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PubMed1991

[Quantitative evaluation of disorders of upright posture using stabilometry].

The authors examined, using the stabilometric method, 14 patients with lesions of the cerebellum, vestibular system and cerebral hemispheres (hemiparetics). Quantitative evaluation of the stability of posture was done using 7 parameters under four conditions: with open eyes, with closed eyes, with additional visual feedback and standing on a 10 cm foam rubber with closed eyes. In patients with a vestibular lesion the authors observed more frequent elevated values in a lateral direction, a marked destabilization of the posture on the foam rubber and effective use of the added visual feedback. Cerebellar patients were unable to use effectively the visual biofeedback for stabilization of posture. They were characterized by an obvious increase of stabilometric parameters in both directions and under all circumstances. The visual biofeedback had a different effect on maintenance of the upright position in hemiparetic patients. Stabilometry enables the authors to quantify posture and to record different characteristics of postural ataxias.

Adolescent↗
PubMed1988

Postural stability by foot-to-ground force measurement.

The present study was made in an attempt to provide methods which by use of foot-to-ground forces were able to measure gait and postural stability parameters in a form apt for clinical use. The present study is based on 7 publications on the methods and results of gait analysis and 6 previously published studies on postural stability and one study using both methods. The present study is a more extensive description of the methods applied. The gait analysis is performed on an instrumented treadmill measuring continuous ground reaction forces for each foot separately. The advantage of the system is an extensive description of gait. The temporal factors, gait unsafety or ataxia is determined, and by the use of the Laws of Newton, the external positive and negative work is calculated for each foot. A material on normal gait has been published. Studies of gait describe improvement after a neurosurgical intervention as well as the influence of intake of alcohol on gait. The postural stability is measured by calculation of the average variations in the centre of the feet's pressure on a force plate. The advantage compared to previous studies is that one figure is considered a sufficient expression of the postural stability. A material of normal persons have been established and sequent studies have shown informative concerning the influence of various drugs and surgical interventions on the postural stability. The developed methods provide objective data permitting further basic studies. Applied studies should be done within the specialties of orthopedics, anaesthesia, neurosurgery, neurology and as part of search for effects and side-effects in pharmacology.

Biomechanical Phenomena↗
PubMed1978

Postural sway in amputees and normal subjects.

The postural sway of amputees was investigated quantitatively in fifty patients with above-the-knee amputations and in twenty-nine patients with below-the-knee amputations. The factors evaluated were: (1) the mean speed of sway: (2) the range of movement in the sagittal and coronal planes; and (3) the dependence on vision as indicated by the ratio of eyes-open to eyes-closed values. The results demonstrated that in amputees there is an increased dependence on vision for maintenance of the erect posture. Postural sway in patients with below-the-knee amputations was found to be significantly greater than that in those with above-the-knee amputations. Postural sway increased with age; but the visual dependence for the control of postural sway was independent of age.

Age Factors↗
PubMed1993

Postural control reduced by subanesthetic nitrous oxide narcosis.

The effects of subanesthetic (21%) nitrous oxide (N2O) narcosis on postural control, as measured by posturography were studied in 12 subjects. Vibration induced body sway, with open and closed eyes, and body sway induced by a visual stimulus were evaluated. Adaptation was measured as the quotient of body sway variance between the second and first halves of each trial. Change in postural strategy was evaluated as change in the variance of shear forces relative to change in body sway. Subjective evaluation of narcosis was recorded. Body sway variance increased significantly during exposure to N2O, and equally for all body sway inducing stimuli. With the eyes open, adaptation to vibratory perturbation was significantly reduced by N2O. Postural strategy was unaffected by N2O, but differed significantly between stimuli, with relatively less involvement of shear forces during vibratory perturbation in the eyes open condition than during the other body sway inducing stimuli. Subjective evaluation of narcosis correlated with body sway variance during the visual stimulus. The present findings indicate that subanesthetic N2O narcosis reduces postural control. Adaptation to a balance disturbing stimulus, with undisturbed vision, is decreased by N2O. Visual clues are shown to be crucial to the postural strategy adopted to maintain balance. The effects of N2O are assumed to be due to impairment of sensorimotor integration in the CNS.

Adaptation, Physiological↗
PubMed1994

Postural sway patterns of normal men and women and men with mental retardation during a two-legged stance test.

Previous research has shown that in healthy subjects during a quiet two-legged stance, sagittal postural sway is greater than lateral postural sway with a ratio approximating 1.5. The purpose of this study was to examine the postural sway profiles of healthy men and women, and men with mental retardation (MR). Subjects consisted of 22 men (M), 22 women (W) and 22 men with MR. Postural sway characteristics were examined using a Kistler force platform. Each subject performed six trials, three with vision and three with vision occluded. Each trial was 15sec in duration, and the subject was instructed to stand motionless on the force platform. A custom-designed computer program sampled the lateral and sagittal sway characteristics for each trial, at a sample rate of 50Hz. Results indicated that the MR group exhibited significantly more lateral sway than the other two groups, and that the sagittal/lateral sway ratio was significantly lower in this group. Moreover, the MR group showed a greater amount of sway in the no-vision condition than either the M or W groups. Using the sagittal/lateral sway ratio, discriminant analyses indicated that group membership could be predicted in 75% to 82% of the cases in the vision condition, and 64% to 73% of the cases in the no-vision condition. It is concluded that the sagittal/lateral sway ratio provides a valid and objective assessment measure to determine the postural control/balance capacities of persons with MR. In addition, it is hypothesized that this ratio may prove useful in quantifying the effectiveness of therapeutic intervention programs on balance performance.

Adult↗
PubMed1993

Comparison of the effects of zolpidem and triazolam on memory functions, psychomotor performances, and postural sway in healthy subjects.

Zolpidem is a rapid-onset, short-duration imidazopyridine hypnotic drug and is specific agonist of the omega-1 (BZD1) receptors. Its hypnotic characteristics resemble those of triazolam. The aims of this study were to assess the effects of zolpidem on memory (the main objective), psychomotor performances, and postural sway (secondary objectives) in 18 healthy subjects and to compare them with those of triazolam and placebo. Short- and long-term memory (paired words associate and pictures test), psychomotor performances (critical flicker fusion frequency, choice reaction time, digit symbol substitution test), and postural sway were evaluated before and 1.5, 4, 6, and 8 h after the administration of a single dose of zolpidem (10 mg), triazolam (0.25 mg), and placebo. For each assessment, the maximal effect for both hypnotic drugs occurred 1.5 hour after intake. Both drugs decreased psychomotor performance, impaired memory, and increased postural sway. The effects of both hypnotic agents were short lasting, and no alterations were found 6 and 8 hours, respectively, after drug intake. No clinically relevant differences were found between zolpidem and triazolam for memory, psychomotor performance, postural sway, or adverse effects. It may be concluded that zolpidem, like triazolam, impairs short- and long-term memory, psychomotor performances, and postural sway and that these effects are of short duration.

Adult↗
PubMed1995

Estrogen replacement therapy and postural stability in the elderly.

Postural instability and falls in the elderly patient constitute a major health care problem. The etiology is often multifactorial, involving abnormal sensory input (visual, vestibular, and somatosensory), poor central processing, and suboptimal musculoskeletal biomechanics. Estrogen replacement therapy has been shown to prevent Alzheimer's disease and to improve cognitive performance in women with dementia. It was, therefore, postulated that estrogen replacement may improve central processing speed, which would result in improved postural stability. In this prospective, randomized, double-blinded study, 87 elderly female subjects (age > 69) were examined by repeated dynamic platform posturography, to measure the effect of estrogen therapy versus placebo upon postural stability. Results indicate that those receiving estrogen had no significant improvement in postural stability at 2 and 8 months of treatment relative to those receiving placebo. Trail Making B test was used as the psychometric test of central processing speed. There was no significant effect of estrogen on this measure over the 8 months of observations. It is concluded that 8 months of estrogen replacement therapy has no significant effect on central processing speed or postural stability in a healthy older female population.

Aged↗
PubMedDate not supplied

Influence of arousal and attention on the control of postural sway.

Healthy young adults (n = 39) were asked to perform four different secondary cognitive tasks during quiet unperturbed stance, in order to investigate the influence of physiological arousal and attention distraction on the control of spontaneous postural sway. During each task, postural activity was quantified in terms of center-of-pressure displacement, leg-muscle activation, and ankle and hip rotation. Arousal was monitored via skin conductance, and questionnaires were used to assess state anxiety. Respiratory trunk movements were also recorded, to assess potential arousal-related destabilizing effects, but failed to show a strong association with the postural measures. The nature of the secondary task affected the postural responses in that subjects tended to lean slightly forward, and exhibited higher levels of activation in tibialis anterior, when performing a mental-arithmetic task. Although this task affected both attention and arousal, the leaning effect was limited to subjects who reported higher levels of anxiety-related autonomic or somatic symptoms during testing, and the degree of leaning was correlated with the level of physiological arousal. A secondary task that diverted attention but did not affect physiological arousal (listening to a spoken-word recording) failed to elicit changes in postural response. These findings suggest that the changes in leaning were associated with task-related changes in physiological arousal, and highlight the need to account for the potentially confounding influence of arousal when studying attentional effects. Given the potential influence on stability, the results also suggest that leaning should be monitored or controlled during balance assessment, particularly when dealing with individuals who may be anxious or afraid of falling.

Adult↗
PubMedDate not supplied

A link-segment model of upright human posture for analysis of head-trunk coordination.

Sensory-motor control of upright human posture may be organized in a top-down fashion such that certain head-trunk coordination strategies are employed to optimize visual and/or vestibular sensory inputs. Previous quantitative models of the biomechanics of human posture control have examined the simple case of ankle sway strategy, in which an inverted pendulum model is used, and the somewhat more complicated case of hip sway strategy, in which multisegment, articulated models are used. While these models can be used to quantify the gross dynamics of posture control, they are not sufficiently detailed to analyze head-trunk coordination strategies that may be crucial to understanding its underlying mechanisms. In this paper, we present a biomechanical model of upright human posture that extends an existing four mass, sagittal plane, link-segment model to a five mass model including an independent head link. The new model was developed to analyze segmental body movements during dynamic posturography experiments in order to study head-trunk coordination strategies and their influence on sensory inputs to balance control. It was designed specifically to analyze data collected on the EquiTest (NeuroCom International, Clackamas, OR) computerized dynamic posturography system, where the task of maintaining postural equilibrium may be challenged under conditions in which the visual surround, support surface, or both are in motion. The performance of the model was tested by comparing its estimated ground reaction forces to those measured directly by support surface force transducers. We conclude that this model will be a valuable analytical tool in the search for mechanisms of balance control.

Biomechanical Phenomena↗
PubMed1999

Association of ipsilateral motor automatisms and contralateral dystonic posturing: a clinical feature differentiating medial from neocortical temporal lobe epilepsy.

BACKGROUND: Clinical features that may help to differentiate medial temporal lobe epilepsy (MTLE) from neocortical temporal lobe epilepsy (NTLE) are lacking. OBJECTIVE: To investigate the localizing and lateralizing value of the association of ipsilateral motor automatisms and contralateral dystonic posturing in patients with medically refractory temporal lobe epilepsy. PATIENTS AND METHODS: Videotapes of 60 patients with well-defined MTLE, NTLE, or both were reviewed to assess the presence and the localizing value of unilateral dystonic posturing associated with motor automatisms. RESULTS: Twenty-eight of the 60 patients exhibited unilateral dystonic posturing. This sign was observed in patients with MTLE and NTLE. It was mostly contralateral to the seizure focus in patients with MTLE and exclusively ipsilateral in patients with NTLE. Unilateral motor automatisms occurred in 26 of the 60 patients with MTLE or NTLE. It was predominantly ipsilateral to the seizure focus in patients with MTLE and exclusively contralateral in patients with NTLE. The association of ipsilateral motor automatisms and contralateral dystonic posturing was found in 14 patients with MTLE but in none of the patients with NTLE. Two patients who had medial and neocortical seizure onset also exhibited this clinical feature. This association was not significantly correlated with the postoperative outcome in patients with MTLE. CONCLUSIONS: The association of ipsilateral motor automatisms and contralateral dystonic posturing may help to differentiate MTLE from NTLE with a reliable lateralizing value. This clinical association may reflect a specific pattern in the spread of the ictal discharge.

Adult↗
PubMed1987

An assessment of posture in bipedal rats.

Alteration in posture was examined following foreleg amputation in rats. After the surgical induction of bipedal stance, a detailed, quantified, and longitudinal assessment of rat posture and the amount of time spent in the upright stance was undertaken. An experimental group of rats had both forelimbs amputated. A group of unaltered quadrupedal rats served as controls. A standardized series of photographs of altered and control rats was taken. Postural differences between the two groups of rats were analyzed through photographic analysis of their profiles in upright and in crouched positions. Analysis of the photographs showed that the percentage of rats assuming upright posture did not differ between the experimental and control groups. Foreleg amputation forced the rats to adopt an altered posture, but did not result in habitual assumption of upright stance to a greater degree than that of controls. Adaptation to bipedalism was marked by a tucking of the hindlimbs under the body, and a flexure of the vertebral column and the head.

Amputation, Surgical↗
PubMed1976

Head posture and craniofacial morphology.

The associations between craniofacial morphology and the posture of the head and the cervical column were examined in a sample of 120 Danish male students aged 22-30 years. Two head positions were recorded on lateral cephalometric radiographs, one determined by the subject's own feeling of a natural head balance (self balance position), and the other by the subject looking straight into a mirror (mirror position). Craniofacial morphology was described by 42 linear and angular variables, and postural relationships by 18 angular variables. A comprehensive set of correlations was found between craniofacial morphology and head posture. The correlations were similar for both head positions investigated. Of the postural variables, the position of the head in relation to the cervical column showed the largest set of correlations with craniofacial morphology. Extension of the head in relation to the cervical column was found in connection with large anterior and small posterior facial heights, small antero-posterior craniofacial dimensions, large inclination of the mandible to the anterior cranial base and to the nasal plane, facial retrognathism, a large cranial base angle, and a small nasopharyngeal space. The possible role of functional factors in mediating the relationship between morphology and posture was discussed.

Adult↗
PubMed1988

Postural control in single-limb stance.

Postural control in single-limb stance has previously been shown to be impaired among soccer players with functional instability (FI) of the ankle joint. The aim of the present study was to further study the role of the ankle in postural control. A dynamic method was used involving optoelectronic movement recordings of body segments and force-plate recordings of the reaction ground force. Surface electromyography was recorded for the peroneus longus muscle. Thirty physically active men were selected. Fifteen of them had FI of the ankle chosen for recording. The results show that different patterns exist for maintaining equilibrium in single-limb stance. The ankle has a central role for postural corrections. The position of center of pressure is highly correlated to the position of the ankle and peroneal muscle activity. When the body was in disequilibrium, corrections were made at the hip. It is proposed that a change from an inverted pendulum model to a multisegmental chain model takes place when adjustments at the ankle joint no longer suffice to maintain postural control. The men with FI showed impaired postural control associated with increased upper segmental corrections.

Adolescent↗
PubMed2004

Postural tremor in Wilson's disease: a magnetoencephalographic study.

The following study included 5 Wilson's disease (WD) patients showing a right-sided postural forearm tremor (4-6 Hz) and addressed the question of whether the primary motor cortex (M1) is involved in tremor generation. Using a 122-channel whole-head neuromagnetometer and surface electromyogram (EMG), we investigated cerebromuscular coupling. Postural tremor was observed in a sustained 45-degree posture of the right-sided forearm. Data were analyzed using dynamic imaging of coherent sources (DICS), revealing cerebromuscular coupling between EMG and cerebral activity. Coherent sources were superimposed on individual high-resolution T1-weighted magnetic resonance images (MRI). Phase lags between EMG and cerebral areas showing strongest coherence were determined by means of a Hilbert transform of both signals. In all patients, postural tremor was associated with strong coherence between tremor EMG and activity in contralateral primary sensorimotor cortex (S1/M1) at tremor or double tremor frequency. Phase lag values between S1/M1 activity and EMG revealed efferent and afferent components in the corticomuscular coupling. Taken together, our results indicate that postural tremor in WD is mediated through a pathological oscillatory drive from the primary motor cortex.

Adult↗
PubMed1988

Intersegmental modulation of abdominal postural responses initiated by mechanostimulation of the swimmeret in lobster.

In a multiganglionic preparation of the lobster abdominal nerve cord, composed of the first through fifth ganglia (A1-A5) and attached second swimmeret, tactile stimulation of the cuticular surface of the swimmeret initiates a postural motor program in A2 for abdominal extension, whereas deflection of feathered hair sensilla that fringe the swimmeret rami does not affect postural motor activity recorded from A2 (Kotak and Page, 1986a). This report demonstrates that partial isolation of A2 from adjacent abdominal ganglia by sectioning the A1-A2 or the A2-A3 connectives both increases the strength of the extension response evoked by cuticular stimulation and disinhibits a postural flexion inhibition response initiated by feathered hair stimulation. Complete isolation of A2, by cutting the A1-A2 and the A2-A3 connectives, further increases the strength of these postural responses. Intersegmental inhibition of these responses originates in the ganglia adjacent to A2, since mechanoresponsiveness of A2 is not affected by resection of a more distant connective (A3-A4). These results provide evidence for the presence in adjacent abdominal ganglia of intersegmental interneurons that regulate the access of swimmeret sensory activity to the postural motor neurons in A2.

Abdomen↗
PubMed2003

Effect of posture on respiratory function and drive in preterm infants prior to discharge.

Our objective was to determine the effect of posture on respiratory function and drive in prematurely born infants immediately prior to discharge. Twenty infants (6 oxygen-dependent), median gestational age 29 weeks (range, 25-32), were studied at a median postconceptional age (PCA) of 36 weeks (range, 33-39). On 2 successive days, infants were studied both supine and prone; each posture was maintained for 3 hr. The order on each day in which postures were studied was randomized between infants. At the end of each 3-hr period, tidal volume (Vt), inspiratory (Ti) and expiratory (Te) time, respiratory rate, and minute ventilation were measured. In addition, respiratory drive was assessed by measuring the pressure generated in the first 100 msec of an imposed airway occlusion (P(0.1)), and respiratory muscle strength was assessed by recording the maximum inspiratory pressure (Pimax) generated against an occlusion which was maintained for at least five breaths. Overall, tidal volume was higher (P < 0.05), but respiratory rate (P < 0.05), P(0.1) (P < 0.05), and Pimax (P < 0.05) were lower in the prone compared to the supine position. There were no significant differences in Ti or Te between the two postures. In oxygen-dependent infants only, minute volume was higher in the prone position (P < 0.05). In conclusion, posture-related differences in respiratory function are present in prematurely born infants studied prior to neonatal unit discharge.

Drive↗
PubMed1994

Influence of head-neck posture on airflow and pulmonary mechanics in preterm neonates.

The influence of head-neck posture (neutral, 15 degrees, 30 degrees, and 45 degrees extension and flexion) on airflow and pulmonary mechanics was evaluated in 10 spontaneously breathing healthy preterm neonates (mean +/- SD; birth weight, 1.32 +/- 0.23 kg; gestational age, 29.4 +/- 2.4 weeks; study age, 36.6 +/- 1.6 weeks) who had had respiratory distress syndrome. Head-neck postures were quantified using specially constructed wooden wedges. Airflow was measured by a pneumotachometer via face mask. Lung compliance (CL) and resistance (RL) were measured using an esophageal balloon. Airflow interruption was designated as mild (10-40%), moderate (40-80%), and severe (> 80-100%) decrease of airflow. At neutral head-neck posture, 42.8 +/- 7.5% SEM of breaths had airflow interruption (71.4% mild, 19.9% moderate, 8.7% severe). There was no significant change with 15 degrees and 30 degrees head-neck flexion and extension. However, at 45 degrees flexion the overall incidence of airflow interruption (77.3 +/- 4.8%, P < 0.05) and RL (86.6 +/- 6.7 vs. 64.2 +/- 3.9 cmH2O/L/s, mean +/- SEM; P < 0.05) significantly increased. Extension to 45 degrees caused severe airflow interruption and increased RL in some infants, but no statistically significant change for the whole group. The incidence of severe airflow interruption significantly increased (P < 0.05) from 8.7% at neutral head-neck posture to 26.3% at hyperflexion (45 degrees). No changes in CL were observed. We conclude that minor (15-30 degrees) deviations from neutral neck posture are insignificant, whereas hyperflexion, and in some infants, hyperextension, can significantly affect airflow and pulmonary mechanics.

Airway Resistance↗
PubMed1996

Measurement of lung mechanics at different lung volumes and esophageal levels in normal subjects: effect of posture change.

Lung elastance and resistance increase in the supine posture. To evaluate the effects of change in posture on regional lung mechanics at different lung volumes, lung elastance and resistance were measured at graded volume subdivisions and three esophageal levels at seated and supine body positions, using the esophageal balloon technique. Volumes were adjusted to be the same in both postures. In general, lung elastance (both static and dynamic) tended to be higher in supine posture and uniform at all lung volumes, except at 80% vital capacity, where it increased sharply. The ratio of dynamic to static lung elastance was slightly higher at the cephalad esophageal level, where regional flow rates and relative volume expansion are lower. Lung resistance varied inversely with lung volume but was higher at corresponding volume subdivisions in the supine posture. It decreased at more cephalad esophageal levels, where volume expansion and flow are less. Thus, the increase in regional flow at low volume subdivisions (most marked in the supine position) also contributed to higher lung resistance at these volumes. These findings are explained on the basis of a combination of Newtonian physics as well as nonlinear viscoelastic properties of the lung as applied to regional flow and volume expansion.

Adult↗