The Effect of Aerobic and Anaerobic Exercise Protocols on

182 Pages·2007·0.85 MB·English

The Effect of Aerobic and Anaerobic Exercise Protocols on Postural Control

Zachary G. Fox ATC, LAT

A thesis submitted to the faculty of The University of North Carolina at Chapel Hill in partial
fulfillment of the requirements for the degree of Masters of Arts in the Department of
Exercise and Sport Science (Athletic Training)

Chapel Hill
2007

Approved by:

Advisor: Dr. Kevin M. Guskiewicz

Reader: Dr. Troy Blackburn

Reader: Dr. Claudio Battaglini

Reader: Jason P. Mihalik
© 2007
Zachary G. Fox
ALL RIGHTS RESERVED

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ABSTRACT

ZACHARY G. FOX

The Effect of Aerobic and Anaerobic Exercise Protocols on Postural Control

“(Under the direction of Kevin M. Guskiewicz, PhD, ATC)”

Sideline management of a suspected mild head injury includes postural control
assessments typically performed shortly after exercise. The purpose of this study was to
evaluate the effects of fatigue on postural control in healthy college-aged athletes using
forceplate measures and the Balance Errors Scoring System (BESS). Post exercise recovery
of postural control measures were also observed following each exercise protocol at specific
time intervals. Thirty-six Division I collegiate athletes participated in this study. Statistical
analysis revealed a significant decrease in postural control assessed immediately after an
anaerobic and aerobic exercise protocol performed to fatigue (p < 0.001). Postural control
deficits from fatigue returned to baseline between eight and thirteen minutes following each
exercise protocol. Administering the BESS immediately following exercise may yield false-
positive findings due to the effect from fatigue. Athletic trainers and clinicians should be
aware of the impact of fatigue on postural control and the fatigue recovery time course when
determining an appropriate time to administer sideline assessments of postural control
following a suspected mild head injury.
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DEDICATION
My mom and dad have been most influential in my life up to this point. They have
guided me down a successful path and driven me to achieve my goals. Without their love
and support, I would not be the person who I am today.
But over the last two years, and for the rest of my life, my fiancé Terri has been right
by my side, day after day, giving me the love and direction I need to continue to excel. Many
nights she was unwillingly left alone while I was tucked away in the office studying or
working hard on numerous projects. But every night, she always took the time to drop in,
say hello, and remind me how much she loved me and how proud she was of me. I know I
didn’t say it enough, but you deserve a giant thank you for being so understanding, so caring,
and for sticking through the tough days with me when school got busy. You helped me
mature and become who I am today, and I deeply appreciate it. You will never know just
how much you mean to me. I love you always, and cannot wait to spend the rest of my life
with you.
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ACKNOWLEDGEMENTS
Many outstanding people were involved in making this thesis project possible. First, I
would like to express my gratitude to my advisor, Dr. Kevin Guskiewicz for his leadership
and effort toward the completion of this project. You always made time for me in your
ridiculously busy schedule, and I thank you. I also must give special thanks to Dr. Troy
Blackburn and Dr. Claudio Battaglini for all of their analysis and insight into this thesis.
Troy, your return to UNC could not have come at better time (for me), and I thank you for
the direction you lead me. And Claudio, I now know why every undergrad I speak to says
you are their favorite professor. Your assistance has been very much appreciated.
I can honestly say this thesis would not have been what it is without one exceptionally
smart and extremely hard working doctoral student, Jason Mihalik. I cannot express how
much your guidance and dedication was appreciated. I called on you far too many times, and
every single time you responded with nothing but help and support. Never once did you lose
your cool, let me down, or shy me away. I could not have asked for a better committee
member. Cheers!!! And a huge thank you to you!
Finally to my classmates. Thank you all for helping me out when I needed it the most.
We stuck by one another over the last two years, and got it done. I’ll never forget the
countless 80’s nights, quarter darts, and enjoyable J-Bus rides. I sincerely wish you all the
best in your future endeavors. Never a doubt.
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TABLE OF CONTENTS

List of Tables .......................................................................................................................... ix
List of Figures .......................................................................................................................... x
CHAPTER I ............................................................................................................................. 1
Statement of the Problem ...................................................................................................... 4
Null Hypotheses .................................................................................................................... 5
Research Hypotheses ............................................................................................................ 5
Definition of Terms .............................................................................................................. 5
Delimitations ......................................................................................................................... 8
Limitations ............................................................................................................................ 8
Assumptions .......................................................................................................................... 9
Dependent Variables ............................................................................................................. 9
Independent Variables .......................................................................................................... 9
Significance of the Study ...................................................................................................... 9
LITERATURE REVIEW ...................................................................................................... 11
Introduction ......................................................................................................................... 11
Postural Control System ..................................................................................................... 12
Sensory Component ........................................................................................................ 12
Visual Input ..................................................................................................................... 13
Vestibular Input .............................................................................................................. 14
Somatosensory Input ....................................................................................................... 14
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Sensorimotor Component (Integration) .......................................................................... 16
Biomechanical Component – Strategies for Maintaining Postural Control .................. 19
Postural Control Assessment .............................................................................................. 20
Forceplate Measures ...................................................................................................... 22
Balance Error Scoring System (BESS) ........................................................................... 25
Fatigue ................................................................................................................................ 27
Defining Fatigue ............................................................................................................. 27
Effects of Fatigue on Postural Control ........................................................................... 30
Mild Head Injury ................................................................................................................ 34
Defining Mild Head Injury.............................................................................................. 34
Evaluation of Mild Head Injury ...................................................................................... 35
Effects of MHI on Postural Control ................................................................................ 38
Methodological Considerations .......................................................................................... 41
Design Methods .............................................................................................................. 41
Summary ............................................................................................................................. 43
CHAPTER III ........................................................................................................................ 45
METHODS ............................................................................................................................ 45
Subjects ............................................................................................................................... 45
Instrumentation ................................................................................................................... 46
Forceplate ....................................................................................................................... 46
Balance Error Scoring System (BESS) ........................................................................... 46
Exercise Protocol ............................................................................................................ 47
Heart Rate Monitor ......................................................................................................... 49
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Ratings of Perceived Exertion ........................................................................................ 49
Procedures ........................................................................................................................... 49
Data Reduction ................................................................................................................... 51
Statistical Analyses ............................................................................................................. 51
RESULTS .............................................................................................................................. 59
CHAPTER V ......................................................................................................................... 66
Postural Control and Recovery Time from Fatigue ............................................................ 67
Research Hypotheses .......................................................................................................... 70
Clinical Significance ........................................................................................................... 73
Limitations .......................................................................................................................... 74
Future Research .................................................................................................................. 75
Summary ............................................................................................................................. 76
APPENDIX A: .................................................................................................................... 77
APPENDIX B: .................................................................................................................. 111
APPENDIX C: .................................................................................................................. 115
REFERENCES .................................................................................................................... 166

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List of Tables

Table 1: Pre-assessment guidelines ....................................................................................52

Table 2: Borg Rating of Perceived Exertion Scale .............................................................53

Table 3: Statistical Analysis............................................................................................... 54

Table 4: Descriptive Statistics for Participants… ..............................................................63

Table 5: Descriptive statistics presented by sport participation (means ± SD) .................63

Table 6: Exercise Protocol Raw Data used for Repeated Measures ANOVA (means ±
SD)…....................................................................................................................64

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List of Figures

Figure 1: Balance Error Scoring System…........................................................................55

Figure 2: Diagrammatic Representation of the Yo-Yo Intermittent Recovery Test…......56
Figure 3: Yo-Yo Intermittent Recovery Test, stage-by-stage…........................................57

Figure 4: Formula for Center of Pressure Average Sway Velocity………........................58

Figure 5: Protocol x Time interaction effect for total BESS score..............................…...65

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