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Rectifying postures reconstructed from joint angles to meet constraints.

Postures are often described and modeled using angles between body segments rather than joint coordinates. Models can be used to predict these angles as a function of anthropometry and postural requirements. Postural representation, however, requires the joint coordinates. The use of conventional forward kinematics to derive joint coordinates from predicted angles may violate task constraints, such as the placement of a hand on a target or a foot on a pedal. Errors arise because the anthropometry or other motion characteristics of a subject, for which the prediction is to be made, may differ from the data from which the prediction model was derived. We describe how to rectify model-predicted postures to exactly satisfy such task constraints. We require that the model used for predicting the angles also produce estimates of the variation in these predictions. We show how to alter the initial angle predictions, with the amount of perturbation at each angle dependent on the accuracy of its estimation, so as to exactly satisfy the joint coordinate constraints. Finally, we show in an empirical example that this correction usually produces better overall predictions of posture than those obtained initially.

Anthropometry↗

The awakening cortisol response: no evidence for an influence of body posture.

It has recently been reported that the orthostatic challenge associated with postural change from sitting to an upright position is stimulatory to the hypothalamic-pituitary-adrenal axis as evidenced by increased salivary free cortisol. This stimulatory influence is potentially a confound for the many psychoneuroendocrine studies for which salivary free cortisol is the main dependent variable. This particularly relates to laboratory psychosocial stress procedures in which subjects are invited to stand in order to deliver public speech and the studies which have explored the cortisol response to awakening in which postural shift has not been controlled for. We therefore examined, in a balanced cross over design whether the awakening cortisol response was influenced by standing, shortly after awakening or remaining supine during the response study period. In addition and in the same subjects we measured the cardiovascular response and saliva cortisol response to the orthostatic challenge of shifting from a supine to a standing position later in the diurnal cortisol cycle. The expected cortisol response to awakening was demonstrated but there was no evidence that the postural shift, supine to standing, confounded the response. This same postural shift later in the day induced the expected increase in heart rate but cortisol simply followed the circadian decline. Under the conditions of the present study we found no evidence that the postural shift supine to standing could induce a cortisol secretory episode such as to contribute towards the awakening response.

Adult↗

Posture Training Support: preliminary report on a series of patients with diminished symptomatic complications of osteoporosis.

Back supports are often used to minimize or prevent complications of osteoporosis. Nevertheless, the few related studies to date reveal that the currently available thoracolumbar and lumbosacral supports have substantial limitations, including (1) poor compliance because of discomfort or restricted motion, (2) expense, (3) unacceptable cosmetic and aesthetic appearance, and (4) medical contraindications to the use of rigid supports. We report the initial results of a clinical trial of the Posture Training Support (a thoracolumbar support) in 29 women and 1 man with osteoporosis or osteopenia of the spine (ages 37 to 87 years), who were referred because of back pain or kyphosis. We hypothesize that this inexpensive, unobtrusive device promotes improvement in posture and reduces back pain either by acting as a proprioceptive reinforcer or by producing a force posteriorly below the inferior angles of the scapulae and thus decreasing the anterior compressive forces that are commonly exerted on the spine. Among the 23 patients who reported substantial back pain before use of the support, relief of the pain was "significant" in 17 and minimal in 6. Nineteen patients noted improvement in their posture. No patient reported worsening of back pain or posture, nor did any patient discontinue use of the device for cosmetic reasons, discomfort, or other complaints. Four patients previously could not tolerate other back supports, and 14 had previously used other supports without substantial improvement. These preliminary results suggests that the Posture Training Support may be of considerable symptomatic and prophylactic value to patients with osteoporosis who cannot tolerate conventional back supports.

Adult↗

Cognitive representations of hand posture in ideomotor apraxia.

Ideomotor apraxia (IM) is a disorder of skilled action characterized by spatiotemporal errors in pantomiming object use and in using objects. Recent evidence suggests that at least some patients with IM may exhibit particular deficits in forming hand configurations appropriate for object use. Sirigu et al. [Cortex 31 (1995) 41] reported an apraxic who positioned her hand inappropriately when attempting to use objects in accordance with stored knowledge of object-specific manipulation, but in reaching tasks could grasp the same objects appropriately in response to their structure. To this point, however, apraxics' ability to respond to functional and structural attributes of objects has not been empirically assessed. We investigated the hypothesis that patients with IM (n=9) due to left inferior parietal damage would be impaired in producing and recognizing hand postures associated with familiar objects, indicating deficient memorial representations for object-specific hand postures. In contrast, we predicted relatively unimpaired ability to produce and recognize appropriate hand postures with novel objects, indicating integrity of "on line" spatiomotor procedures coding hand position in response to object structure. Apraxics' performance was contrasted with 10 healthy controls and 8 brain-lesioned non-apraxics. Consistent with our predictions, the apraxics responded abnormally with familiar objects but normally in recognizing hand postures appropriate for novel objects. In addition, performance with objects calling for a prehensile response (pinch or clench) was superior to that with objects evoking a non-prehensile response (palm or poke). These data suggest degradation of inferior parietally-mediated representations of the precise hand postures associated with familiar objects. Furthermore, they are consistent with possible over-reliance upon dorsal system procedures for calculating precision and power grip in response to object structure.

Aged↗

Laterality of tail resting posture in three species of New World primates.

A variety of mammalian species including prosimian and simian primates wrap their tails around their bodies as a means of thermoregulation and for reasons of comfort during resting or sleep. Adopting such a resting posture requires an animal to move its tail either to the right or to the left of the midline of its body, and thus to perform a lateralized behavior. The purpose of this study was to assess the occurrence of lateral biases in tail resting posture in three species of New World primates. Twenty squirrel monkeys, spider monkeys, and howler monkeys, respectively, were observed and data on tail resting posture were collected and analyzed. The results demonstrate (1) that individual squirrel monkeys and spider monkeys exhibit highly significant lateral biases in tail resting posture; (2) a lack of a lateral bias at the group level; (3) that howler monkeys fail to show side preferences in tail wrapping; (4) a lack of sex differences in this behavior in all three species; and (5) a lack of significant correlations between preferred side of tail resting posture and preferred side of hand use in simple reaching tasks which had been assessed with a subset of animals in previous studies. Thus, the present study provides evidence for a behavioral asymmetry which is well-known to occur in rats but has not been described so far in nonhuman primates, and which might offer an additional approach to the investigation of the mechanisms underlying functional cerebral asymmetries.

Alouatta↗

Organization of posture controls: an analysis of sensory and mechanical constraints.

We analyse two components of posture control in standing human subjects: (1) the mechanical properties which constrain the body's ability to execute stabilizing postural movements and (2) the mechanical and neural properties which constrain the ability of the vestibular system to sense changes in body orientation. Rules are then proposed to describe the central organization of posture controls within the sensory and mechanical constraints. The organizational rules and knowledge of constraints are combined to predict the effects of selective semicircular canal and utricular otolith lesions on postural stability and the patterns of body and head movements used to maintain balance. Our analysis leads to the prediction that semicircular canal and otolith deficits destabilize patients at different frequencies, and force them to use different patterns of body and head movements. These predictions are compared to posture controls observed in patients with different types of vestibular deficits. The additional steps required to prove or disprove the theory are discussed.

Humans↗

Postural control in sitting children with cerebral palsy.

Children with cerebral palsy (CP) display postural problems, largely interfering with daily life activities. Clarification of neural mechanisms controlling posture in these children could serve as a base for more successful intervention. Studies on postural adjustments following horizontal forward and backward displacements of a movable platform in ten school-age children with spastic diplegia and non-disabled controls revealed that sitting CP children, like standing CP children, show direction specific postural adjustments, indicating that the basic pattern of muscle coordination in these conditions is conserved. Dysfunctions are especially present in the modulation of the response pattern of ventral muscles during forward translations. They consist of: (1) a stereotyped and non-variable activation of all ventral muscles; (2) an abnormal top-down muscle recruitment; and (3) an excessive degree of antagonistic co-activation. The altered patterns of muscle coordination could be the result of two interacting mechanisms, the primary deficit due to the early brain damage and a compensation due to the postural instability. Especially the latter dysfunction furnishes opportunities for therapeutic help.

Cerebral Palsy↗

A review of biomechanics of the central nervous system--part II: spinal cord strains from postural loads.

OBJECTIVE: To review spinal cord strains arising from postural loads. DATA COLLECTION: A hand search of available reference texts and a computer search of literature from the Indexed Medicus sources were collected, with special emphasis placed on spinal cord strains caused by various postural rotations and translations of the skull, thorax, and pelvis RESULTS: All spinal postures will deform the neural elements within the spinal canal. Flexion causes the largest canal length changes and, hence, the largest nervous system deformations. Neural tissue strains depend on the spinal level, the spinal movement generated, and the sequence of movements when more than one spinal area is moved. CONCLUSIONS: Rotations of the global postural components (head, thoracic cage, pelvis, and legs) cause stresses and strains in the central nervous system and peripheral nervous system. Translations of the skull, thorax, and pelvis, as well as combined postural loads, need to be studied for their effects on the spinal canal and neural tissue deformations. Flexion of any part of the spinal column may generate axial tension in the entire cord and nerve roots. Slight extension is the preferred position of the spine as far as reducing the magnitude of mechanical stresses and strains in the central nervous system is concerned.

Animals↗

Sex differences in catalepsy: evidence for hormone-dependent postural mechanisms in haloperidol-treated rats.

Catalepsy, a symptom of Parkinson's disease and related disorders can be produced in rats and other laboratory animals by the blockade of nigrostriatal dopamine using dopaminergic antagonists such as haloperidol. When haloperidol-induced cataleptic rats are placed facing downward on an inclined plane, they will brace against the resulting downward force by pushing backwards, and if they lose postural stability, or their position on the inclined plane, they will jump forward. Females, however, jump from the inclined plane at a significantly lower angle than do males. Frame-by-frame analysis of the jumping sequences revealed that females and males use a different combination of postural adjustments to maintain their position on the inclined plane prior to jumping. Furthermore, gonadal hormone manipulations at birth and in adulthood reveal that these sex differences in postural adjustments are dependent on the organizational effects of gonadal hormones in the perinatal period. These results provide evidence for sex differences in postural support mechanisms and suggest that the sex of subjects, or their hormonal state, must be considered when studying the behavioral aspects of neurological disorders such as Parkinson's disease which include a postural component.

Animals↗

Physical activity improves gaze and posture control in the elderly.

Ageing is associated with a decrease in the quality of balance regulation, in particular through dysfunctions of gaze control and postural stabilization, which results in an increased risk of falling. Conversely, the practice of physical and sporting activities has been shown to improve every level of postural regulation. This study is to assess the effects of the practice of physical activities on vestibulospinal reflex and ocular movements of visual and vestibular origins in elderly people. Gaze control and posture stabilization were evaluated in 13 healthy aged women who regularly practised physical activities and in 13 healthy aged sedentary women of a similar age, by dynamic posturographic test with electromyography, as well as electronystagmography with caloric and rotational vestibular tests, ocular saccades, smooth pursuit and optokinetic tests. The gaze and posture control performance of the active group was better; the proprioceptive and vestibular sensitivities were higher, visual detection quality was good, and reaction time was low. Regular physical activity develops or maintains the efficiency of the reflexes involved in postural control, especially through adequate neurosensorial information, which allows the central integrative structures to generate a more appropriate motor response.

Aged↗

[Standing posture of adults: effects of a stroke].

PURPOSE: The goal of this study was to compare the standing posture of stroke patients with standing posture of healthy subjects. We have used an analysis of the centres of pressure sways. MATERIAL AND METHOD: The centres of pressure sways of the subjects were recorded on a force platform. Each subject have carried out 5 trials of 60 s while maintaining a static standing posture, with eyes opened and then closed. These sways were broken down into two spectral frequencies. The first ones being the sways of the vertical projection of the centre of gravity and the second ones being the difference between the centre of pressure and the centre of gravity, expressing the neuromuscular stiffness. RESULTS: The 6 hemiplegic patients were 53.3 +/- 5.3 years old. The time since the stroke is 35.1 +/- 29.9 months. The 5 healthy subjects were 47.2 +/- 6.6 years old. The results showed that the root mean square of the neuromuscular stiffness spectral frequencies for the hemiplegic group was higher than the one of the healthy group. CONCLUSION: The hypothesis could be in static standing posture, the stiffness of the hips adductors and abductors muscles and the ankles flexors and extensors muscles is higher for the hemiplegic group than the healthy group. This increase of the stiffness could be explained by a disturbance of the muscle tone or/and the muscle coordination found amongst the hemiplegic patients. This first study encourages us to use this methodology to assess the evolution of the standing posture for hemiplegic patients during the rehabilitation period.

Biomechanical Phenomena↗

The effect of the canalith repositioning maneuver on resolving postural instability in patients with benign paroxysmal positional vertigo.

OBJECTIVE: Patients with benign paroxysmal positional vertigo (BPPV) often experience postural instability as well as brief episodes of vertigo. The purpose of this study was to determine whether successful resolution of the episodic vertigo, through use of the canalith repositioning treatment, would be accompanied by improvement in postural stability. STUDY DESIGN: Prospective clinical study. SETTING: Outpatient tertiary care facility in a university. PATIENTS: Thirty-three patients with a diagnosis of the canalithiasis form of BPPV affecting the posterior canal unilaterally. All patients had complete remission of the positional vertigo after treatment. Patients with abnormal caloric or rotary chair test results were excluded from the study. INTERVENTION: The posterior canal BPPV was treated by the canalith repositioning treatment. MAIN OUTCOME MEASURES: Postural stability was assessed by computerized dynamic posturography before and 1 to 2 weeks after treatment. Six different subtests were used. RESULTS: A significant number of patients had abnormal stability, as measured with computerized dynamic posturography, before treatment. After treatment there was a significant increase in the number of subjects with normal results on the different subtests; however, not all patients had normal postural stability. Younger subjects were more likely to show improved stability. CONCLUSIONS: Treatment of BPPV using the canalith repositioning treatment results in improved postural stability in patients with BPPV. Not all patients have normal stability after treatment, however, and assessment and treatment of the balance problems may be necessary.

Adult↗

Prenatal development of arm posture.

Fetal arm posture was studied longitudinally in 10 uncomplicated pregnancies using real-time ultrasound. Observation were performed at four weekly intervals from 12 to 36 weeks, and at 38 weeks. The percentage of assessments with optimal visualization of elbow, wrist and fingers was 84% at 12 weeks and more than 90% thereafter (range 92-98%). There was a clear developmental trend towards increased flexion. Flexion of the elbow occurred frequently from 12 weeks onwards with an increased incidence at 16 weeks, that in the fingers from 20 weeks onwards and from 28 weeks to term age in the wrist. All three trends were statistically significant. There was considerable intra-individual consistency in terms of the ages at which flexion increased. In fact the increase of flexion occurred one session later in only 6/30 registrations. The combined data of the elbow, wrist and fingers revealed preferential arm posture at 12 weeks with the elbow flexed and the wrist and fingers extended. From 16 to 28 weeks, the predominant posture consisted of elbow flexion, wrist extension and finger flexion and complete flexion thereafter. The development of fetal arm posture does not comply with a proximo-distal trend in that there was first an increase in flexion at the elbow, followed by the fingers and finally the wrist. The implications of our findings for understanding the prenatal development of the central nervous system and subsequent postural adjustments to extrauterine life are discussed.

Arm↗

Open-mouth posture and maxillary arch width in young children: a three-year evaluation.

A large biracial sample of children were assessed for open mouth posture and maxillary arch width once a year for 3 years. Analyses revealed that although the youngsters exhibited open-mouth posture at high levels, over time, there was a significant decrease in this behavior. Racial and gender differences, as well as a race-by-time interaction, were also evidenced. The children displayed a significant increase in maxillary arch width across time, with gender and racial differences seen in this growth pattern. Finally, when the youngsters were classified as exhibiting primarily open-mouth or closed-mouth posture, it was observed that children with open-mouth posture displayed a significantly slower pattern of maxillary growth compared with children who display anterior lip seal posture. The implications of the findings were discussed.

Analysis of Variance↗

Prognosis of adult men with heat exhaustion with regard to postural stability and neurobehavioral effects: a 6-month follow-up study.

The medical complications of heat disorders, including hematological, cardiovascular and renal damage, have been well documented. However, very little has been written on its neurological complications. In an earlier study, we reported that men with heat exhaustion, studied 2 weeks after the acute episode, had significantly more symptoms of neurasthenia, poorer performance in short-term memory and slower reaction time. The cases (as a group) had significantly poorer postural stability. The objective of this study was to assess the prognosis of men with heat exhaustion with regard to postural stability and neurobehavioral functions 12, 3 and 6 months after the acute episode. The study is prospective in design and spans a 2-year period. All soldiers who were diagnosed to have heat exhaustion (cases) from 1 March 1998 were included in the study. For each case, a healthy soldier (matched for age, ethnicity, years of education and military vocation) was recruited to serve as control. Each subject had a neurobehavioral assessment by using the Swedish Performance Evaluation System (SPES), a computerized test battery. The postural stability of the subjects was assessed using a computerized postural sway system. Each subject took the test 2 weeks after the acute episode and repeated the test 3 and 6 months later for duration of 2 years. We report here the findings of 21 heat exhaustion cases and 18 controls, which completed all the three tests (i.e. done 2 weeks after the acute episode and 3 and 6 months later). Significant differences were only detected in some of the neurobehavioral and neurophysiological parameters between the cases and the control for first two tests but not the third test. The prognosis of adult with heat exhaustion is good. There were no significant differences in neurobehavioral tests and postural stability among the cases and controls 612 months after the episode.

Adolescent↗

Influence of action and expectation on visual control of posture.

Previous studies have shown that human subjects presented with a moving visual environment initiate a postural re-adjustment in the direction of motion. The present study investigated how active control or expectation of the displacement of a visual scene affects this postural response. Center of foot pressure (COP) and head displacement were recorded using a sway platform and a tracking system, respectively. The subjects faced a visual scene (1 x 1 m, at a distance of 45 cm) which moved transiently (with a velocity of 1 cm/s) in a direction parallel to the interaural axis. When the displacement of the visual scene was under the active control of the subjects, visually induced body sway was strongly inhibited, in comparison with the response to unexpected stimuli. Prior knowledge of the characteristics of the forthcoming displacement was sufficient, in most subjects, to reduce postural re-adjustment, even when subjects did not exert active control. Finally, the visually induced postural response was strongly reduced even when subjects only triggered the stimulus, without any knowledge about the direction of motion. In conclusion, it appears that although vision is of primary importance in the control of postural orientation, high level processes such as expectation can modulate its impact by providing cues as to whether forthcoming visual flow is the consequence of self-motion or object-motion.

Adult↗

Multisensory fusion: simultaneous re-weighting of vision and touch for the control of human posture.

We examined the generally held belief that the postural control system is able to re-weight its available sensory inputs in order to optimize stance control in altered sensory environments. Our view is that previous accounts of sensory re-weighting provide only indirect evidence, which is subject to alternative explanations. The present results provide strong evidence for sensory re-weighting as the primary mechanism for changes observed in postural sway between conditions. Subjects were presented with small-amplitude, oscillatory visual and somatosensory stimuli at 0.20 and 0.28 Hz, respectively, in five conditions that manipulated the amplitudes of stimulus motion. Gain calculated in each trial with respect to each of the two stimuli was found to change systematically as stimulus motion amplitudes changed across condition. The observed pattern of gain rules out a constant-weight, linear account of posture and is consistent with the re-weighting hypothesis. Parameter fits of a third-order, linear stochastic model to postural sway trajectories in each condition showed that changes in gain across condition were primarily due to changes in coupling coefficients rather than changes in parameters that characterize the stability of the postural system. Visual gain was found to depend upon visual motion amplitude and touch gain was found to depend upon touch motion amplitude, indicating intra-modality dependencies. Visual gain also depended upon touch motion amplitude, indicating an inter-modality dependence. To our knowledge, simultaneous re-weighting of more than one sensory input has never been rigorously demonstrated. These techniques may be able to resolve the source of balance control deficits across populations with far more certainty than currently possible.

Adult↗

The relevance of posturally induced microvascular constriction after revascularisation in patients with chronic leg ischaemia.

In patients with severe chronic lower limb ischaemia, postural vasoconstriction is disturbed, resulting in enhanced skin microcirculatory perfusion on leg dependency. After vascular reconstructive surgery, postoperative oedema formation is frequently seen. In 31 patients with leg ischaemia undergoing revascularisation we investigated whether and, if so, for how long after surgery postural vasoconstriction would take to recover, and whether disturbed vasoconstriction correlates with the occurrence of postoperative oedema. Capillary microscopy and laser Doppler fluxmetry were used to assess nutritional and total skin perfusion, respectively. The measurements were performed before and up to 37 days after surgery. After revascularisation, the mean ankle blood pressure index rose from 40 to 82%. All patients, except those with persistently disturbed vasoconstriction showed improved microcirculatory parameters. Postural vasoconstriction was restored in 24 patients, occurring approximately on the eighth postoperative day. All patients who failed to recover vasoconstriction developed postoperative oedema. This study shows that the disturbance in postural vasoconstriction can be reversible, probably due to recovery of arteriolar smooth muscle tone, and that patients with persistently disturbed postural vasoconstriction, are prone to develop postoperative oedema.

Adult↗