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Postural control of the lumbar spine in unstable sitting.

OBJECTIVE: To evaluate the neuromuscular strategy adopted during sitting balance on an unstable surface in the frontal plane. DESIGN: Electromyographic evaluation of trunk muscles. SETTING: University spine biomechanics laboratory. PARTICIPANTS: Seventy asymptomatic men (mean age, 34.5 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: "Balancers" and "nonbalancers" were identified by principal component analysis of their lumbar spine side flexion angle during sitting balance. Average electromyographic levels were used as a measure of muscle activation. Pearson correlations were used to identify coactivation versus asymmetrical muscle activation of opposite muscle groups. RESULTS: External oblique, internal oblique, and thoracic erector spinae (TES) were most active, and most likely to be used asymmetrically, with other muscles showing low levels of coactivation. Between groups, the average electromyographic levels in the balancers was lower than in the nonbalancers (P<.05), with further differences in the symmetry of external oblique, internal oblique, and TES activation between groups. CONCLUSIONS: Sitting balance in the frontal plane appears to involve a combined feedforward-feedback strategy of muscle activation. Successful balance was characterized by low levels of muscle coactivity, along with higher levels of asymmetric activation in the global trunk muscles, specifically external oblique, internal oblique, and TES.

Adult↗

Force platform measures for evaluating postural control: reliability and validity.

The reliability and validity of force platform measures used to evaluate steadiness of stance were investigated in a group of 28 healthy subjects in four basic stance positions: two-legged, step, tandem, and one-legged stance. In each stance position five indices of steadiness were obtained by sampling the three orthogonal force signals and the two horizontal center of pressure (CP) signals for 15 seconds and computing the standard deviation for each signal. Correlations between these five indices derived from the force platform showed that the relationship between force and CP measures was generally weak. In fact, approximately 40% of the correlations were nonsignificant (p greater than .05). There was a strong trend for the retest reliability of force measures to be higher than the retest reliability of CP measures. The difference was statistically significant in three stances (p less than .05). Force measures were more sensitive than CP measures in discriminating the changes in steadiness which resulted from alterations to the base of support in the four stance positions. Factor analysis showed that force measures were the best predictors of steadiness in each stance, but the axis varied according to the particular stance condition. Although it may be appropriate in some cases to justify the choice of measure according to the nature of the clinical condition being studied, these results provide a rationale for choosing force measures in preference to CP measures on the fundamental principles of reliability and validity.

Adult↗

Postural control in young and elderly adults when stance is perturbed: dynamics.

Responses in maintaining or restoring standing balance were measured in 24 healthy young and 15 healthy elderly adults (mean ages 26 and 72) under four task conditions: two involving self-generated motions and two involving imposed disturbances. The two primary objectives of the study were to quantify the whole-body dynamics of these responses and to identify any age related differences in those dynamics. Response dynamics were analyzed using a seven-link biomechanical model. In terms of approximate population-mean values, maximum whole-body center of mass (CM) excursions ranged to 3 cm, maximum center of support-surface reaction (CR) excursions ranged to 8 cm, vertical reaction force changes ranged to 50 N, anteroposterior support surface reactions ranged to 30 N, maximum joint torques used per side ranged to 20 Nm and peak angular momenta about a transverse axis through the ankles ranged to 6 kg m2 s-1. The elderly adults, compared to the young tended to exhibit higher-frequency oscillations in excursions and larger horizontal excursions of their CM and CR, tended to develop larger support surface reactions and use larger response joint torques, and tended to arrest less of their angular momentum in their first cycle of response during the two imposed-disturbance tasks. Only some of these tendencies proved statistically significant. The results suggest that healthy elderly subjects with no apparent musculoskeletal or neurological impairments differ from healthy young adult subjects in their responses to modest perturbations of upright stance. However, the differences are generally not large and their magnitudes are perturbation-specific.

Acceleration↗

Age-related changes in postural control associated with location of the center of gravity and foot pressure.

The purpose of this study was to assess the limitations of the head and lumbar movements in relation to the center of gravity which is needed to maintain standing balance with aging. The subjects of the study were 22 healthy volunteers. The subjects were divided into two age categories, the young group (mean 21.7 +/- 2.9 years, 7 males and 6 females); and the elderly group (mean 71.3 +/-2.6 years, 3 males and 4 females). The instruments for measuring lumbar and head movements and the center of pressure (COP) were a three-dimensional motion analysis system and a force plate. In addition, the peak foot pressure was measured during standing using the F-Scan system. The subjects were first asked to stand relaxed for 10 s. They then shifted from the starting position to the four directions (sways); anterior, posterior, right, and left. They tried to maintain standing balance at the maximal possible distance position for each sway for 10 seconds. Analyzing parameters were performed by measuring the average maximal linear displacement (cm) of the head and lumbar markers, the COP (cm), and the peak foot pressure (percent of body weight per squared centimeters; BW%/cm2) in each subject. The data of the young group for lumbar maximal displacement were greater than those of the elderly group in the anterior, posterior, and lateral sways. A significant difference between the young and elderly data was found in the posterior sway. According to the data of the head's maximal displacement, the elderly group was greater than the young group in all sways except for the anterior side. For the data of peak foot pressure in the posterior sway, the elderly group's data was greater than the young group's data. The forefoot area data of the young group was significantly greater than that of the elderly group and the heel area data of the elderly was significantly greater than that of the young group in the right sway. The results suggest that evaluating the maximal displacement of head and lumbar positions and toe's activity in the forefoot are all important factors associated with the center of gravity in healthy adults.

Adolescent↗

Intranigral kainic acid: evidence for nigral non-dopaminergic neurons controlling posture and behavior in a manner opposite to the dopaminergic ones.

The unilateral, intranigral administration of kainic acid (k.a.) produced a syndrome characterized by early sequelae of contra- and ipsilateral circling and by a chronic contralateral turning associated with moderate loss of neurons in the pars reticulata. The acute contralateral circling seems to be related to dopaminergic nigro-neostriatal neuron stimulation, since it was prevented by previous intranigral injections of 6-OHDA. The acute ipsilateral circling and the chronic contralateral turning, on the other hand, seem to be independent of the integrity of the dopaminergic system and may be due to an initial stimulation, followed by destruction, of a nigral neuronal system which mediates turning behavior in a manner opposite to that of nigro-striatal dopamine. Treatment with D-amphetamine or apomorphine changed the contralateral into ipsilateral turning, while haloperidol potentiated the contralateral turning. Bilateral injection of k.a. into the nigra resulted in chronic stereotyped sniffing and gnawing, which were not inhibited by haloperidol. Moreover, haloperidol did not produce catalepsy in these animals. It is suggested that the intranigral k.a. injection destroyed a neuronal system antagonistic to dopamine and resulted in a reduction of the response to DA-receptor stimulation of the c. striatum.

3,4-Dihydroxyphenylacetic Acid↗

Environmental topography and postural control demands shape aging-associated decrements in spatial navigation performance.

This study tests the hypothesis that aging-induced cognitive permeation of sensorimotor functions contributes to adult age differences in spatial navigation performance. Virtual maze-like museums were projected in front of a treadmill. Sixteen 20-30-year-old men and sixteen 60-70-year-old men performed a way-finding task in city-block or variable topographies while walking with or without support. Walking support attenuated age-related decrements in navigational learning. Navigation load increased trunk-angle variability for older adults only. Age differences in spatial knowledge persisted despite perfect place-finding performance. City-block topography was easier than variable topography for younger adults only, indicating age-related differences in reliance on spatial relational learning. Attempts at supporting older adults' navigation performance should consider sensorimotor/cognitive interactions and qualitative differences in navigational activity.

Adult↗

Oral motor control, posturing, and myofunctional variables in 8-year-olds.

One hundred thirty-three rural second graders were evaluated for diadochokinetic abilities and myofunctional variables. Single-syllable diadochokinetic rates were significantly correlated with open-mouth resting postures. Slow trisyllable diadochokinetic rates were significantly correlated with a dentalized resting tongue posture and dentalized swallow patterns. The implications of these relationships are discussed.

Articulation Disorders↗

Movement patterns of intrinsic minus fingers. Role of intrinsic and extrinsic muscles in finger posture control.

A detailed study of the patterns of two movements (pure metacarpophalangeal flexion and pure interphalangeal extension) in intrinsic minus fingers shows that the long extensors and long flexors produce simultaneous movement at the metacarpophalangeal and interphalangeal joints. A comparison of the patterns of these movements in totally intrinsic minus and interosseous minus fingers shows that in the latter the lumbricals are probably largely inactive during attempted pure metacarpophalangeal flexion and contribute to restrain metacarpophalangeal extension considerably during attempted pure interphalangeal extension. Active participation by the interosseous muscles appears necessary for completing these movements.

Fingers↗

What is balance?

Balance is a term frequently used by health professionals working in a wide variety of clinical specialities. There is no universally accepted definition of human balance, or related terms. This article identifies mechanical definitions of balance and introduces clinical definitions of balance and postural control. Postural control is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. Postural control strategies may be either predictive or reactive, and may involve either a fixed-support or a change-in-support response. Clinical tests of balance assess different components of balance ability. Health professionals should select clinical assessments based on a sound knowledge and understanding of the classification of balance and postural control strategies.

Gravity Sensing↗

Interacting Constraints and the Emergence of Postural Behavior in ACL-Deficient Subjects.

In this study, the authors examined how task, informational, and sensorimotor system constraints influence postural control. Postural behavior of subjects with (n = 15) and without (n = 15) a key sensorimotor system constraint, anterior cruciate ligaments (ACLs) in 1 knee, was examined during 1- and 2-legged stance with and without vision. Postural control was assessed on a commonly used postural sway meter and on a dynamic stabilometer. Data on postural sway characteristics were obtained for 30 s under 6 different conditions: standing, with eyes open and closed, on both legs, on the injured leg, and on the noninjured leg. The interaction of task, informational, and sensorimotor constraints was observed only on the dynamic stabilometer and not the postural sway meter. Vision was the most important informational constraint on postural control for subjects on the dynamic stabilometer, particularly for the ACL-deficient group standing on the injured leg. Under more static task constraints, ACL deficiency did not prove a significant disadvantage, because vision was confirmed as a significant source of exproprioceptive information. The results support the functionality of using dynamic tasks such as a stabilometer in assessing postural behavior of subjects with sensorimotor system constraints.

Journal Article↗

Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories.

A new conceptual and theoretical framework for studying the human postural control system is introduced. Mathematical techniques from statistical mechanics are developed and applied to the analysis and interpretation of stabilograms. This work was based on the assumption that the act of maintaining an erect posture could be viewed, in part, as a stochastic process. Twenty-five healthy young subjects were studied under quite-standing conditions. Center-of-pressure (COP) trajectories were analyzed as one-dimensional and two-dimensional random walks. This novel approach led to the extraction of repeatable, physiologically meaningful parameters from stabilograms. It is shown that although individual stabilograms for a single subject were highly variable and random in appearance, a consistent, subject-specific pattern emerged with the generation of averaged stabilogram-diffusion plots (mean square COP displacement vs time interval). In addition, significant inter-subject differences were found in the calculated results. This suggests that the steady-state behavior of the control mechanisms involved in maintaining erect posture can be quite variable even amongst a population of age-matched, anthropometrically similar, healthy individuals. These posturographic analyses also demonstrated that COP trajectories could be modelled as fractional Brownian motion and that at least two control systems-a short-term mechanism and a long-term mechanism-were operating during quit standing. More specifically, the present results suggest that over short-term intervals open-loop control schemes are utilized by the postural control system, whereas over long-term intervals closed-loop control mechanisms are called into play. This work strongly supports the position that much can be learned about the functional organization of the postural control system by studying the steady-state behavior of the human body during periods of undisturbed stance.

Adult↗

Independent and convergent signals from the pontomedullary reticular formation contribute to the control of posture and movement during reaching in the cat.

We have addressed the nature of the postural control signals contained within the discharge activity of neurons in the pontomedullary reticular formation, including reticulospinal neurons, during a reaching task in the cat. We recorded the activity of 142 neurons during ipsilateral reaching movements that required anticipatory postural adjustments (APAs) in the supporting limbs to maintain equilibrium. Discharge activity in 82/142 (58%) neurons was significantly increased before the onset of the reach. Most of these neurons discharged either in a phasic (22/82), tonic (10/82), or phasic/tonic (41/82) pattern. In each of these 3 groups, the onset of the discharge activity in some neurons was temporally related either to the go signal or to the onset of the movement. In many neurons, one component of the discharge sequence was better related to the go signal and another to the onset of the movement. Based on our previous behavioral study during the same task, we suggest that reticular neurons in which the discharge activity is better related to the go signal contribute to the initiation of the APAs that precede the movement. Neurons in which the discharge activity is better related to the movement signal might contribute to the initiation of the movement and to the production of the postural responses that accompany that movement. Together our results suggest the existence of neurons that signal posture and movement independently and others that encode a convergent signal that contributes to the control of both posture and movement.

Animals↗

Spatial zones for muscle coactivation and the control of postural stability.

It is hypothesized that, depending on the motor task, the angular range of a joint may be subdivided into zones in which agonist and antagonist muscles are coactive, only one group of muscles is active or neither group is active. It is further hypothesized that central commands may change the size and location of these spatial zones. We investigated whether spatial zones are used by the nervous system and how they may be changed to provide postural stability of the elbow. We compared responses to sudden unloading of the elbow flexors in neurologically normal subjects with those in patients with postural control deficits due to unilateral hemispheric and/or subcortical lesions. By studying responses in patients, we sought to determine whether the specification of zones of agonist/antagonist muscle coactivation ("coactivation zones") may be essential for postural stability. At an initial elbow angle (130 degrees; full extension is 180 degrees), flexors were pre-activated by compensating an initial load which was equal to approximately 30% of the subject's maximal isometric voluntary contraction effort. Subjects were instructed not to correct the arm displacement elicited by a sudden decrease in the load. Data from 10 trials were collected at each of 4-6 final load levels (separated by 1.5-2 Nm) in order to map out the relationship between torque and angle in each subject. The procedure was repeated from a more flexed initial position of the elbow (100 degrees). EMG activity from two elbow flexors and two elbow extensors, as well as torque, velocity and joint position were recorded. Healthy control subjects and patients with mild clinical symptoms had coactivation zones or small silent zones around the final positions established after unloading. In these subjects, final positions of the limb were stable. Voluntary movement, i.e., transition of the limb from one initial position to another, was associated with a change in the location of the zone in articular space. The presence of large silent zones in patients with moderate or severe symptoms was correlated with postural instability and oscillations about the final position of the arm after unloading. The comparison of results from healthy and hemiparetic subjects implies that the central specification of the size and the location of a coactivation zone may be fundamental for the control of posture and movement.

Adult↗