Effect of different neuromuscular training modalities on postural stability in healthy recreation people: A randomized controlled trial

Effect of different neuromuscular training modalities on postural stability in healthy recreation people: A randomized controlled trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Effect of different neuromuscular training modalities on postural stability in healthy recreation people: A randomized controlled trial Dragan Marinkovic, Drazenka Macak, Vukasin Stanic, Dejan M Madic, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4100808/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Dec, 2024 Read the published version in Scientific Reports → Version 1 posted 11 You are reading this latest preprint version Abstract This study aimed to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy recreation participants. 180 gender-balanced groups (age 24.02 ± 2.07 years) were divided into: MIX (n = 47), DNS (n = 45), VIBRO (n = 44), and control group (CONTROL, n = 43) and underwent two months treatment. The single and double-leg Center of Force (COF) parameters were collected. A 2x4 mixed-design analysis of covariances indicated that improvements were trivial to large in most of the PS measures of MIX and DNS, while no significant change occurred in VIBRO and CONTROL. In the MIX and DNS, the average COF path length of double and single support on the left leg and ML displacements of single support on the right leg vastly improved (Hedge’s g av : MIX vs. DNS); MIX group improved COF path length of double support (1.99 vs. 0.79), COF path length of single support on the left leg (1.64 vs. 1.28), and ML displacement of single support on the right leg (0.92 vs. 0.75) to a greater extent. Combined modalities seem more efficient than single modalities for enhancing measures. postural control exercise vibration training balance neuromuscular adaptation Figures Figure 1 Figure 2 Introduction Postural stability (PS) is a vital function that helps maintain equilibrium during standing still, locomotion, and any activities requiring high balance performance 1 . Under static and dynamic conditions, PS is a fundamental factor for the quality of movement in everyday activities or sports 2 – 4 . Previous studies have reported that PS and adaptive ability are required in sports because the sensory and motor systems interact to regulate postural adjustments by processing information from the visual, vestibular, and somatosensory systems 5 . The interest in using different exercises and protocols for improving PS in sports and physiotherapy has grown in the last few decades. Experts have proposed various training modalities to increase neuromuscular stability, balance, postural control, and general stability. Dynamic Neuromuscular Stabilization (DNS) is a complex of correction exercises with a neuromuscular approach based on improving breathing, fundamental movements, and principles of developmental kinesiology 6 . Frank et al. 7 emphasize that the basic principles of DNS concentrate on core stabilization, centralization of joints and segments, movement awareness, quality respiratory function and support. DNS offers a rehabilitative and manual approach that practitioners can use to improve functional treatment and optimize the movement system in athletes by rebuilding stability performance 7 – 14 . One of the latest research on applying DNS in a sample of elite futsal players and race walkers indicates that DNS therapy effectively increases performance and balance 15 , 16 . Research has shown that the level of tension in the abdominal wall is significantly higher during DNS exercises than in other forms of exercise. This increased tension helps to stabilize the spine and improves overall posture. It also helps to reduce the risk of injury and improve performance in activities that require trunk stability, such as lifting heavy objects or performing athletic movements 17 . Current research on the effect of DNS is focused on functional movements (FM) and indicates improvement in complex movement abilities and motor control patterns 18 . Another conclusion, in line with previous research, points out that the DNS approach can increase stabilization patterns of the trunk and synergistic movement of the extremities during motor activities 10 . Whole body vibration training (WBV) is a neuromuscular training approach that has recently become very popular among researchers and practitioners in health and sport. It is usually an additional method used in a conventional training routine. During WBV training, the athlete's body experiences a low-frequency amplitude of vibration and mechanical stimulation on a vibrating platform, which initiates muscle contractions based on the reflex of tonic vibration 19 . A recent literature review found that WBV can improve power, muscle strength, performance, endurance, flexibility, neuromuscular activity, lower limb motor control, and stability 20 – 23 . Several studies have carried the same approach on different participant groups and found that WBV improved static balance, PS, and movement of postural sway 24 – 29 . A few additional studies demonstrated improvements in some components of dynamic PS 28 , 30 . Fort et al. 25 analyzed the effect of the WBV program on female basketball players and concluded that this method could enhance PS and explosive strength within 15 weeks of exercise. Bullock et al. 31 indicate the positive effects on elite athletes' critical balance abilities and stabilization. A literature review found that WBV may also enhance PS in aged and untrained people, concluding that this method could benefit healthy outcomes 29 , 32 – 35 . More recent evidence highlights that WBV training may be an effective means of enhancing balance ability in jumpers and may have practical implications for athletes seeking to improve their performance. As such, athletes are encouraged to consider incorporating WBV training into their training regimen to maximize their balance ability 36 . However some previous research 37 , 38 suggest that the WBV protocol does not affect balance abilities after training in healthy non-athletes and that the application of this method as additional training provides good results than using separately 39 . Designing the training program to achieve optimal benefits for PS in healthy young adults plays an essential role in general personal health management. Although different training protocols have improved PS and general stability in everyday activities, there is still considerable debate regarding the optimal exercise modalities within an exercise program. However, there are different approaches in DNS protocols and WBV with their variety in type, frequency, and training application; according to previous research, it is essential to examine and compare the effectiveness of the interventions. Regarding that, a fundamental problem with much of the literature on the effect of exercise on PS is how different method combinations and approaches could improve PS. In recent years, the importance of sports and physiotherapy has increased, and many injuries have occurred, so studying the different practical training approaches in prevention is necessary. There are limited comparative investigations on DNS and WBV training on PS and balance in healthy young participants. Given that only a few studies exist regarding specific programs for healthy young adults, there is a need to determine the effects of WBV and DNS on PS. Researchers need to conduct additional studies to combine the exercise model with WBV and DNS protocols for PS. Therefore, the purpose of this study is to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy young participants. Results General linear models (a 2x4 mixed design ANCOVA for each PS measure) estimated that mean changes of all PS measures largely differed between the groups, excluding mean changes in COF path length in single support on the right leg, which differed to a medium extent (see Table 1 ). Postural stability measures Double support Single support – right leg Single support – left leg Area (cm²) 22.69**, 0.28 60.52**, 0.50 60.95**, 0.51 COF travelled way (mm) 63.90**, 0.52 3.98*, 0.06 94.86**, 0.62 Displacement ML (mm) 87.86**, 0.60 22.75**, 0.28 21.57**, 0.27 Displacement AP (mm) 149.59**, 0.72 33.60**, 0.37 84.13**, 0.59 Table 1. Group by time interaction effects on PS measures from the general linear models (the 2x4 ANCOVAs). Values are F (1, 175) values, partial eta squared ( ). Abbreviation: Area = Sway Area; COF = Center of Force; ML = Medio-Lateral; AP = Anterior-Posterior; ** significant 2x4 interaction effect at p<0.001 (corrected p-values); * significant 2x4 interaction effect at p<0.01 (corrected p-values for each measure). Table 2 presents the estimated mean changes (mean difference from initial to final testing [95% CIs]) within the groups from the 2x4 ANCOVA models. On average, participants in MIX significantly improved all PS measures; however, large improvements only occurred in COF path length of double and single support on the left leg and ML displacement of single support on the right leg. We observed trivial to medium/large improvements in the rest of the measures of double and single support on the right and left leg. Similarly, on average, participants in DNS significantly improved all PS measures except the COF path length of single support on the right leg. Even though the COF path length of single support on the left leg vastly improved and the COF path length of double support and ML displacement of single support on the right leg tended to improve to a large extent, improvements in the rest of the measures of the double and single support on the right and left leg were trivial to medium/large. Nevertheless, participants in VIBRO and CONTROL retained a similar average of almost all PS measures, except Area, COF path length, and AP displacement of single support on the right leg, which significantly lowered in CONTROL from initial to final testing. Therefore, the proceeding contrast analysis only compared changes in PS measures between MIX and DNS and ML displacement in double support between MIX, DNS, and VIBRO. PS measures Group Pre-post changes ¥ Hedge’s g av Mean [95% CI ] Mean 95% CI Double support Area (cm²) Mix -0.03** [-0.03, -0.02] 0.48 [0.07, 0.90] Dns -0.01** [-0.01, 0.00] 0.22 [-0.20, 0.64] Vibro -0.004 [-0.01, 0.00] 0.10 [-0.54, 0.33] Control 0.005 [0.00, 0.01] 0.10 [-0.53, 0.33] COF travelled way (mm) Mix -1.11** [-1.23, -0.98] 1.99 [1.49, 2.49] Dns -0.44** [-0.57, -0.31] 0.79 [0.36, 1.23] Vibro -0.03 [-0.16, 0.10] 0.06 [-0.36, 0.48] Control 0.01 [-0.12, 0.14] 0.02 [-0.45, 0.41] Displacement ML (mm) Mix -1.30** [-1.43, -1.17] 0.43 [0.01, 0.84] Dns -0.98** [-1.11, -0.85] 0.32 [-0.10, 0.74] Vibro -0.16* [-0.29, -0.03] 0.05 [-0.37, 0.47] Control 0.01 [-0.12, 0.14] 0.00 [-0.43, 0.43] Displacement AP (mm) Mix -1.32** [-1.43, -1.22] 0.42 [0.00, 0.83] Dns -0.84** [-0.95, -0.74] 0.27 [-0.15, 0.27] Vibro -0.02 [-0.13, 0.08] 0.01 [-0.41, 0.43] Control 0.02 [-0.09, 0.13] 0.01 [-0.44, 0.42] Single support – right leg Area (cm²) Mix -0.033** [-0.04, -0.03] 0.26 [-0.15, 0.67] Dns -0.011** [-0.02, -0.01] 0.10 [-0.32, 0.51] Vibro -0.002 [-0.01, 0.00] 0.02 [-0.40, 0.44] Control 0.004* [0.00, 0.01] 0.04 [-0.46, 0.39] COF travelled way (mm) Mix -0.03* [-0.05, -0.01] 0.01 [-0.40, 0.42] Dns -0.02 [-0.37, 0.01] 0.01 [-0.41, 0.43] Vibro -0.01 [-0.03, 0.02] 0.00 [-0.42, 0.42] Control 0.24* [0.00, 0.05] 0.01 [-0.44, 0.42] Displacement ML (mm) Mix -2.00** [-2.41, -1.59] 0.92 [0.49, 1.36] Dns -1.71** [-2.13, -1.29] 0.75 [0.31, 1.18] Vibro -0.08 [-0.50, 0.34] 0.02 [-0.40, 0.44] Control -0.14 [-0.57, 0.29] -0.03 [-0.40, 0.46] Displacement AP (mm) Mix -2.08** [-2.40, -1.76] 0.30 [-0.11, 0.71] Dns -1.60** [-1.93, -1.28] 0.23 [-0.19, 0.65] Vibro -0.08 [-0.40, 0.25] 0.01 [-0.41, 0.43] Control 0.40* [0.07, 0.74] -0.06 [-0.37, 0.49] Single support – left leg Area (cm²) Mix -0.036** [-0.04, -0.03] 0.29 [-0.12, 0.70] Dns -0.011** [-0.02, -0.01] 0.08 [-0.34, 0.50] Vibro -0.002 [-0.01, 0.00] 0.01 [-0.40, 0.43] Control 0.005* [0.00, 0.01] 0.04 [-0.39, 0.46] COF travelled way (mm) Mix -5.37** [-5.93, -4.82] 1.64 [1.16, 2.11] Dns -4.21** [-4.77, -3.65] 1.28 [0.82, 1.74] Vibro -0.11 [-0.67, 0.46] 0.03 [-0.39, 0.45] Control 0.03 [-0.55, 0.60] -0.01 [-0.44, 0.42] Displacement ML (mm) Mix -2.11** [-2.52, -1.59] 0.43 [0.02, 0.85] Dns -1.85** [-2.27, -1.42] 0.38 [-0.04, 0.38] Vibro -0.07 [-0.50, 0.36] 0.01 [-0.40, 0.43] Control -0.47* [-0.91, -0.03] 0.10 [-0.33, 0.53] Displacement AP (mm) Mix -2.20** [-2.43, -1.96] 0.30 [-011, 0,71] Dns -1.70** [-1.94, -1.46] 0.23 [-0.19, 0.66] Vibro -0.08 [-0.32, 0.16] 0.01 [-0.41, 0.43] Control 0.04 [-0.28, 0.21] 0.01 [-0.42, 0.43] Table 2 . Unstandardized and standardized mean differences [95% Confidence Intervals] from initial to final testing. Values are based on estimated marginal means from the 2x4 ANCOVA models with mean-centred BMI = 22.11 kg/m2 (simple main effects). Abbreviation: Area = Sway Area; COF = Center of Force; ML = Medio-Lateral; AP = Anterior-Posterior; ** significant mean differences from initial to final testing at p < 0.001 (corrected p-values); * significant mean differences from initial to final testing at p < 0.05 (corrected p-values). ¥ reverse scoring. Contrast analysis showed significantly larger improvements (mean difference between mean changes [95% CIs]) of double support measures in the MIX than in the DNS: Area for 0.02cm 2 [0.01, 0.03], COF path length for 0.67mm [0.49, 0.85], ML displacement for 0.32mm [0.13, 0.50], and AP displacement for 0.48mm [0.33, 0.63]. However, on average, participants in the MIX and DNS improved ML displacement more than participants in the VIBRO by 1.14mm [1.32, 0.95] and 0.82mm [0.63, 1.01], respectively. Participants in MIX improved two measures on the right and three on the left leg more than in DNS, on average, for the measures of single support . On the right leg, the Area and AP displacement improved by 0.02cm 2 [0.02, 0.08] and 0.29mm [-0.87, 0.30] more in MIX than in the DNS, respectively. On the left leg, MIX also improved the Area, COF path length, and AP displacement by 0.025cm 2 [0.018, 0.031], 1.16mm [0.37, 1.95], and 0.49mm [0.16, 0.83] more than the DNS group. However, mean differences between the mean changes of MIX and DNS were similar in COF path length (0.01mm [-0.01, 0.04]) and ML displacement (0.29mm [-0.30, 0.87]) on the right leg and ML displacement (0.26mm [-0.34, 0.86]) on the left leg. Figure 1 illustrates effect sizes (Hedge’s g with 95% CIs) for mean group changes. Discussion The purpose of this study is to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy young participants. This RCT compared the two months effects of three different training modalities, dynamic neuromuscular stabilization (DNS), whole-body vibration training (VIBRO), and both combined (MIX) on PS measures of double and single leg support in healthy adults. After two months, all PS measures significantly improved ( trivial to large ) in MIX and DNS. However, only COF travelled way of double and single support on the left leg, and ML displacements of single support on the right leg largely improved in both groups. However, MIX improved the average of those measures to a greater extent. Participants in VIBRO and CONTROL did not improve PS measures of double and single support from initial to final testing. In the results of this study, DNS is effective for improving some parameters of postural control balance, and previous research confirms that DNS training modalities effectively increase different aspects of stability 7 – 14 , 40 . DNS training typically involves a series of exercises designed to activate and stabilize the deep stabilizing muscles of the trunk and pelvis, such as the diaphragm, transversus abdominis, and pelvic floor muscles. Participants performed these exercises in positions that mimic the developmental stages of movement, from lying on the back to crawling, kneeling, and standing. By training the body to move naturally and functionally, DNS improve posture, balance, coordination, and overall movement quality. Another stimulation in this training method is neuromuscular intra-abdominal pressure (IAP) activation through balanced coactivation between deep spinal and abdominal muscles, diaphragm, and pelvis 7 , 41 . CNS and muscle system initiation could enhance core and PS, pointing out that the DNS training method could benefit healthy young people's balance and stabilisation. The VIBRO group did not demonstrate significant improvements, which aligns with past research suggesting that the efficacy of Whole Body Vibration (WBV) training may hinge on vibration frequency 42 , 43 . Vibratory stimulation activates the Tonic Vibration Reflex (TVR), characterized by muscle contractions prompted by the excitation of Ia afferents in the muscle spindles 19 , 20 , 29 . However, concurrently, it inhibits the Stretch Reflex and the H-reflex - a phenomenon often called the "vibration paradox" 44 , 45 . Presynaptic inhibition of the Ia afferents in the muscle spindles can be attributed to this inhibition. The resulting suppression of pathways responsive to stretch and the excitation of pathways responsive to vibration could explain the lack of improvement in postural stability (PS) parameters, which is particularly relevant given the significant role of mobility in overall stability 46 . Nevertheless, WBV training could serve as an additional stimulus for athletes, and combined training methods might yield better results than individual ones 39 . However, WBV training in synergy with the DNS exercise neutralizes that inhibition in a multidisciplinary approach. Modalities, including inhibition via WBV training and activation via DNS movement, could improve stability with two mechanisms. First, WBV training is a type of exercise that involves standing, sitting, or lying on a vibrating platform while performing various movements. Experts believe that this type of training stimulates muscle contractions and increases blood flow, improving muscle strength, causing muscles and tendons to act like springs, storing energy slightly, and releasing mechanical forces abruptly 20 , 21 , 24 , 25 , 27 , 28 , 47 . An accumulation of mechanical energy within the body is essential, which can increase internal forces and decrease the stretching abilities of the muscle. WBV initiates core muscle contraction with vibration stimulation based on the tonic vibration reflex, increasing strength-explosive strength 19 , 25 , 39 , 48 . Secondly, the designers of DNS exercises aimed to improve joint coordination, mobility, and stability of the body's core muscles, which are essential for proper movement and posture. These exercises require the activation of specific muscle groups to generate force and maintain stability, and the distribution of this force throughout the body is crucial for adequate movement. DNS optimizes the distribution of internal forces of the muscles acting on each spine and body segment, making balance in forces that could be important for stability. Moreover, due to the great variety of movement in different body parts, this type of exercise improves flexibility and range of motion with a combination of fundamental movements and principles of developmental kinesiology 49 . This research combines two modalities conducted by the MIX group. It suggests that WBV training before DNS exercises can enhance muscle activation and warm-up, improving force production, stretching during stabilization exercises, and increasing stabilization. An important implication of these findings is that the modified method combining DNS and WBV put a new perspective on specific core strength and stability training in healthy individuals. However, the primary constraint of this study is that it is uncertain whether the attribution of PS is due to training or previous experience in exercise. Further investigation is needed because the study only examined young people (average age 24.02 ± 2.07 years) who likely have a high potential for improving PS due to differences in biological maturation. Moreover, researchers need to conduct more research to explore the improvement of PS with different interventions in the context of sports activities. Testing between 9:00 and 13:00 hours could have affected performance due to the circadian rhythm, thus representing another study limitation. Future research should include older individuals and those with PS problems to obtain more dependable outcomes 27 . Furthermore, researchers should evaluate the effectiveness of these methods using more demanding tests and unpredictable requirements that occur in real-life and sports competitions. In conclusion of the study, healthy participants aged 22–26 positively impacted PS parameters when DNS and WBV were combined. DNS training separately also showed a positive impact, which suggests that it is an effective method for improving PS. However, WBV training showed almost no impact, indicating that there may be better approaches for enhancing stability capacity in healthy individuals. Nonetheless, the combined use of DNS and WBV was highly effective and could help optimize stability capacity during everyday activities in a healthy population. By improving PS, individuals can perform daily tasks more efficiently and confidently, reducing their risk of falls and injuries. Therefore, combining DNS and WBV may be a valuable addition to rehabilitation programs, athletic training, and other therapeutic interventions to improve stability and balance. Methods Participants. In a randomised, controlled interventional trial, we enrolled a gender-balanced group of 180 healthy young participants (age 24.02 ± 2.07 years; height 174.98 ± 8.98 cm; mass 68.16 ± 12.28 kg). Exclusion criteria were: (i) history of neurological or musculoskeletal disorders; (ii) clinical conditions that could impair balance (motor disorders; medical conditions like diabetes, heart disease, stroke, issues with vision, thyroid, nerves, or blood vessels). Inclusion criteria for this study were: (i) the absence of injuries in the past 6 months (ii) the absence of other medical conditions, including COVID-19 (ii) no programmed physical activity in the past 3 months. We recruited the initial sample of respondents through an open online application that lasted two months (n = 250), after which we started the first selection of respondents (n = 230). We completed recruitment after filling in the optimal sample of subjects. We then divided the study sample into the MIX group (n = 58), DNS group (n = 57), VIBRO group (n = 57), and CONTROL group (n = 58) using stratified randomization. At the end of the experimental program, the final sample was 180 (MIX = 45; DNS = 45; VIBRO = 44; CONTROL = 43). When stratifying, researchers use proportionate sampling to maintain the correct proportions of genders in every group. At baseline, we found no significant differences (p > 0.05) in age, height, weight, and BMI (Table 3 ) between the groups. After explaining the experimental protocol, each subject provided written informed consent before participating in the study, per the Declaration of Helsinki and the Novi Sad University Human Research Ethics Committee guidelines (ethical approval number: 46-06-04/2020-1; the recruitment period for this study was 15.4.2022). The study was full registered at ClinicalTrials.gov under NCT06294002 on 05/03/2024 under the name “Neuromuscular Training & Postural Stability (STABLEFIT)”. Figure 2 shows the flow diagram of participants in this study. Table 3 Anthropometric characteristics of participants. a Data are presented as mean ± standard deviation. Abbreviations: BMI = body mass index arithmetic mean; SD, standard deviation. TOTAL (n = 180) Exercise programs CONTROL (n = 43) MIX (n = 47) DNS (n = 45) VIBRO (n = 44) Gender (m/f) 90/90 24/23 22/23 22/22 21/22 Age (years) a 24.02 ± 2.07 23.73 ± 2.05 24.10 ± 1.93 24.11 ± 2.42 24.16 ± 1.89 Weight (kg) a 68.16 ± 12.28 67.41 ± 12.51 67.34 ± 11.39 69.74 ± 13.68 68.17 ± 11.63 Height (cm) a 174.98 ± 8.98 174.92 ± 9.44 174.59 ± 9.05 175.55 ± 9.23 174.87 ± 8.39 BMI kg/m 2 ) a 22.11 ± 2.63 21.85 ± 2.44 21.98 ± 2.58 22.43 ± 2.70 22.18 ± 2.87 Experimental design. PS parameters were tested and analyzed at the Faculty of Sport and Physical Education, University of Novi Sad, Serbia, to evaluate the effects of a two months experimental training program. The researchers conducted the initial and final tests two days before and after the two-month treatment period. We divided participants into three experimental groups: Dynamic neuromuscular stabilization group (DNS), Whole-body vibration group (VIBRO), and Dynamic neuromuscular stabilization with whole-body vibration group (MIX). These groups underwent two months of intervention training, while the control (CONTROL) group did not exercise or use any training intervention or other habitual training during the two months. Experimental programs were valid when the participants finished at least 80% of all training sessions, and the training program was not supplemental with other exercises. All subjects trained three days a week, interspersed with at least one day of rest. To guarantee the quality and correct execution of training protocols, a set of professional coaches with licenses and certificates and researchers supervised all training programs in small groups. Experimental procedures. Dynamic neuromuscular stabilization group (DNS). DNS group's protocol involved 5 min moderate intensity warm-up, 40 min DNS movements according to the DNS approach 7 , different diaphragmatic breathing, mobility and controlled movement exercises and 5 min cool-down. Exercises gradually increased in complexity and difficulty level regarding DNS training principles 18 . We instructed the participants to refrain from engaging in high-intensity anaerobic or anaerobic resistance training throughout the study period to prevent potential disruptions in the study results. Whole body vibration group (VIBRO). WBV was performed on Power Plate Next Generation vibration platform (Power Plate North America, Chicago, IL). All training routines were approximately 50 minutes long, commencing with 5 minutes of moderate-intensity warm-up and concluding with a cool-down period. The program consisted of 8–10 static and dynamic exercises for PS that progressively increased in difficulty and complexity over the course. During the training process, the frequency increased from 20 to 35 Hz in the last week of the experiment; the exercise duration was from 20–60 seconds (in the last week), followed by 1-minute seated rest. Moreover, the complexity and difficulty of exercise increased over the experimental period. The resting period between sets was constant from the start to the end of the training process. During the experiment, the WBV intervention group performed three weekly training sessions. We advised the participants to avoid participating in high-intensity anaerobic or anaerobic resistance training during the study to ensure that it would not interfere with the outcomes. There were no changes to trial outcomes after the trial commenced. Principles and basic procedures were adapted from previous research 25 , 27 , 29 , 38 , 50 . Dynamic neuromuscular stabilization with whole body vibration group (MIX). During the two months, participants in the MIX group performed training consisting of 3 weekly sessions. The protocol consisted of a 50-minute exercise program with a 5-minute moderate-intensity warm-up and cool-down period per training session. The structural core of training included 20 minutes of WBV and 20 minutes of DNS training. Both protocols followed the previous research and training recommendations but involved shorter durations and fewer sets. Exercises with VIBRO were performed on Power Plate Next Generation vibration platform (Power Plate North America, Chicago, IL). The program consisted of 6–8 exercises (static and dynamic) for balance and PS. Exercise progressively increases by the level of difficulty. During the training process, the frequency was also increased from 20 to 35 Hz in the last week of the experiment; the exercise duration was from 20 to 60 seconds (in the last week), followed by a 1-minute seated rest. The resting period between sets was constant from the start to the end of the training process. To avoid interfering with the study's results, we recommended that participants abstain from engaging in high-intensity or anaerobic resistance training throughout the study. We adapted basic principles and procedures from previous research 25 , 27 , 29 , 38 , 50 . Following WBV, participants engaged in 20 minutes of DNS training, which included specific movement exercises according to the DNS approach. Participants performed breathing, coordination, mobility, and stability core exercises and routines suggested in previous studies 7 , 18 , 40 , 49 . During the experiment, the MIX intervention group performed three training sessions weekly. Test procedures. The testing occurred at the Faculty of Sport and Physical Education, University of Novi Sad, Serbia. All participants were tested in the morning before their training session in indoor environmental conditions (temperature: 18–21°C; relative humidity: 40–60%). Before starting a performance task, general information about the examinees was recorded, including gender, age, height, and mass. Participants were instructed to wear minimal clothing and remove all footwear for height and mass measurements. Participants had to eat and drink sparingly and empty their bladder/excrete as needed before presenting for assessment. We used a stadiometer (0.1 cm accuracy, SECA Instruments Ltd, Hamburg, Germany) for height and mass measurements. We assessed static PS using a laboratory-grade 0.5 m Footscan® plate (RSscan International, Lammerdries, Belgium) with 4096 sensors and a scanning rate of up to 300 Hz. The subject performed an individual single and double-leg task with three trials, each lasting 30 seconds with a two-minute break between each trial. During the double-leg stance test, participants were instructed to maintain an upright and as still as possible. We asked them to stand in their natural, comfortable position with their eyes open and fixed on a cross positioned at approximately eye level on a blackboard situated 5 meters away. Participants stood barefoot with their feet positioned shoulder-width apart on a platform, keeping their arms by their sides. Each participant was required to maintain this stable posture, and measurement started after 10 seconds (preparation period to avoid transient effects). We instructed participants to balance on one foot during the single-limb stance test. Participants positioned this foot to point directly forward, aligning with reference lines in the frontal and sagittal planes. The swinging leg was flexed at the hip and knee joints to approximately 90 degrees while both arms hung naturally and relaxed at their sides. We further instructed participants to maintain as steady a posture as possible, focusing their gaze straight ahead on a point situated 65 centimetres away on the wall. We randomized the order of testing between the left and right legs. Each participant was required to maintain this stable position, and measurement started after 5 seconds (preparation period to avoid transient effects). Tests for static PS were the gold standard in measuring balance and were used to obtain biomechanical parameters of static PS 51 . We performed all measurements in triplicate and retained the mean score for subsequent evaluations and analyses. We randomized the sequence of performing the balance tasks. The software calculated the single and double-leg Sway Area (cm²), Center of Force (COF) travelled way (mm), Medio-Lateral (ML) displacement (mm), and Anterior-Posterior (AP) displacement (mm) as primary outcomes. The following protocol was chosen based on their varying difficulty and common use, as stated in previous research and is cited as reliable 52 – 55 . Statistical analyses. G*power 3.1 power analysis software (Heinrich-Heine-University, Düsseldorf, Germany) estimated the minimum total sample size (N = 140) given the critical F (3, 136) = 2.67, an effect size f = 0.14 (partial η 2 = 0.02), p = 0.05, 1-β = 0.80, groups = 4, time points = 2, and correlation among the measurements = 0.50. The authors presented data as means and 95% confidence intervals [95% CIs]. The Kolmogorov–Smirnov, Leven's, Box's, and Mauchly's tests confirmed the assumptions of normality, homogeneity of variances and covariances, and sphericity, respectively. General linear models (twelve separate 2x4 mixed-design analyses of covariances for each PS measure) estimated whether mean changes [95% CIs] in PS measure from initial to final testing depended on whether participants received the DNS, VIBRO, and MIX exercise program or did not (CONTROL) after controlling for mean-centred BMI (22.11 ± 2.63) 56 , 57 . Following the time-by-group interaction effects, which revealed whether estimated changes over time depended on the participants’ group (i.e., differed at least between one group-comparison pair), we computed simple effects tests to estimate mean changes over time (mean difference from initial to final testing) within the groups. The follow-up investigation proceeded with contrast analysis, which estimated the degree to which estimated mean changes of PS measures differed between the group-comparison pairs. The authors calculated the effect size for time-by-group interaction effects and simple effects using partial eta squared (partial η 2 : 0.01 small; 0.06 medium; 0.14 large) 58 and Hedge’s g average (Hedge’s av : <|0.20| trivial; |0.20| small; |0.50| medium; |0.80| large) 59 , respectively. The Bonferroni test corrected p-values and 95% CI; the alpha level was p ≤ 0.05. We used SPSS version 23.0 (SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 8.0 (GraphPad Software, San Diego, California, USA) to analyze and plot the data, respectively. Ethics declarations. The Ethics Committee of the Faculty of Sport and Physical Education, University of Novi Sad, Serbia, obtained ethical review and approval. The experimental procedures reported in this study were performed following the ethical standards of the Declaration of Helsinki, and the participants signed informed consent forms. Declarations Data availability. The raw data supporting the conclusions of this article will be made available by the authors without undue reservation. Acknowledgements The Provincial Secretariat for Higher Education and Scientific Research, Autonomous Province of Vojvodina, Republic of Serbia, supported the preparation of this paper, grant number (142-451-3098); Ministry of Science, Technological Development and Innovation, Government of Serbia, Serbia. Authors’ contributions D.M. participated in the conceptualization of the study and contributed to data collection and data reduction/analysis; D.MAC., D.M. participated in the design of the study; V.S. and A.I. participated in the design of the study and contributed to data collection and writing; D.R. and Z.G. contributed to writing - review and editing; D.MAC. contributed to data analysis and interpretation of results. T.T, D.MM., A.I. and P.D. participated in supervision and review. M.S. participated in visualization and editing. 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Frontiers in Psychology 13 , doi:10.3389/fpsyg.2022.844678 (2022). Cholewicki, J., Juluru, K., Radebold, A., Panjabi, M. M. & McGill, S. M. Lumbar spine stability can be augmented with an abdominal belt and/or increased intra-abdominal pressure. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 8 , 388-395, doi:10.1007/s005860050192 (1999). Luo, J., McNamara, B. & Moran, K. The use of vibration training to enhance muscle strength and power. Sports medicine (Auckland, N.Z.) 35 , 23-41, doi:10.2165/00007256-200535010-00003 (2005). Maghbouli, N., Khodadost, M. & Pourhassan, S. The effectiveness of vibration therapy for muscle peak torque and postural control in individuals with anterior cruciate ligament reconstruction: a systematic review and meta-analysis of clinical trials. 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Vibration exercise: the potential benefits. International journal of sports medicine 32 , 75-99, doi:10.1055/s-0030-1268010 (2011). Kobesova, A. & Osborne, N. The Prague School of Rehabilitation. International Musculoskeletal Medicine 34 , 39-41, doi:10.1179/1753614612Z.00000000014 (2012). Jordan, M. J., Norris, S. R., Smith, D. J. & Herzog, W. Vibration training: an overview of the area, training consequences, and future considerations. J Strength Cond Res 19 , 459-466, doi:10.1519/13293.1 (2005). Hass, C. J., Waddell, D. E., Wolf, S. L., Juncos, J. L. & Gregor, R. J. Gait initiation in older adults with postural instability. Clinical Biomechanics 23 , 743-753, doi:10.1016/j.clinbiomech.2008.02.012 (2008). Bauer, C., Groger, I., Rupprecht, R. & Gassmann, K. G. Intrasession reliability of force platform parameters in community-dwelling older adults. Arch Phys Med Rehabil 89 , 1977-1982, doi:10.1016/j.apmr.2008.02.033 (2008). Springer, B. A., Marin, R., Cyhan, T., Roberts, H. & Gill, N. W. Normative values for the unipedal stance test with eyes open and closed. Journal of geriatric physical therapy (2001) 30 , 8-15, doi:10.1519/00139143-200704000-00003 (2007). Troester, J. C., Jasmin, J. G. & Duffield, R. Reliability of Single-Leg Balance and Landing Tests in Rugby Union; Prospect of Using Postural Control to Monitor Fatigue. J Sports Sci Med 17 , 174-180 (2018). Verhagen, E. et al. The effect of a balance training programme on centre of pressure excursion in one-leg stance. Clinical Biomechanics 20 , 1094-1100, doi:10.1016/j.clinbiomech.2005.07.001 (2005). Hue, O. et al. Body weight is a strong predictor of postural stability. Gait & posture 26 , 32-38, doi:10.1016/j.gaitpost.2006.07.005 (2007). Cibulková, N. et al. Bariatric surgery and exercise: A pilot study on postural stability in obese individuals. PLoS ONE 17 , doi:10.1371/journal.pone.0262651 (2022). Cohen, J. Statistical power analysis for the behavioral sciences . (Academic press, 2013). Lakens, D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol 4 , 863, doi:10.3389/fpsyg.2013.00863 (2013). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4100808","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":286334338,"identity":"89e52e2c-6074-477f-9813-390e6c14125f","order_by":0,"name":"Dragan Marinkovic","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIie2OsQqCUBSGTwjH5UircEGfICgEl4xeJQluU+AjOOlWq71Fk7NwoclwFZokcBaCJoeuQ0vEJbeG+531/87/A2g0f0ohDxCMYrSCm3E9Epr/Fp6l10ZEZRAezPLJoh7caWzdO5Xil7u5yGoeJrTP2SmBRVaYvq1UCg6COuGhbeXMimFyBkTlML9q3wq1jHpYS8VQD6uHllo4UkFGCKFUQD2sHlpK7iBxb2kl9jYTiGql4saDLgG5qWhu1AerY5qoh30i/xtj8hqNRqP5yguuQkDn3B/iAAAAAABJRU5ErkJggg==","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":true,"prefix":"","firstName":"Dragan","middleName":"","lastName":"Marinkovic","suffix":""},{"id":286334341,"identity":"f4e9892a-1e19-42f4-a86b-fa780c4c0163","order_by":1,"name":"Drazenka Macak","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Drazenka","middleName":"","lastName":"Macak","suffix":""},{"id":286334342,"identity":"cbd592aa-caa3-4ffb-9c47-299f7da3012a","order_by":2,"name":"Vukasin Stanic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Vukasin","middleName":"","lastName":"Stanic","suffix":""},{"id":286334343,"identity":"2de38c7b-7185-4a62-8f85-a3843de0e602","order_by":3,"name":"Dejan M Madic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Dejan","middleName":"M","lastName":"Madic","suffix":""},{"id":286334344,"identity":"9389eb0a-b02b-4217-9731-34a8b80ef2ba","order_by":4,"name":"Danilo Radanovic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Danilo","middleName":"","lastName":"Radanovic","suffix":""},{"id":286334345,"identity":"b0eff7ea-dcf9-4db3-9d83-6f75d1b0b06f","order_by":5,"name":"Zoran Gojkovic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Medicine, Serbia","correspondingAuthor":false,"prefix":"","firstName":"Zoran","middleName":"","lastName":"Gojkovic","suffix":""},{"id":286334346,"identity":"28e801ae-1598-495c-9019-262b8b31e493","order_by":6,"name":"Miodrag Spasic","email":"","orcid":"","institution":"University of Split, Faculty of Kinesiology, Croatia","correspondingAuthor":false,"prefix":"","firstName":"Miodrag","middleName":"","lastName":"Spasic","suffix":""},{"id":286334347,"identity":"cf658d3f-bf1d-46a2-b78e-fd58c334319f","order_by":7,"name":"Aleksandra Ilic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Aleksandra","middleName":"","lastName":"Ilic","suffix":""},{"id":286334348,"identity":"3767fbfd-d68e-4ebf-8357-61c22ead8305","order_by":8,"name":"Tatjana Trivic","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Tatjana","middleName":"","lastName":"Trivic","suffix":""},{"id":286334349,"identity":"f15c0124-7915-438d-8807-e3d788279777","order_by":9,"name":"Patrik Drid","email":"","orcid":"","institution":"University of Novi Sad, Faculty of Sport and Physical Education","correspondingAuthor":false,"prefix":"","firstName":"Patrik","middleName":"","lastName":"Drid","suffix":""}],"badges":[],"createdAt":"2024-03-14 12:32:57","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4100808/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4100808/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-024-83828-z","type":"published","date":"2024-12-30T15:57:34+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":53959846,"identity":"977330da-da63-47c4-9aa3-3bd3a913eeb1","added_by":"auto","created_at":"2024-04-02 17:53:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29643,"visible":true,"origin":"","legend":"\u003cp\u003eHedge’s g\u003csub\u003eav\u003c/sub\u003e for PS measures mean changes from initial to final testing within the groups. Legend: a) Double leg support; b) Single support – right leg; c) Single support – left leg; Area Sway Area; COF Center of Force; ML Medio-Lateral; AP Anterior-Posterior; Grey shaded– trivial or small changes; below the green line – medium improvements; above the green line – large improvements.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4100808/v1/8eb3542e6a2dc8d3ae206ca0.png"},{"id":53959845,"identity":"d0e24add-0ecc-4c7e-813a-6f9fb31e8164","added_by":"auto","created_at":"2024-04-02 17:53:26","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":45701,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of participant enrolment, allocation, and analysis.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-4100808/v1/650275dd7a02f0d9b5b7039c.png"},{"id":73093364,"identity":"bd0af9d6-7754-4bc2-9311-6c82bffabf52","added_by":"auto","created_at":"2025-01-06 16:15:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":868130,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4100808/v1/5eef45c3-9399-4816-9c32-aeacf1cea9cf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of different neuromuscular training modalities on postural stability in healthy recreation people: A randomized controlled trial","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePostural stability (PS) is a vital function that helps maintain equilibrium during standing still, locomotion, and any activities requiring high balance performance \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Under static and dynamic conditions, PS is a fundamental factor for the quality of movement in everyday activities or sports \u003csup\u003e\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Previous studies have reported that PS and adaptive ability are required in sports because the sensory and motor systems interact to regulate postural adjustments by processing information from the visual, vestibular, and somatosensory systems \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The interest in using different exercises and protocols for improving PS in sports and physiotherapy has grown in the last few decades. Experts have proposed various training modalities to increase neuromuscular stability, balance, postural control, and general stability.\u003c/p\u003e \u003cp\u003eDynamic Neuromuscular Stabilization (DNS) is a complex of correction exercises with a neuromuscular approach based on improving breathing, fundamental movements, and principles of developmental kinesiology \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Frank et al. \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e emphasize that the basic principles of DNS concentrate on core stabilization, centralization of joints and segments, movement awareness, quality respiratory function and support. DNS offers a rehabilitative and manual approach that practitioners can use to improve functional treatment and optimize the movement system in athletes by rebuilding stability performance \u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. One of the latest research on applying DNS in a sample of elite futsal players and race walkers indicates that DNS therapy effectively increases performance and balance \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Research has shown that the level of tension in the abdominal wall is significantly higher during DNS exercises than in other forms of exercise. This increased tension helps to stabilize the spine and improves overall posture. It also helps to reduce the risk of injury and improve performance in activities that require trunk stability, such as lifting heavy objects or performing athletic movements \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Current research on the effect of DNS is focused on functional movements (FM) and indicates improvement in complex movement abilities and motor control patterns \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Another conclusion, in line with previous research, points out that the DNS approach can increase stabilization patterns of the trunk and synergistic movement of the extremities during motor activities \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eWhole body vibration training (WBV) is a neuromuscular training approach that has recently become very popular among researchers and practitioners in health and sport. It is usually an additional method used in a conventional training routine. During WBV training, the athlete's body experiences a low-frequency amplitude of vibration and mechanical stimulation on a vibrating platform, which initiates muscle contractions based on the reflex of tonic vibration \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. A recent literature review found that WBV can improve power, muscle strength, performance, endurance, flexibility, neuromuscular activity, lower limb motor control, and stability \u003csup\u003e\u003cspan additionalcitationids=\"CR21 CR22\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Several studies have carried the same approach on different participant groups and found that WBV improved static balance, PS, and movement of postural sway \u003csup\u003e\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. A few additional studies demonstrated improvements in some components of dynamic PS \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. Fort et al.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e analyzed the effect of the WBV program on female basketball players and concluded that this method could enhance PS and explosive strength within 15 weeks of exercise. Bullock et al. \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e indicate the positive effects on elite athletes' critical balance abilities and stabilization. A literature review found that WBV may also enhance PS in aged and untrained people, concluding that this method could benefit healthy outcomes \u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan additionalcitationids=\"CR33 CR34\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. More recent evidence highlights that WBV training may be an effective means of enhancing balance ability in jumpers and may have practical implications for athletes seeking to improve their performance. As such, athletes are encouraged to consider incorporating WBV training into their training regimen to maximize their balance ability \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. However some previous research \u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e suggest that the WBV protocol does not affect balance abilities after training in healthy non-athletes and that the application of this method as additional training provides good results than using separately \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDesigning the training program to achieve optimal benefits for PS in healthy young adults plays an essential role in general personal health management. Although different training protocols have improved PS and general stability in everyday activities, there is still considerable debate regarding the optimal exercise modalities within an exercise program. However, there are different approaches in DNS protocols and WBV with their variety in type, frequency, and training application; according to previous research, it is essential to examine and compare the effectiveness of the interventions. Regarding that, a fundamental problem with much of the literature on the effect of exercise on PS is how different method combinations and approaches could improve PS. In recent years, the importance of sports and physiotherapy has increased, and many injuries have occurred, so studying the different practical training approaches in prevention is necessary. There are limited comparative investigations on DNS and WBV training on PS and balance in healthy young participants.\u003c/p\u003e \u003cp\u003eGiven that only a few studies exist regarding specific programs for healthy young adults, there is a need to determine the effects of WBV and DNS on PS. Researchers need to conduct additional studies to combine the exercise model with WBV and DNS protocols for PS. Therefore, the purpose of this study is to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy young participants.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eGeneral linear models (a 2x4 mixed design ANCOVA for each PS measure) estimated that mean changes of all PS measures largely differed between the groups, excluding mean changes in COF path length in single support on the right leg, which differed to a medium extent (see Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePostural stability measures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDouble support\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSingle support \u0026ndash; right leg\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSingle support \u0026ndash; left leg\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eArea (cm\u0026sup2;)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.69**, 0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60.52**, 0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60.95**, 0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCOF travelled way (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e63.90**, 0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.98*, 0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e94.86**, 0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisplacement ML (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e87.86**, 0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.75**, 0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.57**, 0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisplacement AP (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e149.59**, 0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33.60**, 0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e84.13**, 0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Group by time interaction effects on PS measures from the general linear models (the 2x4 ANCOVAs). Values are F\u003csub\u003e(1, 175)\u003c/sub\u003e values, partial eta squared ( ). Abbreviation: Area = Sway Area; COF = Center of Force; ML = Medio-Lateral; AP = Anterior-Posterior; ** significant 2x4 interaction effect at p\u0026lt;0.001 (corrected p-values); * significant 2x4 interaction effect at p\u0026lt;0.01 (corrected p-values for each measure).\u003c/p\u003e\n\u003cp\u003eTable 2 presents the estimated mean changes (mean difference from initial to final testing [95% CIs]) within the groups from the 2x4 ANCOVA models. On average, participants in \u003cem\u003eMIX\u003c/em\u003e significantly improved all PS measures; however, large improvements only occurred in COF path length of double and single support on the left leg and ML displacement of single support on the right leg. We observed trivial to medium/large improvements in the rest of the measures of double and single support on the right and left leg. Similarly, on average, participants in \u003cem\u003eDNS\u003c/em\u003e significantly improved all PS measures except the COF path length of single support on the right leg. Even though the COF path length of single support on the left leg vastly improved and the COF path length of double support and ML displacement of single support on the right leg tended to improve to a large extent, improvements in the rest of the measures of the double and single support on the right and left leg were trivial to medium/large. Nevertheless, participants in \u003cem\u003eVIBRO\u003c/em\u003e and \u003cem\u003eCONTROL\u003c/em\u003e retained a similar average of almost all PS measures, except Area, COF path length, and AP displacement of single support on the right leg, which significantly lowered in CONTROL from initial to final testing. Therefore, the proceeding contrast analysis only compared changes in PS measures between MIX and DNS and ML displacement in double support between MIX, DNS, and VIBRO.\u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\u003cbr\u003e\n \u003cp\u003ePS measures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003ePre-post changes\u003c/em\u003e\u003csup\u003e\u0026yen;\u003c/sup\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cem\u003eHedge\u0026rsquo;s g\u003c/em\u003e\u003csub\u003e\u003cem\u003eav\u003c/em\u003e\u003c/sub\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e[95% CI\u003c/strong\u003e]\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDouble support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eArea (cm\u0026sup2;)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.03**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.03, -0.02]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.07, 0.90]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.01**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.01, 0.00]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.20, 0.64]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.01, 0.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.54, 0.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.00, 0.01]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.53, 0.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eCOF travelled way (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.11**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.23, -0.98]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e1.99\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[1.49, 2.49]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.44**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.57, -0.31]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.36, 1.23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.16, 0.10]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.36, 0.48]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.12, 0.14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.45, 0.41]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement ML (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.30**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.43, -1.17]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.01, 0.84]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.98**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.11, -0.85]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.10, 0.74]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.16*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.29, -0.03]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.37, 0.47]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.12, 0.14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.43, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement AP (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.32**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.43, -1.22]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.00, 0.83]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.84**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.95, -0.74]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.15, 0.27]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.13, 0.08]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.41, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.09, 0.13]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.44, 0.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle support \u0026ndash; right leg\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eArea (cm\u0026sup2;)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.033**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.04, -0.03]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.15, 0.67]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.011**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.02, -0.01]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.32, 0.51]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.01, 0.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.44]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e0.004*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[0.00, 0.01]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.46, 0.39]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eCOF travelled way (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.03*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.05, -0.01]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.37, 0.01]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.41, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.03, 0.02]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.42, 0.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e0.24*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[0.00, 0.05]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.44, 0.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement ML (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-2.00**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.41, -1.59]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e0.92\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[0.49, 1.36]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.71**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.13, -1.29]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.31, 1.18]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.50, 0.34]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.44]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.57, 0.29]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.46]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement AP (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-2.08**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.40, -1.76]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.11, 0.71]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.60**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.93, -1.28]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.19, 0.65]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.25]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.41, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.40*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.07, 0.74]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.37, 0.49]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"6\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle support \u0026ndash; left leg\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eArea (cm\u0026sup2;)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.036**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.04, -0.03]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.12, 0.70]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.011**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.02, -0.01]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.34, 0.50]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.01, 0.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.00, 0.01]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.39, 0.46]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eCOF travelled way (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-5.37**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-5.93, -4.82]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e1.64\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[1.16, 2.11]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-4.21**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-4.77, -3.65]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.82, 1.74]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.67, 0.46]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.39, 0.45]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.55, 0.60]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.44, 0.42]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement ML (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-2.11**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.52, -1.59]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[0.02, 0.85]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.85**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.27, -1.42]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.04, 0.38]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.50, 0.36]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.40, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-0.47*\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-0.91, -0.03]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.33, 0.53]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eDisplacement AP (mm)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-2.20**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-2.43, -1.96]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-011, 0,71]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e-1.70**\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003e[-1.94, -1.46]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.19, 0.66]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVibro\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.32, 0.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.41, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.28, 0.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e[-0.42, 0.43]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. Unstandardized and standardized mean differences [95% Confidence Intervals] from initial to final testing. Values are based on estimated marginal means from the 2x4 ANCOVA models with mean-centred BMI\u0026thinsp;=\u0026thinsp;22.11 kg/m2 (simple main effects). Abbreviation: Area\u0026thinsp;=\u0026thinsp;Sway Area; COF\u0026thinsp;=\u0026thinsp;Center of Force; ML\u0026thinsp;=\u0026thinsp;Medio-Lateral; AP\u0026thinsp;=\u0026thinsp;Anterior-Posterior; ** significant mean differences from initial to final testing at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (corrected p-values); * significant mean differences from initial to final testing at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 (corrected p-values). \u0026yen; reverse scoring.\u003cp\u003eContrast analysis showed significantly larger improvements (mean difference between mean changes [95% CIs]) of \u003cstrong\u003edouble support\u003c/strong\u003e measures in the MIX than in the DNS: Area for 0.02cm\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e [0.01, 0.03], COF path length for 0.67mm [0.49, 0.85], ML displacement for 0.32mm [0.13, 0.50], and AP displacement for 0.48mm [0.33, 0.63]. However, on average, participants in the MIX and DNS improved ML displacement more than participants in the VIBRO by 1.14mm [1.32, 0.95] and 0.82mm [0.63, 1.01], respectively. Participants in MIX improved two measures on the right and three on the left leg more than in DNS, on average, for the measures of \u003cstrong\u003esingle support\u003c/strong\u003e. On the right leg, the Area and AP displacement improved by 0.02cm\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e [0.02, 0.08] and 0.29mm [-0.87, 0.30] more in MIX than in the DNS, respectively. On the left leg, MIX also improved the Area, COF path length, and AP displacement by 0.025cm\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e [0.018, 0.031], 1.16mm [0.37, 1.95], and 0.49mm [0.16, 0.83] more than the DNS group. However, mean differences between the mean changes of MIX and DNS were similar in COF path length (0.01mm [-0.01, 0.04]) and ML displacement (0.29mm [-0.30, 0.87]) on the right leg and ML displacement (0.26mm [-0.34, 0.86]) on the left leg. Figure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates effect sizes (Hedge\u0026rsquo;s g with 95% CIs) for mean group changes.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe purpose of this study is to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy young participants. This RCT compared the two months effects of three different training modalities, dynamic neuromuscular stabilization (DNS), whole-body vibration training (VIBRO), and both combined (MIX) on PS measures of double and single leg support in healthy adults. After two months, all PS measures significantly improved (\u003cem\u003etrivial to large\u003c/em\u003e) in MIX and DNS. However, only COF travelled way of double and single support on the left leg, and ML displacements of single support on the right leg largely improved in both groups. However, MIX improved the average of those measures to a greater extent. Participants in VIBRO and CONTROL did not improve PS measures of double and single support from initial to final testing.\u003c/p\u003e \u003cp\u003eIn the results of this study, DNS is effective for improving some parameters of postural control balance, and previous research confirms that DNS training modalities effectively increase different aspects of stability \u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9 CR10 CR11 CR12 CR13\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e. DNS training typically involves a series of exercises designed to activate and stabilize the deep stabilizing muscles of the trunk and pelvis, such as the diaphragm, transversus abdominis, and pelvic floor muscles. Participants performed these exercises in positions that mimic the developmental stages of movement, from lying on the back to crawling, kneeling, and standing. By training the body to move naturally and functionally, DNS improve posture, balance, coordination, and overall movement quality. Another stimulation in this training method is neuromuscular intra-abdominal pressure (IAP) activation through balanced coactivation between deep spinal and abdominal muscles, diaphragm, and pelvis \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e. CNS and muscle system initiation could enhance core and PS, pointing out that the DNS training method could benefit healthy young people's balance and stabilisation.\u003c/p\u003e \u003cp\u003eThe VIBRO group did not demonstrate significant improvements, which aligns with past research suggesting that the efficacy of Whole Body Vibration (WBV) training may hinge on vibration frequency \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e. Vibratory stimulation activates the Tonic Vibration Reflex (TVR), characterized by muscle contractions prompted by the excitation of Ia afferents in the muscle spindles \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. However, concurrently, it inhibits the Stretch Reflex and the H-reflex - a phenomenon often called the \"vibration paradox\" \u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e. Presynaptic inhibition of the Ia afferents in the muscle spindles can be attributed to this inhibition. The resulting suppression of pathways responsive to stretch and the excitation of pathways responsive to vibration could explain the lack of improvement in postural stability (PS) parameters, which is particularly relevant given the significant role of mobility in overall stability \u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e. Nevertheless, WBV training could serve as an additional stimulus for athletes, and combined training methods might yield better results than individual ones \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHowever, WBV training in synergy with the DNS exercise neutralizes that inhibition in a multidisciplinary approach. Modalities, including inhibition via WBV training and activation via DNS movement, could improve stability with two mechanisms. First, WBV training is a type of exercise that involves standing, sitting, or lying on a vibrating platform while performing various movements. Experts believe that this type of training stimulates muscle contractions and increases blood flow, improving muscle strength, causing muscles and tendons to act like springs, storing energy slightly, and releasing mechanical forces abruptly \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e. An accumulation of mechanical energy within the body is essential, which can increase internal forces and decrease the stretching abilities of the muscle. WBV initiates core muscle contraction with vibration stimulation based on the tonic vibration reflex, increasing strength-explosive strength \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. Secondly, the designers of DNS exercises aimed to improve joint coordination, mobility, and stability of the body's core muscles, which are essential for proper movement and posture. These exercises require the activation of specific muscle groups to generate force and maintain stability, and the distribution of this force throughout the body is crucial for adequate movement. DNS optimizes the distribution of internal forces of the muscles acting on each spine and body segment, making balance in forces that could be important for stability. Moreover, due to the great variety of movement in different body parts, this type of exercise improves flexibility and range of motion with a combination of fundamental movements and principles of developmental kinesiology \u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. This research combines two modalities conducted by the MIX group. It suggests that WBV training before DNS exercises can enhance muscle activation and warm-up, improving force production, stretching during stabilization exercises, and increasing stabilization.\u003c/p\u003e \u003cp\u003eAn important implication of these findings is that the modified method combining DNS and WBV put a new perspective on specific core strength and stability training in healthy individuals. However, the primary constraint of this study is that it is uncertain whether the attribution of PS is due to training or previous experience in exercise. Further investigation is needed because the study only examined young people (average age 24.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07 years) who likely have a high potential for improving PS due to differences in biological maturation. Moreover, researchers need to conduct more research to explore the improvement of PS with different interventions in the context of sports activities. Testing between 9:00 and 13:00 hours could have affected performance due to the circadian rhythm, thus representing another study limitation. Future research should include older individuals and those with PS problems to obtain more dependable outcomes \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Furthermore, researchers should evaluate the effectiveness of these methods using more demanding tests and unpredictable requirements that occur in real-life and sports competitions.\u003c/p\u003e \u003cp\u003eIn conclusion of the study, healthy participants aged 22\u0026ndash;26 positively impacted PS parameters when DNS and WBV were combined. DNS training separately also showed a positive impact, which suggests that it is an effective method for improving PS. However, WBV training showed almost no impact, indicating that there may be better approaches for enhancing stability capacity in healthy individuals. Nonetheless, the combined use of DNS and WBV was highly effective and could help optimize stability capacity during everyday activities in a healthy population. By improving PS, individuals can perform daily tasks more efficiently and confidently, reducing their risk of falls and injuries. Therefore, combining DNS and WBV may be a valuable addition to rehabilitation programs, athletic training, and other therapeutic interventions to improve stability and balance.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e \u003cb\u003eParticipants.\u003c/b\u003e In a randomised, controlled interventional trial, we enrolled a gender-balanced group of 180 healthy young participants (age 24.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07 years; height 174.98\u0026thinsp;\u0026plusmn;\u0026thinsp;8.98 cm; mass 68.16\u0026thinsp;\u0026plusmn;\u0026thinsp;12.28 kg). Exclusion criteria were: (i) history of neurological or musculoskeletal disorders; (ii) clinical conditions that could impair balance (motor disorders; medical conditions like diabetes, heart disease, stroke, issues with vision, thyroid, nerves, or blood vessels). Inclusion criteria for this study were: (i) the absence of injuries in the past 6 months (ii) the absence of other medical conditions, including COVID-19 (ii) no programmed physical activity in the past 3 months.\u003c/p\u003e \u003cp\u003eWe recruited the initial sample of respondents through an open online application that lasted two months (n\u0026thinsp;=\u0026thinsp;250), after which we started the first selection of respondents (n\u0026thinsp;=\u0026thinsp;230). We completed recruitment after filling in the optimal sample of subjects. We then divided the study sample into the MIX group (n\u0026thinsp;=\u0026thinsp;58), DNS group (n\u0026thinsp;=\u0026thinsp;57), VIBRO group (n\u0026thinsp;=\u0026thinsp;57), and CONTROL group (n\u0026thinsp;=\u0026thinsp;58) using stratified randomization. At the end of the experimental program, the final sample was 180 (MIX\u0026thinsp;=\u0026thinsp;45; DNS\u0026thinsp;=\u0026thinsp;45; VIBRO\u0026thinsp;=\u0026thinsp;44; CONTROL\u0026thinsp;=\u0026thinsp;43). When stratifying, researchers use proportionate sampling to maintain the correct proportions of genders in every group. At baseline, we found no significant differences (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) in age, height, weight, and BMI (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) between the groups. After explaining the experimental protocol, each subject provided written informed consent before participating in the study, per the Declaration of Helsinki and the Novi Sad University Human Research Ethics Committee guidelines (ethical approval number: 46-06-04/2020-1; the recruitment period for this study was 15.4.2022). The study was full registered at ClinicalTrials.gov under NCT06294002 on 05/03/2024 under the name \u0026ldquo;Neuromuscular Training \u0026amp; Postural Stability (STABLEFIT)\u0026rdquo;. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the flow diagram of participants in this study.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnthropometric characteristics of participants. \u003csup\u003ea\u003c/sup\u003e Data are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. Abbreviations: BMI\u0026thinsp;=\u0026thinsp;body mass index arithmetic mean; SD, standard deviation.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTOTAL\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;180)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eExercise programs\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCONTROL\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;43)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMIX (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDNS (n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVIBRO (n\u0026thinsp;=\u0026thinsp;44)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003cp\u003e(m/f)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90/90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24/23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22/23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22/22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21/22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight (kg) \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.16\u0026thinsp;\u0026plusmn;\u0026thinsp;12.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.41\u0026thinsp;\u0026plusmn;\u0026thinsp;12.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.34\u0026thinsp;\u0026plusmn;\u0026thinsp;11.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.74\u0026thinsp;\u0026plusmn;\u0026thinsp;13.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68.17\u0026thinsp;\u0026plusmn;\u0026thinsp;11.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight (cm) \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e174.98\u0026thinsp;\u0026plusmn;\u0026thinsp;8.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e174.92\u0026thinsp;\u0026plusmn;\u0026thinsp;9.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e174.59\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e175.55\u0026thinsp;\u0026plusmn;\u0026thinsp;9.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e174.87\u0026thinsp;\u0026plusmn;\u0026thinsp;8.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI kg/m\u003csup\u003e2\u003c/sup\u003e) \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eExperimental design.\u003c/b\u003e PS parameters were tested and analyzed at the Faculty of Sport and Physical Education, University of Novi Sad, Serbia, to evaluate the effects of a two months experimental training program. The researchers conducted the initial and final tests two days before and after the two-month treatment period. We divided participants into three experimental groups: Dynamic neuromuscular stabilization group (DNS), Whole-body vibration group (VIBRO), and Dynamic neuromuscular stabilization with whole-body vibration group (MIX). These groups underwent two months of intervention training, while the control (CONTROL) group did not exercise or use any training intervention or other habitual training during the two months. Experimental programs were valid when the participants finished at least 80% of all training sessions, and the training program was not supplemental with other exercises. All subjects trained three days a week, interspersed with at least one day of rest. To guarantee the quality and correct execution of training protocols, a set of professional coaches with licenses and certificates and researchers supervised all training programs in small groups.\u003c/p\u003e \u003cp\u003e \u003cb\u003eExperimental procedures.\u003c/b\u003e \u003cem\u003eDynamic neuromuscular stabilization group (DNS).\u003c/em\u003e DNS group's protocol involved 5 min moderate intensity warm-up, 40 min DNS movements according to the DNS approach\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e, different diaphragmatic breathing, mobility and controlled movement exercises and 5 min cool-down. Exercises gradually increased in complexity and difficulty level regarding DNS training principles \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. We instructed the participants to refrain from engaging in high-intensity anaerobic or anaerobic resistance training throughout the study period to prevent potential disruptions in the study results.\u003c/p\u003e \u003cp\u003e \u003cem\u003eWhole body vibration group (VIBRO).\u003c/em\u003e WBV was performed on Power Plate Next Generation vibration platform (Power Plate North America, Chicago, IL). All training routines were approximately 50 minutes long, commencing with 5 minutes of moderate-intensity warm-up and concluding with a cool-down period. The program consisted of 8\u0026ndash;10 static and dynamic exercises for PS that progressively increased in difficulty and complexity over the course. During the training process, the frequency increased from 20 to 35 Hz in the last week of the experiment; the exercise duration was from 20\u0026ndash;60 seconds (in the last week), followed by 1-minute seated rest. Moreover, the complexity and difficulty of exercise increased over the experimental period. The resting period between sets was constant from the start to the end of the training process. During the experiment, the WBV intervention group performed three weekly training sessions. We advised the participants to avoid participating in high-intensity anaerobic or anaerobic resistance training during the study to ensure that it would not interfere with the outcomes. There were no changes to trial outcomes after the trial commenced. Principles and basic procedures were adapted from previous research \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cem\u003eDynamic neuromuscular stabilization with whole body vibration group (MIX).\u003c/em\u003e During the two months, participants in the MIX group performed training consisting of 3 weekly sessions. The protocol consisted of a 50-minute exercise program with a 5-minute moderate-intensity warm-up and cool-down period per training session. The structural core of training included 20 minutes of WBV and 20 minutes of DNS training. Both protocols followed the previous research and training recommendations but involved shorter durations and fewer sets. Exercises with VIBRO were performed on Power Plate Next Generation vibration platform (Power Plate North America, Chicago, IL). The program consisted of 6\u0026ndash;8 exercises (static and dynamic) for balance and PS. Exercise progressively increases by the level of difficulty. During the training process, the frequency was also increased from 20 to 35 Hz in the last week of the experiment; the exercise duration was from 20 to 60 seconds (in the last week), followed by a 1-minute seated rest. The resting period between sets was constant from the start to the end of the training process. To avoid interfering with the study's results, we recommended that participants abstain from engaging in high-intensity or anaerobic resistance training throughout the study. We adapted basic principles and procedures from previous research \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e. Following WBV, participants engaged in 20 minutes of DNS training, which included specific movement exercises according to the DNS approach. Participants performed breathing, coordination, mobility, and stability core exercises and routines suggested in previous studies \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. During the experiment, the MIX intervention group performed three training sessions weekly.\u003c/p\u003e \u003cp\u003e\u003cb\u003eTest procedures.\u003c/b\u003e The testing occurred at the Faculty of Sport and Physical Education, University of Novi Sad, Serbia. All participants were tested in the morning before their training session in indoor environmental conditions (temperature: 18\u0026ndash;21\u0026deg;C; relative humidity: 40\u0026ndash;60%). Before starting a performance task, general information about the examinees was recorded, including gender, age, height, and mass. Participants were instructed to wear minimal clothing and remove all footwear for height and mass measurements. Participants had to eat and drink sparingly and empty their bladder/excrete as needed before presenting for assessment. We used a stadiometer (0.1 cm accuracy, SECA Instruments Ltd, Hamburg, Germany) for height and mass measurements.\u003c/p\u003e \u003cp\u003eWe assessed static PS using a laboratory-grade 0.5 m Footscan\u0026reg; plate (RSscan International, Lammerdries, Belgium) with 4096 sensors and a scanning rate of up to 300 Hz. The subject performed an individual single and double-leg task with three trials, each lasting 30 seconds with a two-minute break between each trial. During the double-leg stance test, participants were instructed to maintain an upright and as still as possible. We asked them to stand in their natural, comfortable position with their eyes open and fixed on a cross positioned at approximately eye level on a blackboard situated 5 meters away. Participants stood barefoot with their feet positioned shoulder-width apart on a platform, keeping their arms by their sides. Each participant was required to maintain this stable posture, and measurement started after 10 seconds (preparation period to avoid transient effects). We instructed participants to balance on one foot during the single-limb stance test. Participants positioned this foot to point directly forward, aligning with reference lines in the frontal and sagittal planes. The swinging leg was flexed at the hip and knee joints to approximately 90 degrees while both arms hung naturally and relaxed at their sides. We further instructed participants to maintain as steady a posture as possible, focusing their gaze straight ahead on a point situated 65 centimetres away on the wall. We randomized the order of testing between the left and right legs. Each participant was required to maintain this stable position, and measurement started after 5 seconds (preparation period to avoid transient effects).\u003c/p\u003e \u003cp\u003eTests for static PS were the gold standard in measuring balance and were used to obtain biomechanical parameters of static PS \u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e. We performed all measurements in triplicate and retained the mean score for subsequent evaluations and analyses. We randomized the sequence of performing the balance tasks.\u003c/p\u003e \u003cp\u003eThe software calculated the single and double-leg Sway Area (cm\u0026sup2;), Center of Force (COF) travelled way (mm), Medio-Lateral (ML) displacement (mm), and Anterior-Posterior (AP) displacement (mm) as primary outcomes. The following protocol was chosen based on their varying difficulty and common use, as stated in previous research and is cited as reliable \u003csup\u003e\u003cspan additionalcitationids=\"CR53 CR54\" citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStatistical analyses.\u003c/b\u003e G*power 3.1 power analysis software (Heinrich-Heine-University, D\u0026uuml;sseldorf, Germany) estimated the minimum total sample size (N\u0026thinsp;=\u0026thinsp;140) given the critical F\u003csub\u003e(3, 136)\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;2.67, an effect size f\u0026thinsp;=\u0026thinsp;0.14 (partial η\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.02), p\u0026thinsp;=\u0026thinsp;0.05, 1-β\u0026thinsp;=\u0026thinsp;0.80, groups\u0026thinsp;=\u0026thinsp;4, time points\u0026thinsp;=\u0026thinsp;2, and correlation among the measurements\u0026thinsp;=\u0026thinsp;0.50. The authors presented data as means and 95% confidence intervals [95% CIs]. The Kolmogorov\u0026ndash;Smirnov, Leven's, Box's, and Mauchly's tests confirmed the assumptions of normality, homogeneity of variances and covariances, and sphericity, respectively. General linear models (twelve separate 2x4 mixed-design analyses of covariances for each PS measure) estimated whether mean changes [95% CIs] in PS measure from initial to final testing depended on whether participants received the DNS, VIBRO, and MIX exercise program or did not (CONTROL) after controlling for mean-centred BMI (22.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63) \u003csup\u003e\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e. Following the time-by-group interaction effects, which revealed whether estimated changes over time depended on the participants\u0026rsquo; group (i.e., differed at least between one group-comparison pair), we computed simple effects tests to estimate mean changes over time (mean difference from initial to final testing) within the groups. The follow-up investigation proceeded with contrast analysis, which estimated the degree to which estimated mean changes of PS measures differed between the group-comparison pairs. The authors calculated the effect size for time-by-group interaction effects and simple effects using partial eta squared (partial η\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e: 0.01 small; 0.06 medium; 0.14 large) \u003csup\u003e\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e and Hedge\u0026rsquo;s g average (Hedge\u0026rsquo;s\u003csub\u003eav\u003c/sub\u003e: \u0026lt;|0.20| trivial; |0.20| small; |0.50| medium; |0.80| large) \u003csup\u003e\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e, respectively. The Bonferroni test corrected p-values and 95% CI; the alpha level was p\u0026thinsp;\u0026le;\u0026thinsp;0.05. We used SPSS version 23.0 (SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 8.0 (GraphPad Software, San Diego, California, USA) to analyze and plot the data, respectively.\u003c/p\u003e \u003cp\u003e\u003cb\u003eEthics declarations.\u003c/b\u003e The Ethics Committee of the Faculty of Sport and Physical Education, University of Novi Sad, Serbia, obtained ethical review and approval. The experimental procedures reported in this study were performed following the ethical standards of the Declaration of Helsinki, and the participants signed informed consent forms.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability.\u0026nbsp;\u003c/strong\u003eThe raw data supporting the conclusions of this article will be made available by the authors without undue reservation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Provincial Secretariat for Higher Education and Scientific Research, Autonomous Province of Vojvodina, Republic of Serbia, supported the preparation of this paper, grant number (142-451-3098); Ministry of Science, Technological Development and Innovation, Government of Serbia, Serbia.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eD.M. participated in the conceptualization of the study and contributed to data collection and data reduction/analysis; D.MAC., D.M. participated in the design of the study; V.S. and A.I. participated in the design of the study and contributed to data collection and writing; D.R. and Z.G. contributed to writing - review and editing; D.MAC. contributed to data analysis and interpretation of results. T.T, D.MM., A.I. and P.D. participated in supervision and review. M.S. participated in visualization and editing. All authors contributed to the manuscript writing. All authors have read and approved the final version of the manuscript and agree with the authors\u0026apos; presentation order.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNotarnicola, A.\u003cem\u003e et al.\u003c/em\u003e Effects of training on postural stability in young basketball players. \u003cem\u003eMuscles, ligaments and tendons journal\u003c/em\u003e \u003cstrong\u003e5\u003c/strong\u003e, 310-315, doi:10.11138/mltj/2015.5.4.310 (2015).\u003c/li\u003e\n\u003cli\u003eAndreeva, A. \u0026amp; Melnikov, A. 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(Academic press, 2013).\u003c/li\u003e\n\u003cli\u003eLakens, D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. \u003cem\u003eFront Psychol\u003c/em\u003e \u003cstrong\u003e4\u003c/strong\u003e, 863, doi:10.3389/fpsyg.2013.00863 (2013).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"postural control, exercise, vibration training, balance, neuromuscular adaptation","lastPublishedDoi":"10.21203/rs.3.rs-4100808/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4100808/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study aimed to determine the effects of dynamic neuromuscular stabilization (DNS), whole-body vibration (WBV), and a combination of DNS and WBV (MIX) training modalities on postural stability (PS) in healthy recreation participants.\u003c/p\u003e \u003cp\u003e180 gender-balanced groups (age 24.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07 years) were divided into: MIX (n\u0026thinsp;=\u0026thinsp;47), DNS (n\u0026thinsp;=\u0026thinsp;45), VIBRO (n\u0026thinsp;=\u0026thinsp;44), and control group (CONTROL, n\u0026thinsp;=\u0026thinsp;43) and underwent two months treatment. The single and double-leg Center of Force (COF) parameters were collected.\u003c/p\u003e \u003cp\u003eA 2x4 mixed-design analysis of covariances indicated that improvements were trivial to large in most of the PS measures of MIX and DNS, while no significant change occurred in VIBRO and CONTROL. In the MIX and DNS, the average COF path length of double and single support on the left leg and ML displacements of single support on the right leg vastly improved (Hedge\u0026rsquo;s g\u003csub\u003eav\u003c/sub\u003e: MIX vs. DNS); MIX group improved COF path length of double support (1.99 vs. 0.79), COF path length of single support on the left leg (1.64 vs. 1.28), and ML displacement of single support on the right leg (0.92 vs. 0.75) to a greater extent. Combined modalities seem more efficient than single modalities for enhancing measures.\u003c/p\u003e","manuscriptTitle":"Effect of different neuromuscular training modalities on postural stability in healthy recreation people: A randomized controlled trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-02 17:53:22","doi":"10.21203/rs.3.rs-4100808/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-23T08:10:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-20T15:00:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44062771194298711094779769623771756081","date":"2024-10-02T08:13:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-16T14:49:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"97319079653311850966293510256066361961","date":"2024-08-31T09:55:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84383341793717424379307656352349308604","date":"2024-06-07T11:15:19+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-29T08:18:52+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-27T11:48:28+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-03-29T04:08:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-29T04:07:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2024-03-14T12:31:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e89b03c7-793c-42cc-9d31-8b9555bae6dd","owner":[],"postedDate":"April 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-01-06T16:02:38+00:00","versionOfRecord":{"articleIdentity":"rs-4100808","link":"https://doi.org/10.1038/s41598-024-83828-z","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2024-12-30 15:57:34","publishedOnDateReadable":"December 30th, 2024"},"versionCreatedAt":"2024-04-02 17:53:22","video":"","vorDoi":"10.1038/s41598-024-83828-z","vorDoiUrl":"https://doi.org/10.1038/s41598-024-83828-z","workflowStages":[]},"version":"v1","identity":"rs-4100808","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4100808","identity":"rs-4100808","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}