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Muscle synergies involved in shifting the center of pressure while making a first step.

We used the framework of the uncontrolled manifold (UCM) hypothesis to analyze multi-muscle synergies involved in making a step by a standing person. We hypothesized that leg and trunk muscles are organized into stable groups (muscle modes, M-modes) related to shifts of the center of pressure (COP) in the anterior-posterior and medio-lateral directions. Another hypothesis was that the magnitudes of the modes co-vary across repetitive trials to stabilize a certain magnitude of the COP shift in both directions. M-modes were defined using principal component analysis applied to indices of changes in the electromyographic (EMG) activity prior to releasing variable loads that were held by the subject using a pulley system. For the task of releasing the load behind the body three M-modes associated with a backward COP shift were defined. Four M-modes were defined for the task of releasing the load at the body side associated with a lateral COP shift. Multiple regression analysis was used to relate changes in the M-mode magnitudes to COP shifts. EMG changes prior to making a step were quantified over five 100 ms time windows before the lift-off of the stepping leg. Two components of the variance in the M-mode space computed across repetitions of a stepping task were quantified-a component that did not affect the average COP shift in a particular direction (variance within the UCM, V (UCM)), and a component that affected the COP shift (variance orthogonal to the UCM, V (ORT)). V (UCM) was significantly higher than V (ORT) for both directions of the COP shifts. This relation was observed for the M-modes in the stepping leg as well as in the support leg. The stepping leg showed a different time evolution of the ratio V (UCM)/V (ORT) such that the difference between the two variance components disappeared closer to the time of the lift-off. The findings corroborate both main hypotheses. The study supports a view that control of whole-body actions involves grouping the muscles, using fewer elemental variables to scale the muscle activity, and forming synergies in the space of the elemental variables that stabilize time profiles of important performance variables.

Adult↗

Sensory re-weighting in human postural control during moving-scene perturbations.

The aim of the current study was to further investigate a recently proposed "sensory re-weighting" hypothesis, by evoking anterior-posterior (AP) body sway using visual stimuli during sway-referencing of the support surface. Twelve healthy adults participated in this study. Subjects stood on the platform while looking at a visual scene that encompassed the full horizontal field of view. A sequence of scene movements was presented to the subjects consisting of multiple visual push/pull perturbations; in between the first two push/pull sequences, the scene either moved randomly or was stationary. The peak-squared velocity of AP center-of-pressure (COP) was computed within a 6 s window following each push and pull. The peak-squared velocity was lowest for the push/pull sequence immediately following the random moving scene. These results are consistent with the sensory re-weighting hypothesis, wherein the sensory integration process reduced the contribution of visual sensory input during the random moving scene interval. We also found evidence of habituation to moving scene perturbations with repeated exposure.

Adult↗

Children use different anticipatory control strategies than adults to circumvent an obstacle in the travel path.

Carrying out the daily activities of work and play requires the ability to integrate available sensory information in order to navigate complex, potentially cluttered, environments. The expression of locomotor adjustment behaviour is still maturing during mid- to late-childhood (Grasso et al. in Neurosci Biobehav Rev 22(4): 533-539, 1998a; McFadyen et al. in Gait Posture 13:7-16, 2001), which raises the question, do children coordinate their body segments differently than adults when circumventing an obstacle in their travel path? Healthy young children (n=5; age 10.3+/-1.5 years) and adults (n=6; age 26.3+/-2.9 years) were asked to walk at their natural pace during unobstructed walking, as well as during the avoidance to the right or left of a cylindrical obstacle located in the travel path 3 m from the initial starting position. Fourteen infrared markers were fixed to participants and tracked using the Optotrak motion analysis system (60 Hz; Northern Digital Inc, Canada). Data analyses included center of mass (COM) clearance from the obstacle, gait speed, angular movement of the head and trunk (yaw, pitch and roll) and medial-lateral (M-L) COM displacement. Onset of change in these variables from unobstructed walking was also calculated as the time from OBS crossing. Although there were no differences in when adults or children altered their M-L COM trajectory, adults reoriented their head and trunk segments at the same time as their COM while children reoriented their head and trunk prior to changing COM direction. A comparison of foot placement data for this task indicated that while adults changed their gait patterns well in advance of obstacle crossing, children initiated M-L adjustments to gait patterns just prior to OBS crossing. Vallis and McFadyen (Exp Brain Res 152 (3):409-414, 2003) indicated that during circumvention of an obstacle, adults coordinate body segments for a single transient change in COM trajectory while maintaining the underlying travel direction. The present data suggest, however, that children partition obstacle avoidance into two tasks, initially steering with proactive movement of the head and trunk segments and finally making adjustments to their gait trajectory, via stride and step width changes, to ensure adequate obstacle clearance just prior to obstacle crossing. This study demonstrates different anticipatory control strategies used by children as compared to adults to circumvent obstacles in the travel path. The different head and trunk anticipatory segmental coordination suggests that children gather visual information differently when circumventing an obstacle in their travel path and are more dependent on visual input to guide their circumvention strategy.

Adult↗

Pronounced overestimation of support surface tilt during stance.

A veridical internal notion of the kinematic state of the foot support is essential for postural control. The means by which this is obtained is still a matter of debate. We therefore measured the conscious perception of support tilt during transient anterior-posterior rotations of a motion platform in six healthy subjects, using a psychophysical matching procedure. Furthermore, we evaluated subjects' postural responses (in terms of displacement of subjects' center of mass, COM, and their ankle torque, as represented by the center of foot pressure, COP). The platform tilts were applied in absence of visual and auditory orientation cues. The platform rotations consisted of smoothed position ramps with different dominant frequencies (0.025, 0.05, 0.1, 0.2, 0.4, and 0.8 Hz) and different amplitudes (0.125 degrees, 0.25 degrees, 0.5 degrees, 1 degree, 2 degrees, 4 degrees, and 8 degrees) for the forward and backward directions, which yielded a 6x14 stimulus matrix. The stimuli were repeated five times in a random order. For the matching procedure, subjects tried to maintain an upright body orientation, while trying to orient a light-weight rod, which was attached to a belt around their waists, parallel to the perceived platform surface. We measured the stimulus-evoked angular excursions of the rod and of the subjects' COM as well as the COP shift. We found that the subjects' rod indications overestimated the platform tilts, particularly with small stimulus amplitudes. To characterize the overestimation, we compared the rod indications obtained while subjects stood on the tilting platform, to rod indications in a situation in which they stood next to the platform and tried to match the rod angle to the now visually perceived platform angle. From this comparison, we inferred that the subjects' kinesthetically derived notion of platform tilt overestimates the actual tilt by a factor of approximately 4. The estimates were linearly related to the angle between body (COM) and platform, i.e., to approximately the angle of the ankle joint, a finding which suggests a proprioceptive source of the overestimation. Further analyses supported this view; they showed that the onset latencies of the rod indications could be approximated by a theoretical indication mechanism with a reaction time of about 0.31 s, a velocity threshold of 0.099 degrees/s, and a displacement threshold of 0.12 degrees. These threshold values are well in line with previous work on the leg proprioceptive detection threshold of conscious perception of body sway. We therefore assume that the phenomenon of support tilt overestimation reflects a still unknown mechanism of leg proprioception in postural control.

Adaptation, Physiological↗

Deterministic center of pressure patterns characterize postural instability in Parkinson's disease.

Static posturographic recordings were obtained from six Parkinson's patients and six age-matched, healthy control participants. The availability of vision and visuo-spatial cognitive load were manipulated. Postural sway patterns were analyzed using recurrence quantification analysis (RQA), which revealed differences in center of pressure (COP) dynamics between Parkinson's and control participants. AP COP trajectories for the Parkinson's group were not only significantly more variable than for the control group, but also exhibited distinct patterns of temporal dynamics. The visual manipulation did not differentially affect the two groups. No cognitive load effects were found. The results are generally consistent with the hypothesis that pathological physiological systems exhibit a tendency for less flexible, more deterministic dynamic patterns.

Adult↗

The influence of dynamic visual cues for postural control in children aged 7-12 years.

Young children rely heavily on vision for postural control during the transition to walking. Although by 10 years of age, children have automatic postural responses similar to adults, it is not clear when the integration of sensory inputs becomes fully developed. The purpose of this study was to examine this transition in the sensory integration process in children aged 7-12 years. Healthy children and adults stood on a fixed or sway-referenced support surface while viewing full-field optic flow scenes that moved sinusoidally (0.1 and 0.25 Hz) in an anterior-posterior direction. Center of pressure was recorded, and measures of sway amplitude and phase were calculated at each stimulus frequency. Children and adults had significant postural responses during approximately two-thirds of the trials. In adults, there was a 90% decrease in sway on the fixed surface compared with the sway-referenced surface, but only a 50% decrease in children. The phase between the optic flow stimulus and postural response in children led that of adults by 52 degrees at 0.1 Hz and by 15 degrees at 0.25 Hz. Adults and children aged 7-12 years have similar ability to use dynamic visual cues for postural control. However, 7-12-year-old children do not utilize somatosensory cues to stabilize posture to the same extent as adults when visual and somatosensory cues are conflicting.

Adult↗

How performing a mental arithmetic task modify the regulation of centre of foot pressure displacements during bipedal quiet standing.

We investigated the effect of performing a mental arithmetic task with two levels of difficulty on the regulation of centre of foot pressure (COP) displacements during bipedal quiet standing in young healthy individuals. There was also a control condition in which no concurrent task was required. A space-time-domain analysis showed decreased COP displacements, along the antero-posterior axis, when participants concurrently performed the most difficult mental arithmetic task. Frequency-domain and stabilogram-diffusion analyses further suggested these decreased COP displacements to be associated with an increased stiffness and a reduction of the exploratory behaviours in the short term, respectively.

Adult↗

Attentional demands associated with the use of a light fingertip touch for postural control during quiet standing.

The purpose of the present experiment was to investigate whether and how using a light fingertip touch for postural control during quiet standing requires additional attentional demands. Nine young healthy university students were asked to respond as rapidly as possible to an unpredictable auditory stimulus while maintaining stable seated and upright postures in three sensory conditions: vision, no-vision and no-vision/touch. Touch condition involved a gentle light touch with the right index finger on a nearby surface at waist height. Center of foot pressure (CoP) displacements were recorded using a force platform. Reaction times (RTs) values were used as an index of the attentional demand necessary for calibrating the postural system. Results showed decreased CoP displacements in both the vision and no-vision/touch conditions relative to the no-vision condition. More interestingly, a longer RT in the no-vision/touch than in the vision and no-vision conditions was observed. The present findings suggest that the ability to use a light fingertip touch as a source of sensory information to improve postural control during quiet standing is attention demanding.

Adult↗

Lower extremity control and dynamics during backward angular impulse generation in backward translating tasks.

Observation of complex whole-body movements suggests that the nervous system coordinates multiple operational subsystems using some type of hierarchical control. When comparing two backward translating tasks performed with and without backward angular impulse, we have learned that task-specific modifications in trunk-leg coordination contribute to the regulation of total-body center of mass (CoM) position relative to the reaction force (RF). In this study, we hypothesized that task-specific differences in trunk-leg coordination would affect the control of the lower extremity joints during the impulse-generation phase of the tasks. Eight highly skilled performers executed a series of backward translating jumps with and without backward rotation (back somersault and back timer, respectively). Sagittal plane kinematics, RFs and electromyograms of lower extremity muscles were acquired during the take-off phase of both tasks. Lower extremity joint kinetics was calculated using inverse dynamics. The results indicate that between-task differences in the relative angles between the lower extremity segments and the net joint forces/RF contributed to significant reductions in knee-extensor net joint moments and increases in hip-extensor net joint moments during the push interval of the back somersault as compared to the back timer. Between-task differences in backward trunk angular velocity also contributed to the re-distribution of work done by the lower extremity net joint moments. Between-task differences in lower extremity joint kinetics were associated with synergistic activation of the bi-articular muscles crossing the knee and hip. These results indicated that task-specific control of CoM relative to the RF in order to regulate the backward angular-impulse-involved modification in the control and dynamics of the knee and hip joints. These results indicate that between-task differences in the control objectives at the total-body level (position of CoM relative to the RF) alters the control and dynamics of the multi-joint lower extremity subsystem.

Adult↗

Evidence for a common process in gait initiation and stepping on to a new level to reach gait velocity.

The aim of this study was to examine the adaptability of the gait initiation process when confronted with stepping on (SO) to a new level. Eight young adults performed gait initiation at two different speed conditions in a level walking (LW) situation and in a SO situation aimed at walking on an elevated (16 cm) level surface. As in a previous study using a single step, we found in SO a contradiction between the characteristics of anticipatory postural adjustments (APA) and gait velocity, i.e. the peak of anteroposterior velocity of the body's centre of gravity (CG) reached at the end of the first step. In normal and fast gaits, gait velocity was similar in both situations, whereas the duration and amplitude of the APA were smaller in SO than in LW. The reduction of APA in SO allowed the forward velocity of CG at the time of foot contact of the stepping limb to be lower than in LW. This is explained by the fact that the majority of body lift, beginning at this time, required a greater increase in forward velocity than in LW. Thus, with lower APA in SO, the gait velocity could be similar in both situations. From LW to SO, the spatio-temporal patterns in the forward velocity of CG varied within characteristic phases of the movement, but in a predictable way as gait velocity changed. These results gave evidence of an adaptation of the gait initiation process for the new constraints, despite the contradiction between APA and gait velocity. The spatio-temporal parameters of the anticipation phase in SO were pre-set according to the new requirements of the task: reaching gait velocity with a body lift. Furthermore, the time for reaching gait velocity was independent of both the amplitude of this velocity and the situation. This expressed the capacity of the subjects to use in SO the same optimal conditions to reach gait velocity as in LW, i.e. essentially in a ballistic manner.

Adaptation, Physiological↗

A direct comparison of local dynamic stability during unperturbed standing and walking.

Standing and walking are very different tasks. It might be reasonable, therefore, to assume that the mechanisms used to maintain the stability of standing and walking should be quite different. However, many studies have shown that postural stability measures can generally predict risk of falls, even though most falls occur during locomotor tasks and not during postural tasks. This suggests that there is at least some commonality among the mechanisms governing the control of both standing and walking. The present study was conducted to determine whether the postural stability either is or is not directly related to locomotor stability. Twenty healthy adults, age 18-73 years, walked on a motorized treadmill at their preferred walking speed for three trials of 5 min. They also stood on a force plate for three trials of 5 min. Both tasks were performed without imposing any additional external perturbations. The motion of each subject's trunk segment was recorded and described using a multi-dimensional state space defined in the same manner for both tasks. Local dynamic stability was quantified from the mean divergence over time of locally perturbed trajectories in state space, which was parameterized as a double exponential process. Divergence parameters were compared to determine the relationship between local dynamic stability during standing and walking. Standing and walking exhibited local dynamic stability properties that were significantly different (P<0.001) and not correlated (P>0.1). Divergence parameters were also compared to traditional center of pressure (COP) measures obtained from standing trials. COP measures were significantly correlated to local divergence parameters for standing, but not to those for walking. This study provides direct evidence that the mechanisms governing standing and walking stability are significantly different.

Adolescent↗

Multisensory control of human upright stance.

The interaction of different orientation senses contributing to posture control is not well understood. We therefore performed experiments in which we measured the postural responses of normal subjects and vestibular loss patients during perturbation of their stance. Subjects stood on a motion platform with their eyes closed and auditory cues masked. The perturbing stimuli consisted of either platform tilts or external torque produced by force-controlled pull of the subjects' body on a stationary platform. Furthermore, we presented trials in which these two stimuli were applied when the platform was body-sway referenced (i.e., coupled 1:1 to body position, by which ankle joint proprioceptive feedback is essentially removed). We analyzed subjects' postural responses, i.e., the excursions of their center of mass (COM) and center of pressure (COP), using a systems analysis approach. We found gain and phase of the responses to vary as a function of stimulus frequency and in relation to the absence versus presence of vestibular and proprioceptive cues. In addition, gain depended on stimulus amplitude, reflecting a non-linearity in the control. The experimental results were compared to simulation results obtained from an 'inverted pendulum' model of posture control. In the model, sensor fusion mechanisms yield internal estimates of the external stimuli, i.e., of the external torque (pull), the platform tilt and gravity. These estimates are derived from three sensor systems: ankle proprioceptors, vestibular sensors and plantar pressure sensors (somatosensory graviceptors). They are fed as global set point signals into a local control loop of the ankle joints, which is based on proprioceptive negative feedback. This local loop stabilizes the body-on-foot support, while the set point signals upgrade the loop into a body-in-space control. Amplitude non-linearity was implemented in the model in the form of central threshold mechanisms. In model simulations that combined sensor fusion and thresholds, an automatic context-specific sensory re-weighting across stimulus conditions occurred. Model parameters were identified using an optimization procedure. Results suggested that in the sway-referenced condition normal subjects altered their postural strategy by strongly weighting feedback from plantar somatosensory force sensors. Taking this strategy change into account, the model's simulation results well paralleled all experimental results across all conditions tested.

Adult↗

Altered timing of postural reflexes contributes to falling in persons with chronic stroke.

The purpose of this study was to determine differences in the timing of postural reflexes and changes in kinematics between those who fell (fallers) in response to standing platform translations and those who did not (non-fallers). Forty-four persons with stroke were exposed to unexpected forward and backward platform translations while standing. Surface electromyography from bilateral tibialis anterior, gastrocnemius, rectus femoris, and biceps femoris were recorded along with kinematic data. Those that fell in response to the translations were compared to those who did not fall in terms of (1) postural reflex onset latency, (2) the time interval between the activation of distal and proximal muscles (i.e. intralimb coupling), and (3) changes in joint angles and trunk motion. Approximately 85% of falls occurred in response to the forward translations. Postural reflex onset latencies were delayed and intralimb coupling durations were longer in the faller versus non-faller group. At the time that the platform completed the translating motion (300 ms), the faller group demonstrated higher trunk velocity, greater change in paretic ankle angle, and the trunk was further behind the ankle compared to the non-faller group. This study suggests that following platform translations, delays in the timing of postural reflexes and disturbed intralimb coupling result in changes in kinematics, which contribute to falls in persons with stroke.

Aged↗

Evidence for positive force feedback during involuntary aftercontractions.

We examined the involuntary isotonic muscle aftercontraction which follows a 1-min voluntary contraction at 60% of maximum voluntary force. Aftercontractions provide a unique paradigm for investigating the automatic postural control of the upper limb in man. Previous work has shown that the strength of these contractions in m. deltoid is linearly dependent on the inclination of the subject's body in the gravitational field. The current experiments were designed to test if this was due to the gravitational loading on the arm as this also changes with body inclination. The subject sat with the head stationary to prevent changes in vestibular orientation. Aftercontractions in m. deltoid were evoked with the normal weight of the arm present and also with arm loadings equal to 0, 25, 50 and 75% of this value. These reductions were produced by a counter lever apparatus. The results showed that the EMG amplitude of this involuntary contraction depended linearly on the loading of the arm. This is interpreted as being the result of positive load feedback. Aftercontraction EMG amplitude at 100% load was 2.7 times greater than at 0% load. The results are discussed in the context of recent work on positive load feedback in man and animals.

Adult↗

Perceived versus actual head-on-trunk orientation during arm movement control.

Static roll head tilt induces bias in the trajectory of upper limb voluntary movements. The aim of the experiment was to investigate whether this bias is dependant on the perception of body configuration rather than on its actual configuration. We used the 'return' phenomenon as a method to produce dissociation between perceived and actual head tilt. Static roll head tilt in supine subjects was sustained for 15 min during which subjects were periodically required to estimate verbally the tilt of their head respective to their trunk and draw, with their right index finger, straight lines aligned with their trunk. After 15 min, subjects' head were realigned with the trunk, and subjects continued to give verbal estimate of head position and perform the motor task. Results showed that the initial angular deviation of the lines in the direction opposite to head tilt gradually diminished. The adaptation was noticeable within the first 3-5 min of tilt and subsequently diminished. Verbal estimates confirmed the return phenomenon, i.e. subjects perceived their head as slowly returning towards its neutral position after a few minutes of sustained tilt. When realigned with the trunk, subjects experienced the illusion that their head was tilted in the opposite direction to the initial head tilt and a line deviation in the opposite direction to those made on initial exposure was observed (after-effect). These results indicate that the angular deviation in motor production observed in condition of static head tilt were largely related to the perceived body configuration and therefore favour the hypothesis that the conscious perception of body configuration plays a key role in organising sensorimotor tasks.

Adult↗

Modeling postural instability with Galvanic vestibular stimulation.

In this study the effect of a pseudorandom binaural bipolar Galvanic stimulus generated by a sum of nonharmonically related sine waves on postural control was functionally assessed using computerized dynamic posturography (CDP), and the results compared to vestibulopathic patient populations and astronauts exposed to microgravity. The standardized CDP test battery comprised six sensory organization tests (SOTs) that combined three visual conditions (eyes open, eyes closed, and sway-referenced vision) with two proprioceptive conditions (fixed and sway-referenced support surfaces). Subjects (12) performed 18 randomized trials (three trials of each of the six SOTs) as a baseline, repeated the 18 trials with Galvanic vestibular stimulation (GVS), and then performed a post-GVS baseline. A 10 min rest period was inserted between each test battery. Anterioposterior postural sway increased significantly and was in the abnormal range (fifth percentile) during GVS for SOTs where visual input was compromised (sway-referenced surround) or absent. Postural stability returned to baseline when GVS was removed. An analysis of sensory input scores (somatosensory, visual, and vestibular) demonstrated the specificity of GVS in distorting vestibular input to postural control. The SOT scores observed in astronauts on landing day did not differ significantly to that generated by GVS in our normal subjects. GVS also induced a similar pattern of instability on CDP as profound bilateral vestibular loss, although not as severe. The results suggest that unpredictably varying GVS quantitatively and qualitatively models postural instability of vestibular origin.

Adult↗

Compatibility of postural behavior induced by two aspects of visual feedback: time delay and scale display.

Fourteen healthy adults were tested to assess the potential influence on stance maintenance of two parts of the visual feedback technique (display scale and time delay). The task consisted in their keeping a spot on the screen representing their center of pressure, CoP (i.e. successive points of application of the ground reaction forces detected by the force platform on which they were standing) to a minimum size. The analysis focused on elementary motions computed from the complex CoP trajectories, that is the horizontal motion of the center of gravity (CoG(h)) and the difference between the CoP and the vertical projection of the center of gravity (CoP-CoG(v)). The former is recognized as the main variable in postural control, and several interesting features can be extracted from the latter. The results indicate that setting a delay and increasing the display scale induce substantial reductions in CoP-CoG(v) and CoG(h) displacements, respectively. Interestingly, when the two effects are combined, these single effects cohabit quite happily. Fractional Brownian motion modeling of these trajectories revealed clearly that, in each case, these effects originate principally from poor or improved control, respectively. This feature confirms that these elementary motions are involved differently in the postural system and that study of the complex CoP might not be of great interest. By generating opposing but complementary trends, the visual feedback technique should thus be perceived as a promising tool for inducing particular postural behavior in healthy and disabled individuals.

Adult↗

Postural responses triggered by multidirectional leg lifts and surface tilts.

The aim of the present study was to investigate the relationship between proactive and reactive components of postural control. We contrasted the kinematic and electromyographic (EMG) responses to multidirectional voluntary leg lifts with those elicited by unexpected surface tilts. In particular, we addressed the role of trunk stabilization following either a voluntary or forced weight shift from double to single limb support. Nine young female subjects stood with a standing posture of 45 degrees toe-out and their arms abducted to shoulder level. On the experimenter's signal, subjects either (1) lifted one leg as fast as possible in one of six directions (R/L side, R/L diagonal front, R/L diagonal back) to a height of 45 degrees or (2) maintained standing as the support surface tilted at a rate of 53 degrees /s to a height of 10 degrees in one of six directions (R/L-up, R/L diagonal toes-up, R/L diagonal toes-down). For both tasks, our results showed that the center of pressure (COP) displacement began before or in conjunction with displacement of the center of mass (COM), after which the COP oscillated about the horizontal projection of the COM. In addition, the muscles were recruited in a distal-to-proximal sequence, either in anticipation of the voluntary leg lift or in response to the sudden surface tilt. Thus, the COP was being used dynamically to control displacement of the COM. The axial postural strategy comprising head, trunk, and pelvis movements was quantified by means of principal component analysis. More than 95% of the variance in the data could be described by the first two eigenvectors, which revealed specific coordination patterns dominated by pelvis rotation in one direction and head/trunk rotation in the opposite direction. Unexpected surface tilting elicited an automatic response strategy that focused on controlling the orientation of the head and trunk with respect to the vertical gravity vector while trunk verticality was compromised for movement generation and the recovery of postural equilibrium during leg lifting. In conclusion, regardless of the type (voluntary versus involuntary) or direction of perturbation, the strategy employed by the central nervous system to control the body COM displacement concerns mainly trunk stabilization.

Adult↗