@misc{GebelBuschStelzeletal.2022,
  author    = {Gebel, Arnd and Busch, Aglaja and Stelzel, Christine and Hortob{\´a}gyi, Tibor and Granacher, Urs},
  title     = {Effects of Physical and Mental Fatigue on Postural Sway and Cortical Activity in Healthy Young Adults},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-56441},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-564419},
  pages     = {1 -- 14},
  year      = {2022},
  abstract  = {Physical fatigue (PF) negatively affects postural control, resulting in impaired balance performance in young and older adults. Similar effects on postural control can be observed for mental fatigue (MF) mainly in older adults. Controversial results exist for young adults. There is a void in the literature on the effects of fatigue on balance and cortical activity. Therefore, this study aimed to examine the acute effects of PF and MF on postural sway and cortical activity. Fifteen healthy young adults aged 28 ± 3 years participated in this study. MF and PF protocols comprising of an all-out repeated sit-to-stand task and a computer-based attention network test, respectively, were applied in random order. Pre and post fatigue, cortical activity and postural sway (i.e., center of pressure displacements [CoPd], velocity [CoPv], and CoP variability [CV CoPd, CV CoPv]) were tested during a challenging bipedal balance board task. Absolute spectral power was calculated for theta (4-7.5 Hz), alpha-2 (10.5-12.5 Hz), beta-1 (13-18 Hz), and beta-2 (18.5-25 Hz) in frontal, central, and parietal regions of interest (ROI) and baseline-normalized. Inference statistics revealed a significant time-by-fatigue interaction for CoPd (p = 0.009, d = 0.39, Δ 9.2\%) and CoPv (p = 0.009, d = 0.36, Δ 9.2\%), and a significant main effect of time for CoP variability (CV CoPd: p = 0.001, d = 0.84; CV CoPv: p = 0.05, d = 0.62). Post hoc analyses showed a significant increase in CoPd (p = 0.002, d = 1.03) and CoPv (p = 0.003, d = 1.03) following PF but not MF. For cortical activity, a significant time-by-fatigue interaction was found for relative alpha-2 power in parietal (p < 0.001, d = 0.06) areas. Post hoc tests indicated larger alpha-2 power increases after PF (p < 0.001, d = 1.69, Δ 3.9\%) compared to MF (p = 0.001, d = 1.03, Δ 2.5\%). In addition, changes in parietal alpha-2 power and measures of postural sway did not correlate significantly, irrespective of the applied fatigue protocol. No significant changes were found for the other frequency bands, irrespective of the fatigue protocol and ROI under investigation. Thus, the applied PF protocol resulted in increased postural sway (CoPd and CoPv) and CoP variability accompanied by enhanced alpha-2 power in the parietal ROI while MF led to increased CoP variability and alpha-2 power in our sample of young adults. Potential underlying cortical mechanisms responsible for the greater increase in parietal alpha-2 power after PF were discussed but could not be clearly identified as cause. Therefore, further future research is needed to decipher alternative interpretations.},
  language  = {en}
}
@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}
}
@misc{AlbertOwolabiGebeletal.2020,
  author    = {Albert, Justin Amadeus and Owolabi, Victor and Gebel, Arnd and Brahms, Clemens Markus and Granacher, Urs and Arnrich, Bert},
  title     = {Evaluation of the Pose Tracking Performance of the Azure Kinect and Kinect v2 for Gait Analysis in Comparison with a Gold Standard},
  series = {Postprints der Universit{\"a}t Potsdam : Reihe der Digital Engineering Fakult{\"a}t},
  journal   = {Postprints der Universit{\"a}t Potsdam : Reihe der Digital Engineering Fakult{\"a}t},
  number    = {3},
  doi       = {10.25932/publishup-48413},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-484130},
  pages     = {24},
  year      = {2020},
  abstract  = {Gait analysis is an important tool for the early detection of neurological diseases and for the assessment of risk of falling in elderly people. The availability of low-cost camera hardware on the market today and recent advances in Machine Learning enable a wide range of clinical and health-related applications, such as patient monitoring or exercise recognition at home. In this study, we evaluated the motion tracking performance of the latest generation of the Microsoft Kinect camera, Azure Kinect, compared to its predecessor Kinect v2 in terms of treadmill walking using a gold standard Vicon multi-camera motion capturing system and the 39 marker Plug-in Gait model. Five young and healthy subjects walked on a treadmill at three different velocities while data were recorded simultaneously with all three camera systems. An easy-to-administer camera calibration method developed here was used to spatially align the 3D skeleton data from both Kinect cameras and the Vicon system. With this calibration, the spatial agreement of joint positions between the two Kinect cameras and the reference system was evaluated. In addition, we compared the accuracy of certain spatio-temporal gait parameters, i.e., step length, step time, step width, and stride time calculated from the Kinect data, with the gold standard system. Our results showed that the improved hardware and the motion tracking algorithm of the Azure Kinect camera led to a significantly higher accuracy of the spatial gait parameters than the predecessor Kinect v2, while no significant differences were found between the temporal parameters. Furthermore, we explain in detail how this experimental setup could be used to continuously monitor the progress during gait rehabilitation in older people.},
  language  = {en}
}
@misc{GebelLuederGranacher2019,
  author    = {Gebel, Arnd and L{\"u}der, Benjamin and Granacher, Urs},
  title     = {Effects of Increasing Balance Task Difficulty on Postural Sway and Muscle Activity in Healthy Adolescents},
  series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  number    = {583},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-43921},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-439211},
  pages     = {15},
  year      = {2019},
  abstract  = {Evidence-based prescriptions for balance training in youth have recently been established. However, there is currently no standardized means available to assess and quantify balance task difficulty (BTD). Therefore, the objectives of this study were to examine the effects of graded BTD on postural sway, lower limb muscle activity and coactivation in adolescents. Thirteen healthy high-school students aged 16 to 17 volunteered to participate in this cross-sectional study. Testing involved participants to stand on a commercially available balance board with an adjustable pivot that allowed six levels of increasing task difficulty. Postural sway [i.e., total center of pressure (CoP) displacements] and lower limb muscle activity were recorded simultaneously during each trial. Surface electromyography (EMG) was applied in muscles encompassing the ankle (m. tibialis anterior, medial gastrocnemius, peroneus longus) and knee joint (m. vastus medialis, biceps femoris). The coactivation index (CAI) was calculated for ankle and thigh muscles. Repeated measures analyses of variance revealed a significant main effect of BTD with increasing task difficulty for postural sway (p < 0.001; d = 6.36), muscle activity (p < 0.001; 2.19 < d < 4.88), and CAI (p < 0.001; 1.32 < d < 1.41). Multiple regression analyses showed that m. tibialis anterior activity best explained overall CoP displacements with 32.5\% explained variance (p < 0.001). The observed increases in postural sway, lower limb muscle activity, and coactivation indicate increasing postural demands while standing on the balance board. Thus, the examined board can be implemented in balance training to progressively increase BTD in healthy adolescents.},
  language  = {en}
}
@misc{BohleRimpelSchauenburgetal.2019,
  author    = {Bohle, Hannah and Rimpel, J{\´e}r{\^o}me and Schauenburg, Gesche and Gebel, Arnd and Stelzel, Christine and Heinzel, Stephan and Rapp, Michael Armin and Granacher, Urs},
  title     = {Behavioral and Neural Correlates of Cognitive-Motor Interference during Multitasking in Young and Old Adults},
  series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  number    = {563},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-43597},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-435972},
  pages     = {20},
  year      = {2019},
  abstract  = {The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.},
  language  = {en}
}