PubMed Health⌕ Search

Biomedical subjects

E A Keshner

Publications and source records attributed to E A Keshner.

26 records · Page 2Linked to original sources

Current concepts of the vestibular system reviewed: 2. Visual/vestibular interaction and spatial orientation.

The vestibular system contributes to the generation of conjugate eye movements, spatial orientation, and postural control. The functional connections of the vestibular end-organs and of the descending vestibulospinal pathways and their importance to postural control were reviewed in the previous paper by Keshner and Cohen (pp. 320-330). This paper reviews the ascending vestibular pathways, the visual/vestibular interactions, and the role of the vestibular system in oculomotor control and spatial orientation.

Eye Movements↗

Neck, trunk and limb muscle responses during postural perturbations in humans.

This study examined the EMG onsets of leg, trunk, and neck muscles in 10 standing human subjects in response to support surface anterior and posterior translations, and to plantar and dorsiflexion rotations. The objective of the study was to test the hypothesis that the responses radiating upward from distal leg muscles represent part of a large ascending synergy encompassing axial muscles along the entire length of the body. If these responses are not ascending, then the muscles of the neck, and possibly the trunk, can be independently activated by vestibular, proprioceptive or visual inputs. We analysed the timing of postural muscle responses within and between body segments in order to determine whether they maintained a consistent temporal relationship under translational and rotational platform movement paradigms. Our results did not strongly support an ascending pattern of activation in all directions of platform perturbation. Temporal differences between activation patterns to platform perturbations in the forward or backward directions were revealed. In response to posterior platform translations we observed an ascending pattern of muscle responses along the extensor surface of the body. In addition, responses elicited in the neck flexor and abdominal muscles occurred as early as those of the stretched ankle muscles. This pattern of upward radiation from stretched ankle muscles was not as clear for anterior platform displacements, where early neck flexor muscle responses were observed during the ascending sequence on the flexor surface of the body. Platform rotations caused fewer responses in the neck and upper trunk muscles than translations, and all muscles responses occurred simultaneously rather than sequentially. Probable differences in the stimulation of vestibular and neck proprioceptive inputs and the mechanical demands of the rotation and translation paradigms are discussed.

Adult↗

Postural coactivation and adaptation in the sway stabilizing responses of normals and patients with bilateral vestibular deficit.

The experiments were designed to test two hypotheses and their corollaries: 1. That adaptation of EMG responses to support surface rotations is due to a decrease in the gain of proprioceptively triggered long-loop stretch reflexes (Nashner 1976), and that the adaptation is dependent on a normally functioning vestibular system (Nashner et al. 1982); 2. That EMG responses to rotations are generated primarily by vestibulo-spinal reflexes triggered by head accelerations (Allum and Pfaltz 1985) and comprise a coactivation of opposing leg muscles (Allum and Büdingen 1979). Adaptation with successive dorsi-flexive rotations of the support surface was investigated in the EMG responses of the ankle muscles, soleus (SOL) and tibialis anterior (TA), as well as the neck muscles, trapezius (TRAP) and splenius capitis (SPLEN CAP), both for normal subjects and for patients with bilateral peripheral vestibular deficit. Both normals and patients who first received the stimulus with their eyes open demonstrated decreasing activation at medium latency (ML), that is, with an onset at about 125 ms, and long latency (LL) responses with an onset ca 200 ms. This was the case for both ankle and neck muscles when the EMG response areas for the first 3 and second 7 of 10 trials were compared. Ankle muscle responses in the patients were diminished in area with respect to normals both with the eyes open and with the eyes closed. Ankle torque recordings from the patients were also smaller in amplitude, and these attenuated differently from normal torque responses. Functional coupling of the opposing ML and LL SOL and TA muscle responses was confirmed by the nearly coincident onset times and significantly correlated EMG response areas. At ML, ankle torque was highly correlated with TA activity when the influence of SOL was controlled. At LL, SOL activity was highly correlated with torque when the influence of TA was controlled. The delay of torque adaptation beyond the period of ML activity in normals, but not in the patients was attributed to the proportionally balanced coactivated muscle patterns producing a consistent force output and level of stability in normals. The results indicate that the adaptation in EMG response amplitudes during a sway stabilisation task is not dependent on a normally functioning vestibular system nor on visual inputs but rather appears to be due to a generalized habituation in the postural control system.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Reevaluating the theoretical model underlying the neurodevelopmental theory. A literature review.

The purpose of this paper is to evaluate the foundations of prevalent physical therapy technique based on the current research on motor control. The conceptual framework of the neurodevelopmental theory, as described in the writings of the Bobaths, is presented. Their explanations of central nervous system disorders and recommendations for intervention are based upon a unidirectional model of the nervous system in which postural and voluntary motion become two separate and distinct entities. Systems theory is an alternative model of nervous system structure. In systems theory, the organism is a circular network of interacting yet autonomous subsystems, rather than a vertical structure of descending controls. Relevant research that supports the systems viewpoint is discussed and applied to the theories in the neurodevelopmental approach. Thus, another model is offered for understanding the functioning of the central nervous system when it is intact and when it is in a pathological state.

Animals↗

Indicators of the influence a peripheral vestibular deficit has on vestibulo-spinal reflex responses controlling postural stability.

For a controlled sway stabilization task, the areas underlying EMG responses in ankle and neck muscles, as well as amplitudes of ankle torque responses, were shown to be significantly correlated with the clinically defined extent of a patient's peripheral vestibular deficit. The responses, elicited by ankle dorsiflexion of the support surface on which the subject stood, were statistically examined in order to select those measurements which would best indicate differences between a normal, a patient with a unilateral deficit, or one with a bilateral deficit. For this purpose, a stepwise discriminant analysis was performed on measurements of head and trunk angular accelerations in addition to muscle EMG and ankle torque signals. The primary measurements selected to optimally assign a subject to a population were the periods of ankle torque and neck extensor activity associated with correcting for the imposed body displacement backwards and maintaining upright head position respectively. The resulting division into populations was 100% correct. However, within the population of unilateral deficit patients, the technique failed to correctly identify those with acute from those with compensated deficit. This technique of investigating vestibulo-spinal reflex responses is more specific and sensitive than Romberg tests, because it will quantify and specify the underlying cause of the patient's balance and ambulatory disorder.

Adult↗