Acute Effects of Exercise on Posture in Arthritic Patients

Abstract

In this study, we aimed to investigate the acute effects of exercise on postural measures in arthritic patients. We obtained posturographic measurements of 8 women with lower extremity arthritis for 30 s before and after a 60-min aquatic exercise. The center of pressure (COP) was recorded while the volunteers were in an upright position with their eyes open. The time domain measures and the frequency domain measures of the COP time series in the anterior-posterior (AP) and medial-lateral (ML) directions were calculated. In addition, the frequency domain measures were calculated for the COP velocity time series. A paired t-test revealed no significant differences in any time domain measures between pre- and post-exercise; however, there were significant decreases in the 95% power frequency of the COP in the AP direction (0.834±0.296 to 0.627±0.230 Hz, p=0.027) for the frequency domain measures. For the velocity time series, the mean power frequency in both the AP (1.47±0.528 to 1.22±0.360 Hz, p=0.047) and ML (1.28±0.245 to 1.13±0.151 Hz, p=0.022) directions, and the 95% power frequency in the ML direction (3.41±0.653 to 2.96±0.468 Hz, p=0.038) decreased significantly in the post-exercise condition. This study reports that a single session of exercise has a subtle but detectable acute effect on postural balance in arthritic patients.

Key words

postural control - aquatic exercise - lower extremity arthritis

References

• 1 Baratto L, Morasso PG, Re C, Spada G. A new look at posturographic analysis in the clinical context: Sway-density versus other parameterization techniques.  Motor Control. 2002;  6 246-270
• 2 Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsoe B. Aquatic exercise for the treatment of knee and hip osteoarthritis (Review).  Cochrane Database Syst Rev. 2007; 
• 3 Bartlett MJ. Effect of warming up on knee proprioception before sporting activity.  Br J Sports Med. 2002;  36 132-134
• 4 Borg GAV. Perceived exertion – note on history and methods.  Med Sci Sports Exerc. 1973;  5 90-93
• 5 Bouet V, Gahery Y. Muscular exercise improves knee position sense in humans.  Neurosci Lett. 2000;  289 143-146
• 6 Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.  Br Med J. 1997;  315 1065-1069
• 7 Carpenter MG, Frank JS, Winter DA, Peysar GW. Sampling duration effects on centre of pressure summary measures.  Gait Posture. 2001;  13 35-40
• 8 Corbeil P, Blouin JS, Begin F, Nougier V, Teasdale N. Perturbation of the postural control system induced by muscular fatigue.  Gait Posture. 2003;  18 92-100
• 9 Dejesus PV, Hausmano I, Barchi RL. Effect of cold on nerve-conduction of human slow and fast nerve fibers.  Neurology. 1973;  23 1182-1189
• 10 Demura SI, Kitabayashi T, Noda M, Aoki H. Age-stage differences in body sway during a static upright posture based on sway factors and relative accumulation of power frequency.  Percept Mot Skills. 2008;  107 89-98
• 11 Devereux K, Robertson D, Briffa NK. Effects of a water-based program on women 65 years and over: A randomised controlled trial.  Aust J Physiother. 2005;  51 102-108
• 12 Dewhurst S, Riches PE, Nimmo MA, De Vito G. Temperature dependence of soleus H-reflex and M wave in young and older women.  Eur J Appl Physiol. 2005;  94 491-499
• 13 Dioszeghy P, Stalberg E. Changes in motor and sensory nerve-conduction parameters with temperature in normal and diseased nerve.  Electroencephalogr Clin Neurophysiol. 1992;  85 229-235
• 14 Freitas S, Wieczorek SA, Marchetti PH, Duarte M. Age-related changes in human postural control of prolonged standing.  Gait Posture. 2005;  22 322-330
• 15 Giemza C, Ostrowska B, Matczak-Giemza M. The effect of physiotherapy training programme on postural stability in men with hip osteoarthritis.  Aging Male. 2007;  10 67-70
• 16 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 17 Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects.  Ann Rheum Dis. 2001;  60 612-618
• 18 Hen S, Geurts ACH, Bosch PV, Laan R, Mulder T. Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty.  Arch Phys Med Rehabil. 2000;  81 1489-1493
• 19 Hurley MV, Rees J, Newham DJ. Quadriceps function, proprioceptive acuity and functional performance in healthy young, middle-aged and elderly subjects.  Age Ageing. 1998;  27 55-62
• 20 Hurley MV, Scott DL, Rees J, Newham DJ. Sensorimotor changes and functional performance in patients with knee osteoarthritis.  Ann Rheum Dis. 1997;  56 641-648
• 21 Johansson R, Magnusson M. Human postural dynamics.  Crit Rev Biomed Eng. 1991;  18 413-437
• 22 Kim S, Nussbaum MA, Madigan ML. Direct parameterization of postural stability during quiet upright stance: Effects of age and altered sensory conditions.  J Biomech. 2008;  41 406-411
• 23 Maki BE, Holliday PJ, Fernie GR. Aging and postural control – a comparison of spontaneous-sway and induced-sway balance tests.  J Am Geriatr Soc. 1990;  38 1-9
• 24 Masani K, Popovic MR, Nakazawa K, Kouzaki M, Nozaki D. Importance of body sway velocity information in controlling ankle extensor activities during quiet stance.  J Neurophysiol. 2003;  90 3774-3782
• 25 Masui T, Hasegawa Y, Yamaguchi J, Kanoh T, Ishiguro N, Suzuki S. Increasing postural sway in rural-community-dwelling elderly persons with knee osteoarthritis.  J Orthop Sci. 2006;  11 353-358
• 26 Maurer C, Mergner T, Xie J, Faist M, Pollak P, Lucking CH. Effect of chronic bilateral subthalamic nucleus (STN) stimulation on postural control in Parkinson's disease.  Brain. 2003;  126 1146-1163
• 27 Mello RGT, Oliveira LF, Nadal J. Anticipation mechanism in body sway control and effect of muscle fatigue.  J Electromyogr Kinesiol. 2007;  17 739-746
• 28 Morasso PG, Schieppati M. Can muscle stiffness alone stabilize upright standing?.  J Neurophysiol. 1999;  82 1622-1626
• 29 Nardone A, Siliotto R, Grasso M, Schieppati M. Influence of aging on leg muscle-reflex responses to stance perturbation.  Arch Phys Med Rehabil. 1995;  76 158-165
• 30 Nardone A, Tarantola J, Giordano A, Schieppati M. Fatigue effects on body balance.  Electroencephalogr Clin Neurophysiol. 1997;  105 309-320
• 31 Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: Differences between healthy young and elderly adults.  IEEE Trans Biomed Eng. 1996;  43 956-966
• 32 Rocchi L, Chiari L, Horak FB. Effects of deep brain stimulation and levodopa on postural sway in Parkinson's disease.  J Neurol Neurosurg Psychiatry. 2002;  73 267-274
• 33 Roth AE, Miller MG, Ricard M, Ritenour D, Chapman BL. Comparisons of static and dynamic balance following training in aquatic and land environments.  J Sport Rehabil. 2006;  15 299-311
• 34 Schmid M, Conforto S, Camomilla V, Cappozzo A, D’Alessio T. The sensitivity of posturographic parameters to acquisition settings.  Med Eng Phys. 2002;  24 623-631
• 35 Simmons V, Hansen PD. Effectiveness of water exercise on postural mobility in the well elderly: An experimental study on balance enhancement.  J Gerontol A Biol Sci Med Sci. 1996;  51 M233-M238
• 36 Sturnieks DL, Tiedemann A, Chapman K, Munro B, Murray SM, Lord SR. Physiological risk factors for falls in older people with lower limb arthritis.  J Rheumatol. 2004;  31 2272-2279
• 37 Subasi SS, Gelecek N, Aksakoglu G. Effects of different warm-up periods on knee proprioception and balance in healthy young individuals.  J Sport Rehabil. 2008;  17 186-205
• 38 Suomi R, Koceja DM. Postural sway characteristics in women with lower extremity arthritis before and after an aquatic exercise intervention.  Arch Phys Med Rehabil. 2000;  81 780-785
• 39 Toole T, Maitland CG, Warren E, Hubmann MF, Panton L. The effects of loading and unloading treadmill walking on balance, gait, fall risk, and daily function in Parkinsonism.  Neurorehabilitation. 2005;  20 307-322
• 40 Tsang WWN, Hui-Chan CWY. Effect of 4- and 8-wk intensive Tai Chi training on balance control in the elderly.  Med Sci Sports Exerc. 2004;  36 648-657
• 41 Vuillerme N, Nougier V, Prieur JM. Can vision compensate for a lower limbs muscular fatigue for controlling posture in humans?.  Neurosci Lett. 2001;  308 103-106
• 42 Watanabe I, Okubo J, Ishida A. Significance of velocity power-spectrum analysis in postural reflex and equilibrium dysfunction.  Agressologie. 1980;  21 105-111
• 43 Winter DA, Patla AE, Prince F, Ishac M, Gielo-Perczak K. Stiffness control of balance in quiet standing.  J Neurophysiol. 1998;  80 1211-1221

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