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One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up.

STUDY DESIGN: A study of postural control during one-footed and externally disturbed two-footed stance among healthy control subjects and patients with chronic low back pain at the beginning of a functional back restoration program and 6 months later at follow-up examination. OBJECTIVES: To study postural control cross-sectionally among control subjects and patients with low back pain, and to evaluate the effects of functional restoration on the postural control parameters in a follow-up examination. SUMMARY OF BACKGROUND DATA: Deficits of motor skills and coordination have been reported in association with musculoskeletal disorders. It has been found that patients with chronic low back pain have impaired psychomotor control, but the impairment is reversible with successful low back rehabilitation. It is insufficiently known how functional activation and intensive physical training affect postural control. METHODS: Sixty-one healthy volunteers (32 men, 29 women) and altogether 99 patients with low back pain participated in the study. Sixty-eight patients (33 men, 35 women) had moderate and 31 (18 men, 13 women) had severe low back pain. Postural stability was measured with a force platform. In two-footed stance, vibration stimulation on calf and back muscles was used to disturb the balance. Center point of force-velocity (cm/sec), average position shift in anteroposterior direction (cm), and maximal position shift in lateral direction (cm) were used as the parameters. RESULTS: Reliability of all tests was acceptable. Center point of force-velocity was the most sensitive parameter and the one-footed measurement the most sensitivetest for evaluating postural stability. At the beginning, the patients with severe low back pain had poorer one-footed postural control compared with the control subjects (P = 0.0003). The subgroup of patients with moderate low back pain participated in the restoration program. The outcome of the restoration program was considered good if the disability because of low back pain (Oswestry index) decreased during the restoration program and poor if the disability increased or did not change. The one-footed postural stability remained primarily at the same level as the initial results in the control and good outcome groups, but became significantly poorer in the poor outcome group. The difference between poor outcome and control groups was statistically significant (P = 0.04). CONCLUSIONS: Impaired postural stability seems to be one factor in multidimensional symptomatology of patients with chronic low back trouble. Postural stability is easily disturbed in case of impairment in strength, coordination, or effective coupling of muscles in the lumbar and pelvic area. Patients with chronic low back pain seem to experience impairment in these functions, which should be taken into consideration when back rehabilitation programs are planned.

Adult↗

Impairment and recovery of postural control in rabbits with spinal cord lesions.

The aim of this study was to characterize impairment and subsequent recovery of postural control after spinal cord injuries. Experiments were carried out on rabbits with three types of lesion--a dorsal (D), lateral (L), or ventral (V) hemisection (HS) at T(12) level. The animals were maintaining equilibrium on a platform periodically tilted in the frontal plane. We assessed the postural limb/trunk configuration from video recordings and postural reflexes in the hindquarters from kinematical and electromyographic (EMG) recordings. We found that for a few days after DHS or LHS, the animals were not able to maintain the dorsal-side-up position of their hindquarters. This ability was then gradually restored, and the dynamic postural reflexes reached the prelesion value within 2-3 wk. By contrast, a VHS almost completely abolished postural reflexes, and they did not recover for > or =7 wk. The DHS, LHS, and VHS caused immediate and slowly compensated changes in the postural limb/trunk configuration as well as gradually developing changes. After DHS, both hind limbs were placed in an abnormal rostral and medial position. After LHS, the limb on the undamaged side was turned inward and occurred at the abnormal medial position; LHS also caused a gradually developing twisting of the caudal trunk. VHS caused gradually developing extension of the ankle and knee joints. These findings show that ventral spinal pathways are of crucial importance for postural control. When a part of these pathways is spared, postural reflexes can be restored rapidly, but not the postural limb/trunk configuration. Spinal and supraspinal mechanisms responsible for postural deficits and their compensation are discussed.

Animals↗

Cerebellar control of postural scaling and central set in stance.

1. The effects of cerebellar deficits in humans on scaling the magnitude of automatic postural responses based on sensory feedback and on predictive central set was investigated. Electromyographic (EMG) and surface reactive torques were compared in patients with anterior lobe cerebellar disorders and in normal healthy adults exposed to blocks of four velocities and five amplitudes of surface translations during stance. Correlations between the earliest postural responses (integrated EMG and initial rate of change of torque) and translation velocity provided a measure of postural magnitude scaling using sensory information from the current displacement. Correlations of responses with translation amplitude provided a measure of scaling dependent on predictive central set based on sequential experience with previous like displacements because the earliest postural responses occurred before completion of the displacements and because scaling to displacement amplitude disappeared when amplitudes were randomized in normal subjects. 2. Responses of cerebellar patients to forward body sway induced by backward surface displacements were hypermetric, that is, surface-reactive torque responses were two to three times larger than normal with longer muscle bursts resulting in overshooting of initial posture. Despite this postural hypermetria, the absolute and relative latencies of agonist muscle bursts at the ankle, knee, and hip were normal in cerebellar patients. 3. Although they were hypermetric, the earliest postural responses of cerebellar patients were scaled normally to platform displacement velocities using somatosensory feedback. Cerebellar patients, however, were unable to scale initial postural response magnitude to expected displacement amplitudes based on prior experience using central set. Randomization of displacement amplitudes eliminated the set effect of amplitude on initial responses in normal subjects, but responses to randomized and blocked trials were not different in cerebellar patients. 4. Cerebellar patients compensated for hypermetric responses and lack of anticipatory scaling of earliest gastrocnemius activity by scaling large, reciprocally activated tibialis and quadriceps antagonist activity with the displacement velocity and amplitude. Correlations between these antagonist EMG integrals and displacement amplitudes were preserved when amplitudes were randomized, suggesting that feedback-dependent and not set-dependent mechanisms were responsible for scaling of antagonists by cerebellar patients. Antagonist compensation for initial hypermetric responses also could be induced in normals when they overresponded to unexpectedly small amplitudes of surface displacements. 5. The major effects of anterior lobe cerebellar damage on human postural responses involves impairment of response magnitude based on predictive central set and not on use of velocity feedback or on the temporal synergic organization of multijoint postural coordination.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Postural control in the lamprey: A study with a neuro-mechanical model.

The swimming lamprey normally maintains the dorsal-side-up orientation due to activity of the postural control system driven by vestibular organs. Commands for postural corrections are transmitted from the brain stem to the spinal cord mainly by the reticulospinal (RS) pathways. As shown in previous studies, RS neurons are activated by contralateral roll tilt, they exhibit a strong dynamic response, but much weaker static response. Here we test a hypothesis that decoding of these commands in the spinal cord is based on the subtraction of signals in the left and right RS pathways. In this study, we used a neuro-mechanical model. An intact lamprey was mounted on a platform that restrained its postural activity but allowed lateral locomotor undulations to occur. The activity in the left and right RS pathways was recorded by implanted electrodes. These natural biological signals were then used to control an electrical motor rotating the animal around its longitudinal axis toward the stronger signal. It was found that this "hybrid" system automatically stabilized a normal orientation of the lamprey in the gravitational field. The system compensated for large postural disturbances (lateral tilt up to +/-180 degrees ) due to wide angular zones of the gravitational sensitivity of RS neurons. In the nonswimming lamprey, activity of RS neurons and their vestibular responses were considerably reduced, and the system was not able to stabilize the normal orientation. However, the balance could be restored by imposing small oscillations on the lamprey, which elicited additional activation of the vestibular organs. This finding indicates that head oscillations caused by locomotor movements may contribute to postural stabilization. In addition to postural stabilization, the neuro-mechanical model reproduced a number of postural effects characteristic of the lamprey: 1) unilateral eye illumination elicited a lateral tilt ("dorsal light response") due to a shift of the equilibrium point in the vestibular-driven postural network; 2) removal of one labyrinth resulted in a loss of postural control due to an induced left-right asymmetry in the vestibulo-reticulospinal reflexes, which 3) could be compensated for by asymmetrical visual input. The main conclusion of the present study is that natural supraspinal commands for postural corrections in the roll plane can be effectively decoded on the basis of subtraction of the effects of signals delivered by the left and right RS pathways. Possible mechanisms for this transformation are discussed.

Animals↗

Age-related changes of postural control: effect of cognitive tasks.

BACKGROUND: Postural control and falls in the elderly constitute a major health problem. The interest in balance deficits is growing, as concern about the rising costs of health care increases. This issue is particularly relevant to the elderly population in which falls occur most frequently. Postural control in the elderly was studied using a cognitive approach. OBJECTIVE: The purpose of this study was to study the characteristics of central processing of postural control while performing cognitive tasks. METHODS: A dual-task procedure was developed to estimate the level of automaticity of a quiet upright standing task. The effect of a concurrent attention-demanding task (modified Stroop test) on the efficiency of balance control in the elderly was determined using force platform and electromyography measurements. RESULTS: It was found that there is an increase in postural sway in old subjects compared with young subjects when performing single tasks and dual-task tests. The results of the study demonstrate that postural adjustments require cognitive processing; young and old subjects showed similar interference effects on postural steadiness (postural sway) caused by the concurrent attention-demanding task. The results are corroborated by the hypothesis that a dual task gives information on the restoration of automaticity of postural control in old age by a central reorganization process. When performing a dual task tested on a narrow base of support, the old subjects decreased their body sway, while the younger did not. According to electromyography measurements, the older subjects increased their muscle activity in the tibialis anterior and soleus muscles, using slow-twitch motor units compared with the younger subjects. CONCLUSIONS: Both alterations (cognitive and base of support) have a substantially greater effect on the elderly than on the young. The older subjects decreased their body sway by activating a cocontraction strategy of postural control around the ankle joint, probably because of the danger to their postural stability.

Adult↗

Is essential tremor predominantly a kinetic or a postural tremor? A clinical and electrophysiological study.

Both postural and kinetic tremors may occur in essential tremor (ET), however the relative contribution of each is not clear. ET has been variably defined with respect to kinetic and postural tremors. To examine the relative severity of postural and kinetic tremors in ET, 50 ET cases from a clinic and 55 from a community underwent a videotaped tremor examination. Kinetic and postural tremors were rated using a validated clinical rating scale (score range, 0-3). Thirty-one cases also underwent accelerometry to precisely quantify tremor amplitude. In clinic cases, the mean postural tremor rating was 1.25 (S.D., 0.89). The mean kinetic tremor rating was 52% higher (1.90; S.D., 0.57; P < 0.001). The community cases had similar characteristics. Sixty percent of the 105 cases had postural tremor ratings scoring 0 or 1 (no tremor or low amplitude, intermittent tremor). In clinic cases, the mean amplitude of postural tremor during tremor analysis was 0.51 mm (S.D., 0.66 mm), and the mean amplitude of kinetic tremor was 2.91 mm (S.D., 2.11 mm; P < 0.01). Similar values were obtained for community cases. These quantitative data suggest that kinetic tremor is more severe than postural tremor in ET. The majority of cases had mild or absent postural tremor. Despite this, ET is defined only as a postural tremor in many studies. Our data argue for a more consistent inclusion of kinetic tremor in diagnostic criteria for ET.

Aged↗

The effects of spaceflight on open-loop and closed-loop postural control mechanisms: human neurovestibular studies on SLS-2.

Stabilogram-diffusion analysis was used to examine how prolonged periods in microgravity affect the open-loop and closed-loop postural control mechanisms. It was hypothesized that following spaceflight: (1) the effective stochastic activity of the open-loop postural control schemes in astronauts is increased; (2) the effective stochastic activity and uncorrelated behavior, respectively, of the closed-loop postural control mechanisms in astronauts are increased; and (3) astronauts utilized open-loop postural controls schemes for shorter time intervals and smaller displacements. Four crew members and two alternates from the 14-day Spacelab Life Sciences 2 Mission were included in the study. Each subject was tested under eyes-open, quiet-standing conditions on multiple preflight and postflight days. The subjects' center-of-pressure trajectories were measured with a force platform and analyzed according to stabilogram-diffusion analysis. It was found that the effective stochastic activity of the open-loop postural control schemes in three of the four crew members was increased following spaceflight. This result is interpreted as an indication that there may be in-flight adaptations to higher-level descending postural control pathways, e.g., a postflight increase in the tonic activation of postural muscles. This change may also be the consequence of a compensatory (e.g., "stiffening") postural control strategy that is adopted by astronauts to account for general feeling of postflight unsteadiness. The crew members, as a group, did not exhibit any consistent preflight/postflight differences in the steady-state behavior of their closed-loop postural control mechanisms or in the functional interaction of their open-loop and closed-loop postural control mechanisms. These results are interpreted as indications that although there may be in-flight adaptations to the vestibular system and/or proprioceptive system, input from the visual system can compensate for such changes during undisturbed stance.

Humans↗

A survey of static and dynamic work postures of operating room staff.

Work in health care units is associated with considerable physical strain and many musculoskeletal complaints. Most investigations have concentrated on the work of general hospital nurses; little is known about the physical stress load on other health care workers. We therefore carried out an ergonomic study amongst operating room staff in order to (i) determine the work (posture) stress load on this particular group of health care workers and the effect of static posture on this stress, (ii) identify activities involving poor work postures, and (iii) determine differences between specialties in regard to work posture stress load. The work postures and related work activities of four different groups of staff in operating rooms (surgeons, assistant anaesthesists, instrumentation nurses and circulating nurses) were recorded and evaluated using the specified Ovako Working posture Analysing System (OWAS). Observation during the course of 18 daily surgical programmes (total number of observations: 3714) in the specialties general surgery and ear-nose-throat (ENT) surgery revealed that the work-load according to OWAS for circulating nurses and assistant anaesthesists was not harmful. Some work postures seen among instrumentation nurses and surgeons, however, need improvement. The work posture stress load in these groups is mainly due to the high prevalence of static work postures during the activities "surgery" (surgeons) and "assisting surgery" (instrumentation nurses). Significant differences in ergonomic stress load were observed between general surgeons and ENT surgeons. This survey in operating theatres relates work postures to basic activities and can be used as a starting point from which to improve work conditions in order to reduce or eliminate physical complaints among operating room staff.

Ergometry↗

Perturbed step initiation in cerebellar subjects. 1. Modifications of postural responses.

Recent experiments in healthy subjects have demonstrated that automatic postural responses can be suppressed when subjects are instructed to step instead of maintain stance in response to the surface translation. The aim of the present study was to investigate the role of the cerebellum in coordinating this interaction between the central command to step and peripherally triggered automatic postural responses. Eight subjects with cerebellar degeneration and eight control subjects were instructed to either maintain stance or step forward in response to a backward translation. In order to determine whether prediction of perturbation amplitude assisted suppression of postural responses, three platform translations were presented in both a serial (predictable) and a random (unpredictable) order. Cerebellar subjects were able to suppress their initial postural responses to the same amount as control subjects when instructed to step forward in response to backward translations, despite their hypermetria and inability to scale responses to predictable perturbation amplitudes. Control, but not cerebellar, subjects scaled the size of their postural responses to predictable perturbation amplitudes. The perturbation amplitude, however, had no effect on the size of early automatic responses when they were suppressed by instruction to step. The size of the suppressed postural response was independent of predictability of perturbation amplitudes in both control and cerebellar subjects. The dynamic interaction between automatic postural responses to an external perturbation and anticipatory postural adjustments for step initiation seems independent of prediction of perturbation amplitude and the integrity of the cerebellum. Although cerebellar subjects show larger-than-normal magnitude and variability of postural responses and an inability to scale the size of responses to predictable perturbation amplitudes, the cerebellum does not seem to be critical for suppression of the early postural response with a centrally intended movement.

Adaptation, Physiological↗

Postural adjustments accompanying fast pointing movements in standing, sitting and lying adults.

The present study evaluated the effect of different positions, which varied in the amount of bodily support, on postural control during fast pointing movements. Fourteen adult subjects were studied in standing, various sitting and lying positions. Multiple surface electromyograms (EMGs) of arm, neck, trunk and upper leg muscles and kinematics were recorded during a standard series of unilateral arm movements. Two additional series, consisting of bilateral arm movements and unilateral arm movements with an additional weight, were performed to assess whether additional task-load affected postural adjustments differently in a sitting and standing position. Two pointing strategies were used--despite identical instructions. Seven subjects showed an elbow extension throughout the movements. They used the deltoid (DE) as the prime mover (DE group). The other seven subjects performed the movement with a slight elbow flexion and used the biceps brachii (BB) as the prime mover (BB group). The two strategies had a differential effect on the postural adjustments: postural activity was less and substantially later in the BB-group than in the DE group. Anticipatory postural muscle activity was only present in the DE group during stance. In all positions and task-load conditions the dorsal postural muscles were activated before their ventral antagonists. The activation rate, the timing and--to a lesser extent the amplitude of the dorsal muscle activity was position dependent. The position dependency was mainly found in the caudally located lumbar extensor (LE) and hamstrings (HAM) muscles. The EMG amplitude of LE and HAM was also affected by body geometry (trunk and pelvis position). Position and body geometry had only a minor effect on the activity of the neck and thoracic extensor muscles. This difference in behaviour of lower and upper postural muscles suggests that they could serve different postural tasks: the lower muscles being more involved in keeping the centre of mass within the limits of the support surface, and the upper ones in counteracting the reaction forces generated by movement onset. Increasing task-load by performing bilateral movements and--to a minor extent--during loaded unilateral movements affected the temporal and quantitative characteristics of the postural adjustments during standing and sitting in a similar way. The effect was present mainly during the early part of the response (within 100 ms after prime mover onset). This suggests that feedforward or anticipatory mechanisms play a major role in the task-specific modulation of postural adjustments.

Adaptation, Physiological↗

Postural stability in patients with different durations of benign paroxysmal positional vertigo.

Postural stability maintenance was investigated in patients with "idiopathic" benign paroxysmal positional vertigo of the posterior semicircular canal (BPPV-PSC) and compared to healthy subjects. To measure the postural stability during a quiet upright stance, we used static posturography in two conditions: with open and with closed eyes. The effect of the repositioning Epley's maneuver on the recovery of postural stability in patients with different durations of BPPV-PSC less than 60 days after the first attack of positioning vertigo (group I) and more than 60 days (group II) was examined. The investigation was made 1 h after the positive Dix-Hallpike test and 7 days after treatment with the Epley maneuver. "Sway velocity" (SV) and "relative power spectrum" (RPS) of the stabilograms were calculated to evaluate the postural stability for each subject and each experimental condition. We found a pronounced spectral density peak in the frequency range of 1.0-2.0 Hz and smaller spectral density in the range of 0.15-0.5 Hz compared to that in healthy subjects. Our results showed that the postural maintenance in BPPV-PSC patients depended on the disease duration. Patients with a duration of BPPV symptoms less than 60 days after the first attack demonstrated a high dependence on the visual input for postural stability. One week after the Epley maneuver, differences in the recovery of postural control in both groups of patients were also found. We assume that the disturbed otolith function together with the impaired dynamics of the semicircular canal generate a particular pattern of postural maintenance. The different degree of restoration of postural stability 1 week after the EM treatment in BPPV-PSC patients with different durations of the disease gives us reason to believe that after removing the otoconia from the semicircular canal, some stimulation of other sensory subsystems and adaptation mechanisms occur that lead to a new pattern of postural maintenance.

Follow-Up Studies↗

Trunk posture and spinal stability.

OBJECTIVE: The influence of trunk posture on musculoskeletal stability of the spine was investigated. DESIGN: A biomechanical model was developed to evaluate the influence of posture on spinal stability. Model performance was assessed by comparing predicted muscle recruitment patterns with measured EMG activity from the trunk muscles during static lifting exertions. METHOD: An inverted double-pendulum model of the spine controlled by 12 muscle equivalents of the trunk was implemented to determine spinal load and stability. Model input included trunk posture and lifted mass, output included muscle recruitment patterns necessary to achieve stability of the spine and spinal load. EMG activity recorded from the trunk muscles of 10 subjects were recorded during static exertions in various trunk flexion and asymmetric postures to compare with model output. Stable spinal load was examined as a function of trunk flexion and asymmetry during the lifting exertions. RESULTS: Antagonistic co-contraction was necessary to achieve spinal stability, particularly in upright postures. Stable spinal load was increased in asymmetric postures as a result of antagonistic muscle recruitment, suggesting greater neuromuscular control is necessary to maintain stability in asymmetric lifting postures. As trunk flexion angle increased, stability improved but spinal load was greater. CONCLUSIONS: Results illustrate that muscle recruitment patterns are more accurately explained by stability than by equilibrium alone. Spinal stability is influenced by posture. Specifically, control of spinal stability is reduced in asymmetric postures associated with low-back disorder risk. RELEVANCE: Traditional assessment of low-back disorder risk have focussed on spinal loading. Results illustrate that postural risk factors for low-back pain may be partially attributable to stability considerations.

Adult↗

Preparation of dynamic posture and occurrence of low back pain.

Improper posture is considered as one of the causes for low back pain. This study focused attention on low back pain that occurs when people adopt a dynamic posture. Low back pain in attendants was investigated as a typical example of low back pain in a dynamic posture. When multi-dimensional quantification III was applied to the results of the investigation, low back pain was found to occur in six postural patterns: bending knee posture, the posture of lifting and holding a light object, the posture of tilting the trunk, working posture to push a cart, the posture of turning or lifting a cart, and the posture of stretching. This survey found that low back pain frequently occurred when an unexpected load was imposed on the lumbar region and experiments were conducted to simulate the unexpected loading of this region. The experimental results showed that lumbar muscular activity was not fast enough to cope with the load and resulted in an increased swaying of the trunk. This swaying was considered to induce a load on the lumbar region. It is concluded that low back pain can be prevented if an appropriate preparatory set is taken.

Back Pain↗

The spinal curve in standing and sitting postures in children with idiopathic scoliosis.

STUDY DESIGN: A sample of convenience of children with moderate idiopathic scoliosis without bracing or surgery was studied. The sample consisted of 19 children, aged 9 to 16 years, with mean Cobb angle of 24 degrees. The spinal configurations and paraspinal muscle activity in several commonly assumed postures were examined. OBJECTIVES: To determine how the apex angles, verticality of spine, and muscle activity vary with the assumed posture and whether the location and the number of spinal curves affect these variables. SUMMARY OF BACKGROUND DATA: It has been suggested that the configuration of the spine in commonly assumed postures can affect the spinal curve in scoliosis because of gravitational bending moments. There is, however, a paucity of data obtained in subjects in sitting postures that school-age children assume daily for prolonged periods. Absence of bilateral symmetry in pressure during sitting has been described, but its effect on the spinal apex angle has not been investigated. METHODS: Infrared-emitting markers, whose three-dimensional positions could be tracked by a pair of cameras, were affixed to the spine. The natural postures studied were relaxed standing, relaxed sitting, erect sitting, and writing while seated. Electromyographic activity in muscles close to the spinal apexes was recorded bilaterally for each test posture. RESULTS: Subjects leaned laterally and, in general, anteriorly, in all test postures, rather than placing the C7 vertebra vertically above S1. The direction of lean and the change in the spinal apex angle from standing to sitting varied depending on whether the spinal curve was single or double, thoracic or lumbar. Subjects with single curves, whether thoracic or lumbar, tended to lean laterally toward the convexity of their curve apex--that is, the lean was in a direction that reduced the apex angle. Subjects with double curves (thoracic and lumbar), in all postures except relaxed sitting, tended to lean toward the convexity of the lumbar curve, thereby reducing the lumbar apex angle and exacerbating the thoracic angle. Most subjects' apex angles were smaller in relaxed or erect sitting than in relaxed standing. Electromyographic activity was in general greater on the convex side of the curve, with greatest activity in erect sitting. CONCLUSIONS: The findings indicate that in self-selected postures the gravitational effect of leaning and the muscle activity in paraspinal muscles may serve to reduce the apex angle. Thus, a fully upright, centered posture may not be best for correction of every patient's spinal curve.

Activities of Daily Living↗

Effect of posture on oxygenation and respiratory muscle strength in convalescent infants.

OBJECTIVE: To determine if differences in respiratory muscle strength could explain any posture related effects on oxygenation in convalescent neonates. METHODS: Infants were examined in three postures: supine, supine with head up tilt of 45 degrees, and prone. A subsequent study was performed to determine the influence of head position in the supine posture. In each posture/head position, oxygen saturation (SaO2) was determined and respiratory muscle strength assessed by measurement of the maximum inspiratory pressure (PIMAX). PATIENTS: Twenty infants, median gestational age 34.5 weeks (range 25-43), and 10 infants, median gestational age 33 weeks (range 30-36), were entered into the first and second study respectively. RESULTS: Oxygenation was higher in the prone and supine with 45 degrees head up tilt postures than in the supine posture (p<0.001), whereas PIMAX was higher in the supine and supine with head up tilt of 45 degrees postures than in the prone posture (p<0.001). Head position did not influence the effect of posture on PIMAX or oxygenation. CONCLUSION: Superior oxygenation in the prone posture in convalescent infants was not explained by greater respiratory muscle strength, as this was superior in the supine posture.

Female↗

Postural control in the rabbit maintaining balance on the tilting platform.

A deviation from the dorsal-side-up body posture in quadrupeds activates the mechanisms for postural corrections. Operation of these mechanisms was studied in the rabbit maintaining balance on a platform periodically tilted in the frontal plane. First, we characterized the kinematics and electromyographic (EMG) patterns of postural responses to tilts. It was found that a reaction to tilt includes an extension of the limbs on the side moving down and flexion on the opposite side. These limb movements are primarily due to a modulation of the activity of extensor muscles. Second, it was found that rabbits can effectively maintain the dorsal-side-up body posture when complex postural stimuli are applied, i.e., asynchronous tilts of the platforms supporting the anterior and posterior parts of the body. These data suggest that the nervous mechanisms controlling positions of these parts of the body can operate independently of each other. Third, we found that normally the somatosensory input plays a predominant role for the generation of postural responses. However, when the postural response appears insufficient to maintain balance, the vestibular input contributes considerably to activation of postural mechanisms. We also found that an asymmetry in the tonic vestibular input, caused by galvanic stimulation of the labyrinths, can affect the stabilized body orientation while the magnitude of postural responses to tilts remains unchanged. Fourth, we found that the mechanisms for postural corrections respond only to tilts that exceed a certain (threshold) value.

Animals↗

Changes in motor cortex activity during reaching movements with similar hand paths but different arm postures.

1. Neuronal activity was recorded in the motor cortex of a monkey that performed reaching movements with the use of two different arm postures. In the first posture (control), the monkey used its natural arm orientation, approximately in the sagittal plane. In the second posture (abducted), the monkey had to adduct its elbow nearly to shoulder level to grasp the handle. The path of the hand between targets was similar in both arm postures, but the joint kinematics and kinetics were different. 2. In both postures, the activity of single cells was often broadly tuned with movement direction and static arm posture over the targets. In a large proportion of cells, either the level of tonic activity, the directional tuning, or both, varied between the two postures during the movement and target hold periods. 3. For most directions of movement, there was a statistically significant difference in the direction of the population vector for the two arm postures. Furthermore, whereas the population vector tended to point in the direction of movement for the control posture, there was a poorer correspondence between the direction of movement and the population vector for the abducted posture. These observed changes are inconsistent with the notion that the motor cortex encodes purely hand trajectory in space.

Animals↗

Motor control of locomotor hindlimb posture in the American alligator (Alligator mississippiensis).

Crocodilians are unusual among quadrupedal tetrapods in their frequent use of a wide variety of hindlimb postures, ranging from sprawling to a more erect high walk. In this study, we use synchronized kinematic videos and electromyographic recordings to test how the activity patterns of hindlimb muscles in American alligators (Alligator mississippiensis Daudin) differ between sprawling and more upright postures. Previous force platform analyses suggested that upright posture in alligators would require greater activation by hindlimb extensors to counter increases in the flexor moments exerted about joints by the ground reaction force during upright stance. Consistent with these predictions, ankle extensors (gastrocnemius) and knee extensors (femorotibialis internus and iliotibialis 2) exhibit increases in signal intensity during the use of more upright stance. Bone loading data also predicted that activation patterns for hip adductors spanning the length of the femur would not differ between sprawling and more upright posture. Correspondingly, motor patterns of the adductor femoris were not altered as posture became more upright. However, the adductor puboischiofemoralis externus 3, which inserts far proximally on the femur, displays significant increases in burst intensity that could contribute to the greater femoral adduction that is integral to upright posture. In contrast to patterns in alligators, in mammals EMG burst intensity typically decreases during the use of upright posture. This difference in the motor control of limb posture between these taxa may be related to differences in the relative sizes of their feet. Alligator feet are large relative to the hindlimb and, as a result, the ground reaction force shifts farther from the limb joints during upright steps than in mammals, increasing flexor moments at joints and requiring alligator extensor muscles to exert greater forces to keep the limb in equilibrium. However, several alligator hindlimb muscles show no differences in motor pattern between sprawling and upright posture. The wide range of motor pattern modulations between different postures in alligators suggests considerable independence of neural control among the muscles of the alligator hindlimb.

Alligators and Crocodiles↗