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Balance is a fundamental quality for trampoline athletes, the basis for completing complex skills. We aimed to compare balance control strategies between elite trampolinists (ETs) and sub-elite trampolinists (Sub-ET) by integrating linear and nonlinear center of pressure (COP) measures across stable and unstable surfaces. Twenty-four male athletes (12 ET, 12 Sub-ET) participated. Each participant performed 15-s static standing trials with eyes closed on a firm surface (FI) and a foam surface (FO). COP parameters were extracted, including ellipse area, sway velocity, sway range, and sample entropy (SampEn) in the medio-lateral (ML) and antero-posterior (AP) directions. Repeated-measures ANOVA was applied to examine the effects of group and surface condition. Linear analyses indicated that ET athletes exhibited greater sway amplitudes and faster velocities than Sub-ET athletes, with both groups showing larger sway on FO compared with FI. Nonlinear analyses revealed that ET athletes demonstrated lower SampEn, suggesting more structured and automatized control strategies. ET athletes maintained consistent entropy across both conditions, reflecting stronger adaptability to unstable surfaces. These results emphasize the importance of combining linear and nonlinear measures in balance assessment and suggest that incorporating unstable or trampoline-like surfaces into training may enhance adaptability, improve performance, and reduce injury risk.

Gait initiation (GI) involves passing from bipedal to unipedal stance. It requires a rapid movement of the center of foot pressure (CoP) towards the future swing foot and of the center of mass (CoM) in the direction of the stance foot prior to the incoming step. This anticipatory postural adjustment (APA) allows disengaging the swing leg from the ground and establishing favorable conditions for stepping. This study aimed to describe the neuro-mechanical process that underlies the goal-directed medio-lateral (ML) APA. We hypothesized that controlled knee flexion of the stance leg contributes to the initial ML displacement of the CoP and to the calibration of the first step. Fourteen subjects initiated gait starting from three different initial stance widths of 15 cm (Small), 30 cm (Medium), and 45 cm (Large). Optoelectronic, force platform and electromyogram (EMG) measurements were performed. During APA, soleus activity diminished bilaterally, while tibialis anterior (TA) activity increased, more so in the stance leg than in the swing leg, and to a larger extent with increasing initial stance width. Knee flexion of the stance leg was observed during APA and correlated with the ML CoP displacement towards the swing leg. ML CoP and CoM displacements during APA increased with increasing stance width. The activity of stance-leg TA was correlated with the degree of knee flexion. Swing-leg tensor fasciae latae (TFL) was also active during APA. Across subjects, when stance-leg tibialis activity was low, TFL activity was large and vice versa. The modulation of the ML CoP position during APA allowed the gravity-driven torque to place the CoM just lateral to the stance foot during step execution. Accordingly, the gravity-driven torque, the ML CoM velocity during step execution, and the step width at foot contact (FC) were lower in the Small and greater in the Large condition. Consequently, the position of the stepping foot at FC remained close to the sagittal plane in all three conditions. Conclusively, coordinated activation of hip abductors and ankle dorsiflexors during APA displaces the CoP towards the swing leg, and sets the contact position for the swing foot.

Purpose To determine the sensorimotor and clinical function of patients with confirmed successful outcome after either undergoing acromioclavicular joint (ACJ) stabilization, Bankart repair (BR), or rotator cuff repair (RC), and to compare these measures to the contralateral, healthy side without history of previous injuries or surgeries of the upper extremity. It was hypothesized that patients of each interventional group would have inferior sensorimotor function of the shoulder joint compared to the contralateral, healthy side, while presenting with successful clinical and functional outcomes. Methods Three intervention groups including ten patients who had confirmed successful clinical and functional outcomes after either undergoing ACJ stabilization, BR, or RC were evaluated postoperatively at an average follow-up of 31.7 ± 11.6 months. Additionally, a healthy control group (CG) of ten patients was included. Clinical outcomes were assessed using the Constant–Murley (CM) and American Shoulder and Elbow Surgeons (ASES) Score. Pain was evaluated using the visual analogue scale (VAS). Sensorimotor function was assessed by determining the center of pressure (COP) of the shoulder joint in a one-handed support task in supine position on a validated pressure plate. Results Each interventional group demonstrated excellent clinical outcome scores including the CM Score (ACJ 83.3 ± 11.8; BR 89.0 ± 10.3; RC 81.4 ± 8.8), ASES Score (ACJ 95.5 ± 7.0; BR 92.5 ± 9.6; RC 96.5 ± 5.2), and VAS (ACJ 0.5 ± 0.9; BR 0.5 ± 0.8; RC 0.5 ± 0.8). Overall, the CG showed no significant side-to-side difference in COP, whereas the ACJ-group and the BR-group demonstrated significantly increased COP compared to the healthy side (ACJ 103 cm vs. 98 cm, p  = 0.049; BR: 116 cm vs. 102 cm, p  = 0.006). The RC-group revealed no significant side-to-side difference (120 cm vs. 108 cm, n.s.). Conclusion Centre of pressure measurement detected sensorimotor functional deficits following surgical treatment of the shoulder joint in patients with confirmed successful clinical and functional outcomes. This may indicate that specific postoperative training and rehabilitation protocols should be established for patients who underwent surgery of the upper extremity. These results underline that sensorimotor training should be an important component of postoperative rehabilitation and physiotherapeutic activities to improve postoperative function and joint control. Level of evidence IV.

Crew fatigue from standing posture motion, caused by ship motion, can lead to marine accidents. Therefore, the mechanism of fatigue in crew members ought to be elucidated. The standing posture of humans is maintained by postural state detection through the visual, vestibular, and somatosensory systems. Humans can adjust their posture through corrective postural reactions (CPR) generated after anticipatory postural adjustments (APAs) by using information from these sensory systems. APAs refer to skills acquired by learning from past motions and perturbations and are prepared by the central nervous system based on visual information before the actual perturbation occurs. We hypothesized that APAs would decrease fatigue in crew members by stabilizing their standing posture motions. We aimed to clarify the human standing posture control influenced by APAs based on visual information. To this end, we presented wave images with different wave directions to the participants using a visual simulator and analyzed their standing posture motion. We found that the participants stabilized their standing posture based on the projected wave directions. This showed that the participants predicted ship motion from the wave images and controlled their center of pressure (COP) through APAs. Individual differences in standing postural motion may indicate the subjective variation of APAs based on individual experiences. This study was limited to males aged 20–23 years. To generalize this study, randomized controlled trials should be performed with participants of multiple age groups, including men and women.

The purpose of this study was to examine aging and bimanual effects on finger spatial stability during precision grip. Twenty-one older and 21 younger adults performed precision grip tasks consisting of a single task (grip and lift an object with the thumb and index finger) and a dual task (the grip-lifting task with one hand and a peg board task with the other hand). The center of pressure (COP) trajectory and the grip force were evaluated using a pressure sensor with a high spatial resolution. In the COP trajectory, the main effects of age for the thumb (F1,140 = 46.17, p < 0.01) and index finger (F1,140 = 22.14, p < 0.01) and task difficulty for the thumb (F1,140 = 6.47, p = 0.01) were significant based on ANCOVA. The COP trajectory was statistically decreased in the older adults. The COP trajectory was also decreased in the dual task, regardless of age. The results suggest the existence of a safety strategy to prioritize the spatial stability in the elderly group and in the dual task. This study provides new insights into the interpretation of the COP trajectory.

Prominent conservative treatment options for medial-compartment knee osteoarthritis include footwear that reduces knee adduction moment (KAM) correlated with detrimental loads in the medial compartment of the knee, thus providing clinical benefit. The proposed mechanism by which they reduce KAM is a lateral shift in foot center of pressure (COP) and a consequent shortening of the knee lever arm (KLA), thereby reducing KAM, which can be simply calculated as KLA multiplied by the frontal plane ground reaction force (FP-GRF). The present study investigated this mechanism for a unique biomechanical device capable of shifting COP by means of moveable convex elements attached to the shoe. Fourteen healthy young male subjects underwent gait analysis in two COP configurations of the device for comparison: (1) laterally and (2) medially deviated. Average midstance KLA and KAM were decreased by 8.2% and 8.7%, respectively, in the lateral COP compared to medial. Ground reaction force parameters, frontal plane knee angle (FP-KA), and spine lateral flexion angle (SLF) did not differ between COP configurations. No study parameters differed for terminal stance. Linear mixed effects models showed that COP and FP-GRF components, but not FP-KA and SLF, were significant predictors of KLA. In addition, KLA and FP-GRF were significant predictors of KAM; although, FP-GRF did not change significantly with medio-lateral COP shift, while KLA did. This suggests that the mechanism by which the study device reduces KAM is primarily through shortening of KLA brought on by a lateral shift in COP.

Intervention to improve the balance ability of individuals with impaired balance is needed to prevent falls. While sub-threshold mechanical noise applied to foot soles has been shown to improve balance not only for balance-impaired but also healthy individuals, how calf muscle activity is changed to enhance motor control to achieve improvement has not been explored. To address this issue, we study the calf muscle activity of healthy young adults standing on firm and compliant surfaces, with and without noise applied to their feet. The compliant surface experiment simulates balance impairment. Center of pressure (COP) data was used to assess balance changes, surface electromyography (EMG) recorded muscle activity, and COP-EMG correlations measured muscle contribution to postural control. The Wilcoxon signed-rank test was used to compare the data between the control and noise conditions. On both surfaces, the applied noise enhanced motor control efficiency of all three calf muscle groups studied - the tibialis anterior (TA), lateral gastrocnemius lateralis (LG), and medial gastrocnemius (MG). Noise also increased the contribution of the LG muscle group to postural control in the anteroposterior direction. Our finding suggests that, for balance-impaired individuals with weak calf muscles, higher-frequency noise should be used - this will increase motor control efficiency, i.e., increase posture correction frequency with concomitant reduction in calf muscle contractions, which is well-suited to the weak muscles.

Balance and lower limb strength deficits are associated with a high incidence of falls in older adults. This study investigated the association between balance control during and after stair descent onto a compliant surface and lower limb strength. Thirty-five women and 14 men participated in this study. Stair descent time, mean center of pressure velocity in anteroposterior and mediolateral direction during stair descent (CoP VAP and CoP VML), and CoP velocity in the first 5 s of restabilization phase (CoP V5) were evaluated. Bilateral strength of the knee flexors and extensors, and ankle plantar and dorsal flexors was evaluated. Spearman correlation analysis with Bonferroni correction yielded a significant association between the strength of the knee flexors on the trailing limb and stair descent time in women (r = 0.502, p = 0.002, R2 = 0.246). The same analysis in men revealed a significant association between the strength of the knee flexors on the trailing limb and CoP VAP (r = −0.820, p < 0.001, R2 = 0.280) and CoP VML (r = −0.697, p = 0.006, R2 = 0.359). The strength of the ankle plantar flexors on the trailing limb was significantly associated with stair descent time (r = 0.684, p = 0.007, R2 = 0.429) and CoP VAP (r = −0.723, p = 0.003, R2 = 0.408) in men. Stair descent balance control is associated with knee flexion strength on trailing limb in women, and with ankle plantar flexion and knee flexion strength on the same limb in men.

This paper proposes a new method for estimating the foot plantar center of pressure (CoP) trajectory using an insole sensor and Gaussian process regression (GPR) model. The proposed method is designed to interpolate the points between the sensor array, making it robust for different gait environments, such as plain, uphill slope, downhill slope, and upstairs. Three subjects with different foot sizes were attended to evaluate the performance of the method, and the results were compared and analyzed. This study found that the CoP trajectory is estimated differently depending on the gait environments, and the correlations between the estimation results were analyzed using statistics obtained through box plot and RMSE (inverse correlation) values. The first subject showed the largest difference according to gait environments, while the third subject showed the smallest difference. Additionally, toe angle is defined to compare the differences from the expected CoP trajectories according to the walking environments. The uphill slope and upstairs showed the outside direction of the toe, while the downhill slope showed the inside direction of the toe. The study also found that non-plain (or non-flat) environments such as slopes and staircases were able to be recognized through comparison with the plain environment. The difference between the slopes and the stairs could be distinguished according to the heel strike duration. Finally, the developed algorithm will be applied to the wearable robotic system under development. Overall, the proposed method shows potential for robustly estimating the foot CoP trajectory in different gait environments and could have practical applications in wearable robotic systems.

Smart knee replacement technology seeks to provide an in vivo method of tracking long-term postoperative joint loads with the goal of identifying clinically relevant phenomena linked to postoperative dissatisfaction in real time. This study evaluated the ability of a piezoelectric compartmental force and compartmental center of pressure sensing total knee replacement to sense condylar lift-off, which is a clinically relevant phenomenon commonly attributed to postoperative dissatisfaction. A commercially available total knee replacement was modified to include six piezoelectric transducers capable of measuring compartmental forces and tibiofemoral centers of pressure on the articular surface of the tibial bearing insert. The smart knee replacement was evaluated with a six-degree-of-freedom joint motion simulator applying a varus lift-off profile. The study demonstrated that the lift-off was evident in both the sensed joint loads and the localized tibiofemoral centers of pressure obtained from the piezoelectric sensing system. The results indicated that the piezoelectric smart knee replacement could be effective for detecting this clinically problematic mechanical issue.