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PubMed2005

Cross-correlation between EMG and center of gravity during quiet stance: theory and simulations.

Several signal processing tools have been employed in the experimental study of the postural control system in humans. Among them, the cross-correlation function has been used to analyze the time relationship between signals such as the electromyogram and the horizontal projection of the center of gravity. The common finding is that the electromyogram precedes the biomechanical signal, a result that has been interpreted in different ways, for example, the existence of feedforward control or the preponderance of a velocity feedback. It is shown here, analytically and by simulation, that the cross-correlation function is dependent in a complicated way on system parameters and on noise spectra. Results similar to those found experimentally, e.g., electromyogram preceding the biomechanical signal may be obtained in a postural control model without any feedforward control and without any velocity feedback. Therefore, correct interpretations of experimentally obtained cross-correlation functions may require additional information about the system. The results extend to other biomedical applications where two signals from a closed loop system are cross-correlated.

Computer Simulation↗
PubMed2005

'Initial state' coordinations reproduce the instant flexibility for human walking.

An important feature of human locomotor control is the instant adaptability to unpredictable changes of conditions surrounding the locomotion. Humans, for example, can seamlessly adapt their walking gait following a sudden ankle impairment (e.g., as a result of an injury). In this paper, we propose a theoretical study of the mechanisms underlying flexible locomotor control. We hypothesize that flexibility is achieved by modulating the posture at the beginning of the stance phase-the initial state. Using a walking model, we validate our hypothesis through computer simulations.

Adaptation, Physiological↗
PubMed2005

Factors underlying the perturbation resistance of the trunk in the first part of a lifting movement.

In the first part of lifting movements, the trunk movement is surprisingly resistant to perturbations. This study examined which factors contribute to this perturbation resistance of the trunk during lifting. Three possible mechanisms were studied: force-length-velocity characteristics of muscles, the momentum of the trunk as well as the effect of passive extending of the elbows. A forward dynamics modelling and simulation approach was adopted with two different input signals: (1) stimulation of Hill-type muscles versus (2) net joint moments. Experimental data collected during an unperturbed lifting movement were used as a reference, which a simulated lifting movement had to resemble. Subsequently, the simulated lifting movement was perturbed by applying 10 kg extra mass at the wrist (both before and after lift-off and with/without a fixed elbow), without modifying the input signals. The momentum of the trunk appeared to be insufficient to explain the perturbation resistance of trunk movements as found experimentally. In addition to the momentum of the trunk, the force-length-velocity characteristics of the muscles are necessary to account for the observed perturbation resistance. Initial extension of the elbow due to the mass perturbation delayed the propagation of the load to the shoulder. However, this delay is reduced due to the impedance at the elbow provided by the characteristics of muscles spanning the elbow. So, the force-length-velocity characteristics of the muscles spanning the elbow joint increase the perturbation at the trunk.

Biomechanical Phenomena↗
PubMed2006

Stumbling with optimal phase reset during gait can prevent a humanoid from falling.

The human biped walking shows phase- dependent transient changes in gait trajectory in response to external brief force perturbations. Such responses, referred to as the stumbling reactions, are usually accompanied with phase reset of the walking rhythm. Our previous studies provided evidence, based on a human gait experiment and analyses of mathematical models of gait in the sagittal plane, that an appropriate amount of phase reset in response to a perturbation depended on the gait phase at the perturbation and could play an important role for preventing the walker from a fall, thus increasing gait stability. In this paper, we provide a further material that supports this evidence by a gait experiment on a biped humanoid. In the experiment, the impulsive force perturbations were applied using push-impacts by a pendulum-like hammer to the back of the robot during gait. The responses of the external perturbations were managed by resetting the gait phase with different delays or advancements. The results showed that appropriate amounts of phase resetting contributed to the avoidance of falling against the perturbation during the three-dimensional robot gait. A parallelism with human gait stumbling reactions was discussed.

Biomechanical Phenomena↗
PubMed2006

A model of open-loop control of equilibrium position and stiffness of the human elbow joint.

According to the equilibrium point theory, the control of posture and movement involves the setting of equilibrium joint positions (EP) and the independent modulation of stiffness. One model of EP control, the alpha-model, posits that stable EPs and stiffness are set open-loop, i.e. without the aid of feedback. The purpose of the present study was to explore for the elbow joint the range over which stable EPs can be set open-loop and to investigate the effect of co-contraction on intrinsic low-frequency elbow joint stiffness (K (ilf)). For this purpose, a model of the upper and lower arm was constructed, equipped with Hill-type muscles. At a constant neural input, the isometric force of the contractile element of the muscles depended on both the myofilamentary overlap and the effect of sarcomere length on the sensitivity of myofilaments to [Ca2+] (LDCS). The musculoskeletal model, for which the parameters were chosen carefully on the basis of physiological literature, captured the salient isometric properties of the muscles spanning the elbow joint. It was found that stable open-loop EPs could be achieved over the whole range of motion of the elbow joint and that K (ilf), which ranged from 18 to 42 N m.rad(-1), could be independently controlled. In the model, LDCS contributed substantially to K (ilf) (up to 25 N m.rad(-1)) and caused K (ilf) to peak at a sub-maximal level of co-contraction.

Elbow Joint↗
PubMed2000

Investigating centre of mass stabilisation as the goal of posture and movement coordination during human whole body reaching.

In the light of experimental results showing significant forward centre of mass (CoM) displacements within the base of support, this study investigated if whole body reaching movements can be executed whilst keeping the CoM fixed in the horizontal axis. Using kinematic simulation techniques, angular configurations were recreated from experimental data imposing two constraints: a constant horizontal position of the CoM and an identical trajectory of the hand to grasp an object. The comparison between recorded and simulated trials showed that stabilisation of the CoM was associated with greater backward hip displacements, which became more marked with increasing object distance. This was in contrast to recorded trials showing reductions in backward hip displacements with increasing distance. Results also showed that modifications to angular displacements were necessary only at the shoulder and hip joints, but that these modifications were within the limits of joint mobility. The analysis of individual joint torques revealed that the pattern and timing of simulated trials were similar to those recorded experimentally. Peak joint torque values showed particularly that keeping the CoM at a constant horizontal position resulted in significantly smaller ankle peak flexor and extensor torques. It may be concluded from this study that 'stabilising' the CoM during human whole body reaching represents a feasible strategy, but not the one chosen by subjects under experimental conditions. Our results also do not support the idea of the CoM as the stabilised reference value for the coordination between posture and goal-directed movements.

Adolescent↗
PubMed2000

Postural control model interpretation of stabilogram diffusion analysis.

Collins and De Luca [Collins JJ. De Luca CJ (1993) Exp Brain Res 95: 308-318] introduced a new method known as stabilogram diffusion analysis that provides a quantitative statistical measure of the apparently random variations of center-of-pressure (COP) trajectories recorded during quiet upright stance in humans. This analysis generates a stabilogram diffusion function (SDF) that summarizes the mean square COP displacement as a function of the time interval between COP comparisons. SDFs have a characteristic two-part form that suggests the presence of two different control regimes: a short-term open-loop control behavior and a longer-term closed-loop behavior. This paper demonstrates that a very simple closed-loop control model of upright stance can generate realistic SDFs. The model consists of an inverted pendulum body with torque applied at the ankle joint. This torque includes a random disturbance torque and a control torque. The control torque is a function of the deviation (error signal) between the desired upright body position and the actual body position, and is generated in proportion to the error signal, the derivative of the error signal, and the integral of the error signal [i.e. a proportional, integral and derivative (PID) neural controller]. The control torque is applied with a time delay representing conduction, processing, and muscle activation delays. Variations in the PID parameters and the time delay generate variations in SDFs that mimic real experimental SDFs. This model analysis allows one to interpret experimentally observed changes in SDFs in terms of variations in neural controller and time delay parameters rather than in terms of open-loop versus closed-loop behavior.

Computer Simulation↗
PubMed2005

Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.

Low back pain (LBP) is often accompanied by changes in gait, such as a decreased (preferred) walking velocity. Previous studies have shown that LBP diminishes the normal velocity-induced transverse counter-rotation between thorax and pelvis, and that it globally affects mean erector spinae (ES) activity. The exact nature and causation of these effects, however, are not well understood. The aim of the present study was to examine in detail the effect of walking velocity on global trunk coordination and ES activity as well as their variability to gain further insights into the effects of non-specific LBP on gait. The study included 19 individuals with non-specific LBP and 14 healthy controls. Gait kinematics and ES activity were recorded during treadmill walking at (1) a self-selected (comfortable) velocity, and (2) sequentially increased velocities from 1.4 up to maximally 7.0 km/h. Pain intensity, fear of movement and disability were measured before the experiment. The angular movements of thorax, lumbar and pelvis were recorded in three dimensions. ES activity was recorded with pairs of surface electrodes. Trunk-pelvis coordination and mean amplitude of ES activity were analyzed. In addition, invariant and variant properties of trunk kinematics and ES activity were studied using principal component analysis (PCA). Comfortable walking velocity was significantly lower in the LBP participants. In the transverse plane, the normal velocity-induced change in pelvis-thorax coordination from more in-phase to more antiphase was diminished in the LBP participants, while lumbar and pelvis rotations were more in-phase compared to the control group. In the frontal plane, intersegmental timing was more variable in the LBP than in the control participants, with additional irregular movements of the thorax. Rotational amplitudes were not significantly different between the LBP and control participants. In the LBP participants, the pattern of ES activity was affected in terms of increased (residual) variability, timing deficits, amplitude modifications and frequency changes. The gait of the LBP participants was characterized by a more rigid and less variable kinematic coordination in the transverse plane, and a less tight and more variable coordination in the frontal plane, accompanied by poorly coordinated activity of the lumbar ES. Pain intensity, fear of movement and disability were all unrelated to the observed changes in coordination, suggesting that the observed changes in trunk coordination and ES activity were a direct consequence of LBP per se. Clinically, the results imply that conservative therapy should consider gait training as well as exercises aimed at improving both intersegmental and muscle coordination.

Adult↗
PubMed2005

Trunk muscular activation patterns and responses to transient force perturbation in persons with self-reported low back pain.

Trunk stability requires muscle stiffness associated with appropriate timing and magnitude of activation of muscles. Abnormality of muscle function has been implicated as possible cause or consequence of back pain. This experimental study compared trunk muscle activation and responses to transient force perturbations in persons with and without self-reported history of low back pain. The objective was to determine whether or not history of back pain was associated with (1) altered anticipatory preactivation of trunk muscles or altered likelihood of muscular response to a transient force perturbation and (2) altered muscle activation patterns during a ramped effort. Twenty-one subjects who reported having back pain (LBP group) and twenty-three reporting no recent back pain (NLBP group) were tested while each subject stood in an apparatus with the pelvis immobilized. They performed 'ramped-effort' tests (to a voluntary maximum effort), and force perturbation tests. Resistance was provided by a horizontal cable from the thorax to one of five anchorage points on a wall track to the subject's right at angles of 0 degrees, 45 degrees, 90 degrees, 135 degrees and 180 degrees to the forward direction. In the perturbation tests, subjects first pulled against the cable to generate an effort nominally 15% or 30% of their maximum extension effort. The effort and the EMG activity of five right/left pairs of trunk muscles were recorded, and muscle responses were detected. In the ramped-effort tests the gradient of the EMG-effort relationship provided a measure of each muscle's activation. On average, the LBP group subjects activated their dorsal muscles more than the NLBP group subjects in a maximum effort task when the EMG values were normalized for the maximum EMG, but this finding may have resulted from lesser maximum effort generated by LBP subjects. Greater muscle preactivation was recorded in the LBP group than the NLBP group just prior to the perturbation. The likelihood of muscle responses to perturbations was not significantly different between the two groups. The findings were consistent with the hypothesis that LBP subjects employed muscle activation in a quasi-static task and preactivation prior to a perturbation in an attempt to stiffen and stabilize the trunk. However, interpretation of the findings was complicated by the fact that LBP subjects generated lesser efforts, and it was not known whether this resulted from anatomical differences (e.g., muscle atrophy) or reduced motivation (e.g., pain avoidance).

Adult↗
PubMed2006

Whiplash injury and oculomotor dysfunctions: clinical-posturographic correlations.

Oculomotor dysfunctions are hidden causes of invalidity following whiplash injury. Many patients with whiplash injury grade II present oculomotor dysfunctions related to input disturbances of cervical or vestibular afferents. We used static posturography to investigate 40 consecutive patients with whiplash injury grade II and oculomotor dysfunctions. We demonstrated a relation between length and surface of body sway: the surface value (A) was higher than the length value (L) and this led to an open graph of body sway in the statokinesigram. Oculomotor rehabilitation can resolve the impairment of vestibular function but if therapy is delayed or the patient has been wearing an orthopaedic neck collar, more therapeutic sessions are required. In conclusion, without rehabilitation of the oculomotor muscles other therapies are not sufficient to recover the impairment caused by whiplash injury.

Adolescent↗
PubMed2006

Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers.

Stabilization exercises are intended to optimize function of the muscles that are believed to govern trunk stability. Debate exists whether certain muscles are more important than others in optimally performing these exercises. Thirty healthy volunteers were asked to perform three frequently prescribed stabilization exercises in four-point kneeling. The electromyographic activity of different trunk and hip muscles was evaluated. Average amplitudes obtained during the exercises were normalized to the amplitude in maximal voluntary contraction (% MVIC). During all three exercises, the highest relative muscle activity levels (> 20% MVIC) were consistently found in the ipsilateral lumbar multifidus and gluteus maximus. During both the single leg extension (exercise 1) and the leg and arm extension exercise (exercise 2) the contralateral internal oblique and ipsilateral external oblique reached high levels (> 20%MVIC). During exercise 2 there were also high relative activity levels of the ipsilateral lumbar part and the contralateral thoracic part of the iliocostalis lumborum and the contralateral lumbar multifidus. During the leg and arm extension exercise with contralateral hip flexion (exercise 3) there were high relative muscle activity levels of all back muscles, except for the latissimus dorsi muscle. The lowest relative muscle activity levels (< 10% MVIC) were found in the rectus abdominis and the ipsilateral internal oblique during all exercises, and in the contralateral gluteus maximus during exercises 1 and 2. The results of this study show that in exercises in four-point kneeling performed by healthy subjects, hip and trunk muscles seem to work together in a harmonious way. This shows that when relative activity of muscles is measured, both "global and local" muscles function together in order to stabilize the spine.

Adult↗
PubMed1998

Synergy of the human spine in neutral postures.

The neutral position of the spine is the posture most commonly sustained throughout daily activities. Previous investigations of the spine focused mainly on maximal exertions in various symmetric and asymmetric postures. This report proposes a new synergetic approach for analysis of the spine in neutral postures and evaluates its performance. The model consists of passive components, the osteoligamentous spine, and active components, the spinal muscles. The muscle architecture includes 60 muscles inserting onto both the rib cage and lumbar vertebral bodies. The passive spine is simulated by a finite element model, while kinematic constraints and optimization are used for resolution of a redundant muscle recruitment problem. Although the passive spine alone exhibits little resistance to a vertical load, its load-bearing capacity in neutral posture is significantly enhanced by the muscles, i.e., the passive spine and its muscles must be considered as a synergetic system. The proposed method is used to investigate the response of the spine when the T1 vertebra displaces 40 mm anteriorly and 20 mm posteriorly from its initial position. The sacrum is fixed at all times and the T1 displacements are achieved by the action of muscles. The results suggest that relatively small muscle activations are sufficient to stabilize the spine in neutral posture under the body weight. The results also indicate that muscles attaching onto the rib cage are important for control of the overall spinal posture and maintenance of equilibrium. The muscles inserting onto the lumbar vertebrae are found mainly to enhance the stability of the spine. The proposed method also predicts forces and moments carried by the passive system. Flexion moments ranging from 8000 Nmm to 15,000 Nmm, corresponding to decreases in lordosis of 6 degrees and 7.5 degrees respectively, are found to be carried by the passive spine at the thoracolumbar junction when the T1 vertebra is 40 mm anterior to its initial position.

Finite Element Analysis↗
PubMed2005

Effect of age on body sway assessed by computerized posturography.

The swaying and postural instability frequently seen in elderly subjects had not been analyzed quantitatively in detail until the introduction of computerized posturography. In order to assess the changes of body sway with aging, we performed computerized posturography in 144 subjects (51 men and 93 women, between the ages of 22 and 88 years) without specific neurological or metabolic disorders. The total and timed track length of the center of gravity, reflecting the distance of sway, increased with advancing age, with a highly significant positive correlation, without marked sex differences. The total area covered by the track of the center of gravity (expressing the extent of sway) also showed a similar tendency. Track density per unit area, expressing the efficiency of postural control, in contrast, decreased with age, showing a significant negative correlation with age, but only when the subjects had their eyes open; this decrease did not occur when they had their eyes closed. The Romberg ratio, an index of exacerbation of sway on eye closure, showed little change with a tendency for slight alleviation of sway and improvement in the efficiency of its control. Computerized posturography appears to be a useful tool with which to analyze the mechanism of swaying associated with old age.

Adult↗
PubMed2007

Postural stabilizing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) compared with calcium carbonate assessed by computerized posturography.

Sway and postural instability have drawn attention as a risk factor for osteoporotic fracture, in addition to low bone mineral density (BMD) and poor bone quality. In view of the fracture-reducing effect of alfacalcidol and active absorbable algal calcium (AAA Ca) not readily explained by rather mild increases of BMD, attempts were made to evaluate postural stabilizing effect of alfacalcidol, AAA Ca, and calcium carbonate (CaCO(3)) by computerized posturography. Track of the gravity center was analyzed to calculate parameters related to tract length, track range, and track density to express the degree of sway before and after supplementation in 126 subjects ranging in age between 20 and 81 years randomly divided into four groups. Supplementation with AAA Ca containing 900 mg elemental Ca (group A), no calcium (group B), CaCO(3) also containing 900 mg elemental Ca (group C), or alfacalcidol (group D) continued daily for 12 months. For each parameter, the ratio closed eye value/open eye value (Romberg ratio) was calculated to detect aggravation of sway by eye closure. Age, parameters of Ca and P, and proportions of subjects with fracture and those with low BMD showed no marked deviation among the groups. With eyes open, significant decreases of a track range parameter (REC) from group B was noted in groups A (P = 0.0397) and D (P = 0.0296), but not in group C according to multiple comparison by Scheffe, indicating superior postural stabilizing effect of A and D over C. In the first 2 months, a significant fall was already evident in REC from group B in group D (P = 0.0120) with eyes open. Paired comparison of sway parameters before and after supplementation revealed a significant increase of track density parameter (LNGA), indicating sway control efficiency and a significant decrease of REC in groups A and D compared to group B with eyes open. With eyes closed, only group A showed a significant improvement from group B (P = 0.0456; Fig. 1), with a significant shortening on paired After/Before comparison (P = 0.0142; Fig. 2). Computerized posturography appears to be useful in analyzing sway phenomena especially as to the effects of vitamin D and various Ca preparations.

Adult↗
PubMed2005

Effect of vision on postural sway in anterior cruciate ligament injured knees.

Recent clinical studies have investigated postural sway characteristics in anterior cruciate ligament (ACL)-deficient knees, but the relative contributions of vision and ACL remain unclear. In the current study, we measured and compared postural sway during one-leg standing with eyes open and closed to assess the difference between legs with and without ACL injury, and we discuss the contribution of the ligament relative to vision and to postural sway in patients. We examined 32 patients (17 males, 15 females) with ACL injury before surgery from March 2001 through January 2004. None presented obvious dysfunction in the lower limbs or central nervous system. Using a gravicorder, we measured locus length per time (LG) and environmental area (AR) as the factors of postural sway during two-leg and one-leg standing with eyes open or closed. In the ACL-injured knee, the amount of postural sway increased significantly during injured leg standing with eyes closed (LG, P < 0.0001; AR, P < 0.0001), but it did not increase significantly with eyes open. There were no significant differences with respect to sex or general joint laxity. There was no correlation between postural sway and the anterior translation of the tibia measured by arthrometer KT2000 or between the muscle strength around the knee. We concluded that the amount of postural sway in the ACL-injured knee increased significantly on injured leg standing with eyes closed, and that vision appears to be dominant in compensating for the decreased contribution of the injured ACL.

Adult↗
PubMed2006

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

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

Aged↗
PubMed2006

Involvement of the motor cortex in the bimanual unloading reaction: a transcranial magnetic stimulation study.

The responses of the biceps brachii muscle of the upper arm to magnetic stimulation of the motor cortex during the postural pretuning and forearm unloading tasks were studied in humans. On active unloading, the amplitude of the evoked response decreased in parallel with a decrease in muscle activity. During stationary holding of the load, the muscle response changed in proportion to the load. When, on the background of stationary holding of the load, the other arm took on the same load, the amplitude of the evoked response in the biceps muscle of the arm holding the load decreased without any change in the muscle activity. Passive unloading was accompanied by similar changes in the response evoked by magnetic stimulation as seen with active unloading. The question of whether the decrease in muscle activity (postural pretuning) in active unloading may be associated with both direct corticospinal influences and influences mediated via subcortical structures is discussed.

Evoked Potentials, Motor↗