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Stable parkinsonian syndrome and uneven loss of striatal dopamine fibres following chronic MPTP administration in baboons.

The progressive degeneration of dopamine neurons observed in idiopathic Parkinson's disease was mimicked by injecting low doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to baboons, on a chronic basis. Five Papio papio baboons were treated on two different regimens (chronic intravenous administration at weekly intervals for 20-21 months or, daily MPTP treatment for five days followed five to six months later by chronic weekly injections for 5-21.5 months). All animals were assessed for motor symptoms during and after neurotoxic treatment. Both regimens invariably resulted in the appearance of a progressive and irreversible syndrome characterized by action and resting tremor, cogwheel rigidity, postural impairments, hypokinesia and bradykinesia. In some animals, symptoms of resting tremor and rigidity initially restricted to one side of the body became bilateral within a few months of treatment. Subtle abnormalities that may be found in idiopathic Parkinson's disease such as alterations of the blink reflex response were also noted. Neuropathological examination of caudate nucleus, putamen, substantia nigra and ventral tegmental area in brain sections stained for tyrosine hydroxylase showed a typical uneven striatal dopamine fibre loss and a neuronal depletion in the dopaminergic mesencephalic cell groups that reproduce those observed in idiopathic Parkinson's disease. Immunocytochemical observations and behavioural data show that chronic rather than acute MPTP injection regimens can replicate most of the neuropathological and the clinical features typical of idiopathic Parkinson's disease, possibly by increasing the ability of this neurotoxin to target specific subpopulations of mesencephalic dopaminergic neurons.

Animals↗

Kinesthetic reference for human orthograde posture.

Humans with occluded vision were subjected to superslow tilts of the supporting platform, producing the inclination of the subject's body in the sagittal plane, but subthreshold for the most vestibular and proprioceptive phasic reactions. Two types of perturbation were used: sinusoidal tilts (frequency 0.007 Hz, amplitude 1.5 degrees) and ramps (amplitude 1.0 and 0.25 degrees, angular velocity 0.04 degrees/s). During slow sinusoidal tilts of the platform, the ankle angle and body position undergo periodical changes, but these changes have significant phase lead relative to the platform movement: 119 +/- 26 for ankle angle and 55 +/- 19 degrees for body sway. Gains were about 0.9 for both parameters. Large phase shift (tens of seconds) indicated a long delay in compensation of body inclination by ankle joint. The ramp tilt produced an initial body deviation followed by a slow (seconds or tens of seconds) approach of body position to a new steady level after the termination of ramp. Large slow body movements were superimposed with small irregular oscillations (about 10% of the amplitude of large displacements) of higher frequency. These oscillations resembled normal stabilograms on a stationary support. Thus, the usual process of stabilization of body gravity center was continued, though not around a fixed set-point but relative to a slowly changing position. Data obtained support the hypothesis that, besides operative control assigned to compensate deviations from a reference position, the system of postural control includes at least one additional level, which elaborates this reference using information about mutual position of body links, muscular torques and interaction with the support on the basis of criteria taking into account the energy cost of standing and demands for stability and security.

Adult↗

Temperature in mice after ethanol: effect of probing and regain of righting reflex.

The handling involved in rectally probing a mouse in order to measure body temperature is a stress which results in an increase in body temperature. However, after an injection of ethanol the fall in body temperature caused by ethanol is exacerbated by probing. In mice, decreases in temperature following probing are ethanol-dose dependent and can be generated on both the falling and rising phases of the ethanol induced change in temperature. The effect of probing can be observed when the mice are under the hypnotic influence of ethanol, and regain of righting reflex itself is followed by a fall in temperature. The resumption of motor activity in undisturbed mice following an hypnotic dose of ethanol also is accompanied by a fall in temperature. Therefore, the drop in temperature observed in any of these procedures which involve moving the mice may be attributable to the disruption of heat conservation rather than a stress interaction.

Animals↗

Use of a computerized postural sway measurement system for neurobehavioral toxicology.

The study of standing posture has been associated with nervous system functioning for over a hundred years. Measures of human standing ability have attracted some attention as indicators of neurotoxic insult. The use of postural sway measures as subclinical indicators of toxicity has not been regularly incorporated into most neurobehavioral test batteries, but the development of microcomputer-controlled systems offers new possibilities. The mechanisms involved in controlling postural sway are discussed, as well as the various measurement techniques. In addition, studies involving the effects of some neurotoxic agents are cited. A postural sway measurement system that is noninvasive, has 1-2-minute test periods, provides immediate test results, and is relatively free of practice and motivation effects is described. Results present the normative characteristics of the sway parameters, a comparison of three data transformation techniques, and the effects of height and weight on the sway parameters. Power calculations were also performed to estimate the number of subjects needed to detect effects at both the 80% and 90% power levels.

Adolescent↗

Standing steadiness measurements: empirical selection of testing protocol and outcome measures.

A variety of methods for measuring the effects of neurotoxic exposure have been developed and applied in epidemiologic studies of exposed workers. Although impairment of equilibrium is a common complaint among workers exposed to neurotoxicants, only a few studies have been published in which quantitative measurement of standing steadiness was used to assess occupational neurotoxicity. Possible reasons for limited use of these measures include inadequate evaluation and validation of testing protocols. The current project was undertaken to address some of these issues. Specifically, two studies of normal subjects were undertaken a) to compare standing steadiness measurements made with feet together or feet apart, and b) to assess the reliability of a number of potential summary measures for estimating standing steadiness. Study 1 was performed on eight subjects tested on 2 consecutive days. It demonstrated that a) a feet-together position resulted in greater systematic variance than a feet-apart position, b) sway varied systematically within 60-s trials, c) three 60-s eyes-open/eyes-closed trial pairs did not appear to provide more information than two pairs of trials. In Study 2, 30 subjects were tested on two occasions separated by 2 to 7 days using the procedure selected on the basis of the results from Study 1. Overall, the most reliable of several summary measures of standing steadiness was observed to be speed of sway.

Adult↗

[Home postural evaluation in the elderly: comparison between fallers and non fallers].

OBJECTIVES: To determine the main clinical and posturographic factors correlated with falls in elderly individuals and to specify the role of static posturography in this appraisal. MATERIALS AND METHODS: The study involved 38 people living in an residential center who were autonomously ambulatory and had a Mini Mental Test score> or =24. Fallers (N = 15) had fallen within 1 month, and nonfallers (N = 23) had not fallen for at least a year. Assessment consisted of a series of questions, a complete clinical appraisal, specific independently validated tests, and static posturographic analysis different parameters of the stabilogram with the eyes first open and then closed, all carried out in the center. RESULTS: From the clinical standpoint, spinal pathologic features and the scores on the Functional Reach Test were significantly different between the fallers and nonfallers. In static posturography, fallers' equilibrium was more precarious than that of nonfallers with eyes are closed: significant differences were observed in surface, X length and overall fast Fourier transform score. The comparison between results with open and closed eyes showed that the fallers had a pronounced tendency to retropulsion in the absence of visual participation: a significant difference as regards overall length, Y length, minimum Y and FFT Y (0.5-2 Hz). CONCLUSIONS: To complement a satisfactorily conducted clinical examination, static posturography allows for rapid assessment of equilibrium and posture in elderly patients who fall? Performed at the place where an individual resides, this appraisal constitutes an original and pragmatic element. As an evaluation strategy, it can reveal nonnegligible information within the framework of an appraisal of such, and thereby allows for adjustment of the rehabilitation or compensatory strategy.

Accidental Falls↗

[Effects of rigid-ankle and ankle-foot orthoses in the control of asymetrical undisturbed upright stance].

OBJECTIVE: To limit sensorimotor impairment associated with various diseases, devices aimed at easing such impairment are usually prescribed. A better knowledge of the specific effects of these devices in healthy subjects should help to assess the prescription. MATERIALS AND METHODS: Sixteen young healthy individuals were required to stand still on a double-force platform with an asymmetrical body weight distribution over the 2 legs and to reduce as much as possible their motions. Four conditions (1 used as reference without any orthosis and 3 with an ankle orthosis and 2 soft [ORP-S] and rigid [ORP-R] ankle-foot orthoses) were performed randomly. For each condition, 6 repetitions lasting 32 s were recorded. The centre-of-pressure trajectories from the loaded (CP(Cha)) and unloaded (CP(Déc)) feet and the resulting displacements (CP(Res)) were then computed along both the mediolateral (ML) and anteroposterior (AP) axes. Finally, these trajectories were analysed by their mean positions and parameters (Root Mean Square and Median Frequency) aimed at characterising their frequency spectra. RESULTS: Wearing the ORP-R model resulted in a backward shift of the mean position of the CP(Déc) trajectories, which had repercussions on CP(Res) values. In addition, frequency analysis showed decreased RMS for only the CP(Déc). DISCUSSION-CONCLUSION: We found effects linked to the physical features of various ankle orthoses tested. These effects can be observed because of the separate measure of the unloaded support. This data should improve the prescription of ankle-foot orthoses according to patient needs. These results should be viewed as a first step before their extension to study of patients with hemiparalysis, to improve their prescription in accordance with such patients' needs.

Adult↗

Get up and go test in patients with knee osteoarthritis.

OBJECTIVE: To determine the reliability, minimum detectable change (MDC), and validity of the Get Up and Go (GUG) test. DESIGN: Repeated-measures test-retest for reliability. Correlational study for validity. SETTING: Institutional practice. PARTICIPANTS: Convenience sample of 130 people, 105 with knee osteoarthritis (OA) (80 women; mean age, 62+/-9 y) and 25 healthy controls (21 women; mean age, 57+/-8 y). INTERVENTIONS: Not applicable. Main outcome measures Western Ontario and McMaster Universities Osteoarthritis Index, the Activity of Daily Living Scale of the Knee Outcome Survey, and the 8 scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: Intratester and intertester reliability was.95 (95% confidence interval [CI],.72-.98) and.98 (95% CI,.94-.99), respectively. The MDC, based on measurements by a single tester and between testers, was 1.5 and 1.2 seconds, respectively. Time to perform the GUG test was longer for persons with knee OA than it was for the controls (mean difference, 3.3s; 95% CI, 1.8-4.9). Correlations between the GUG test and measures of physical function did not differ significantly from correlations between the GUG test and measures that do not specifically evaluate physical function. CONCLUSIONS: The GUG test is reliable and has an MDC that is adequate for clinical use. Validity of the GUG test as a single measure of physical function was not supported. Further research should include testing a battery of performance-based measures of physical function.

Case-Control Studies↗

Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people.

OBJECTIVES: To estimate the immediate test-retest reliability of a single measure of several center of pressure (COP) variables, to report the number of trials to be averaged to obtain a reliable measurement of postural steadiness, and to determine the minimal metrically detectable change (MMDC). DESIGN: Cross-sectional study. SETTING: University biomechanics laboratory. PARTICIPANTS: Seven community-living, healthy elderly people over the age of 60 years (range, 62-73y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The COP was estimated from 2 force platforms and the following measures were calculated: (1) root mean square (RMS), (2) COP range, (3) COP mean velocity, (4) mean power frequency (MPF), (5) median power frequency (MedPF), and (6) sway area. Intraclass correlation coefficients (ICCs) were determined by using 9 successive quiet standing trials. RESULTS: The ICCs obtained for 1 measure of 120 seconds were.58 and.58 for the RMS,.83 and.94 for the COP mean velocity,.52 and.62 for the COP range,.44 and.30 for the MPF, and.34 and.47 for the MedPF in anteroposterior (AP) and mediolateral (ML) directions, respectively. The ICC of the COP sway area obtained for 1 measure was.41. Only 2 trials had to be averaged to obtain an ICC over.90 for the COP mean velocity associated with an MMDC of +/-1.2mm/s (AP) and +/-0.6mm/s (ML). CONCLUSIONS: Mean velocity was the most reliable COP measure and using 2 repetitions allowed for reliable measurement of postural steadiness. For the other COP variables, 3 trials of 120 seconds were needed to obtain an ICC over.80.

Aged↗

The influence of Tai Chi training on the center of pressure trajectory during gait initiation in older adults.

OBJECTIVE: To determine if a program of intense Tai Chi exercise that has been shown to reduce the risk of falling in older adults improves postural control by altering the center of pressure (COP) trajectory during gait initiation. DESIGN: Before-after trial. SETTING: Biomechanics research laboratory. PARTICIPANTS: Twenty-eight older adults transitioning to frailty who participated in either a 48-week intervention of intense Tai Chi training or a wellness education (WE) program. INTERVENTIONS: Eight Tai Chi forms emphasizing trunk rotation, weight shifting, coordination, and narrowing of lower-extremity stance were taught twice weekly. WE program participants met once a week and received lectures focused on health. Main outcome measures The COP was recorded during gait initiation both before and after the 48-week intervention by using a forceplate sampling at 300 Hz. The COP trajectory was divided into 3 periods (S1, S2, S3) by identifying 2 landmark events. Displacement and average velocity of the COP trace in the anteroposterior (x) and mediolateral (y) directions, as well as smoothness, were calculated. RESULTS: Tai Chi training increased the posterior displacement of the COP during S1 and improved the smoothness of the COP during S2. CONCLUSIONS: Tai Chi improved the mechanism by which forward momentum is generated and improved coordination during gait initiation, suggesting improvements in postural control.

Aged↗

Mirror versus stationary cross feedback in controlling the center of foot pressure displacement in quiet standing in elderly subjects.

OBJECTIVE: To investigate the effect of mirror feedback on postural control during quiet standing in elderly adults. DESIGN: Before and after intervention trials. SETTING: Pneumology center in France. PARTICIPANTS: Eleven elderly adults (mean age, 70.7+/-4.6 y; mean body weight, 64.5+/-15.0 kg; mean height, 161.4+/-12.0 cm). INTERVENTIONS: Participants were asked to stand upright, as immobile as possible, in 2 eyes-open and mirror-feedback conditions. The latter experimental condition consisted of supplying the subjects with their frontal reflection by positioning a mirror in front of them. MAIN OUTCOME MEASURES: Foot center of pressure (COP) displacements in the mediolateral (ML) and anteroposterior (AP) directions were recorded using a force platform. RESULTS: The mirror-feedback condition had different effects on postural sway, depending on the direction: range, variability, and maximal instantaneous speed of the COP displacements decreased in the ML direction, whereas these effects remained unchanged in the AP direction. CONCLUSIONS: This study provided evidence that mirror feedback may put elderly adults at lower risk of falling.

Aged↗

Reliability of traditional and fractal dimension measures of quiet stance center of pressure in young, healthy people.

OBJECTIVES: To assess reliability of traditional and fractal dimension measures of quiet stance center of pressure (COP). DESIGN: Cross-sectional study. SETTING: University laboratory. PARTICIPANTS: Thirty young healthy men (n=20) and women (n=10) (mean age, 23 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: COP was recorded for 3 trials across 4 conditions: eyes open and eyes closed standing on firm and foam surfaces. Traditional COP variables--peak sway velocity and range of sway, both in the anteroposterior (AP) and mediolateral (ML) directions, and total excursion area, and fractal dimension of the COP in the AP and ML directions--were calculated. Reliability statistics were calculated. RESULTS: Range of sway (AP) was the most reliable traditional variable (intraclass correlation coefficient model 2,1 [ICC(2,1)] range -.28 to .72.). Peak sway velocity (AP) had poorest reliability (ICC(2,1) range, .05-.29). Only 1 of the traditional variables had excellent reliability; total excursion area (firm, eyes closed) (ICC(2,1)=.95). All bar 1 fractal dimension measures had excellent ICCs. Relative technical error of measurement ranged from 4% to 7% for the fractal dimension measures. Coefficients of variation were also very good, ranging from 1.8% to 6.7%. CONCLUSIONS: Fractal dimension measures were more reliable than traditional measures of COP. Although traditional measures are used extensively to assess COP, their reliability is questionable. Fractal dimension measures show promise to reliably quantify COP and warrant further investigation.

Adult↗

The effects of muscle vibration on anticipatory postural adjustments.

The current study investigated the influence of changes in sensory information related to postural stability on anticipatory postural adjustments (APAs) in standing subjects. Subjects performed fast arm movements and a load release task while standing on a stable force platform or on an unstable board. We manipulated sensory information through vibration of the Achilles tendons and additional finger touch (contact forces under 1 N). Changes in the background activity of leg, trunk, and arm muscles and displacements of the center of pressure (COP) were quantified within time intervals typical for APAs. In the arm movement task, leg and trunk muscles showed a significant drop in the APAs with finger touch, while the vibration and standing on the unstable board each led to an increase in the APA magnitude. In the load release task, ventral muscles decreased their APA activity with touch, while dorsal muscles showed increased inhibition during APAs. During vibration, dorsal and ventral muscles showed increased excitation and inhibition during APAs, respectively. An additional analysis of APAs at a joint level, has shown that in both tasks, an index related to the co-activation of agonist-antagonist muscle pairs (C-index) was modulated with touch, vibration, and stability particularly in leg muscles. Small changes in the other index related to reciprocal activation (R-index) were found only in trunk muscles. Light touch and vibration induced opposing changes in the C-index, suggesting their opposite effects on the stabilization of a reference point or vertical. We conclude that the central nervous system deploys patterns of adjustments in which increased co-contraction of distal muscles and reciprocal adjustments in trunk muscles are modified to ensure equilibrium under postural instability.

Adult↗

Added cognitive load through rotary auditory stimulation can improve the quality of postural control in the elderly.

This study examined the effect of rotary auditory stimulation on postural control in the elderly. Thirty-two subjects aged over sixty were submitted to two rotary auditory stimulations, with a meaningful and a non-meaningful message, during a postural task. Although the non-meaningful task did not lead to postural control modification, the meaningful task allowed a reduction in the postural parameter values and therefore, a better stabilisation of posture. The attention, paid to the geography of the sound in understanding the story being told, forced the subject into taking into consideration the regularity and rotation of the stimulation, which meant relying on an auditory anchorage and so facilitated posture regulation.

Acoustic Stimulation↗

Maintenance of upright standing posture during trunk rotation elicited by rapid and asymmetrical movements of the arms.

Nine healthy subjects standing upright, initiated small, medium and large (S, M and L conditions, respectively) forward movements of their right (Rt) arm together with backward movements of their left (Lt) arm. They also performed medium-size movements while holding a 3 kg dumbbell in each hand (D condition). Movements started with the arm hanging alongside the body and ended when the shoulder reached a desired orientation. The arm and trunk movements were videotaped and recorded by accelerometers taped to the wrists, shoulders, and hips bilaterally. The torque around the vertical axis was measured using a force-plate on which the subjects stood. EMGs were recorded with surface electrodes bilaterally from the shoulder, trunk, and thigh muscles. Trajectories of the center of foot pressure were measured in additional experiments. In association with arm movements, there was a small counterclockwise (ccw: the Rt shoulder forward and the Lt backward) rotation of the trunk, followed by large alternate rotations of the trunk, first clockwise (cw) and subsequently ccw. The intervals from the hand acceleration to the shoulder and hip accelerations were, respectively, 0+/-15 ms (mean and S.D. for all subjects) and -17+/-15 ms. The force-plate showed initial cw and later ccw torques 63+/-41 ms after hand acceleration. The EMGs of the Rt hamstrings (Ham) and Lt rectus femoris (RFem) were followed by those of the Lt Ham and Rt RFem which, respectively preceded the alternate trunk rotations. The integrated EMGs and torques increased with increasing amplitude of arm movement and load. The integrated torques increased in the order of S, M, L, and D conditions. The integrated EMGs of the thigh muscles correlated with the integrated torques (medians: r=0.880, 0.696, 0.785, and 0.688, respectively, in the Rt Ham, Lt Ham, Rt RFem, and Lt RFem). The trajectories of the center of foot pressure showed variations, initially toward the Rt side and then the Lt side which, respectively coincided with the initial and later phases of the trunk rotations and the muscle activation. The trunk muscles were generally coactivated between the Rt and Lt muscles, and the integrated EMGs increased with increasing the integrated torques. Our results showed that alternate rotations of the upper trunk, produced by rapid arm movements, were transmitted to the hip in part due to cocontraction of trunk muscles, and each pair of hip joint muscles contributed to the maintenance of the standing posture by stabilizing the hip joints against alternating trunk rotations.

Adaptation, Physiological↗

Kinematics of podokinetic after-rotation: similarities to voluntary turning and potential clinical implications.

We examined the kinematics of voluntary turning in place at three different speeds and of inadvertent turning in place during attempts to step in place following stepping on a rotating disc (podokinetic after-rotation, PKAR). We hypothesized that voluntary turning in place, like online turning during walking, would be characterized by a top-down sequence of yaw rotations in the direction of the turn, i.e. the head would rotate first, followed by the trunk and then the foot. We also hypothesized that in place PKAR would be characterized by a bottom-up sequence of yaw rotations, i.e. the foot would rotate first, followed by the trunk and the head. The alternative possibility was that PKAR, like voluntary turning, would be initiated by the head and trunk and the foot would rotate last. As expected, voluntary turning in place was characterized by a top-down sequence similar to that noted previously during online turning in the midst of walking. Turning velocity did not alter the sequence of rotations in voluntary turning. In place PKAR was also characterized by a top-down sequence, indicating that PKAR may access the same neural circuits employed during voluntary turning. These data suggest that the rotating treadmill may be a useful training tool for addressing difficulties with turning that are experienced by individuals with Parkinson disease (PD).

Adult↗