DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Changes of dynamic postural stability parameters after a Clinical Ai Chi Intervention in Healthy Adults V. Panoutsakopoulos1, M.C. Kotzamanidou2, A. Bommer2,3, J. Lambeck2, D. Daly4, I. Kollias1
[email protected]
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Declaration l No commercial interests to disclose l No ownership of Copyrights for the material indicated as “adapted from…” l The presentation is supported with a travel grand after the approval of an institutional review board
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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outline
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Clinical Ai Chi: Introduction
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Biomechanical concepts: CoP, CoM
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Methods
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Results
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Discussion-Conclusion-Considerations
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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Ai Chi: Introduction
l originated by Jun Konno (1993) l designed as an individual preparation for Watsu, progressing to Ai Chi Ne l based on Zen-Shiatsu by Masunaga (stretch meridians) (Masunaga 1987) l Zen-Shiatsu: how to harmonize yin and yang for better health l a simple aquatic form of Tai Chi Chuan in combination with Qi Gong 5
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Clinical Ai Chi (CAC): Facts l includes 19 continuous slow and broad movements (kata’s) l sequence of choreographed movement patterns l progressive increase in difficulty l performed in shoulder depth l active technique in which balance, breathing and relaxation come together 6
Lambeck & Bommer (2010)
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Clinical Ai Chi kata’s
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Adapted from Prashanth (2014)
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Clinical Ai Chi as exercise stimuli
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Lambeck (2016)
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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Center of Pressure (CoP)
l the center of the distribution of the total force applied to the surface of support l weighted average of all pressures created from the area in contact with the support surface l index of postural stability (Winter et al. 1990, Palmieri et al. 2002, Ruhe et al. 2017)
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Center of Mass (CoM) l a hypothetical point where the entire mass of the body may be assumed to be concentrated l sum of moments = 0 Ö balance l the vertical projection of the CoM onto the ground is often called the centre of gravity (CoG) (Clauser eta al. 1969, Winter 1995)
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
CoP – CoM – CoG – BoS - LoS
CoM
CoP LoS BoS CoG 11
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Dynamic Postural Stability l ability to maintain balance while transitioning from a dynamic to a static state
(Wikstrom et al. 2005)
l move/transfer the CoG around the BoS (Goldie et al. 1989)
l Balance ability can be improved with exercises aiming to improve dynamic stability (Bierbaum et al. 2013, Lesinski et al. 2016, Hamed et al. 2018)
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Importance of the study l CAC include CoG shifts to the limits of reaching (Lambeck & Bommer 2010)
l CAC programs have produced clinically relevant changes in balance and functional mobility in elderly and groups of people with various health problems (Lambeck et al. 2013, Guclu-Gunduz et al. 2013, Skinner et al. 2016, Pérez-de la Cruz et al. 2016, Covill et al. 2017, Kurt et al. 2018)
l The vast majority of the evidence is acquired with balance assessment scales rather than biomechanical evaluation 13
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Dynamic control of the CoM is important in daily living during changing of body purpose position, shifting the CoM or when reaching at stance as specifically described in the International Classification of Functioning, Disability and Health (ICF) Aim of this study was to investigate the effect of a CAC program on CoP and CoM kinematics of selected kata’s 14
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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Methods
l Participants n
Age (yrs)
♂
6
30.6 ± 7.2
♀
4
33.9 ± 10.6 1.69 ± 0.03
l l l l 15
Height (m)
Ma ss (kg)
1.79 ± 0.05 81.0 ± 10.2 58.6 ± 9.3
BMI (kg/cm2)
25.2 ± 2.8 20.6 ± 3.7
pool professionals no previous experience with Clinical Ai Chi no history of injury signed consent
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Experimental design PRE MEASUREMENT
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soothing kata (M/L)
POST MEASUREMENT
accepting kata (A/P)
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Data acquisition and analyses Balance parameters: n K-Delta double force-plate
(K-Invent, Orsay, France)
- Sf: 500Hz
o K-Force analysis software (K-Invent, Orsay, France)
Kinematical parameters: n Casio EX-F1 camera (Casio Computer, Shibuya, Japan) - Sf: 30fps o K-Motion v.15 software
(K-Invent, Orsay, France)
– 2D-DLT (Kollias 1997)
Statistical analysis: n PRE vs. POST comparison: paired samples T-test o Effect size: Cohen’s d 17
[SPSS 10.0.1]
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Experimental set-up
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Examined parameters l l l l l l l l l 19
SA95: CoP 95% ellipse area RMS: CoP Root-Mean-Square amplitude TE-M/L: CoP total excursion – mediolateral TE-A/P: CoP total excursion – anteroposterior LoS: limits of stability TI: torso inclination S: CoM plannar displacement RD: reaching distance MMV: mean BCM movement velocity
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018 RMS
stabilogram amplitude
CoP trajectory
95% ellipse area
CoP excursion range
Vertical Ground Reaction force
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CoP velocity parameters
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
kinematical parameters
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DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
Application of CAC intervention
à = 30°C 22
180 repetitions of the kata’s
DYNAMIC POSTURAL STABILITY IN CLINICAL AI CHI 5th ICEBAT, Las Vegas NV, 14 April 2018
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Results: Soothing kata p
d
95% CI
Δmean
Δsd
