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PubMed2005

Added cognitive load through rotary auditory stimulation can improve the quality of postural control in the elderly.

This study examined the effect of rotary auditory stimulation on postural control in the elderly. Thirty-two subjects aged over sixty were submitted to two rotary auditory stimulations, with a meaningful and a non-meaningful message, during a postural task. Although the non-meaningful task did not lead to postural control modification, the meaningful task allowed a reduction in the postural parameter values and therefore, a better stabilisation of posture. The attention, paid to the geography of the sound in understanding the story being told, forced the subject into taking into consideration the regularity and rotation of the stimulation, which meant relying on an auditory anchorage and so facilitated posture regulation.

Acoustic Stimulation↗
PubMed2005

Postural steadiness during quiet stance does not associate with ability to recover balance in older women.

BACKGROUND: Fall risk depends on ability to maintain balance during daily activities, and on ability to recover balance following a perturbation such as a slip or trip. We examined whether similar neuromuscular variables govern these two domains of postural stability. METHODS: We conducted experiments with 25 older women (mean age=78 yrs, SD=7 yrs). We acquired measures of postural steadiness during quiet stance (mean amplitude, velocity, and frequency of centre-of-pressure movement when standing with eyes open or closed, on a rigid or compliant surface). We also measured ability to recover balance using the ankle strategy after release from a forward leaning position (based on the maximum release angle where recovery was possible, and corresponding values of reaction time, rate of ankle torque generation, and peak ankle torque). FINDINGS: We found that balance recovery variables were not strongly or consistently correlated with postural steadiness variables. The maximum release angle associated with only three of the sixteen postural steadiness variables (mean frequency in rigid, eyes open condition (r=0.36, P=.041), and mean amplitude (r=0.41, P=.038) and velocity (r=0.49, P=.015) in compliant, eyes closed condition). Reaction time and peak torque did not correlate with any steadiness variables, and rate of torque generation correlated moderately with the mean amplitude and velocity of the centre-of-pressure in the compliant, eyes closed condition (r=0.48-0.60). INTERPRETATION: Our results indicate that postural steadiness during quiet stance is not predictive of ability to recover balance with the ankle strategy. Accordingly, balance assessment and fall prevention programs should individually target these two components of postural stability.

Adaptation, Physiological↗
PubMed2005

Does head extension and flexion increase postural instability in elderly subjects when visual information is kept constant?

The present study determined the effects of flexing and extending the head on the postural stability and mean anterior-posterior (A-P) center of mass (CM) position during upright stance in the elderly. To ensure visual input to stability was not a confounding variable, visual information was kept as constant as possible for all head positions. Twelve healthy elderly subjects (72.3 +/- 4.7 years) were asked to stand stationary on a single force-platform. Postural stability (assessed using the rms A-P excursion of the center of pressure (CP)) was determined for standing with the head erect, and with the head flexed and extended. The vestibular contribution to postural stability becomes increasingly important under challenging conditions, so to highlight the effects of vestibular system input, measurements of postural stability under conditions where visual and somatosensory inputs were disrupted were included. Changes in the mean A-P CM position when tilting the head were assessed by determining changes in the mean A-P location of the CP from standing with the head erect. Compared to standing with the head erect and looking straight ahead, postural stability was reduced when the head was flexed or extended (P < 0.01). Changes in mean A-P CM position were only significant when standing with the head flexed (P < 0.05). This suggests that increases in postural instability with the head tilted from the erect position may be in part due to mechanical perturbation rather than solely vestibular disruption.

Aged↗
PubMed2005

Development and evaluation of an optimization-based model for power-grip posture prediction.

An optimization-based model for power-grip posture prediction was proposed. The model was based on the premise that the hand prehensile configuration in a power grip best conforms to the object shape. This premise was embodied by an optimization procedure that minimized the sum of distances from the finger joints to the object surface. The model was evaluated against data from an experiment that measured the grasp postures of 28 subjects having diverse anthropometry. The intra- and inter-person variabilities in grip postures were empirically assessed and used as benchmark values for model evaluation. The evaluation showed that the root-mean-square (RMS) values of angle differences between the predicted and measured postures had a 13.7 degrees grand mean (across all joints, subjects, and two cylindrical handles grasped), whereas the RMS values of the inter- and intra-person variabilities in measured postures had grand means of 13.0 degrees and 4.4 degrees , respectively. The model can be readily generalized to the prediction of postures in power-grasping objects of different shapes, and adapted for testing alternative prehensile strategies or performance criteria.

Adult↗
PubMed2005

The association between later cortical potentials and later phases of postural reactions evoked by perturbations to upright stance.

Previous studies have suggested that early cortical potentials (e.g. N1) that are evoked by perturbations to upright stance are associated with sensory processing of the initial perturbation and that later potentials may represent cognitive processing of this perturbation. However, it has also been suggested that later cortical potentials could reflect sensory and motor processing of later phases of the postural reaction. The current study set out to provide additional insight into the association between perturbation-evoked cortical potentials and postural reactions evoked by whole-body perturbations. By altering the deceleration onset of the perturbation, which altered the timing of later postural responses, we determined whether changes in later postural responses were associated with changes in later potentials. Based on previous work, we hypothesized that later potentials would not be associated with changes in later postural responses. During stance, seven healthy young adults were instructed to maintain their balance following two types of perturbations: (1) acceleration phase immediately followed by a deceleration phase (TASK 1), and (2) acceleration phase followed by a delayed deceleration phase (TASK 2). In spite of profound task differences in later postural responses, results revealed no significant differences in later potentials. This work provides additional support for the idea that latter elements of perturbation-evoked cortical responses are likely independent of evoked motor reactions required to maintain stability.

Adult↗
PubMed2006

Postural reactions to soleus muscle vibration in Parkinson's disease: scaling deteriorates as disease progresses.

Previous research has shown that Parkinson's disease (PD) patients, especially those with postural instability, respond hyperactively to visual, vestibular, and neck proprioceptive sensory manipulation. To determine if this impairment of the sensory information scaling holds true for the lower leg proprioceptive system, we studied postural responses to mechanical vibration (which affects the muscle spindle Ia afferents) applied to the soleus muscles of PD subjects and healthy controls. Early-stage and advanced-stage PD patients as well as age-matched control subjects participated. Each group comprised 11 subjects. Nine pulses of 3-s long vibration were applied randomly to both soleus muscles while subjects kept their eyes closed. Postural responses to these stimuli were measured by static posturography. The effect of dopaminergic medication was established by testing patients in both ON and OFF treatment phases. There was no intergroup difference in the pattern or latencies of responses. However, the amplitudes were significantly larger in advanced PD patients; controls did not differ from early-stage PD patients. Dopaminergic medication had no significant effect on any of the measures. The scaling of postural reactions triggered by lower leg proprioception is disturbed in advanced PD. Neither afferent proprioceptive deficits nor inaccurate timing is involved. This study gives further evidence for the generalized impairment of the scaling of postural responses evoked whenever there is a sudden change of sensory conditions, as occurs with the progression of PD. Such impairment could play a significant role in the pathophysiology of postural instability and falls in PD patients.

Accidental Falls↗
PubMed2003

Predicting the dynamic postural control response from quiet-stance behavior in elderly adults.

Human postural sway, as measured by fluctuations of the center of pressure (COP) under the feet of a quietly standing individual, can be characterized as a stochastic process. The fluctuation-dissipation theorem (FDT) provides a linear relationship between the fluctuations of a quasi-static, stochastic system to the same system's relaxation to equilibrium following a perturbation. We applied a similar linear relationship, based on the FDT, to the human postural control system to explore whether anterior-posterior (AP) fluctuations of the COP during quiet stance can be used to predict the AP response of the postural control system to a weak posteriorly directed mechanical perturbation (tug or pull at the waist). We tested 10 healthy elderly (mean age of 69yr) and 10 healthy young (mean age of 25yr) adult subjects. We found that this linear relationship was applicable to the postural control system of all 10 young and eight of the 10 elderly adult subjects. These results suggest that it is possible to predict an individual's dynamic response to a mild perturbation using quiet-stance data, regardless of age. The existence of this FDT-based linear relationship with respect to the human postural control system suggests that, for a given individual, the postural control system may use the same control mechanisms during quiet stance and mild-perturbation conditions, regardless of age.

Adult↗
PubMed1995

Nystagmus and postural instability after headshake in patients with vestibular dysfunction.

Nystagmus after rapid head-shaking (post-headshake nystagmus) is often seen in patients with vestibulopathy. Post-headshake nystagmus is transient and is frequently associated with symptoms of dizziness, dysequilibrium, or vertigo. The phenomenon presumably reflects headshake-induced asymmetry in vestibulo-ocular reflex pathways, which persists after head-shaking stops. We postulated that the same vestibular imbalance that underlies post-headshake nystagmus might produce an equivalent in postural instability. To test this hypothesis, we investigated the effect of headshake on postural control and eye movements in patients who exhibited post-headshake nystagmus, vestibulopathy, or both. Postural instability was quantified with a dynamic platform device, whereas eye movements were recorded with electrooculography. Ten normal controls and 21 patients with a history of post-headshake nystagmus or unilateral vestibulopathy were evaluated. Subjects were tested for 20 seconds before and immediately after passive horizontal headshake (+/- 30-degree amplitude) at 2 Hz for 20 seconds. Postural stability was assessed while subjects stood with eyes closed, and the floor was modulated proportionally with sway. The difference in normalized peak-to-peak sway (equilibrium score) before and after headshake was assessed in all subjects and compared between groups. Post-headshake nystagmus was documented by electro-oculography recorded during posturography. Results for normal controls and vestibulopathic subjects without post-headshake nystagmus showed only a small transient decline in postural stability after headshake. Those with post-headshake nystagmus (regardless of caloric asymmetry) showed a robust decline in postural stability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Postural deviation evoked by caloric stimulation during upright standing in man.

To understand a disequilibrium of the peripheral vestibular disorders, we tried to analyze the body sway evoked by unilateral or bilateral caloric stimulation with warm and cold water systematically. As for postural deviation, the results of our study are summarized as follows. Unilateral warm stimulation evokes heterolateral and anterior postural deviation. Unilateral cold stimulation evokes homolateral and anterior postural deviation. Bilateral warm stimulation evokes posterior postural deviation. Bilateral cold stimulation evokes anterior postural deviation. Therefore we consider that there are several patterns of static disequilibrium of upright posture in the peripheral vestibular disorders.

Adult↗
PubMed2001

Attention influences sensory integration for postural control in older adults.

This study investigated the influence of attention on the sensory integration component of postural control in young and older adults. Eighteen young and 18 older healthy subjects performed information-processing tasks during different postural challenge conditions. Postural conditions included seated, standing on a firm surface, standing on a sway-referenced floor, and standing on a sway-referenced floor while viewing a sway-referenced scene. During each condition, reaction time (RT) was measured during two simple and one inhibitory RT tasks. For the inhibitory task, the time required to inhibit an action was derived, termed the inhibitory time (IT). Performing a RT task was associated with increased postural sway in older subjects, but not in young subjects. The greatest influence of RT task on sway of older subjects was found during the sway-referenced floor/sway-referenced scene condition. Conversely, postural condition had an influence on RT task performance in both young and older subjects. The IT was increased in both young and older subjects only during the sway-referenced floor/scene condition. These results suggest that the sensory integration component of postural control in particular seems to require attention. Further, our data suggest that attentional processes related to inhibitory control are engaged when sensory integration requirements are high.

Age Factors↗
PubMed2003

Perturbation of the postural control system induced by muscular fatigue.

In this experiment, we induced muscular fatigue of ankle plantar-flexors to examine how it deteriorates the regulation of bipedal quiet upright standing. Postural stability was assessed in conditions with and without vision over 60 s period to examine not only classical postural variables (time- and frequency-domain analyses), but also structural variables (stabilogram-diffusion analysis). Muscular fatigue was induced with repeated plantar-flexion of both legs. With muscular fatigue, subjects exhibited an increased postural sway (faster center of pressure (CP) velocity, and greater CP mean and median frequency) and a decreased long-term scaling exponent compared with the control conditions. The fatigue conditions, however, did not modify the range of oscillations and the variability of the postural oscillations around the mean position of CP. The effects of muscular fatigue were similar with eyes open and eyes closed. These results suggest that fatigue did induce some changes in the control mode of postural stability, but the detection/action capabilities of the sensorimotor system remained partly efficient when the ankle plantar-flexors were fatigued. Furthermore, the decreased long-term scaling exponent observed with fatigue suggests that the control of upright stance operates in a less stochastic and more antipersistent manner when fatigue is present (i.e. past and future behaviors were more negatively correlated and thus more tightly regulated). Altogether, the present results suggest that, compared with the no-fatigue conditions, fatigue places higher demands on the postural control system by increasing the frequency of actions needed to regulate the upright stance.

Adult↗
PubMed2004

Comparison between subthalamic nucleus and globus pallidus internus stimulation for postural performance in Parkinson's disease.

Nine subjects with Parkinson's disease, five subjects with electrodes implanted in the subthalamic nucleus (STN) and four with electrodes in the globus pallidus internus (GPi), were compared with a population of ten age-matched control subjects. The measures studied include a set of summary statistic scores, two stochastic parameters, the distribution of the center of pressure (CoP) displacement angles under each foot, and the distribution of bilateral patterns of CoP displacement angles. A Bayes classifier was designed to monitor the trend of postural performance in patients, with different treatments. Results suggested that the selected measures were sensitive to Parkinsonian postural sway abnormalities and highlight differences in response to treatments. Deep brain stimulation restored a more normal postural sway and levodopa increased sway abnormalities. Furthermore, the selected measures appear to detect different responses to levodopa between the STN and GPi groups: the negative side effects of levodopa on posture were less severe for STN than for GPi patients, perhaps due to the decreased need for levodopa intake in STN subjects. The measures proposed in this preliminary study may be useful adjuncts to evaluate balance and postural control strategies in patients with Parkinson's disease and may allow the comparison of DBS electrode sites, on stance posture.

Electric Stimulation Therapy↗
PubMed2004

Influence of perceptual learning on standing posture balance: repeated training for hardness discrimination of foot sole.

The current study investigated the influence of perceptual learning training for hardness discrimination of sponge rubber by the soles on postural sway. Subjects consisted of 30 healthy male volunteers. They were divided into two groups of 15 each at random: perceptual learning training group and a control group. For hardness discrimination training, rubber sponges 5, 10, and 20 mm thick were combined to change the thickness of rubber to 5, 10, 15, 20, and 25 mm. The hardness discrimination training was administered with eyes closed in the standing position for each day for 10 days. The center of pressure measured using a stabilometer was used as the indicator for postural sway. Postural sway was measured for 30 s with eyes open and closed before and after hardness discrimination training. Statistical analysis was performed for length, enveloped area, and rectangular area. Postural sway after training showed a significant decrease compared to sway before training in the perceptual learning training group. However, there was no change on postural sway in the control group. In conclusion, data indicate that the ability of the healthy subjects to regulate their standing posture improved with improvement of the perceptive ability of the soles.

Adult↗
PubMed1999

The second order autoregressive model in the evaluation of postural stability.

The properties of a new postural stability criterion based on the analysis of the difference between centre of pressure and centre of gravity are discussed. This difference may be regarded as the control variable representing active work of ankle muscles allowing to maintain equilibrium and can be effectively modelled as the second order autoregressive process. The model includes two parameters, which allow us to compute stability margin and respective peak frequency considered here as stability biomarkers characterising the human posture control system. The approach, originally designed for quiet stance, lets us effectively assess the stability changes during performance of postural tasks at different levels of difficulty. The latter feature may indicate that the method can find clinical application in the assessment of postural disorders as a supplementary tool reinforcing traditional measures of postural sway. This is particularly convincing in view of the fact that the correlations between old and new measures are low, what implies that the stability biomarkers contain different information concerning the stability of posture as compared with other indices.

Adult↗
PubMed2005

Development of postural adjustments in sitting position during the first half year of life.

Little is known about the development of postural adjustments during early ontogeny. We examined postural adjustments due to sudden perturbations during sitting in 40 healthy term infants (28 males, 12 females) assessed in groups of eight at 1, 2, 3, 4, and 5 months of age. Surface electromyograms of neck, trunk, and leg muscles were recorded while the infants were exposed to a random series of horizontal forward and backward displacements of the surface of support. Video recordings of spontaneous motor behaviour were analyzed. For part of the analyses, previously collected data on 26 infants aged 6 to 10 months were included. In general, postural adjustments at all ages were direction specific and showed large variation. Within the variation developmental changes could be observed, revealing a transient decrease in postural activity at 3 months of age. After this transition, direction-specific postural activity was correlated with spontaneous motor behaviour. This was true, in particular, for dorsal postural activity. The clinical relevance of these findings is discussed.

Age Factors↗
PubMed1995

Effect of posture on hand preferences during experimental food reaching in bonobos (Pan paniscus).

The effect of posture on hand preferences was examined in an experiment with 5 bonobos (Pan paniscus). To obtain a food reward, the animals had to adopt 1 out of 7 different postures. These postures represented an increasing problem to the maintenance of body equilibrium. It was expected that an increasing demand for equilibrium maintenance would elicit individual preferences and a population-level bias. All animals showed an increasing trend toward left-handedness while shifting to a bipedal posture from a seated posture by way of a quadrupedal posture. The importance of bipedalism in the evolution of left- and right-handedness is discussed briefly.

Animals↗
PubMed2002

Diabetic neuropathy and surface sway-referencing disrupt somatosensory information for postural stability in stance.

In order to determine the type of somatosensory information for postural control that is most affected by neuropathy, we compared the relative effects of three methods of sway-referencing the surface in a group of subjects with profound loss of somatosensory function associated with sensory polyneuropathy from diabetes with age-matched control subjects. Sway-referencing disrupted somatosensory feedback for postural control by servo-controlling the dorsi- and plantar-flexion rotation of the support surface in proportion to anterior-posterior excursion of (1) ankle angle, (2) center of body mass (CoM) angle or (3) filtered center of pressure (CoP). Postural sway in subjects with somatosensory loss was significantly larger than normal on a firm surface but not on the sway-referenced surfaces, suggesting that sway-referencing disrupts somatosensory information for postural control already disrupted by neuropathy. Control subjects standing on any sway-referenced surface swayed significantly more than neuropathy subjects who stood on a firm surface, suggesting that sway-referencing disrupts more somatosensory information than disrupted by severe neuropathy. CoP sway-referencing was less sensitive than ankle or CoM sway-referencing for distinguishing postural sway in subjects with somatosensory loss from age-matched control subjects. Given that filtered CoP sway-referencing disrupts the ability to utilize somatosensory information related to surface reactive force to a greater extent than the other two methods of sway-referencing, then these results support the hypothesis that subjects with diabetic peripheral neuropathy have lost more CoP information, than ankle or CoM angle information, for controlling postural sway in stance.

Adult↗
PubMed2003

Vertical posture and head stability in patients with chronic neck pain.

OBJECTIVE: To evaluate postural performance and head stabilization of patients with chronic neck pain. DESIGN: A single-blind comparative group study. SUBJECTS: Patients with work-related chronic neck pain (n = 9), with chronic whiplash associated disorders (n = 9) and healthy subjects (n = 16). METHODS: During quiet standing in different conditions (e.g. 1 and 2 feet standing, tandem standing, and open and closed eyes) the sway areas and the ability to maintain the postures were measured. The maximal peak-to-peak displacement of the centre of pressure and the head translation were analysed during predictable and unpredictable postural perturbations. RESULTS: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations. CONCLUSION: The results show that disturbances of postural control in chronic neck pain are dependent on the aetiology, and that it is possible to quantify characteristic postural disturbances in different neck pain conditions. It is suggested that the dissimilarities in postural performance are a reflection of different degrees of disturbances of the proprioceptive input to the central nervous system and/or of the central processing of such input.

Adult↗