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PubMed2007

Multisensory information for postural control: sway-referencing gain shapes center of pressure variability and temporal dynamics.

The authors investigated the multisensory control of posture by altering sensory information across the visual and somatosensory systems. The support surface and visual surround were sway-referenced to anterior/posterior center of mass sway and the gain between postural sway and degree of sway referencing was manipulated (gain settings were 0.2, 1.0, and 1.8). These alterations in the sensory environment lead to observed changes in the temporal structure of the center of pressure (COP) trajectories. COP path length increased across gain settings while COP coefficient of variation decreased. The COP became increasingly more deterministic across more challenging sensory organization test (SOT) conditions and with increasing gain, and more nonstationary across more challenging SOT conditions and when the support surface was sway-referenced using a 1.8 gain setting. These findings indicate that changes in the responsiveness of the support surface and/or visual surround within each of the sway-referenced SOT conditions had functional consequences for the control of posture as evidenced by the variations in postural sway dynamics.

Adolescent↗
PubMed2006

Differential integration of kinaesthetic signals to postural control.

The purpose of the present experiment was to identify whether non-visual sensory cues involved in the maintenance of balance control could be weighted differently from one subject to another in condition during which kinaesthetic signals, stemming from the ankle proprioceptors and plantar pressure somatosensory sensors, were altered. A large population of blindfolded healthy young university students (n = 140) were asked to sway as little as possible on: (1) a firm support (Firm condition) and (2) an unstable support used to impair the exploitation of the kinematic ankle proprioceptive and plantar pressure somatosensation (Foam condition). Centre of foot pressure (CoP) displacements were recorded using a force platform. Analyses of the surface area, range, and mean velocity of the CoP displacements showed significant negative correlations between the postural sway observed in the Firm condition and the increase in postural sway observed in the Foam condition. In other words, the alteration of ankle proprioception had a greater destabilising effect in subjects exhibiting the smallest CoP displacements when standing in a normal proprioception condition. The present findings suggest that the exploitation of the kinaesthetic relationships to postural control varied from one subject to another, hence evidencing the need to introduce differential approach to assess the general impact of preferential modes of spatial referencing in postural control.

Adult↗
PubMed1998

Control of reactive balance adjustments in perturbed human walking: roles of proximal and distal postural muscle activity.

Studies on the proactive control of gait have shown that proximal (hip/trunk) muscles are the primary contributors to balance control, while studies on reactive balance control during perturbed gait, examining only activity in distal (leg/thigh) muscles, have shown that these muscles are important in compensating for a gait disturbance. This study tested the hypothesis that proximal muscles are also primary contributors to reactive balance control during perturbed gait. Thirty-three young adults participated in a study in which an anterior slip was simulated at heel strike by the forward displacement of a force plate on which they walked. Surface electromyographic data were recorded from bilateral leg, thigh, hip and trunk muscles. Kinematic data were collected on joint angle changes in response to the perturbation. The results did not support the hypothesis that the proximal muscles contribute significantly to balance control during perturbed gait. The proximal muscles did not demonstrate more consistent activation, earlier onset latency, longer burst duration or larger burst magnitude than distal muscles. Moreover, although proximal postural activity was often present in the first slip trial, it tended to adapt away in later trials. By contrast, the typical postural responses exhibited by young adults consisted of an early (90-140 ms), high-magnitude (4-9 times muscle activity during normal walking) and relatively long duration (70-200 ms) activation of bilateral anterior leg muscles as well as the anterior and posterior thigh muscles. Thus, postural activity from bilateral leg and thigh muscles and the coordination between the two lower extremities were the key to reactive balance control and were sufficient for regaining balance within one gait cycle. The adaptive attenuation of proximal postural activity over repeated trials suggests that the nervous system overcompensates for a novel balance threat in the first slip trial and fine-tunes its responses with experience.

Adult↗
PubMed1998

Development of postural control of gravity forces in children during the first 5 years of walking.

The aim of this work was to propose developmental indexes relative to the control of balance and gravity forces, using force-plate data, for children in their first 5 years of independent walking. The first part of this paper is devoted to the definition of an index to quantify postural capacity during walking. Based on the assumption that the vertical acceleration of center of mass (CM) reflects the capacity of muscular forces between the head-arms-trunk and the stance leg segments to control the external forces, the value of the CM vertical acceleration at foot contact is proposed as a developmental index of the postural capacity of the child to control gravitational forces. This index was analyzed longitudinally in five children, over the course of eight experimental sessions. The children were examined during their first 5 years of independent walking (for a total of 457 step sequences). The covariation between the CM vertical acceleration at foot contact and the gait velocity was considered as a second index characterizing the development of coordination between the postural and dynamic requirements of body progression. From these indexes it was established that the postural capacity needed just to control balance with the leg muscles was not attained before 4-5 years of independent walking, i.e., at about 5-6 years of age.

Acceleration↗
PubMed1998

Role of vestibular information in initiation of rapid postural responses.

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

Adult↗
PubMed1999

Long-term adaptation of postural control in microgravity.

Orbital microgravity represents a unique environment, which allows the isolation of variables assumed to be involved in the mechanism of body positioning in space. In this context, the alignment of the trunk axis along allocentric references and the positioning of the body center of mass inside the supporting base compete for the role of the primary-controlled variable when assuming erect posture. This paper reports the quantitative evaluation of the postural strategies exhibited by two subjects with feet fixed to the floor of the space module along a 4-month period of exposure to microgravity. With respect to previous findings in parabolic flights and short term space missions, the analysis focused on long-term process of sensorimotor adaptation to weightlessness. Results show that while trunk-axis orientation is preserved and used as a stable postural frame of reference, the positioning of the body center of mass appears to be significantly biased backward and turns out to be involved in a long-term process of adaptation throughout the entire flight towards the re-emergence of a typically terrestrial postural regulation compatible with equilibrium.

Adult↗
PubMed2006

Increasing postural sway in rural-community-dwelling elderly persons with knee osteoarthritis.

BACKGROUND: The purpose of this study was to clarify the influence of pain and radiographic findings of osteoarthritis (OA) of the knee on postural stability in rural-community-dwelling elderly persons. METHODS: A total of 314 participants, consisting of 98 men and 216 women, aged 55 to 83 years, were investigated. Subjects were classified into four groups according to the symptoms and radiographic findings: Normal; Pain (pain without radiographic OA); Asymptomatic OA (radiographic OA without pain); Symptomatic OA (pain with radiographic OA). Knee pain was defined as unilateral or bilateral pain of the knee that had persisted for more than 1 month. Radiographic OA was defined as grades 2-4 according to the Kellgren and Lawrence criteria. The movement of the center of pressure (COP) was measured using a force platform to quantify postural sway. RESULTS: Among the men, subjects in the Asymptomatic and Symptomatic OA groups showed higher values of the envelopment area tracing by the movement of the COP (E AREA) and the distance of the movement of the COP per second (LNG/TIME) under closed-eyes condition. Among the women, subjects in the Asymptomatic and Symptomatic OA groups showed higher values of E AREA and LNG/TIME under both open- and closed-eyes conditions. In the regression models consisting of the variables pain and radiographic OA, all estimates for pain were less than zero in both sexes. The value was significant only on the E AREA under closed-eyes conditions in women. On the other hand, all estimates for radiographic OA were higher than zero for both sexes. These values were significant for E AREA and LNG/TIME under open-eyes conditions in women, and E AREA and LNG/TIME under closed-eyes conditions in both sexes. CONCLUSIONS: Subjects with OA showed greater postural sway than those without it. Only radiographic OA was a significant factor for increasing postural sway.

Aged↗
PubMedDate not supplied

Nonstationary properties of postural sway.

Postural sway during quite stance is usually assumed to be a stationary stochastic process. We tested this assumption by investigating the time invariance of the average value and variance of the postural sway of three subjects. The sway was measured with a force plate under three conditions: subject standing on two feet with eyes open; subject standing on two feet with eyes closed; and subject standing on one foot with eyes open. Data were collected in 1 min runs. More than 50 min of data were collected for each subject under each test condition. The data were averaged across all runs for each subject and condition. Trends were found to be present in the data. In addition, there were initial transient increases in the second-order moments about the trends. The transient changes in first- and second-order moments usually disappeared during the first 20 s. In light of these findings, we can reject the hypothesis that postural sway is a stationary process. The results imply that the usual methods to parameterize postural sway have to be either changed or reinterpreted.

Adult↗
PubMedDate not supplied

Components of postural dyscontrol in the elderly: a review.

The concept of a generalized aging effect on a generalized balance mechanism is discussed, and an alternative, multicomponent approach to understanding the heterogeneity of postural dyscontrol in the elderly is presented. Neural sensorimotor components of normal postural control mechanisms are identified and discussed. The effects of Parkinson's disease, hemiplegia, cerebellar degeneration, peripheral vestibular loss, and other disorders on the components of postural control are summarized. Quantitative posturography is advocated to detect preclinical manifestation of multiple musculoskeletal and neuromuscular pathologies and reduced compensatory abilities in posturally unstable elderly adults.

Aged↗
PubMed1992

Postural instability in Parkinson's disease.

Postural instability is one of the most disabling features of Parkinson's disease. Many factors contribute to balance impairment of Parkinson patients, including disturbed postural reflexes and poor control of voluntary movement. Additional factors which place Parkinson patients at risk for falls are side-effects of medication (dyskinesias), the poor response of postural instability to antiparkinsonian medication, orthostatic hypotension, gait abnormalities, muscular weakness in leg muscles and superimposed age-related changes such as reduced peripheral sensation. Future studies should not only investigate means of preventing falls in unstable patients, but should also be directed towards development of new treatment. Because accumulating evidence indicates that postural instability is at least partially related to non-dopaminergic lesions, these novel therapeutic approaches should be aimed at overcoming non-dopaminergic neurotransmitter deficiencies.

Humans↗
PubMed1992

Do fast voluntary movements necessitate anticipatory postural adjustments even if equilibrium is unstable?

Anticipatory postural adjustments (APA) were studied in maximum velocity flexion of lower limb from two initial postures, a bipedal stance (Fbu) and unipedal stance (Fuu). In Fbu, the dynamics of center of gravity (CG) and ankle and hip muscle EMG activity showed large APA. In contrast, in Fuu there were no APA, the CG dynamics and the ankle EMG activity started at the same time as the intentional movement while the hip EMG activity started some 30 ms before the thigh flexion. The knee flexion velocity was lower in Fuu than in Fbu (7 rd/s versus 12 rd/s). These results suggest that fast voluntary movements do not require APA when the postural equilibrium is unstable, and that an alternative strategy is used. The absence of APA in Fuu, in contrast to the presence of APA in Fbu, suggests that the postural command and the focal one are time-locked and organized in a parallel process.

Electromyography↗
PubMedDate not supplied

Use of a computerized postural sway measurement system for neurobehavioral toxicology.

The study of standing posture has been associated with nervous system functioning for over a hundred years. Measures of human standing ability have attracted some attention as indicators of neurotoxic insult. The use of postural sway measures as subclinical indicators of toxicity has not been regularly incorporated into most neurobehavioral test batteries, but the development of microcomputer-controlled systems offers new possibilities. The mechanisms involved in controlling postural sway are discussed, as well as the various measurement techniques. In addition, studies involving the effects of some neurotoxic agents are cited. A postural sway measurement system that is noninvasive, has 1-2-minute test periods, provides immediate test results, and is relatively free of practice and motivation effects is described. Results present the normative characteristics of the sway parameters, a comparison of three data transformation techniques, and the effects of height and weight on the sway parameters. Power calculations were also performed to estimate the number of subjects needed to detect effects at both the 80% and 90% power levels.

Adolescent↗
PubMed2005

Effects of carried weight on random motion and traditional measures of postural sway.

The purpose of the study was to investigate the effects of load weight carried by soldiers upon postural sway. Fourteen US Army enlisted men participated. Postural sway and muscle activity were measured while participants stood on a force plate. The load weight conditions, comprised of Army clothing and load-carriage equipment were 6, 16, and 40 kg. With an increase in load weight, stabilogram-diffusion analysis revealed that random movement of postural sway decreased. Also, with an increase in load weight, center of pressure excursions increased linearly but muscle activity changed minimally. In short, increasing load weight challenged the load carriers' stability, reduced the randomness of postural sway and required the load carriers to exert greater control of the load in order to maintain balance.

Adolescent↗
PubMed2005

Postural steadiness and weight distribution during tandem stance in healthy young and elderly adults.

BACKGROUND: Tandem stance is a clinical measure of standing balance considered to assess postural steadiness in a heel-to-toe position by a temporal measurement. To our knowledge, no studies have evaluated the change of postural steadiness, expressed as force variability, over time. The objective of this paper is to investigate postural steadiness during 30 s of tandem stance in healthy elderly and young adults, and to explore the weight distribution between legs during tandem stance. METHODS: A cross-sectional analysis comparing ground reaction forces and muscle activity in 26 healthy elderly adults (mean age 70.6 years) and 27 healthy young adults (mean age 30.0 years). Ground reaction forces beneath both feet and muscle activity of ankle muscles were recorded while the subjects performed 30 s of tandem stance during two conditions. FINDINGS: Two phases were identified in both groups: First a dynamic phase, a decrease in force variability during the first 3-4 s after foot placement, and thereafter a static phase, maintaining a certain level of force variability. Age-related changes were seen in the decrease in force variability (P<0.001) and ankle muscle activity (P<0.001). However, both groups placed more weight on the rear leg (P<0.001). INTERPRETATION: The first few seconds of tandem stance pose the greatest challenge to postural steadiness and influence the static phase. We suggest that the dynamic phase is the most crucial period of time for assessing balance requirements. Independent of age, tandem stance is not a task for equal weight bearing.

Adult↗
PubMed2005

Vertical torque allows recording of anticipatory postural adjustments associated with slow, arm-raising movements.

BACKGROUND: When performed in the upright position, voluntary arm-raising movements perturb balance. The maintenance of equilibrium requires postural adjustments, some of which can be anticipatory. It is usually suggested that the role of anticipatory postural adjustments is to stabilise the whole body centre of mass. During movements performed at low velocity (i.e. with a lower inertial perturbation), anticipatory postural adjustments have not systematically been detected by classical recording methods (mainly electromyography). The aim of this study was to use vertical torque to characterise anticipatory postural adjustments in slow movement and to determine the significance of this biomechanical parameter. METHODS: Twenty healthy subjects performed self-paced, right arm-raising movements at low and high velocities. Movements were recorded by an optoelectronic system enabling the synchronization of video, force plate and electromyographic data. The force platform provided information on vertical torque and centre of foot pressure anteroposterior displacement. Electromyography activity was recorded from the right anterior deltoid and the bilateral biceps femoris, tibialis anterior and soleus muscles. FINDINGS: Rapid, voluntary, unilateral movements were associated with an early centre of pressure backward shift, anticipatory vertical torque and electromyographic activities. In slow movements, only the anticipatory changes in vertical torque were consistently observed, with the same latency as in rapid movement. INTERPRETATION: The existence of vertical torque in slow movement (when stabilisation of the centre of mass is not necessary) shows that this parameter does not serve to minimise the centre of mass displacement but rather contributes to the generation of arm movement.

Adaptation, Physiological↗
PubMed2006

Torque and EMG in rotation extension of the torso from pre-rotated and flexed postures.

BACKGROUND: Back injury is a common place in our society. Up to two-thirds of back injuries have been associated with trunk rotation. However, the torque production ability with a rotated spine and electromyographic activity of trunk muscles in such efforts is poorly understood. Therefore, the objectives of this study are to study torque production capacity of variously rotated and flexed trunk and to measure the EMG of selected trunk muscles in these activities. METHODS: Nineteen normal young subjects (7 males and 12 females) were recruited. Subjects were stabilized on a posture-stabilizing platform and were instructed to assume a flexed and right rotated posture (20 degrees , 40 degrees and 60 degrees of rotation and 20 degrees , 40 degrees and 60 degrees of flexion) in a random order. The subjects were asked to exert their maximal voluntary contraction in the asymmetric plane of rotation-extension for a period of 5s. The surface EMG of the external and internal obliques, rectus abdominis, latissimus dorsi, erector spinae at the 10th thoracic and 3rd lumbar vertebral levels was recorded bilaterally along with the torque generated. FINDINGS: Whereas the torque generated was significantly affected by both rotation and extension in both genders (P<0.001), the EMG was independent of rotation but affected by flexion in females only (P<0.01). The torques produced by both genders in each of the nine postures was significantly different from each other (P<0.001). The EMG demonstrated a trend of increase with increasing rotation and flexion. The response surfaces of normalized peak EMG of the right external oblique and internal oblique was somewhat similar, indicating a rotator torque and a stabilizing effect. The left latissimus dorsi and right external oblique provided the rotational torque and the right erector spinae provided the extensor effort. Since the rotation-extension was performed in the plane of asymmetry, the effort required the recruitment of muscles involved in left rotation, stability of rotated spine and an extensor effort. INTERPRETATION: The torque production capacity of the human trunk is posture dependent and declines with increasing rotation. However, with increasing rotation and flexion, the magnitude of EMG increases. This implies that with increasing asymmetry, it requires more muscle effort (thus tissue stress) to generate less torque. Increasing asymmetry tends to weaken the system and may enhance chances of injury.

Abdomen↗
PubMed2006

The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke.

Due to motor and sensory deficits in individuals with stroke, we proposed that they must compensate for these impairments during standing with greater dependence on vision. In addition, we hypothesized that asymmetric weight-bearing, which occurs following stroke, is related to increased postural sway and those with greater asymmetry will have greater reliance on vision. Twenty-eight individuals with stroke and 28 healthy older adult controls stood quietly with eyes open (EO) or closed on a force platform while postural sway was quantified by centre of pressure measures and weight-bearing asymmetry was calculated from vertical ground reaction forces. To determine the influence of vision on postural sway, a visual ratio (eyes open/eyes closed (EC)) was calculated for the sway measures. The results demonstrated that individuals with stroke had greater visual dependence for the control of postural sway velocity in the medial-lateral (ML), but not anterior-posterior (AP) direction, compared to controls. Further, we found that greater asymmetry was moderately related to increased medial-lateral sway for the individuals with stroke. Contrary to predictions, those individuals with stroke with mild asymmetry had greater visual dependence than those with more severe asymmetry.

Case-Control Studies↗
PubMed2006

Postural sway and joint kinematics during quiet standing are affected by lumbar extensor fatigue.

The purpose of this study was to investigate changes in postural sway and strategy elicited by lumbar extensor muscle fatigue. Specifically, changes in center of mass (COM), center of pressure (COP), and joint kinematics during quiet standing were determined, as well as selected cross correlations between these variables that are indicative of movement strategy. Twelve healthy male participants stood quietly both before and after exercises that fatigued the lumbar extensors. Whole-body movement and ground reaction force data were recorded and used to calculate mean body posture and variability of COM, COP, and joint kinematics during quiet standing. Three main findings emerged. First, participants adopted a slight forward lean post-fatigue as evidenced by an anterior shift of the COM and COP. Second, post-fatigue increases in joint angle variability were observed at multiple joints including joints distal to the fatigued musculature. Despite these increases, anterior-posterior (AP) ankle angle correlated well with AP COM position, suggesting the body still behaved similar to an inverted pendulum. Third, global measures of sway based on COM and COP were not necessarily indicative of changes in individual joint kinematics. Thus, in trying to advance our understanding of how localized fatigue affects movement patterns and the postural control system, it appears that joint kinematics and/or multivariate measures of postural sway are necessary.

Adult↗