@phdthesis{Gebel2021,
  author    = {Gebel, Arnd},
  title     = {Postural control in youth: From performance to neural correlates},
  doi       = {10.25932/publishup-53303},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-533034},
  school      = {Universit{\"a}t Potsdam},
  pages     = {x, 121},
  year      = {2021},
  abstract  = {Background and objectives: The intricate interdependencies between the musculoskeletal and neural systems build the foundation for postural control in humans, which is a prerequisite for successful performance of daily and sports-specific activities. Balance training (BT) is a well-established training method to improve postural control and its components (i.e., static/dynamic steady-state, reactive, proactive balance). The effects of BT have been studied in adult and youth populations, but were systematically and comprehensively assessed only in young and old adults. Additionally, when taking a closer look at established recommendations for BT modalities (e.g., training period, frequency, volume), standardized means to assess and control the progressive increase in exercise intensity are missing. Considering that postural control is primarily neuronally driven, intensity is not easy to quantify. In this context, a measure of balance task difficulty (BTD) appears to be an auspicious alternative as a training modality to monitor BT and control training progression. However, it remains unclear how a systematic increase in BTD affects balance performance and neurophysiological outcomes. Therefore, the primary objectives of the present thesis were to systematically and comprehensively assess the effects of BT on balance performance in healthy youth and establish dose-response relationships for an adolescent population. Additionally, this thesis aimed to investigate the effects of a graded increase in BTD on balance performance (i.e., postural sway) and neurophysiological outcomes (i.e, leg muscle activity, leg muscle coactivation, cortical activity) in adolescents. Methods: Initially, a systematic review and meta-analysis on the effects of BT on balance performance in youth was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. Following this complementary analysis, thirteen healthy adolescents (3 female/ 10 male) aged 16-17 years were enrolled for two cross-sectional studies. The participants executed bipedal balance tasks on a multidirectional balance board that allowed six gradually increasing levels of BTD by narrowing the balance boards' base of support. During task performance, two pressure sensitive mats fixed on the balance board recorded postural sway. Leg muscle activity and leg muscle coactivation were assessed via electromyography while electroencephalography was used to monitor cortical activity. Results: Findings from the systematic review and meta-analysis indicated moderate-to-large effects of BT on static and dynamic balance performance in youth (static: weighted mean standardized mean differences [SMDwm] = 0.71; dynamic: SMDwm = 1.03). In adolescents, training-induced effects were moderate and large for static (SMDwm = 0.61) and dynamic (SMDwm = 0.86) balance performance, respectively. Independently (i.e. modality-specific) calculated dose-response relationships identified a training period of 12 weeks, a frequency of two training sessions per week, a total of 24-36 sessions, a duration of 4-15 minutes, and a total duration of 31-60 minutes as the training modalities with the largest effect on overall balance performance in adolescents. However, the implemented meta-regression indicated that none of these training modalities (R² = 0\%) could predict the observed performance-increasing effects of BT. Results from the first cross-sectional study revealed that a gradually increasing level of BTD caused increases in postural sway (p < 0.001; d = 6.36), higher leg muscle activity (p < 0.001; 2.19 < d < 4.88), and higher leg muscle coactivation (p < 0.001; 1.32 < d < 1.41). Increases in postural sway and leg muscle activity were mainly observed during low and high levels of task difficulty during continuous performance of the respective balance task. Results from the second cross-sectional study indicated frequency-specific increases/decreases in cortical activity of different brain areas (p < 0.005; 0.92 < d < 1.80) as a function of BTD. Higher cortical activity within the theta frequency band in the frontal and central right brain areas was observed with increasing postural demands. Concomitantly, activity in the alpha-2 frequency band was attenuated in parietal brain areas. Conclusion: BT is an effective method to increase static and dynamic balance performance and, thus, improve postural control in healthy youth populations. However, none of the reported training modalities (i.e., training period, frequency, volume) could explain the effects on balance performance. Furthermore, a gradually increasing level of task difficulty resulted in increases in postural sway, leg muscle activity, and coactivation. Frequency and brain area-specific increases/decreases in cortical activity emphasize the involvement of frontoparietal brain areas in regulatory processes of postural control dependent on BTD. Overall, it appears that increasing BTD can be easily accomplished by narrowing the base of support. Since valid methods to assess and quantify BT intensity do not exist, increasing BTD appears to be a very useful candidate to implement and monitor progression in BT programs in healthy adolescents.},
  language  = {en}
}
@article{MuehlbauerMettlerRothetal.2014,
  author    = {M{\"u}hlbauer, Thomas and Mettler, Claude and Roth, Ralf and Granacher, Urs},
  title     = {One-leg standing performance and muscle activity: Are there limb differences?},
  series = {Journal of applied biomechanics},
  volume    = {30},
  journal   = {Journal of applied biomechanics},
  number    = {3},
  publisher = {Human Kinetics Publ.},
  address   = {Champaign},
  issn      = {1065-8483},
  doi       = {10.1123/jab.2013-0230},
  pages     = {407 -- 414},
  year      = {2014},
  abstract  = {The purpose of this study was to compare static balance performance and muscle activity during one-leg standing on the dominant and nondominant leg under various sensory conditions with increased levels of task difficulty. Thirty healthy young adults (age: 23 +/- 2 years) performed one-leg standing tests for 30 s under three sensory conditions (ie, eyes open/firm ground; eyes open/foam ground [elastic pad on top of the balance plate]; eyes closed/firm ground). Center of pressure displacements and activity of four lower leg muscles (ie, m. tibialis anterior [TA], m. soleus [SOL], m. gastrocnemius medialis [GAS], m. peroneus longus [PER]) were analyzed. An increase in sensory task difficulty resulted in deteriorated balance performance (P < .001, effect size [ES] = .57-2.54) and increased muscle activity (P < .001, ES = .50-1.11) for all but two muscles (ie, GAS, PER). However, regardless of the sensory condition, one-leg standing on the dominant as compared with the nondominant limb did not produce statistically significant differences in various balance (P > .05, ES = .06-.22) and electromyographic (P > .05, ES = .03-.13) measures. This indicates that the dominant and the nondominant leg can be used interchangeably during static one-leg balance testing in healthy young adults.},
  language  = {en}
}
@article{PreussevanderMeerDeshpandeetal.2011,
  author    = {Preusse, Franziska and van der Meer, Elke and Deshpande, Gopikrishna and Kr{\"u}ger, Frank and Wartenburger, Isabell},
  title     = {Fluid intelligence allows flexible recruitment of the parieto-frontal network in analogical reasoning},
  series = {Frontiers in human neuroscienc},
  volume    = {5},
  journal   = {Frontiers in human neuroscienc},
  number    = {3},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1662-5161},
  doi       = {10.3389/fnhum.2011.00022},
  pages     = {14},
  year      = {2011},
  abstract  = {Fluid intelligence is the ability to think flexibly and to understand abstract relations. People with high fluid intelligence (hi-fluIQ) perform better in analogical reasoning tasks than people with average fluid intelligence (ave-fluIQ). Although previous neuroimaging studies reported involvement of parietal and frontal brain regions in geometric analogical reasoning (which is a prototypical task for fluid intelligence), however, neuroimaging findings on geometric analogical reasoning in hi-fluIQ are sparse. Furthermore, evidence on the relation between brain activation and intelligence while solving cognitive tasks is contradictory. The present study was designed to elucidate the cerebral correlates of geometric analogical reasoning in a sample of hi-fluIQ and ave-fluIQ high school students. We employed a geometric analogical reasoning task with graded levels of task difficulty and confirmed the involvement of the parieto-frontal network in solving this task. In addition to characterizing the brain regions involved in geometric analogical reasoning in hi-fluIQ and ave-fluIQ, we found that blood oxygenation level dependency (BOLD) signal changes were greater for hi-fluIQ than for ave-fluIQ in parietal brain regions. However, ave-fluIQ showed greater BOLD signal changes in the anterior cingulate cortex and medial frontal gyrus than hi-fluIQ. Thus, we showed that a similar network of brain regions is involved in geometric analogical reasoning in both groups. Interestingly, the relation between brain activation and intelligence is not mono-directional, but rather, it is specific for each brain region. The negative brain activation-intelligence relationship in frontal brain regions in hi-fluIQ goes along with a better behavioral performance and reflects a lower demand for executive monitoring compared to ave-fluIQ individuals. In conclusion, our data indicate that flexibly modulating the extent of regional cerebral activity is characteristic for fluid intelligence.},
  language  = {en}
}