented wobble board. The study did not show an influence of different methods of communication with patients during home-based rehabilitation. Full article
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<p>Experimental wobble board setup.</p>
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<p>User interface for the experimental wobble board.</p>
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16 pages, 2241 KiB  
Article
Scoring of Human Body-Balance Ability on Wobble Board Based on the Geometric Solution
by Hang Thi Phuong Nguyen, Yeongju Woo, Ngoc Nguyen Huynh and Hieyong Jeong
Appl. Sci. 2022, 12(12), 5967; https://doi.org/10.3390/app12125967 - 11 Jun 2022
Cited by 7 | Viewed by 3024
Abstract
Many studies have reported that the human body-balance ability was essential in the early detection and self-management of chronic diseases. However, devices to measure balance, such as motion capture and force plates, are expensive and require a particular space for installation as well [...] Read more.
Many studies have reported that the human body-balance ability was essential in the early detection and self-management of chronic diseases. However, devices to measure balance, such as motion capture and force plates, are expensive and require a particular space for installation as well as specialized knowledge for analysis. Therefore, this study aimed to propose and verify a new algorithm to score the human body-balance ability on the wobble board (HBBAWB), based on a geometric solution using a cheap and portable device. Although the center of gravity (COG), the projected point of the center of mass (COM) on the fixed ground, has been used as the index for the balance ability, generally, it was not proper to use the COG under the condition of no fixed environment. The reason was that the COG index did not include the information on the slope for the wobble. Thus, this study defined the new index as the perpendicular-projection point (PPP), which was the projected point of the COM on the tilted plane. The proposed geometric solution utilized the relationship among three points, the PPP, the COM, and the middle point between the two feet, via linear regression. The experimental results found that the geometric solution, which utilized the relationship between the three angles of the equivalent model, enabled us to score the HBBAWB. Full article
(This article belongs to the Special Issue Biomechanics and Human Motion Analysis)
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<p>(<b>a</b>) An overview of experimental environment, system, and (<b>b</b>) a definition of variables for an equivalent model, which is expressed as an inverted pendulum on wobble board.</p>
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<p>An example of detected key points as variables in a segmented part (arm), in order to explain how to calculate the location of the center of mass (COM).</p>
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<p>An illustration of the human body on the wobble board with necessary parameters: perpendicular-projection point (PPP), the base of foot (BOF), the center of gravity (COG), the line of gravity, and the perpendicular line under the stable (<b>left side</b>) and unstable (<b>right side</b>) balance conditions.</p>
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<p>A description of boundary conditions based on the location of the perpendicular-projection point (PPP), and the state of human balance on the wobble board under the boundary condition.</p>
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<p>An explanation for the proposed algorithm to score the human body-balance ability on the wobble board (HBBAWB) through the geometric solution under the boundary condition.</p>
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<p>The example of calculating the angle between three points (A, B, C) in three dimensions.</p>
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<p>The results of the specifications were displayed on the screen of the scoring system.</p>
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<p>The results of some examples to score the human body-balance ability on the wobble board (HBBAWB) based on the geometric solution: (<b>a</b>) represents the results under the boundary condition and (<b>b</b>) represents within the boundary condition.</p>
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<p>The results of line plot between angles of <math display="inline"><semantics> <mi>α</mi> </semantics></math> and <math display="inline"><semantics> <msub> <mi>θ</mi> <mn>1</mn> </msub> </semantics></math>: <math display="inline"><semantics> <mi>α</mi> </semantics></math> of blue-colored plot represents the angle between three points of the base of the foot (BOF), the center of mass (COM), and the perpendicular-projection point (PPP), while <math display="inline"><semantics> <msub> <mi>θ</mi> <mn>1</mn> </msub> </semantics></math> of orange-colored plot represents the tilted slope of the wobble board.</p>
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<p>The results of trajectories of the center of gravity (COG) when the human subject stands on the wobble board.</p>
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<p>The results of VideoPose3D and BlazePose GHUM for the comparison of three-dimensional pose estimation performance and accuracy: seventeen double-colored circles represent the results of VideoPose3D, and seventeen red-colored circles represent that of BlazePose GHUM in white-colored circles.</p>
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12 pages, 1000 KiB  
Article
Effect of Combined Balance Exercises and Kinesio Taping on Balance, Postural Stability, and Severity of Ankle Instability in Female Athletes with Functional Ankle Instability
by Sara Mahmoudzadeh Khalili, Amir Hossein Barati, Rafael Oliveira and Hadi Nobari
Life 2022, 12(2), 178; https://doi.org/10.3390/life12020178 - 26 Jan 2022
Cited by 16 | Viewed by 6971
Abstract
Ankle sprain is a common musculoskeletal injury, and recurrent ankle sprains often lead to ankle instability. This study aimed to examine whether a 6-week balance training on a wobble board (WB) combined with kinesio taping (KT) is effective in improving balance, postural stability, [...] Read more.
Ankle sprain is a common musculoskeletal injury, and recurrent ankle sprains often lead to ankle instability. This study aimed to examine whether a 6-week balance training on a wobble board (WB) combined with kinesio taping (KT) is effective in improving balance, postural stability, and ankle stability among female athletes with functional ankle instability (FAI). Twenty-four female athletes with FAI were randomly assigned to study (SG) or control groups (CG). SG attended a 6-week training protocol of combined balance training on the wobble board with KT applied to ankles during exercise. CG only went through a 6-week balance training procedure that was the same as the SG. Before and after the training program, balance and postural stability and the severity of ankle instability were assessed by single-leg Biodex Balance system and Cumberland Ankle Instability Tool (CAIT), respectively. The analysis revealed that the scores of balance and postural stability decreased after the 6-week training for CG (p = 0.002) and SG (p = 0.001), which indicates an improvement for these variables, and the score of CAIT increased, which means the severity of instability reduced (p = 0.001 for both groups). Significant between-group differences were found for balance and postural stability (t = 2.79, p = 0.011, g = −1.99) and the severity of instability (t = 2.082, p = 0.049, g = 1.36), favoring SG compared with CG. This study showed that the addition of KT to balance training is more effective than balance training alone in improving balance, postural stability, and severity of ankle instability in female athletes with FAI. Our findings could provide a preliminary reference for designing combined balance and KT programs for delivering health benefits to females with FAI. Full article
(This article belongs to the Special Issue The Biomechanics of Injury and Rehabilitation)
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<p>Balance exercises on wobble board.</p>
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<p>Kinesio taping technique.</p>
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12 pages, 1479 KiB  
Article
Association between Anthropometric Variables, Sex, and Visual Biofeedback in Dynamic Postural Control Assessed on a Computerized Wobble Board
by Marianna De Maio, Cristina Cortis, Alice Iannaccone, Rubens A. da Silva and Andrea Fusco
Appl. Sci. 2021, 11(18), 8370; https://doi.org/10.3390/app11188370 - 9 Sep 2021
Cited by 6 | Viewed by 2635
Abstract
Anthropometrics and sex influence balance performances, and visual information can change anthropometrics’ relation and the postural sway. Therefore, the aim of the present study was to evaluate the effect of anthropometric characteristics, sex, and visual biofeedback and/or their interaction on a computerized wobble [...] Read more.
Anthropometrics and sex influence balance performances, and visual information can change anthropometrics’ relation and the postural sway. Therefore, the aim of the present study was to evaluate the effect of anthropometric characteristics, sex, and visual biofeedback and/or their interaction on a computerized wobble board. Twenty-seven (14 females, 13 males) young adults performed three 30-s double leg stance trials on a wobble board during two conditions: with visual and without visual biofeedback. Visual biofeedback improved (p = 0.010) balance on a wobble board with respect to the condition without visual biofeedback. Regardless of sex, no differences between conditions were found (p = 0.088). When investigating the effect of anthropometrics variables, sex, and their interactions on conditions, a significant main effect of the lower limb/height ratio, sex, and their interaction on the condition without visual biofeedback was found (p = 0.0008; R2 = 0.57). For the visual biofeedback condition, significant effects for sex and body mass (p = 0.0012; R2 = 0.43) and sex and whole-body moment of inertia (p = 0.0030; R2 = 0.39) were found. Results from the present study showed (1) visual biofeedback improved wobble board balance performance; (2) a significant main effect of lower limb/height ratio, sex, and their interaction on the wobble board performances without visual biofeedback emerged; (3) significant effects were found for sex and body mass and sex and moment of inertia in the visual biofeedback condition. Findings from the present study could have an impact on training and evaluations protocols, especially when several populations such as children, athletes, older adults and people with balance disorders are involved. Full article
(This article belongs to the Special Issue Biomechanical Spectrum of Human Sport Performance Ⅱ)
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<p>Means and standard deviations of wobble board balance performances (WB) for visual biofeedback (VBF) and no visual biofeedback (NVBF) in both sexes. * significantly different from the no visual biofeedback (NVBF) in male and female.</p>
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<p>Wobble board (WB) performance trend over trials for the visual biofeedback (VBF) and no visual biofeedback (NVBF) conditions.</p>
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<p>The interaction of lower limb/height ratio (HTR) and sex in the no visual biofeedback (NVBF) condition.</p>
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<p>Main effect of body mass on the wobble board performance (WB) during the visual biofeedback (VBF) condition in relation to sex.</p>
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<p>Main effect of whole-body moment of inertia (MI) on the wobble board performance (WB) during the visual biofeedback (VBF) condition in relation to sex.</p>
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11 pages, 971 KiB  
Article
Effects of Differential Jump Training on Balance Performance in Female Volleyball Players
by Philip X. Fuchs, Andrea Fusco, Cristina Cortis and Herbert Wagner
Appl. Sci. 2020, 10(17), 5921; https://doi.org/10.3390/app10175921 - 26 Aug 2020
Cited by 11 | Viewed by 4085
Abstract
The purpose of this study was to determine whether coordinative jump training that induces neuromuscular stimuli can affect balance performance, associated with injury risk, in elite-level female volleyball players. During the competitive season, the balance performance of 12 elite female players (highest Austrian [...] Read more.
The purpose of this study was to determine whether coordinative jump training that induces neuromuscular stimuli can affect balance performance, associated with injury risk, in elite-level female volleyball players. During the competitive season, the balance performance of 12 elite female players (highest Austrian division) was obtained via a wobble board (WB; 200 Hz) placed on an AMTI force plate (1000 Hz). Three identically repeated measurements defined two intervals (control and intervention phases), both comparable in duration and regular training. The intervention included 6 weeks of differential training (8 sessions of 15–20 min) that delivered variations in dynamics around the ankle joints. Multilevel mixed models were used to assess the effect on postural control. WB performance decreased from 27.0 ± 13.2% to 19.6 ± 11.3% during the control phase and increased to 54.5 ± 16.2% during the intervention (β = 49.1 ± 3.5; p < 0.001). Decreased sway area [cm²] (β = −7.5 ± 1.6; p < 0.001), anterior–posterior (β = −4.1 ± 0.4; p < 0.001) and mediolateral sway [mm] (β = −2.7 ± 0.6; p = 0.12), and mean velocity [mm∙s−1] (β = −9.0 ± 3.6; p < 0.05) were observed during the intervention compared with the control phase. Inter-limb asymmetry was reduced (β = −41.8 ± 14.4; p < 0.05). The applied training concept enhanced balance performance and postural control in elite female volleyball players. Due to the low additional physiological loads of the program and increased injury risk during the competitive season, we recommend this intervention for supporting injury prevention during this period. Full article
(This article belongs to the Special Issue Applied Biomechanics: Sport Performance and Injury Prevention)
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<p>Exemplary path of the center of pressure of one participant during one trial and the sway area defined as a 95% confidence ellipse. Note: AP, anterior–posterior; ML, mediolateral.</p>
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<p>Discrepancies between development during the control and intervention phases, displayed as the model estimate (β) ± standard error and 95% confidence interval (i.e., grey bars). Note: WB, wobble board performance; Asymmetry, inter-limb asymmetry; AP, anterior–posterior; ML, mediolateral; v<sub>CoP</sub>, mean velocity of the center of pressure; * <span class="html-italic">p</span> &lt; 0.05; *** <span class="html-italic">p</span> &lt; 0.001.</p>
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