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Browsing Theses and Dissertations by Subject "balance"

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    ItemOpen Access
    Movement for mobility: associations between physical activity, postural control, and gait in people with multiple sclerosis
    (Colorado State University. Libraries, 2021) Bandera, Victoria Maria, author; Fling, Brett, advisor; Leach, Heather, advisor; Diehl, Manfred, committee member
    Background: Approximately 80% of people with multiple sclerosis (PwMS) experience impaired balance and mobility. The optimal duration, type and intensity of physical activity (PA) to improve balance and gait is not well understood. Purpose: Examine associations between PA duration, type and intensity with balance and gait in PwMS and neurotypical controls. Methods: Twenty-four PwMS and twenty-one neurotypical controls reported their typical PA routine, including duration [(days/week)x(minutes/bout)], type (aerobic, resistance and/or plyometric (R/P) and yoga), and intensity (rating of perceived exertion (RPE) 6-20). Balance was assessed by the mini Balance Evaluation Systems Test (Mini-BESTest). Gait speed was measured by the two-minute walk test at a normal pace and a fast pace. Pearson's and Spearman's correlations examined associations among PA variables, balance, and gait speed. Independent t-tests and Mann-Whitney U tests examined differences in gait speeds and balance, between participants who did vs. did not perform each PA type. MANOVA and Kruskal-Wallis tests compared gait and balance performance in participants who reported ≥150 PA minutes/week, and vigorous PA (RPE > 14) vs. those who did not. Results: No significant associations were found between PA duration and any outcomes in either group. Conversely, PA intensity was significantly associated with reactive postural control, rs(24) = .458, p < .05, sensory orientation, rs (24) = .487, p < .05, and dynamic gait, rs(24) = .429, p < .05, and anticipatory postural control in neurotypical controls, rs(21) = .476, p < .05. As for PA type, self-reported habitual R/P was associated with nearly significantly superior dynamic gait performance in PwMS, p = .07, but significantly lower normal gait speed in neurotypical controls, p < .05. Participants who met and/or exceeded the 150-minute per week PA guideline did not have differences in any outcomes. Habitually vigorous PA was associated with significantly improved anticipatory postural control, H(1) = 5.86, p < .05, and nearly significantly improved Mini-BEST scores in neurotypical participants H(1) = 3.273, p = 0.07. Minimally clinically important differences in fast gait speed (> 0.10 m/s) were found in neurotypical participants habitually performing vigorous PA compared to light-to-moderate PA. Conclusions: These findings suggest PA intensity and participation in R/P and yoga are associated with better balance and gait performance. Future studies should reevaluate these associations incorporating PA intensity measured by self-report perceived intensity and objectively measured, and incorporating R/P training into PA routines to improve balance and gait outcomes in PwMS.
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    ItemOpen Access
    Relationships between asymmetries in functional movements and the Star Excursion Balance Test
    (Colorado State University. Libraries, 2012) Overmoyer, Grant, author; Reiser, Raoul, II, advisor; Browning, Ray, committee member; Gilkey, David, committee member
    Lower extremity functional asymmetries (LEFA) as well as the Star Excursion Balance Test (SEBT) have been used to screen for injury risk and assess post-injury function. Both have also been shown to relate to physical performance. However, the relationships between LEFA, observed during different tasks, are not well understood, nor are the relationships between LEFA and side-to-side asymmetries in SEBT scores. As a result, it is difficult to determine which methods are most appropriate to assess detrimental asymmetries and whether they might be interchangeable. PURPOSE: The goal of this investigation was to examine the correlation in LEFA using measurement of vertical ground reaction forces (GRFv) during quiet standing, body weight squats, maximal effort counter-movement jumps (CMJ) and single-leg drop landings from a 30.5 cm platform (SLDL). Another goal was to investigate bilateral asymmetries in the SEBT anterior (Ant), posteromedial (PostMed) and posterolateral (PostLat) excursion directions, in both the correlations to each other and the correlations to the four functional movement tasks listed above. METHODS: Twenty recreationally active men (n=9) and women (n=11) (mean ± SD age: 21.9 ± 2.6 yrs; height 171 ± 8.8 cm; mass 67.2 ± 1.9 kg) performed three measured trials of each excursion direction of the SEBT, five 20 second quiet standing trials, five unloaded (body weight) squats, five CMJ and five SLDL on each side. Leg length measurements, GRFv data and SEBT scores for each leg were collected. Asymmetry was calculated by subtracting the % load on the preferred kicking leg (KL), or during the SEBT the percent of the bilaterally summed score on the KL, from that of the non-preferred kicking leg (NKL). Results were analyzed using Pearson's correlation and paired t-tests. Eleven subjects were reassessed for repeatability measures. RESULTS: Significant correlations (p<0.05) were found between asymmetries in several of the parameters measured in the LEFA tasks. Standing and average GRFv during CMJ significantly correlated to each other (r= 0.458); average GRFv during squats significantly correlated with standing GRFv (r= -0.452); both maximum and average GRFv during the squat significantly correlated with average and maximum GRFv during CMJ (r= -0.571 to -0.768). Average GRFv to peak in the SLDL significantly related to the squat (r= -0.494 to -0.500) and peak GRFv during the SLDL significantly related to CMJ average GRFv (r= -0.470). Further significance was identified among asymmetries in several SEBT excursion directions, particularly between the Ant versus PostMed (r= 0.406 to 0.564), and Ant versus PostLat (r= 0.470 to 0.570). There was a wide range of significant correlations in regards to combinations of these scores in the SEBT (r= 0.470 to 0.973). And finally, correlations were found to exist between several of the LEFA tasks and SEBT excursion directions. These included squats versus PostMed and Ant (r= 0.489 to 0.593 and r= 0.315 to 0.514, respectively), CMJ versus all excursion directions (r= -0.379 to -0.649) and the SLDL slope to peak, average GRFv to peak and average GRFv to 300ms, versus Ant (r= -0.402 to -0.609). LEFA tasks and SEBT asymmetries were generally found to be highly repeatability (α= 0.758 to 0.992 and α= 0.752 to 0.976, respectively), but with generally much lower and a wider range of repeatability shown in the absolute measures of asymmetry (LEFA: α= 0.212 to 0.791 and SEBT: α= 0.133 to 0.802). CONCLUSION: While most measures were highly repeatable, because the correlations between tests were of only mild to moderate strength, it is unlikely that any one test studied here could be used to accurately predict performance on any of the other tests, at least in a relatively healthy young population. Therefore, multiple tests may be necessary with specific attention on those that most closely replicate the movement patterns and specific performance needs of the individual.