Traditional kava use and body sway: A pilot investigation
Main Article Content
Keywords
balance, centre of pressure, naturalistic test setting, Pacific, psychopharmacology, kava
Abstract
Introduction The (traditionally influenced) consumption of kava (Piper methysticum) has been associated with increased body sway, raising concerns about fall risk. However, studies typically utilise pill-styled kava extracts with a lack of understanding regarding experienced naturalistic kava drinkers. This pilot study investigated the effects of naturalistic kava consumption over a six-hour period on postural control.
Methods Six experienced male kava drinkers consumed 100ml of kava every 10 minutes over six hours in a culturally responsive setting. Postural control was examined at three time points (Pre, Mid, and Post) using a 30-seconds eyes-closed feet-together postural balance test conducted on a 3D force plate. Centre of pressure path length, average velocity, and area of the 95th percentile ellipse data were extracted and compared between time points using a one-way repeated measures ANOVA.
Findings There were no significant differences in the centre of pressure parameters. Based on the Pre and Post differences for path length and average velocity logged values, this study would require 19 participants to achieve an 80% power and 5% significance level.
Discussion Irrespective of limited sample size, our preliminary results do not support that kava consumption negatively affects postural control, findings that appear to be corroborated by a recent neuroscience study. The perceived risks of naturalistic kava consumption with regards to falls may be overstated. Further study on the physiological implications of kava consumption in naturalistic settings is needed to quantify the actual risks.
Highlights
• Kava is a culturally significant drink for Pacific people
• Anecdotal reports describe impaired balance following high traditional use volumes
• Postural control was tested during and following kava use in a pilot study
• Contrary to hypothesis, results do not show that kava negatively affects postural control
References
2. Aporosa SA, Atkins M, Brunton R. Kava drinking in traditional settings: Towards understanding effects on cognitive function. Human Psychopharmacology: Clinical Experimental 2020; 5(2):e2725. https://doi.org/10.1002/hup.2725
3. Aporosa SA. (2015). The new kava user: Diasporic identity formation in reverse. New Zealand Sociology 2015; 30(4):58-77. https://search.informit.org/doi/10.3316/informit.799954852007112
4. Aporosa SA, Ballard H, Pandey R, McCarthy M J. The impact of traditional kava (Piper methysticum) use on cognition: Implications for driver fitness. Journal of Ethnopharmacology 2022; 291(115080):1-15. https://doi:10.1016/j.jep.2022.1150807
5. Aporosa SA, Atkins M, Leov J. Decolonising quantitative methods within a Pacific research space to explore cognitive effects following kava use. Pacific Dynamics: Journal of Interdisciplinary Research 2021; 5(1):74-92. https://doi:10.26021/10642
6. Aporosa SA. De-mythologizing and re-branding of kava as the new ‘world drug’ of choice. Journal of Drug Science, Policy and Law 2019; 5:1-13. Aporosa SA. De-mythologizing and re-branding of kava as the new ‘world drug’ of choice. Journal of Drug Science, Policy and Law 2019; 5:1-13. https://doi.org/10.1177/2050324519876131
7. Teschke R, Sarris J, Lebot V. Kava hepatotoxicity solution: A six-point plan for new kava standardization. Phytomedicine 2011; 18(2):96-103. https://doi.org/10.1016/j.phymed.2010.10.002
8. New Zealand Government. Standard 2.6.3 – Kava – Food Standards (Proposal P1025 – Code Revision) Variation—Australia New Zealand Food Standards Code – Amendment No. 154 (2015, May 8). Retrieved from https://gazette.govt.nz/notice/id/2015-gs1906
9. Aporosa SA. Improving road safety and health: Understanding kava’s impact on driver fitness. Technical report prepared for (and accepted by) Health Research Council of New Zealand 2021; July 31. https://hdl.handle.net/10289/14570
10. Pawluk W. Sequencing (Temporal Order Judgment). 2018. https://corticalmetrics.freshdesk.com/support/solutions/articles/42000004765-sequencing-temporal-order-judgment
11. Pawluk W. Timing perception. 2018. https://corticalmetrics.freshdesk.com/support/solutions/articles/42000004766-timing-perception
12. Lebot V in Blades J. Pacific countries to promote kava as food product. 2018. www.radionz.co.nz/international/programmes/datelinepacific/audio/2018671657/pacific-countries-to-promote-kava-as-food-product
13. Bian T, Corral P, Wang Y, et al. Kava as a clinical nutrient: Promises and challenges. Nutrients 2020; 12(10):3044. https://doi:10.3390/nu12103044
14. Lebot V, Legendre L. Comparison of kava (Piper methysticum Forst.) varieties by UV absorbance of acetonic extracts and high-performance thin-layer chromatography. Journal of Food Composition and Analysis 2016; 48:25-33.
15. Cheung C, Baker J, Byrne JM, Perrault KA. Investigating volatiles as the secondary metabolome of Piper methysticum from root powder and water extracts using comprehensive two-dimensional gas chromatography. Journal of Ethnopharmacology 2022; 294:115346-115346. doi:10.1016/j.jep.2022.115346
16. Zinberg N. Drug, set, and setting: The basis for controlled intoxicant use. 1986. Yale University Press, Connecticut.
17. Aporosa S.A. ‘Doped’ on kava: Understanding kava’s impacts on cognition and driving. 2022. Pacific Studies Press, Suva. (in press, due Nov.)
18. Tecun A. Tongan kava: Performance, adaptation, and identity in diaspora. Performance of the Real E-journal 2017; 1(1):52-64. http://www.otago.ac.nz/performance-of-the-real/otago666947.pdf
19. Moseley HN. ‘Fiji Islands’. In Notes by a naturalist on the "Challenger", being an account of various observations made during the voyage of H.M.S. "Challenger" around the world, in the years 1872-1876, under the commands of Capt. Sir G. S. Nares and Capt. F. T. Thomson. 1879. Macmillan & Co, London.
20. Pollock NJ. Introduction. Canberra Anthropology 1995; 18(Special volume, The power of kava. 1&2):1-19.
21. Garner LF, Klinger J.D. Some visual effects caused by the beverage kava. Journal of Ethnopharmacology 1985; 13:307-11.
22. Prescott J, Jamieson D, Emdur N, Duffield P. Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alcohol Review 1993; 12(1):49-57.
23. Denniston AKO, Murray PI. Oxford handbook of ophthalmology. 2018. Oxford University Press, United Kingdom.
24. Abbott P. Kava: A review of the safety of traditional and recreational beverage consumption (Technical Report). 2016; Food and Agriculture Organization of the United Nations and World Health Organization, Rome.
25. Arnold DM, Burns KE, Adhikari NK, et al. The design and interpretation of pilot trials in clinical research in critical care. Critical Care Medicine 2009; 37(1 Suppl):S69-74. https://doi:10.1097/CCM.0b013e3181920e33
26. Aporosa S.A. Yaqona (kava) and education in Fiji: Investigating ‘cultural complexities’ from a post-development perspective. 2014. Massey University Press, Albany.
27. Murray L, Beaven CM, Hébert-Losier K. The effects of running a 12-km race on neuromuscular performance measures in recreationally competitive runners. Gait & Posture 2019;7 0:341–346. https://doi.org/10.1016/j.gaitpost.2019.03.025
28. Bauer C, Gröger I, Rupprecht R, Gaßmann KG. Intrasession reliability of force platform parameters in community-dwelling older adults. Archives of Physical Medicine and Rehabilitation 2008; 89(10):1977-1982.
29. Hébert-Losier K, Murray L. Reliability of centre of pressure, plantar pressure, and plantar-flexion isometric strength measures: A systematic review. Gait & Posture 2020; 75:46–62. https://doi.org/10.1016/j.gaitpost.2019.09.027
30. Golriz S, Hebert JJ, Foreman KB, Walker BF. The reliability of a portable clinical force plate used for the assessment of static postural control: repeated measures reliability study. Chiropractic & Manual Therapies 2112; 20:1–6.
31. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. 1988. Lawrence Erlbaum Associates, New Jersey.
32. Perez J, Holmes JF. Altered mental status and ataxia secondary to acute kava ingestion. The Journal of Emergency Medicine 2005; 28(1):49-51.
33. Tarbah F, Barguil Y, Weinmann W, et al. Death after consumption of kava beverage in combination with alcohol and cannabis. In F. Pragst & R. Aderjan (Eds.), 13th GTFCh-Symposium: Ausgewaehlte Aspekte der Forensischen Toxikologie, Beitraege zum Symposium der Gesellschaft fuer Toxikologische und Forensische Chemie. 2003; April 3–5. Mosbach, Germany. Heppenheim, Germany: Verlag Dr. Dieter Helm.
34. Piirtola M, Era P. Force platform measurements as predictors of falls among older people – A review. Gerontology (Basel). 2006; 52(1):1–16. https://doi.org/10.1159/000089820
35. Ruhe A, Fejer R, Walker B. The test–retest reliability of centre of pressure measures in bipedal static task conditions – A systematic review of the literature. Gait & Posture 2010; 32(4):436–445. https://doi.org/10.1016/j.gaitpost.2010.09.012
36. Johansson J, Nordström A, Gustafson Y, et al. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age and Ageing 2017; 46(6):964–970. https://doi.org/10.1093/ageing/afx083
37. Boulgaride LK, McGinty SM, Willett JA, Barnes CW. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Physical Therapy 2003; 83 (4):328–339. https://doi.org/10.1093/ptj/83.4.328
38. Kautu BB, Phillips J, Steele K, et al, A behavioral survey of the effects of kavalactones on caenorhabditis elegans neuromuscular transmission. Journal of Experimental Neuroscience 2017; 11:1179069517705384.
39. Hébert-Losier K. Clinical implications of hand position and lower limb length measurement method on Y-balance test scores and interpretations. Journal of Athletic Training. 2017;52(10):910–917. https://doi.org/10.4085/1062-6050-52.8.02
40. Salavati M, Hadian MR, Mazaheri M, et al. Test–retest reliability of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability. Gait & Posture 2009; 30(1):126. https://doi.org/10.1016/j.gaitpost.2008.11.016
41. Wickstrom G, Bendix T. The “Hawthorne effect” what did the original Hawthorne studies actually show? Scandinavian Journal of Work, Environment & Health 2000; 26(4):363–367. https://doi.org/10.5271/sjweh.555
42. Robles-García V, Corral-Bergantiños Y, Espinosa N, et al. Spatiotemporal gait patterns during overt and covert evaluation in patients with Parkinson’s disease and healthy subjects: Is there a Hawthorne effect? Journal of Applied Biomechanics 2015; 1(3):189–194. https://doi.org/10.1123/jab.2013-0319
43. Sinclair J, Hobbs SJ, Taylor PJ, et al. The influence of different force and pressure measuring transducers on lower extremity kinematics measured during running. Journal of Applied Biomechanics 2014; 30(1):166–172. https://doi.org/10.1123/jab.2012-0238
44. Aporosa SA, Tomlinson M. Kava hangover and gold-standard science. Anthropologica: Journal of the Canadian Anthropology Society 2014; 56(1):163-175. https://www.jstor.org/stable/24469648
45. Pawluk W. Accuracy. 2018. https://corticalmetrics.freshdesk.com/support/solutions/articles/42000004764-accuracy
46. Pawluk W. Focus. 2018. https://corticalmetrics.freshdesk.com/support/solutions/articles/42000004762-focus
47. Pawluk W. Plasticity. 2018. https://corticalmetrics.freshdesk.com/support/solutions/articles/42000004763-plasticity
48. Showman AF, Baker JD, Linares C, et al. Contemporary Pacific and Western perspectives on ‘awa (Piper methysticum) toxicology. Fitoterapia 2015; 100:56-67.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Articles on this website and article downloads are provided free of charge by Open Access under a Creative Commons with the author retaining all copyright to the material. eg © PacifichealthDialog 2021. Except as provided by the NZ Copyright Act, no part of this publication may be reproduced or stored in a retrieval system in any form or by any means without the prior written permission of the copyright owner and the Pacific Health Dialog. Manuscripts can be used for private study but must not be used for commercial purposes.
S. 'Apo' Aporosa, University of Waikato
Research and Teaching Fellow
Te Huataki Waiora School of Health & Te Kura Whatu Oho Mauri School of Psychology
The University of Waikato
Private Bag 3105
Hamilton 3240
Aotearoa New Zealand
Kim Hébert-Losier, University of Waikato
Senior Lecturer
Te Huataki Waiora School of Health
Division of Health, Engineering, Computing and Science
The University of Waikato
Adams Centre for High Performance
Tauranga 3116
Aotearoa New Zealand
T: +64 7 837 9476
Harvey Aughton, University of Waikato
Masters student
Te Huataki Waiora School of Health
Division of Health, Engineering, Computing and Science
The University of Waikato
Private Bag 3105
Hamilton 3240
Aotearoa New Zealand