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PubMed1996

The effects of the saddle seat on seated postural control and upper-extremity movement in children with cerebral palsy.

A repeated-measures experimental cross-over study was conducted with school-aged children with spastic cerebral palsy (spastic CP) to compare the effects of flat-bench versus saddle-bench seating on postural control and reaching motions. The saddle bench allowed significantly better postural control as measured by the clinical rating scale Sitting Assessment for Children with Neuromotor Dysfunction and by a study-defined variable, Spinal Extension. No statistically significant differences were found for any other variables using aggregate data-analysis techniques. However, the group results and those of single-subject data analysis suggest that the saddle seat may help such children to develop and maintain seated postural control and upper-extremity movement patterns.

Arm↗

PubMed1999

Development of hindlimb postural control during the first postnatal week in the rat.

The development of the postural control of hindlimbs was investigated during the first postnatal week in the rat. The whole body was tilted in a vertical plane with the nose up. The proportion of animals producing a complete extension of both hindlimbs increased with age until the end of the first postnatal week. Motor responses were evoked by the pitch tilt already at birth with a slight extension of the hips, the knees and the ankles remaining bent in most cases. The extension produced at the ankle level increased gradually during the first postnatal week. This was correlated with a change in the EMG activity recorded from the triceps surae muscles (ankle extensors) during this postural reaction. There was a gradual acquisition of a tonic pattern. Characteristics of EMG responses changed significantly with age demonstrating an important increase in the use of triceps surae muscles in this postural task. These data demonstrate that the first postnatal week is a critical period for the development of postural reactions in the hindlimbs. They also suggest the existence of a proximo-distal gradient in the maturation of postural control. The mechanisms responsible for this reflex and for the maturation of posture are discussed.

Action Potentials↗

PubMed2005

Long-term exposure to solvents impairs vigilance and postural control in serigraphy workers.

OBJECTIVES: To investigate the effects of solvent exposure (mainly aromatic hydrocarbons) on central regulation of vigilance and postural control, particularly in occasional difficult situations that provide sensorial conflicts. METHODS: Twenty-two workers occupationally exposed to solvents for an average of approximately 6 years and 21 controls were compared by the use of a questionnaire on their state of vigilance and quality of sleep and on performance measurements of postural control under six different sensorimotor conditions. Their current median exposure levels to aromatic hydrocarbons was 80.1 mg/m(3). RESULTS: Exposed workers reported reduced alertness but not disturbance of sleep quality compared with controls. Moreover, they had the worst postural performance in all sensory conditions and demonstrated a reduced ability to resolve sensory conflict situations. The precision of stance was clearly affected by solvent exposure in contrast with energy consumption required to regulate proper balance control. CONCLUSIONS: The depressive effect of aromatic hydrocarbon exposure on cortical and subcortical structures controlling vigilance and postural stability could lead to increased risk of occupational accident, especially due to falls. The detection of central neurotoxic effects by posturographic and vigilance tests could be useful in preventive strategies.

Adult↗

PubMedDate not supplied

Effects of different treatments on postural performance in patients with cervical root compression. A randomized prospective study assessing the importance of the neck in postural control.

Patients with cervical root compression were used as a "model" to investigate the possible importance of neck disorders and cervical sensory information in postural control. We assessed postural performance with posturography before and after treatment in 71 consecutive patients with MRI-verified cervical root compression without medullary compression. The patients were randomized to surgery (n = 22), physiotherapy (n = 24) or treatment with cervical collars (n = 25). There were no differences in postural performance or pain intensity between the groups before treatment. After treatment, the surgery group manifested significant improved postural performance and reduced neck pain scores, as compared to the two conservative treatment groups, and their postural performance had improved to the same level manifested by healthy controls. The conservative treatment groups manifested no consistent significant changes in postural performance or pain scores. Decreased muscular tension due to reduction of cervical pain after surgery and normalization of cervical proprioception are suggested as possible explanations of the improved postural control.

Female↗

PubMed2002

Effects of lifetime ethanol consumption on postural control: a computerized dynamic posturography study.

The relationship between lifetime alcohol consumption and postural control was investigated in 35 subjects with no clinically-detectable neurologic abnormalities, using computerized dynamic posturography (CDP) procedures. The estimated total number of lifetime alcoholic drinks was positively correlated with anteroposterior sway spectral power within the 2-4 Hz and 4-6 Hz frequency bands, in three Sensory Organization Test (SOT) conditions: eyes closed with stable support surface (SOT 2), eyes open with sway-referenced support (SOT 4), and eyes closed with sway-referenced support (SOT 5). All correlations remained significant after controlling for subject age, and were increased after excluding nine drug-abusing subjects. In contrast to the strong findings for frequency-based measures, no correlation was observed using conventional amplitude-based sway measures. These results suggest that 1) alcohol consumption compromises postural control in an exposure-dependent manner, and 2) sway frequency analysis reveals pathological processes not manifested in conventional CDP measures of sway amplitude.

Adult↗

PubMed1977

The role of the electrosensory system in postural control of the weakly electric fish Eigenmannia virescens.

The role of the electrosensory inputs in postural control was examined in the weakly electric fish Eigenmannia virescens. These fish exhibit tonic postural tilt in response to a tilted plexiglas substrate in both transverse and longitudinal planes (rolling and head-up pitching responses, respectively), but not to electrically "transparent" agar substrate. The fish's pitching and rolling responses were abolished when the electrosensory inputs from the trunk were bilaterally eliminated even though the fish's visual and mechanosensory lateral-line systems remained intact. Unilateral lesion abolished the rolling response but not the pitching response. These results demonstrate the functional role of the electrosensory system in postural control, in addition to its known role in social communication and in object location, and the underlying neuronal mechanism is discussed.

Animals↗

PubMed1990

Anticipatory postural control in children.

Postural responses, triggered by sensory feedback, are present very early in a child's development. The purpose of the present study was to investigate the ability of children to anticipate postural disturbances caused by self-initiated movements and their ability to coordinate anticipatory postural adjustments with movement execution. Children (N = 32) aged 4 to 14 years were asked to stand quietly on a stable force plate and to raise their right arm forward (or backward) to the horizontal position after a visual stimulus. Changes in the center of pressure beneath the feet were recorded before and during the arm raise. The anticipatory (feedforward) postural patterns seen before the arm movement, and noted in a previous study of adults, were present in the youngest of the children (4 years, 2 months). Longer reaction times and inconsistent postural responses (in the anteroposterior direction) suggest that children are less capable than adults of coordinating the anticipated postural adjustment with the forthcoming limb movement, however. In the lateral plane, anticipatory postural responses were initiated more consistently.

Journal Article↗

PubMed2002

Postural control during lifting.

Any voluntary motion of the body causes an internal perturbation of balance. Load transfer during manual material handling may increase these perturbations. This study investigates effects of stance condition on postural control during lifting. Nineteen healthy subjects repeatedly lifted and lowered a load between a desk and a shelf. The base of support was varied between parallel and step stance. Ground reaction force and segmental kinematics were measured. Load transfer during lifting perturbed balance. In parallel stance postural response consisted of axial movements in the sagittal plane. Such strategy was accompanied by increased posterior shear forces after lift-off. Lifting in step stance provided extended support in anterior/posterior direction. The postural control mechanisms in the sagittal plane are less complex as compared to parallel stance. However, lifting in step stance was asymmetrical and thus accompanied by distinct lateral transfer of the body. Lateral shear forces were larger as compared to parallel stance. Both lifting techniques exhibit positive and negative aspects. We cannot recommend either one as being better in terms of postural control.

Adult↗

PubMed2003

Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke.

BACKGROUND: There are a number of different approaches to physiotherapy treatment following stroke. Central to these are approaches based on 'neurophysiological' principles, 'motor learning' principles and 'orthopaedic' principles. OBJECTIVES: To determine if there is a difference in the recovery of postural control and lower limb function in patients with stroke if physiotherapy treatment is based on orthopaedic or neurophysiological or motor learning principles, or on a mixture of these treatment principles. SEARCH STRATEGY: This review drew on the search strategy developed by the Stroke Group as a whole. Relevant trials were identified in the Stroke Group Trials Register of Controlled Trials which was last searched in May 2001. We also searched the Cochrane Controlled Trials Register (Cochrane Library, Issue 4 1999), MEDLINE (1966-1999), EMBASE (1980-1999) and CINAHL (1982-1999) and contacted experts and researchers with an interest in stroke. SELECTION CRITERIA: Studies - randomised or quasi-randomised controlled trials. Participants - adults with a clinical diagnosis of stroke. Interventions - physiotherapy treatment approaches aimed at promoting the recovery of postural control and lower limb function. Outcomes - measures of disability, motor impairment or participation. DATA COLLECTION AND ANALYSIS: Two independent reviewers categorised the identified trials according to the inclusion/exclusion criteria, documented the methodological quality and extracted the data. MAIN RESULTS: Eleven trials were included in the review, three of which were included in two comparisons. Four trials compared a neurophysiological approach with another approach; four trials compared a motor learning approach with another approach; four studies compared a mixed approach with another approach; two trials reported comparisons of sub-groups of the same approach. A large number of heterogeneous outcome measures were used, limiting the comparison of trial results. No one type of approach had a significantly better outcome than any other type of approach. REVIEWER'S CONCLUSIONS: There is insufficient evidence to conclude that any one physiotherapy treatment approach is more effective than another in promoting the recovery of postural control or lower limb function.

Adult↗

PubMed1998

Postural control in benign paroxysmal positional vertigo before and after recovery.

Thirty-two patients affected by idiopathic benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal were studied before, 3 days and I month after a resolutive Semont manoeuvre by means of dynamic posturography. The overall postural control in BPPV patients was shown to be impaired, as demonstrated by the pathological equilibrium scores. Data obtained before treatment showed a specific pattern of vestibular involvement and a pathological composite score. After the liberatory manoeuvre the Sensory Organization Test indicated a significant improvement in the pathological composite and vestibular scores. However, significant differences from controls were still detected 3 days and 1 month after clinical recovery from BPPV. The results clearly show that, in BPPV patients, there is an impairment of the vestibular system, which seems unable to maintain a normal postural balance. This deficit can be particularly detected when dynamic posturography evaluates the vestibular cues. After the liberatory manoeuvre a consistent improvement in the overall postural control has been observed but the residual differences from controls seem to suggest that damage to the otoconial maculae influences postural control, even when there is significant improvement in the clinical signs.

Analysis of Variance↗

PubMed2004

A new interpretation of spontaneous sway measures based on a simple model of human postural control.

This study shows that center-of-pressure (COP) traces that closely resemble physiologically measured COP functions can be produced by an appropriate selection of model parameters in a simple feedback model of the human postural control system. Variations in the values of stiffness, damping, time delay, and noise level determine the values of 15 sway measures commonly used to characterize spontaneous sway. Results from model simulations indicate that there is a high degree of correlation among these sway measures, and the measures cluster into three different groups. Only two principal components accounted for about 92% of the variation among the different sway measures analyzed. This model can be used to formulate hypotheses regarding the cause of postural control deficits reported in the literature. This is accomplished using a multidimensional optimization procedure to estimate model parameters from a diverse set of spontaneous sway measures. These model parameters describe physiologically meaningful features of the postural control system as opposed to conventional sway measures that provide only a parametric description of sway. To show the application of this method, we applied it to published data of spontaneous sway from elderly subjects and contrasted it to the data of young healthy subjects. We found that modest increases in stiffness and damping and a fairly large increase in noise level with aging could account for the variety of sway measures reported in the literature for elderly subjects.

Age Factors↗

PubMed1995

The effects of visual input on open-loop and closed-loop postural control mechanisms.

In an earlier posturographic investigation (Collins and De Luca 1993) it was proposed that open-loop and closed-loop control mechanisms are involved in the regulation of undisturbed, upright stance. In this study, stabilogram-diffusion analysis was used to examine how visual input affects the operational characteristics of these control mechanisms. Stabilogram-diffusion analysis leads to the extraction of repeatable center-of-pressure (COP) parameters that can be directly related to the resultant steady-state behavior and functional interaction of the neuromuscular mechanisms underlying the maintenance of erect posture. Twenty-five healthy male subjects (aged 19-30 years) were included in the study. An instrumented force platform was used to measure the time-varying displacements of the COP under each subject's feet during quiet standing. The subjects were tested under eyes-open and eyes-closed conditions. The COP trajectories were analyzed as one-dimensional and two-dimensional random walks, according to stabilogram-diffusion analysis. Using this technique, it was found that visual input affects the performance of the postural control system in one of two different ways--either it significantly modifies the steady-state behavior of the open-loop postural control mechanisms, or it significantly alters the characteristics of the other closed-loop feedback mechanisms that are involved in balance control. This result is interpreted as an indication that the visual system is integrated into the postural control system in one of two different ways. The experimental population was roughly evenly divided between these two schemes. For the first group (13 of 25 subjects), visual input principally caused a decrease in the "effective" stochastic activity of the open-loop control mechanisms in both the mediolateral and anteroposterior directions. For the second group (12 of 25 subjects), visual input caused an increase in the effective stochastic activity and uncorrelated behavior of the closed-loop control mechanisms in the anteroposterior direction only. On the basis of these results, it is hypothesized that visual input, in both schemes, serves to decrease the stiffness of the musculoskeletal system. In the former case, this may be accomplished by decreasing the level of muscular activity across the joints of the lower limb, whereas, in the latter case, reduced stiffness may be achieved by reducing the gain(s) of the other postural feedback mechanisms, i.e., the proprioceptive and/or vestibular systems. Using stabilogram-diffusion analysis, it was also found that the two groups of subjects behaved similarly under eyes-closed conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1997

Sensory strategies in human postural control before and after unilateral vestibular neurotomy.

Vestibular inputs tonically activate the anti-gravitative leg muscles during normal standing in humans, and visual information and proprioceptive inputs from the legs are very sensitive sensory loops for body sway control. This study investigated the postural control in a homogeneous population of 50 unilateral vestibular-deficient patients (Ménière's disease patients). It analyzed the postural deficits of the patients before and after surgical treatment (unilateral vestibular neurotomy) of their diseases and it focused on the visual contribution to the fine regulation of body sway. Static posturographic recordings on a stable force-plate were done with patients with eyes open (EO) and eyes closed (EC). Body sway and visual stabilization of posture were evaluated by computing sway area with and without vision and by calculating the percentage difference of sway between EC and EO conditions. Ménière's patients were examined when asymptomatic, 1 day before unilateral vestibular neurotomy, and during the time-course of recovery (1 week, 2 weeks, 1 month, 3 months, and 1 year). Data from the patients were compared with those recorded in 26 healthy, age- and sex-matched participants. Patients before neurotomy exhibited significantly greater sway area than controls with both EO (+52%) and EC (+93%). Healthy participants and Ménière's patients, however, displayed two different behaviors with EC. In both populations, 54% of the subjects significantly increased their body sway upon eye closure, whereas 46% exhibited no change or significantly swayed less without vision. This was statistically confirmed by the cluster analysis, which clearly split the controls and the patients into two well-identified subgroups, relying heavily on vision (visual strategy, V) or not (non-visual strategy, NV). The percentage difference of sway averaged +36.7%+/-10.9% and -6.2%+/-16.5% for the V and NV controls, respectively; +45.9%+/-16.8% and -4.2%+/-14.9% for the V and NV patients, respectively. These two distinct V and NV strategies seemed consistent over time in individual subjects. Body sway area was strongly increased in all patients with EO early after neurotomy (1 and 2 weeks) and regained preoperative values later on. In contrast, sway area as well as the percentage difference of sway were differently modified in the two subgroups of patients with EC during the early stage of recovery. The NV patients swayed more, whereas the V patients swayed less without vision. This surprising finding, indicating that patients switched strategies with respect to their preoperative behavior, was consistently observed in 45 out of the 50 Ménière's patients during the whole postoperative period, up to 1 year. We concluded that there is a differential weighting of visual inputs for the fine regulation of posture in both healthy participants and Ménière's patients before surgical treatment. This differential weighting was correlated neither with age or sex factors, nor with the clinical variables at our disposal in the patients. It can be accounted for by a different selection of sensory orientation references depending on the personal experience of the subjects, leading to a more or less heavy dependence on vision. The change of sensory strategy in the patients who had undergone neurotomy might reflect a reweighting of the visual and somatosensory cues controlling balance. Switching strategy by means of a new sensory selection of orientation references may be a fast adaptive response to the lesion-induced postural instability.

Adult↗

PubMed1998

Development of postural control--differences between ventral and dorsal muscles?

Postural control is organized in basic, direction specific synergies which can be adapted to task-related conditions. Studies on the development of postural adjustments in young sitting children revealed that largely variable, direction specific muscle activation patterns are already present in 5-6 month old children not able to sit without support. With increasing age, the variation in muscle activation patterns decreases, resulting in a selection of the most complete patterns of synergist activation at 9-10 months of age. The synergy of the dorsal extensor muscles (during a forward sway of the body) develops faster than the synergy of the ventral flexors (during backward body-sway). A 'fixed' extensor synergy is prominently present between 9 months and 3 years, i.e. during the period when standing and walking abilities develop. With increasing age the 'fixed' extensor synergy gradually dissolves. The flexor synergy shows a larger flexibility than the extensor synergy, a difference which can be attributed to differences in stability limits and differences in the degree of supraspinal modulation.

Humans↗

PubMed1996

Using technology-based techniques to assess postural control and gait in older adults.

Increasingly sophisticated instrumentation and techniques to assess gait and postural control in older adults are now available. These technology-based methods may be most useful in understanding the mechanisms underlying age-related and disease-related changes in gait and postural control. Further work is needed to ensure that these methods: (1) are used in a hypothesis-driven manner; (2) are made more simple, portable, and user friendly; and (3) are used in an appropriate and cost-effective manner.

Adult↗

PubMed1991

Effects of restrained cervical mobility on voluntary eye movements and postural control.

The effects of restrained cervical mobility on pursuit eye movements (PEMS), voluntary saccades and postural control, as measured by posturography, were studied in 11 healthy subjects whose cervical spine movement had been restrained for 5 days by means of a rigid neck-collar. At day 5 mean peak velocity of voluntary saccades at amplitudes of 40 degrees and 60 degrees was significantly reduced, as was mean peak gain of PEMs at a stimulus velocity of 50 degrees/s; the variance of body position in vibration-induced body sway was significantly increased, but there was no difference in variance of galvanically-induced body sway or in velocity of vibration-induced body sway. The results suggest that restriction of cervical movements per se affects voluntary eye movements, a conclusion also consistent with findings in patients with tension headache. Restriction of cervical movement only marginally affects postural control.

Adult↗

PubMedDate not supplied

Evaluation of abnormalities of orthostatic postural control in systemic sclerosis.

OBJECTIVE: Systemic sclerosis (SSc) is a multi-systemic disease of unknown etiology characterized by damage to the small arteries, arterioles and capillaries. The documented occurrence of various neuropathies in SSs patients led us to hypothesize that there is a potential for postural control impairments in such disease. This study was aimed at evaluating the orthostatic postural control of SSc patients who do not manifest balance or hearing symptoms. METHODS: Postural stability was assessed in 36 female SSc patients by means of a static computerized posturography technique. Their immunological and microvascular condition were evaluated by means of blood tests and microcapillaroscopy of the digital vessels. Posturography and microcapillaroscopy were performed before and after treating the patients with Iloprost. In order to compare results, posturography was also carried out on a control group composed of 10 healthy women of similar age. Both groups were studied in two different sensory conditions, i.e. with eyes opened and with eyes closed. RESULTS: Posturography results showed relevant differences in body sway between patients and control subjects. Fourier spectral analysis of body sway showed that, independently from visual control, SSc patients exhibit a higher level of low/middle frequency oscillations (both on the lateral and the anteroposterior axis). No relationship was established between disease stage and postural performance. CONCLUSION: This study seems to indicate a subtle neurophysiological dysfunction in the orthostatic postural control of female SSc patients. Further tests on the somatosensory neurological function of SSc patients may help support the above mentioned findings.

Dizziness↗

PubMed1979

Changes in canine postural control after injury to anterior vermal cerebellum.

For a preliminary exploration of cerebellar influences on postural control, dogs were trained to stand quietly erect. Posture was perturbed by sinusoidal movement of the supporting table while the dogs were sighted and while they were blindfolded or stimulated by sinusoidal optokinetic stimuli. Postural responses were evaluated by measuring the relative amplitude of pelvis movement over a series of perturbing frequencies; frequency response descriptions were derived. Lesions of the cerebellar vermis in 3 dogs involved the cortex of lobules V and VI, of lobules IV, V and VI, and of lobules IV--VII plus damage to the medial portion of nucleus fastigius. The two smaller lesions degraded the animal's tracking ability under all three conditions temporarily with extensive but incomplete compensation in 14--21 days. The larger lesion effectively and permanently eliminated the animal's ability to track table or visual field motion. Elimination of visual cues by blindfolding or perturbing the posture with optokinetic stimuli significantly exaggerated the control deficiencies produced by the lesions. It is concluded that the visual input to the cerebellar vermis finds expression through postural control channels.

Animals↗