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PubMed2001

Influence of a visuo-spatial, verbal and central executive working memory task on postural control.

In this study, participants were required to perform different working memory (WM) tasks (a verbal task, a visuo-spatial task with two levels of difficulty and a central executive task) under different challenges to postural control (sitting, shoulder width stance and tandem stance). When a WM task was added, changes in postural sway were characterized by an increase in frequency and decrease in amplitude of sway indicating a tighter control. We found no changes in postural control between the different types of WM tasks, which might support a general capacity limitation hypothesis. However, no changes were found in performance of the WM when postural stance was modified and no changes were found in postural sway, when the difficulty level of the visuo-spatial task was modified. Consequently, the results seem to indicate that the addition of a WM task, regardless of task type or task difficulty, forces the central nervous system to choose a tighter control strategy.

Adult↗
PubMed2001

Postural control and cognitive task performance in healthy participants while balancing on different support-surface configurations.

Postural control during normal upright stance in humans is a well-learned task. Hence, it has often been argued that it requires very little attention. However, many studies have recently shown that postural control is modified when a cognitive task is executed simultaneously especially in the elderly and in the presence of pathology. This study examined postural control modifications when a cognitive task of varying difficulty levels is added. Postural stance difficulty was also varied. Results from this study suggest that a generalized capacity interference may occur due to the larger interference found with the addition of a cognitive task in the more novel and difficult postural task. Because the performance of the cognitive task was tapered by a speed-difficulty trade-off, it was not possible to determine whether a change in the level of difficulty of the cognitive task occurred and if it would produce larger dual-task interference.

Adult↗
PubMed2003

Hand posture modulates neuronal interaction in the primary somatosensory cortex of humans.

OBJECTIVE: To investigate the effects of hand posture on the modulation of neuronal interactions in the cortical finger regions of the human somatosensory cortex. METHODS: Neuronal magnetic fields, evoked by electrical stimuli to the thumb and/or to the index finger of the right hand, were recorded in different hand postures ('OPEN': opened hand and 'CLOSE': both fingers in opposite position to pick up something) by using a whole head type magnetoencephalography. The equivalent current dipole (ECD) for components in the primary (SI) and secondary somatosensory cortices (SII) was calculated. The interaction ratio (IR) was calculated as a ratio of the vector sum of ECD moments evoked by respective stimulation of each finger to the ECD moment evoked by simultaneous stimulation of both fingers. RESULTS: The mean IR of N20m was significantly larger in CLOSE than in OPEN (p=0.033, ANOVA). On the contrary, the IR of P40m was larger in OPEN than in CLOSE (p=0.042). The IR of SII components was not significantly different between the different hand postures (p=0.35). CONCLUSIONS: Neuronal interaction between the thumb and index finger in the human SI is modulated by hand posture. Provided that forming hand posture is related to receiving sensory input, the interaction modulation may play a role in the facilitation of somatosensory processing. SIGNIFICANCE: Our results suggest experimental evidence for the immediate modulation of neuronal activity in the somatosensory area.

Adult↗
PubMed2004

Characteristics of learning voluntary control of posture in lesions of the pyramidal and nigrostriatal systems.

The aim of the study reported here was to investigate impairments on the learning of voluntary control of the center of pressures using visual feedback in patients with lesions of the corticospinal and nigrostriatal systems. Participants were 33 patients with Parkinson's disease and 20 patients with hemipareses due to circulatory lesions in the basin of the middle cerebral artery. Subjects stood on a stabilometric platform and used two computer games over 10 days to learn to shift the body relative to the foot to move the centre of pressures, indicated by the position of a cursor on the screen, with the target and to move the target to a specified part of the screen. The games differed in terms of the postural tasks. In one, the direction of movement of the center of pressures was not known to the subjects, and subjects learned a general strategy for posture control; the other formed a strictly defined postural coordination. Both groups of patients were found to have impairments of voluntary control of the position of the center of pressures. There were no differences between groups of patients, in terms of the severity of the initial performance deficit in the task involving shifts of the center of pressures in different directions (the general strategy for controlling the center of pressures), while learning of this task was more difficult for patients with Parkinson's disease. The initial deficit in the fine postural coordination task was more marked in patients with Parkinsonism, though learning in these patients was significantly better than in patients with hemipareses. It is suggested that the mechanisms of involvement of the nigrostriatal and corticospinal systems in learning the voluntary control of posture have elements in common as well as unique elements.

Adult↗
PubMed1988

Mental and physical stress as moderators of the postural response in insulin-dependent diabetic patients.

Two simple stressors, mental arithmetic and isometric handgrip, were studied as moderators of the physiological response to standing in insulin-dependent diabetic patients and in healthy controls. Continuous (beat-to-beat) measures were taken of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and skin conductance (SC) during postural change under baseline and stressor conditions. Diabetic patients without symptoms of neuropathy and healthy controls showed generally similar responses to postural change and to the stressor conditions. SBP and DBP were more responsive to the mental and physical stressors than were HR or SC, especially after standing. Two diabetic patients with postural hypotension showed significant increases in overall BP levels and less of a fall in BP during postural change under the stressor conditions, despite minimal HR or SC responses. Results indicate that these strategies are effective in increasing BP during postural change in both diabetic and nondiabetic individuals and may be useful in the management of orthostatic hypotension.

Adult↗
PubMed2006

Reduced variability of postural strategy prevents normalization of motor changes induced by back pain: a risk factor for chronic trouble?

Variability is fundamental to biological systems and is important in posturomotor learning and control. Pain induces a protective postural strategy, although variability is normally preserved. If variability is lost, does the normal postural strategy return when pain stops? Sixteen subjects performed arm movements during control trials, when the movement evoked back pain and then when it did not. Variability in the postural strategy of the abdominal muscles and pain-related cognitions were evaluated. Only those subjects for whom pain induced a reduction in variability of the postural strategy failed to return to a normal strategy when pain stopped. They were also characterized by their pain-related cognitions. Ongoing perception of threat to the back may exert tighter evaluative control over variability of the postural strategy.

Back Pain↗
PubMed1990

Respiratory function in patients with spinal cord injuries: effects of posture.

The purpose of this study was to evaluate the respiratory function of spinal cord injuries (SCI) during different postures. Measurements were performed with a Fukuda PM 80 spirometer on 31 chronic stable SCI and 22 normal controls. Among the SCI patients, there were 12 quadriplegics and 19 paraplegics. The respiratory parameters, including forced vital capacity (FVC) and forced expiratory volume during first second (FEV1.0) were collected in each subject during supine, sitting and standing postures. The results revealed that SCI patient had impaired FVCs (p less than 0.05), the degree of impairment depending upon the level of cord injury (r = 0.81). The FEV1.0/FVC ratio of SCI was normal. For quadriplegics, the FVC during sitting and standing fell on 30 to 50% of normal values. The FVCs of paraplegics during all postures were around 80% of the predicted values. The FVC in the control group was reduced by 5 to 7% when changing postures from erect to supine. This study concludes that respiratory impairment does occur in SCI. The results obtained display a typical pattern of restrictive pulmonary impairment. The severity of the impairment is affected by the level of cord damage and is posturally dependent.

Adult↗
PubMed2003

Surgical management of anomalous head posture because of horizontal gaze palsy or acquired vertical nystagmus.

PURPOSE: To confirm the effectiveness of the Kestenbaum-Anderson principle in the surgical management of compensatory head posture because of horizontal gaze palsy and acquired vertical nystagmus. METHODS: Nine patients with anomalous head posture because of horizontal gaze palsy, and four patients with acquired vertical nystagmus and oscillopsia and compensatory torticollis underwent surgery according to the Kestenbaum-Anderson principle. As in the treatment of congenital nystagmus, the eyes have to be shifted in the orbits, in the direction of anomalous head posture. Homonymously based prisms were used preoperatively to assess the potential benefit of surgery. At the time of surgery, the clinical conditions of the patients had been stable for at least 1 year. RESULTS: After surgery, compensatory head posture and visual performances improved in all cases and the results remained stable for at least 2 years. CONCLUSIONS: Contrary to what is generally believed, the ocular condition of the patients with compensatory head posture secondary to neurological causes can be often improved with surgery. The aim of surgery is obviously not to modify ocular motility, but rather to improve the head position.

Adult↗
PubMed1991

Posturally induced microvascular constriction in patients with different stages of leg ischaemia: effect of local skin heating.

1. Skin microcirculation was investigated in 12 asymptomatic subjects and 76 patients, grouped according to their ankle-to-brachial systolic blood pressure index, in order to evaluate to what extent posturally induced microvascular constriction is dependent on the stage of leg ischaemia at different local skin temperatures. 2. Skin microcirculation was assessed in the supine and sitting position by using laser Doppler fluxmetry at unheated skin temperature and at 36 degrees C, and transcutaneous oximetry at 37 degrees C and 44 degrees C. 3. Skin perfusion and oxygenation diminished with decreasing ankle-to-brachial systolic blood pressure index. In healthy control subjects, perfusion and oxygenation were reduced when changing from the supine to the sitting position, but were enhanced in patients with severe leg ischaemia (ankle-to-brachial systolic blood pressure less than 30%), indicating disturbed posturally induced vasoconstriction. 4. Increasing the local skin temperature resulted in a higher perfusion and masked the posturally induced vasoconstriction in healthy subjects. In patients with severe leg ischaemia, however, perfusion was unaltered by the temperature increase, apparently because the microvessels were already maximally dilated. The induction of reactive hyperaemia produced no additional increase in perfusion or oxygenation. 5. It is concluded that posturally induced microvascular constriction in the skin is disturbed in patients with severe leg ischaemia (ankle-to-brachial systolic blood pressure index less than 30%). Disturbed microvascular constriction upon dependency was also seen in healthy subjects after local skin heating. This suggests that posturally induced vasoconstriction is mainly regulated by local mechanisms.

Adult↗
PubMed1999

Posture correction as part of behavioural therapy in treatment of myofascial pain with limited opening.

In this study, we applied cognitive behavioural intervention to subjects who had painful limited mouth opening, with or without posture correction in daily life. The efficacy of non-intervention control was then compared with it in order to study the effectiveness of posture correction as part of a biobehavioural therapy. The visual analogue scale (VAS) value of pain intensity at maximum mouth opening and disturbance in daily life sharply declined in the group which received only cognitive behavioural intervention and those who received it together with posture correction in daily life compared to the non-intervention control group although there was little difference between the intervention groups. Moreover, pain-free unassisted mouth opening was restored earlier in the group which had added posture correction. This suggests that posture correction in daily life has a positive effect in alleviating myofascial pain with limited mouth opening.

Adult↗
PubMed2001

Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan.

OBJECTIVE: To evaluate the effects of coordination exercise on postural stability in older individuals by Chinese shadow boxing, Tai Chi Chuan (TCC). DESIGN: Cross-sectional study. SETTING: Research project in a hospital-based biomechanical laboratory. PARTICIPANTS: The TCC group (n = 25) had been practicing TCC regularly for 2 to 35 years. The control group (n = 14) included healthy and active older subjects. INTERVENTION: Static postural stability test: progressively harder sequential tests with 6 combinations of vision (eyes open, eyes closed, sway-referenced) and support (fixed, sway-referenced); and dynamic balance test: 3 tests of weight shifting (left to right, forward-backward, multidirectional) at 3 speeds. MAIN OUTCOME MEASURES: Static and dynamic balance of Sensory Organization Testing (SOT) of the Smart Balance Master System. RESULTS: In static postural control, the results showed no differences between the TCC or control group in the more simple conditions, but in the more complicated SOT (eyes closed with sway surface, sway vision with sway surface), the TCC group had significantly better results than the control group. The TCC group also had significantly better results in the rhythmic forward-backward weight-shifting test. Duration of practice did not seem to affect the stability of elder people. CONCLUSION: The elderly people who regularly practiced TCC showed better postural stability in the more challenged conditions than those who do not (eg, the condition with simultaneous disturbance of vision and proprioception). TCC as a coordination exercise may reduce the risk of a fall through maintaining the ability of posture control.

Adolescent↗
PubMed2002

Static trunk posture in sitting and standing during pregnancy and early postpartum.

OBJECTIVE: To investigate the postural alignment of the upper body in the sagittal plane during sitting and standing postures as pregnancy progressed and then in the postpartum period. DESIGN: Longitudinal, repeated-measures design. SETTING: Biomechanics laboratory in an Australian university. PARTICIPANTS: A volunteer convenience sample of 9 primiparous and multiparous women and 12 nulliparous women serving as a control group. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects were filmed while sitting and during quiet standing at intervals throughout pregnancy and at 8 weeks postpartum. A repeated-measures analysis of variance was used to assess systematic changes in the alignment of the pelvic, thoracic, and head segments, and the thoracolumbar and cervicothoracic spines. Student t tests were used to compare the postpartum and nulliparous control groups. RESULTS: There was no significant effect of pregnancy on the upper-body posture, although there was a tendency in some subjects for a flatter thoracolumbar spinal curve in sitting as pregnancy progressed. Postpartum during standing, the pelvic segment had a reduced sagittal plane anterior orientation, and the thoracolumbar spine was less extended, indicating a flatter spinal curve compared with the control group. CONCLUSIONS: There was no significant effect of pregnancy on upper-body posture during sitting and standing, although individuals varied in their postural response. A flatter spinal curve was found during standing postpartum.

Adult↗
PubMed2003

Validation of postural radiographs as a way to measure change in pelvic obliquity.

OBJECTIVE: To evaluate the validity of using postural radiographs to assess change in pelvic obliquity. DESIGN: Blinded comparison of reference lines and instrument development of postural radiographs. SETTING: Veterans Administration hospital. PARTICIPANTS: Thirty-nine subjects with no history of low back pain. INTERVENTION: Repeated postural radiographs without heel lifts and with (1/4)-in (6.35-mm) and (1/2)-in (12.7-mm) heel lifts. MAIN OUTCOME MEASURE: The change of pelvic obliquity as measured by the intersulcate, interalar, and sacral surface lines on postural radiographs. RESULTS: A (1/4)-in heel lift resulted in changes of 4.6+/-4.0mm, 3.6+/-3.1mm, and 5.8+/-3.9mm and a (1/2)-in heel lift in changes of 7.8+/-4.3mm, 7.8+/-4.6mm, and 5.2+/-3.8mm for the intersulcate, interalar, and sacral surface lines, respectively. Pearson correlation coefficients were used to correlate the change in pelvic obliquity with the corresponding heights of heel lifts; for the (1/4)-in heel lift, they were.67,.88, and.71, and for (1/2)-in heel lift they were.73,.79, and.87 for the intersulcate, interalar, and sacral surface lines, respectively (all P<.001). CONCLUSION: All the reference lines seem to be valid measures of change of pelvic obliquity relative to the size of the lifts (ie, the changes in pelvic obliquity seem to be causally related and correlated with the lifts). These results also suggest that postural radiographs can be used to determine the magnitude of pelvic obliquity.

Adult↗
PubMed2000

Reflex sympathetic dystrophy: misdiagnosis in patients with dysfunctional postures of the upper extremity.

The purpose of this case-control study was to assess the frequency of the inappropriate diagnosis of reflex sympathetic dystrophy (RSD) in patients who presented with dysfunctional postures of the upper extremity (n = 43). This group of patients with a dysfunctional posture was compared with a randomly selected control group of patients who presented with pain but no dysfunctional posture (n = 88). The patients underwent radiographic evaluation after review of previous medical records and history and physical examination. Patients with dysfunctional postures had a significantly higher frequency (63%) of a previous inappropriate diagnosis of RSD compared with the control group (6%). None of the patients in either group had objective findings consistent with a diagnosis of RSD. Patients presenting with dysfunctional postures of the upper extremity may be misdiagnosed as having RSD and rarely meet the criteria for this diagnosis.

Adolescent↗
PubMed2000

Gait and postural stability in obese and nonobese prepubertal boys.

OBJECTIVE: To examine differences in gait and postural stability of obese and nonobese prepubertal boys. DESIGN: Percentage of gait cycle in double support was examined to determine significant differences. Postural stability was compared using temporal and frequency measures of the center of pressure in static stance. SETTING: Gait was examined using videography on a 30-meter walkway. Postural stability was examined using a measurement platform. PARTICIPANTS: Ten obese (>95th percentile in body mass index) and 10 nonobese (15th to 90th percentile in body mass index) prepubertal boys aged 8 to 10yrs. INTERVENTION: Participants were examined at three walking cadences as determined by preferred gait cadence. Full vision, darkness, and visually confused conditions were used to accentuate static postural stability differences. MAIN OUTCOME MEASURES: In the presence of dynamic stability differences (gait), static stability measures further investigated stability differences. RESULTS: Obese boys spent significantly (p < .02) greater percentage of gait cycle in dual stance. Obese boys showed significantly (p < .01) greater sway areas, energy, and variability primarily in the medial/lateral direction. CONCLUSIONS: Dual stance differences suggest diminished dynamic stability in obese boys. Greater sway areas in medial/lateral direction in obese boys and the absence of significant frequency measures suggest that the instability observed in obese boys is caused by excess weight rather than underlying postural instability.

Child↗
PubMedDate not supplied

[Relationship of an increased internal rotation of the hip with pelvic tilt, spinal alignment and posture - does the so-called antetorsion syndrome exist?].

AIM: A cross-sectional study of pupils should show a possible relation between hip movement, posture and spinal alignment. METHODS: 143 children aged 6 to 17 years were clinically examined with particular respect to internal rotation and extension of the hip, spinal alignment and posture to determine if the so-called antetorsion syndrome exists in children as a remnant of the uprising of man. RESULTS: Internal hip rotation decreased with age without any difference regarding the age between children with and without hip contracture. Children with hip flexion deformity had a significantly higher ability for internal hip rotation (p = 0.0471), but both hip extension and internal rotation were not related to spinal alignment (p = 0.5585/0.5612). On the other hand a normal posture is related with a "normal" back and age (p = 0.0004). The spinal alignment itself did not differ in the age groups. 30 % of the children with sufficient posture and 38 % of the ones with insufficient posture had a hip contracture. The latter showed an increased internal hip rotation by 12 degrees (p = 0.0079). CONCLUSION: On the basis of these results, a relationship between muscular performance, neuromuscular maturity, decreased hip extension and increased internal hip rotation can be assumed. This so-called antetorsion syndrome exists in 20 % of the examined children. A relation to the spinal alignment especially the hollow-round back, cannot be found.

Adolescent↗
PubMedDate not supplied

[The KIL-system for qualitative and quantitative evaluation of posture in lateral view].

AIM: To register also minor variations of posture sa simple and economic procedure should be worked out to categorize posture types concerning quality as well quantity. METHOD: On the Image of the lateral body profile three reference points were determined which allow us to measure two distances and two angles. RESULTS: The relation of the two distances reflects the degree of kyphosis, the angles indicate on the one hand the inclination of the spinal sagittal configuration and on the other hand the degree of lordosis. The measured values are shown in the Kyphosis-Inclination-Lordosis system (KIL system). The components of measurement have proved successful also for static as well as for dynamic posture assessments. The method was simple and economic as postulated. CONCLUSION: The method allowed us to analyse reliably the effect of active primary Intervention also for minor variations in posture on pupils at the age of 11 to 15 over a period of three years. The quantitative analyse made it possible - contrarily to the usual postural types going by what Staffel said - to define subcategories and with it a precise selection of individuals who need a secondary intervention. The method has been set up for check-ups in school, but an application to other groups should be possible.

Anthropometry↗
PubMed2004

Effect of an acute bout of soccer heading on postural control and self-reported concussion symptoms.

Our purpose was to determine if an acute bout of heading soccer balls adversely affected postural control and self-reported symptoms of cerebral concussion. Thirty-one college-aged soccer players were randomly placed into either a kicking group or a heading group. Subjects either kicked or headed 18 soccer balls over the course of 40 minutes. Subjects had their postural control assessed while standing on a force plate and completed a concussion symptoms checklist on three separate occasions: prior to, immediately following, and 24 hours after kicking or heading. There were no significant differences between the heading and kicking groups on the postural control measures prior to, immediately following, and 24 hours after kicking/heading. The heading group did, however, report significantly more concussion symptoms than the kicking group immediately after heading, but not 24 hours after heading. The number of previous concussions sustained by subjects did not influence the effects of heading. An acute bout of soccer heading appears to cause an increase in self-reported symptoms of cerebral concussion lasting less than 24 hours but no quantifiable deficits in postural control. Further research is needed to investigate the cumulative effects of soccer heading on postural control and other objective measures of brain function.

Adult↗