The evidence behind the method.

How we use research

The method was developed in clinical and high-performance practice since 2010. It's built on methods that have been shown in trials to reduce injury and improve balance. No trial has tested the Neuroplasticity Gym program itself yet. Until our own study does, we won't call it proven.

In NAX, counts, hold times, minutes, streaks and tape-measured tests are shown as numbers. Joint angles, load estimates, the twin and any score built from them are labelled experimental. A lit muscle on the twin means the hold met the program's standard. It isn't a measurement of muscle activity.

References

1. Maps follow use. Jenkins WM, Merzenich MM, Ochs MT, et al. (1990). Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviorally controlled tactile stimulation. J Neurophysiol 63:82–104. PMID 2299388. Animal study. Trained fingertip use enlarged those fingertips' map in the brain.
2. The trunk moves first. Bouisset S, Zattara M (1987). Biomechanical study of the programming of anticipatory postural adjustments associated with voluntary movement. J Biomech 20:735–42. PMID 3654672. Classic lab study. Postural adjustments start before a fast arm movement.
3. Deep abdominal timing. Hodges PW, Richardson CA (1997). Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res 114:362–70. PMID 9166925. Fine-wire study. The deepest abdominal fires ahead of the arm in every direction.
4. Late in back pain. Hodges PW, Richardson CA (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine 21:2640–50. PMID 8961451. Case-control study. The same muscle fired late in people with low back pain.
5. Recruitment under fatigue. Adam A, De Luca CJ (2005). Firing rates of motor units in human vastus lateralis muscle during fatiguing isometric contractions. J Appl Physiol 99:268–80. PMID 16036904. Lab study in young men. As a steady hold fatigued, new motor units joined the work. Reading the shake as new units coming online is our interpretation.
6. The diaphragm's two jobs. Hodges PW, Gandevia SC (2000). Activation of the human diaphragm during a repetitive postural task. J Physiol 522:165–75. PMID 10618161. Fine-wire study. The diaphragm kept breathing and held the trunk at the same time.
7. Pressure stiffens the spine. Hodges PW, Eriksson AE, Shirley D, et al. (2005). Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech 38:1873–80. PMID 16023475. Three people. Pressure alone raised lumbar stiffness by 8 to 31%. Very small, but a clean design.
8. Where attention goes. Wulf G, McNevin N, Shea CH (2001). The automaticity of complex motor skill learning as a function of attentional focus. Q J Exp Psychol A 54:1143–54. PMID 11765737. Experiment. An external focus made a balance skill more automatic.
9. Gains are specific. Lesinski M, et al. (2015). Dose-response relationships of balance training in healthy young adults. Sports Med. PMID 25430598. Meta-analysis. Balance training works, and the gains are largely specific to the task trained.
10. Sleep consolidates. Walker MP, Brakefield T, Morgan A, et al. (2002). Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron 35:205–11. PMID 12123620. Experiment. A motor sequence improved after a night's sleep without more practice. Later work debates the size of the effect.
11. Stress favours habit. Schwabe L, Wolf OT (2009). Stress prompts habit behavior in humans. J Neurosci 29:7191–8. PMID 19494141. Experiment. Stressed people acted more from habit than from goals.
12. Bracing and power. Tayashiki K, et al. (2016). Effect of abdominal bracing training on strength and power of trunk and lower limb muscles. Eur J Appl Physiol. Small trial. Eight weeks of bracing training raised lifting power by 15.6%.
13. Load spikes, not training. Gabbett TJ (2016). The training–injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 50:273–80. PMID 26758673. Review. Sudden spikes in load drive soft-tissue injury; steady high training load protects.
14. Moving differently in pain. Hodges PW, Tucker K (2011). Moving differently in pain: a new theory to explain the adaptation to pain. Pain 152:S90–8. PMID 21087823. Theory and review. Pain redistributes activity within and between muscles to protect.
15. Low back pain. Saragiotto BT, et al. (2016). Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev CD012004. Systematic review. Better than minimal care; similar to other exercise.
16. Push-off fades with age. DeVita P, Hortobágyi T (2000). Age causes a redistribution of joint torques and powers during gait. J Appl Physiol 88:1804–11. PMID 10797145. Kerrigan DC, et al. (1998). Arch Phys Med Rehabil 79:317–22. PMID 9523785. Gait studies. Older adults push off less at the ankle and work more at the hip.
17. Posture and falls. McDaniels-Davidson C, et al. (2018). Kyphosis and incident falls among community-dwelling older adults. Osteoporos Int 29:163–9. PMID 29018904. Cohort study. More rounding of the upper back went with more falls.
18. Fewer falls. Sherrington C, et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev CD012424. Systematic review, high-certainty evidence. Balance and functional exercise cut the rate of falls by 24%.

The twin

The 3-D twin uses a skeleton from Open3D (CC BY-SA 4.0) and muscles from BodyParts3D, The Database Center for Life Science (CC BY 4.0). The geometry is unmodified; only the colours change on screen.