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Biomedical subjects

F E Zajac

Publications and source records attributed to F E Zajac.

At least 19 recordsLinked to original sources

Muscle contributions to support during gait in an individual with post-stroke hemiparesis.

Walking requires coordination of muscles to support the body during single stance. Impaired ability to coordinate muscles following stroke frequently compromises walking performance and results in extremely low walking speeds. Slow gait in post-stroke hemiparesis is further complicated by asymmetries in lower limb muscle excitations. The objectives of the current study were: (1) to compare the muscle coordination patterns of an individual with flexed stance limb posture secondary to post-stroke hemiparesis with that of healthy adults walking very slowly, and (2) to identify how paretic and non-paretic muscles provide support of the body center of mass in this individual. Simulations were generated based on the kinematics and kinetics of a stroke survivor walking at his self-selected speed (0.3 m/s) and of three speed-matched, healthy older individuals. For each simulation, muscle forces were perturbed to determine the muscles contributing most to body weight support (i.e., height of the center of mass during midstance). Differences in muscle excitations and midstance body configuration caused paretic and non-paretic ankle plantarflexors to contribute less to midstance support than in healthy slow gait. Excitation of paretic ankle dorsiflexors and knee flexors during stance opposed support and necessitated compensation by knee and hip extensors. During gait for an individual with post-stroke hemiparesis, adequate body weight support is provided via reorganized muscle coordination patterns of the paretic and non-paretic lower limbs relative to healthy slow gait.

Aged↗

Effect of equinus foot placement and intrinsic muscle response on knee extension during stance.

Equinus gait, a common movement abnormality among individuals with stroke and cerebral palsy, is often associated with knee hyperextension during stance. Whether there exists a causal mechanism linking equinus foot placement with knee hyperextension remains unknown. To investigate the response of the musculoskeletal system to equinus foot placement, a forward dynamic simulation of normal walking was perturbed by augmenting ankle plantarflexion by 10 degrees at initial contact. The subsequent effect on knee extension was assessed when the muscle forces were allowed, or not allowed, to change in response to altered kinematics and intrinsic force-length-velocity properties. We found that an increase in ankle plantarflexion at initial contact without concomitant changes in muscle forces caused the knee to hyperextend. The intrinsic force-length-velocity properties of muscle, particularly in gastrocnemius and vastus, diminished the effect of equinus posture alone, causing the abnormal knee extension to be less pronounced. We conclude that the effect of ankle position at initial contact on knee motion should be considered in the analysis of equinus gait.

Ankle↗

Muscle mechanical work requirements during normal walking: the energetic cost of raising the body's center-of-mass is significant.

Inverted pendulum models of walking predict that little muscle work is required for the exchange of body potential and kinetic energy in single-limb support. External power during walking (product of the measured ground reaction force and body center-of-mass (COM) velocity) is often analyzed to deduce net work output or mechanical energetic cost by muscles. Based on external power analyses and inverted pendulum theory, it has been suggested that a primary mechanical energetic cost may be associated with the mechanical work required to redirect the COM motion at the step-to-step transition. However, these models do not capture the multi-muscle, multi-segmental properties of walking, co-excitation of muscles to coordinate segmental energetic flow, and simultaneous production of positive and negative muscle work. In this study, a muscle-actuated forward dynamic simulation of walking was used to assess whether: (1). potential and kinetic energy of the body are exchanged with little muscle work; (2). external mechanical power can estimate the mechanical energetic cost for muscles; and (3.) the net work output and the mechanical energetic cost for muscles occurs mostly in double support. We found that the net work output by muscles cannot be estimated from external power and was the highest when the COM moved upward in early single-limb support even though kinetic and potential energy were exchanged, and muscle mechanical (and most likely metabolic) energetic cost is dominated not only by the need to redirect the COM in double support but also by the need to raise the COM in single support.

Biomechanical Phenomena↗

Muscle force redistributes segmental power for body progression during walking.

The ankle plantar flexors were previously shown to support the body in single-leg stance to ensure its forward progression [J. Biomech. 34 (2001) 1387]. The uni- (SOL) and biarticular (GAS) plantar flexors accelerated the trunk and leg forward, respectively, with each opposing the effect of the other. Around mid-stance their net effect on the trunk and the leg was negligible, consistent with the body acting as an inverted pendulum. In late stance, their net effect was to accelerate the leg and trunk forward, consistent with an active push-off. Because other muscles are active in the beginning and end of stance, we hypothesized that their active concentric and eccentric force generation also supports the body and redistributes segmental power to enable body forward progression. Muscle-actuated forward dynamical simulations that emulated observed walking kinematics and kinetics of young adult subjects were analyzed to quantify muscle contributions to the vertical and horizontal ground reaction force, and to the acceleration and mechanical power of the leg and trunk. The eccentric uniarticular knee extensors (vasti, VAS) and concentric uniarticular hip extensors (gluteus maximus, GMAX) were found to provide critical support to the body in the beginning of stance, before the plantar flexors became active. VAS also decelerated the forward motion of both the trunk and the leg. Afterwards when VAS shortens in mid-stance, it delivered the power produced to accelerate the trunk and also redistributed segmental power to the trunk by continuing to decelerate the leg. When present, rectus femoris (RF) activity in the beginning of stance had a minimal effect. But in late stance the lengthening RF accelerated the knee and hip into extension, which opposed swing initiation. Though RF was lengthening, it still accelerated the trunk forward by decelerating the leg and redistributing the leg segmental power to the trunk, as SOL does though it is shortening instead of lengthening. Force developed from highly stretched passive hip structures and active force produced by the uniarticular hip flexors assisted GAS in swing initiation. Hamstrings (HAM) decelerated the leg in late swing while lengthening and accelerated the leg in the beginning of stance while shortening. We conclude that the uniarticular knee and hip extensor muscles are critical to body support in the beginning of stance and redistribution of segmental power by muscles throughout the gait cycle is critical to forward progression of the trunk and legs.

Computer Simulation↗

Mutability of bifunctional thigh muscle activity in pedaling due to contralateral leg force generation.

Locomotion requires uninterrupted transitions between limb extension and flexion. The role of contralateral sensorimotor signals in executing smooth transitions is little understood even though their participation is crucial to bipedal walking. However, elucidating neural interlimb coordinating mechanisms in human walking is difficult because changes to contralateral sensorimotor activity also affect the ipsilateral mechanics. Pedaling, conversely, is ideal for studying bilateral coordination because ipsilateral mechanics can be independently controlled. In pedaling, the anterior and posterior bifunctional thigh muscles develop needed anterior and posterior crank forces, respectively, to dominate the flexion-to-extension and extension-to-flexion transitions. We hypothesized that contralateral sensorimotor activity substantially contributes to the appropriate activation of these bifunctional muscles during the limb transitions. Bilateral pedal forces and surface electromyograms (EMGs) from four thigh muscles were collected from 15 subjects who pedaled with their right leg against a right-crank servomotor, which emulated the mechanical load experienced in conventional two-legged coupled-crank pedaling. In one pedaling session, the contralateral (left) leg pseudo-pedaled (i.e., EMG activity and pedal forces were pedaling-like, but pedal force was not allowed to affect crank rotation). In other sessions, the mechanically decoupled contralateral leg was first relaxed and then produced rhythmic isometric force trajectories during either leg flexion or one of the two limb transitions of the pedaling leg. With contralateral force production in the extension-to-flexion transition (predominantly by the hamstrings), rectus femoris activity and work output increased in the pedaling leg during its flexion-to-extension transition, which occurs simultaneously with contralateral extension-to-flexion in conventional pedaling. Similarly, with contralateral force production in the other transition (i.e., flexion-to-extension; predominantly by rectus femoris), hamstrings activity and work output increased in the pedaling leg during its extension-to-flexion transition. Therefore rhythmic isometric force generation in the contralateral leg supported the ongoing bifunctional muscle activity and resulting work output in the pedaling leg. The results suggest that neural interlimb coordinating mechanisms fine-tune bifunctional muscle activity in rhythmic lower-limb tasks to ensure limb flexion/extension transitions are executed successfully.

Adult↗

Simulation analysis of muscle activity changes with altered body orientations during pedaling.

Testing hypotheses related to the effect of gravitational orientation on neural control mechanisms is difficult for most locomotor tasks, like walking, because body orientation with respect to gravity affects both sensorimotor control and task mechanics. To examine the mechanical effect of body orientation independently from changes in workload and posture, Brown et al. (J. Biomech. 29 p. 1349, 1996) studied pedaling at altered body orientations. They found that subjects pedaling at different orientations changed needlessly their muscle excitations, putatively to preserve body-upright pedaling kinematics. We tested the feasibility of this hypothesis using simulations based on a three biomechanical-function pair organization for control of lower limb muscles (limb extension/flexion pair, extension/flexion transition pair, and foot plantarflexion/dorsiflexion pair), where each pair consists of alternating agonistic/antagonistic muscles. Adjustment of only three parameters, one to scale the muscle excitations of each pair, was sufficient to preserve pedaling kinematics to altered body orientation. Because these adjustments produced changes in muscle excitation and net joint moments similar to those observed in pedaling subjects, the hypothesis is supported. Moreover, the effectiveness of a decoupled gain adjustment procedure where each parameter was adjusted by error in only one aspect of the pedaling trajectory during each iteration (i.e., cadence adjusted the Ext/Flex parameter; peak-to-peak variation in crank velocity over the cycle adjusted the transition parameter; average ankle angle over the cycle adjusted the foot parameter) further supports the distinct function of each muscle pair.

Bicycling↗

Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking.

Walking is a motor task requiring coordination of many muscles. Previous biomechanical studies, based primarily on analyses of the net ankle moment during stance, have concluded different functional roles for the plantar flexors. We hypothesize that some of the disparities in interpretation arise because of the effects of the uniarticular and biarticular muscles that comprise the plantar flexor group have not been separated. Furthermore, we believe that an accurate determination of muscle function requires quantification of the contributions of individual plantar flexor muscles to the energetics of individual body segments. In this study, we examined the individual contributions of the ankle plantar flexors (gastrocnemius (GAS); soleus (SOL)) to the body segment energetics using a musculoskeletal model and optimization framework to generate a forward dynamics simulation of normal walking at 1.5 m/s. At any instant in the gait cycle, the contribution of a muscle to support and forward progression was defined by its contribution to trunk vertical and horizontal acceleration, respectively, and its contribution to swing initiation by the mechanical energy it delivers to the leg in pre-swing (i.e., double-leg stance prior to toe-off). GAS and SOL were both found to provide trunk support during single-leg stance and pre-swing. In early single-leg stance, undergoing eccentric and isometric activity, they accelerate the trunk vertically but decelerate forward trunk progression. In mid single-leg stance, while isometric, GAS delivers energy to the leg while SOL decelerates it, and SOL delivers energy to the trunk while GAS decelerates it. In late single-leg stance through pre-swing, though GAS and SOL both undergo concentric activity and accelerate the trunk forward while decelerating the downward motion of the trunk (i.e., providing forward progression and support), they execute different energetic functions. The energy produced from SOL accelerates the trunk forward, whereas GAS delivers almost all its energy to accelerate the leg to initiate swing. Although GAS and SOL maintain or accelerate forward motion in mid single-leg stance through pre-swing, other muscles acting at the beginning of stance contribute comparably to forward progression. In summary, throughout single-leg stance both SOL and GAS provide vertical support, in mid single-leg stance SOL and GAS have opposite energetic effects on the leg and trunk to ensure support and forward progression of both the leg and trunk, and in pre-swing only GAS contributes to swing initiation.

Adult↗

Muscle contributions to specific biomechanical functions do not change in forward versus backward pedaling.

Previous work had identified six biomechanical functions that need to be executed by each limb in order to produce a variety of pedaling tasks. The functions can be organized into three antagonistic pairs: an Ext/Flex pair that accelerates the foot into extension or flexion with respect to the pelvis, an Ant/Post pair that accelerates the foot anteriorly or posteriorly with respect to the pelvis, and a Plant/Dorsi pair that accelerates the foot into plantarflexion or dorsiflexion. Previous analyses of experimental data have inferred that muscles perform the same function during different pedaling tasks (e.g. forward versus backward pedaling) because the EMG timing was similar, but they did not present rigorous biomechanical analyses to assess whether a muscle performed the same biomechanical function, and if so, to what degree. Therefore, the objective of this study was to determine how individual muscles contribute to these biomechanical functions during two different motor tasks, forward and backward pedaling, through a theoretical analysis of experimental data. To achieve this objective, forward and backward pedaling simulations were generated and a mechanical energy analysis was used to examine how muscles generate, absorb or transfer energy to perform the pedaling tasks. The results showed that the muscles contributed to the same primary Biomechanical functions in both pedaling directions and that synergistic performance of certain functions effectively accelerated the crank. The gluteus maximus worked synergistically with the soleus, the hip flexors worked synergistically with the tibialis anterior, and the vasti and hamstrings functioned independently to accelerate the crank. The rectus femoris used complex biomechanical mechanisms including negative muscle work to accelerate the crank. The negative muscle work was used to transfer energy generated elsewhere (primarily from other muscles) to the pedal reaction force in order to accelerate the crank. Consistent with experimental data, a phase shift was required from those muscles contributing to the Ant/Post functions as a result of the different limb kinematics between forward and backward pedaling, although they performed the same biomechanical function. The pedaling simulations proved necessary to interpret the experimental data and identify motor control mechanisms used to accomplish specific motor tasks, as the mechanisms were often complex and not always intuitively obvious.

Bicycling↗

Bicycle drive system dynamics: theory and experimental validation.

Bicycle pedaling has been studied from both a motor control and an equipment setup and design perspective. In both cases, although the dynamics of the bicycle drive system may have an influence on the results, a thorough understanding of the dynamics has not been developed. This study pursued three objectives related to developing such an understanding. The first was to identify the limitations of the inertial/frictional drive system model commonly used in the literature. The second was to investigate the advantages of an inertial/frictional/compliant model. The final objective was to use these models to develop a methodology for configuring a laboratory ergometer to emulate the drive system dynamics of road riding. Experimental data collected from the resulting road-riding emulator and from a standard ergometer confirmed that the inertial/frictional model is adequate for most studies of road-riding mechanics or pedaling coordination. However, the compliant model was needed to reproduce the phase shift in crank angle variations observed experimentally when emulating the high inertia of road riding. This finding may be significant for equipment setup and design studies where crank kinematic variations are important or for motor control studies where fine control issues are of interest.

Bias↗

General coordination principles elucidated by forward dynamics: minimum fatique does not explain muscle excitation in dynamic tasks.

The target article presents a framework for coordination of one- and two-joint muscles in a variety of tasks. Static optimization analyses were performed that minimize muscle fatigue, and it is claimed that the predicted muscle forces account for essential features of EMG activity qualitatively well. However, static optimization analyses use the observed joint moments, which implicitly assumes that they minimize the total muscle fatigue of the task. We use a forward dynamics (i.e., relationship between muscle forces and the kinematics and kinetics of task performance) modeling approach to show that this assumption does not appear to be true in cycling (which was used as an example task in the target article). Our results challenge the hypothesized coordination framework and the underlying concept that general coordination principles for dynamic tasks can be elucidated using inverse-dynamics-based analyses.

Biomechanical Phenomena↗

Contralateral movement and extensor force generation alter flexion phase muscle coordination in pedaling.

The importance of bilateral sensorimotor signals in coordination of locomotion has been demonstrated in animals but is difficult to ascertain in humans due to confounding effects of mechanical transmission of forces between the legs (i.e., mechanical interleg coupling). In a previous pedaling study, by eliminating mechanical interleg coupling, we showed that muscle coordination of a unipedal task can be shaped by interlimb sensorimotor pathways. Interlimb neural pathways were shown to alter pedaling coordination as subjects pedaling unilaterally exhibited increased flexion-phase muscle activity compared with bilateral pedaling even though the task mechanics performed by the pedaling leg(s) in the unilateral and bilateral pedaling tasks were identical. To further examine the relationship between contralateral sensorimotor state and ipsilateral flexion-phase muscle coordination during pedaling, subjects in this study pedaled with one leg while the contralateral leg either generated an extensor force or relaxed as a servomotor either held that leg stationary or moved it in antiphase with the pedaling leg. In the presence of contralateral extensor force generation, muscle activity in the pedaling leg during limb flexion was reduced. Integrated electromyographic activity of the pedaling-leg hamstring muscles (biceps femoris and semimembranosus) during flexion decreased by 25-30%, regardless of either the amplitude of force generated by the nonpedaling leg or whether the leg was stationary or moving. In contrast, rectus femoris and tibialis anterior activity during flexion decreased only when the contralateral leg generated high rhythmic force concomitant with leg movement. The results are consistent with a contralateral feedforward mechanism triggering flexion-phase hamstrings activity and a contralateral feedback mechanism modulating rectus femoris and tibialis anterior activity during flexion. Because only muscles that contribute to flexion as a secondary function were observed, it is impossible to know whether the modulatory effect also acts on primary, unifunctional, limb flexors or is specific to multifunctional muscles contributing to flexion. The influence of contralateral extensor-phase sensorimotor signals on ipsilateral flexion may reflect bilateral coupling of gain control mechanisms. More generally, these interlimb neural mechanisms may coordinate activity between muscles that perform antagonistic functions on opposite sides of the body. Because pedaling and walking share biomechanical and neuronal control features, these mechanisms may be operational in walking as well as pedaling.

Adult↗

Ankle and hip postural strategies defined by joint torques.

Previous studies have identified two discrete strategies for the control of posture in the sagittal plane based on EMG activations, body kinematics, and ground reaction forces. The ankle strategy was characterized by body sway resembling a single-segment-inverted pendulum and was elicited on flat support surfaces. In contrast, the hip strategy was characterized by body sway resembling a double-segment inverted pendulum divided at the hip and was elicited on short or compliant support surfaces. However, biomechanical optimization models have suggested that hip strategy should be observed in response to fast translations on a flat surface also, provided the feet are constrained to remain in contact with the floor and the knee is constrained to remain straight. The purpose of this study was to examine the experimental evidence for hip strategy in postural responses to backward translations of a flat support surface and to determine whether analyses of joint torques would provide evidence for two separate postural strategies. Normal subjects standing on a flat support surface were translated backward with a range of velocities from fast (55 cm/s) to slow (5 cm/s). EMG activations and joint kinematics showed pattern changes consistent with previous experimental descriptions of mixed hip and ankle strategy with increasing platform velocity. Joint torque analyses revealed the addition of a hip flexor torque to the ankle plantarflexor torque during fast translations. This finding indicates the addition of hip strategy to ankle strategy to produce a continuum of postural responses. Hip torque without accompanying ankle torque (pure hip strategy) was not observed. Although postural control strategies have previously been defined by how the body moves, we conclude that joint torques, which indicate how body movements are produced, are useful in defining postural control strategies. These results also illustrate how the biomechanics of the body can transform discrete control patterns into a continuum of postural corrections.

Adult↗

In vivo tracking of the human patella using cine phase contrast magnetic resonance imaging.

Improper patellar tracking is often considered to be the cause of patellar-femoral pain. Unfortunately, our knowledge of patellar-femoral-tibial (knee) joint kinematics is severely limited due to a lack of three-dimensional, noninvasive, in vivo measurement techniques. This study presents the first large-scale, dynamic, three-dimensional, noninvasive, in vivo study of nonimpaired knee joint kinematics during volitional leg extensions. Cine-phase contrast magnetic resonance imaging was used to measure the velocity profiles of the patella, femur, and tibia in 18 unimpaired knees during leg extensions, resisted by a 34 N weight. Bone displacements were calculated through integration and then converted into three-dimensional orientation angles. We found that the patella displaced laterally, superiorly, and anteriorly as the knee extended. Further, patellar flexion lagged knee flexion, patellar tilt was variable, and patellar rotation was fairly constant throughout extension.

Adult↗

Phase reversal of biomechanical functions and muscle activity in backward pedaling.

Computer simulations of pedaling have shown that a wide range of pedaling tasks can be performed if each limb has the capability of executing six biomechanical functions, which are arranged into three pairs of alternating antagonistic functions. An Ext/Flex pair accelerates the limb into extension or flexion, a Plant/Dorsi pair accelerates the foot into plantarflexion or dorsiflexion, and an Ant/Post pair accelerates the foot anteriorly or posteriorly relative to the pelvis. Because each biomechanical function (i.e., Ext, Flex, Plant, Dorsi, Ant, or Post) contributes to crank propulsion during a specific region in the cycle, phasing of a muscle is hypothesized to be a consequence of its ability to contribute to one or more of the biomechanical functions. Analysis of electromyogram (EMG) patterns has shown that this biomechanical framework assists in the interpretation of muscle activity in healthy and hemiparetic subjects during forward pedaling. Simulations show that backward pedaling can be produced with a phase shift of 180 degrees in the Ant/Post pair. No phase shifts in the Ext/Flex and Plant/Dorsi pairs are then necessary. To further test whether this simple yet biomechanically viable strategy may be used by the nervous system, EMGs from 7 muscles in 16 subjects were measured during backward as well as forward pedaling. As predicted, phasing in vastus medialis (VM), tibialis anterior (TA), medial gastrocnemius (MG), and soleus (SL) were unaffected by pedaling direction, with VM and SL contributing to Ext, MG to Plant, and TA to Dorsi. In contrast, phasing in biceps femoris (BF) and semimembranosus (SM) were affected by pedaling direction, as predicted, compatible with their contribution to the directionally sensitive Post function. Phasing of rectus femoris (RF) was also affected by pedaling direction; however, its ability to contribute to the directionally sensitive Ant function may only be expressed in forward pedaling. RF also contributed significantly to the directionally insensitive Ext function in both forward and backward pedaling. Other muscles also appear to have contributed to more than one function, which was especially evident in backward pedaling (i.e. , BF, SM, MG, and TA to Flex). We conclude that the phasing of only the Ant and Post biomechanical functions are directionally sensitive. Further, we suggest that task-dependent modulation of the expression of the functions in the motor output provides this biomechanics-based neural control scheme with the capability to execute a variety of lower limb tasks, including walking.

Adult↗

Locomotor strategy for pedaling: muscle groups and biomechanical functions.

A group of coexcited muscles alternating with another group is a common element of motor control, including locomotor pattern generation. This study used computer simulation to investigate human pedaling with each muscle assigned at times to a group. Simulations were generated by applying patterns of muscle excitations to a musculoskeletal model that includes the dynamic properties of the muscles, the limb segments, and the crank load. Raasch et al. showed that electromyograms, pedal reaction forces, and limb and crank kinematics recorded during maximum-speed start-up pedaling could be replicated with two signals controlling the excitation of four muscle groups (1 group alternating with another to form a pair). Here a four-muscle-group control also is shown to replicate steady pedaling. However, simulations show that three signals controlling six muscle groups (i.e., 3 pairs) is much more biomechanically robust, such that a wide variety of forward and backward pedaling tasks can be executed well. We found the biomechanical functions necessary for pedaling, and how these functions can be executed by the muscle groups. Specifically, the phasing of two pairs with respect to limb extension and flexion and the transitions between extension and flexion do not change with pedaling direction. One pair of groups (uniarticular hip and knee extensors alternating with their anatomic antagonists) generates the energy required for limb and crank propulsion during limb extension and flexion, respectively. In the second pair, the ankle plantarflexors transfer the energy from the limb inertia to the crank during the latter part of limb extension and the subsequent limb extension-to-flexion transition. The dorsiflexors alternate with the plantarflexors. The phasing of the third pair (the biarticular thigh muscles) reverses with pedaling direction. In forward pedaling, the hamstring is excited during the extension-to-flexion transition and in backward pedaling during the opposite transition. In both cases hamstrings propel the crank posteriorly through the transition. Rectus femoris alternates with hamstrings and propels the crank anteriorly through the transitions. With three control signals, one for each pair of groups, different cadences (or power outputs) can be achieved by adjusting the overall excitatory drive to the pattern generating elements, and different pedaling goals (e.g., smooth, or energy-efficient pedaling; 1- or 2-legged pedaling) by adjusting the relative excitation levels among the muscle groups. These six muscle groups are suggested to be elements of a general strategy for pedaling control, which may be generally applicable to other human locomotor tasks.

Adaptation, Physiological↗

Role of vestibular information in initiation of rapid postural responses.

Patients with bilateral vestibular loss have difficulty maintaining balance without stepping when standing in tandem, on compliant surfaces, across narrow beams, or on one foot, especially with eyes closed. Normal individuals (with no sensory impairment) maintain balance in these tasks by employing quick, active hip rotation (a "hip strategy"). The absence of a hip strategy in vestibular patients responding to translations of a short support surface has previously been taken as evidence that the use of hip strategy requires an intact vestibular system. However, many tasks requiring hip strategy alter one or a combination of important system characteristics, such as initial state of the body (tandem stance), dynamics (compliant surfaces), or biomechanical limits of stability (narrow beams). Therefore, the balance deficit in these tasks may result from a failure to account for these support surface alterations when planning and executing sensorimotor responses. In this study, we tested the hypothesis that vestibular information is critical to trigger a hip strategy even on an unaltered support surface, which imposes no changes on the system characteristics. We recorded the postural responses of vestibular patients and control subjects with eyes closed to rearward support surface translations of varying velocity, in erect stance on a firm, flat surface. Subjects were instructed to maintain balance without stepping, if possible. Faster translation velocities (25 cm/s or more) produced a consistent pattern of early hip torque (first 400 ms) in control subjects (i.e., a hip strategy). Most of the patients with bilateral vestibular loss responded to the same translation velocities with similar torques. Contrary to our hypothesis, we conclude that vestibular function is not necessary to trigger a hip strategy. We postulate, therefore, that the balance deficit previously observed in vestibular patients during postural tasks that elicit a hip strategy may have been due to the sensorimotor consequences of the system alterations imposed by the postural tasks used in those studies. Preliminary results from two younger patients who lost vestibular function as infants indicate that age, duration of vestibular loss, and/or the timing of the loss may also be factors that can influence the use of hip strategy as a rapid postural response.

Adult↗