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Does postural instability affect the initiation of human gait?

During gait initiation (GI), decoupling of the center of mass and center of pressure allows the center of mass to fall forwards. Subjects initiated gait rapidly before and after tibial nerve block of the tibial nerve. Static single limb stability, stance limb ground reaction forces, electromyogram and temporal data were measured. It was hypothesized that postural stability would decrease post-block and that this would affect the kinetic and temporal properties of GI. Subjects had significantly decreased postural stability post-block and changes in normal gait kinetics, however, no changes were noted in ground reaction forces or relative temporal data of the GI task. The finding that GI was unaffected by diminished single leg postural instability suggests that GI is a pre-programmed task.

Adaptation, Physiological↗

Developmental sequence in the acquisition of anticipation during a new co-ordination in a bimanual load-lifting task in children.

The aim of this experiment was to test the capacity of children to develop anticipation at various stages of their growth. We studied the learning process of an artificial co-ordination by means of a procedure of double unloading in two groups of children, and a group of adults. Elbow-joint angle measurement was used to assess for the improvement of the forearm stabilization through the six learning sessions. The main results report a developmental sequence of the acquisition of anticipatory postural adjustments (APA) similar to the one established for the ontogenesis of APA. A difference in learning dynamics, but also in the final level of performance, is reported between children aged 5-6 and children aged 7-8 years. The improvement occurring at the age of 7 years probably indicates maturation of internal representations, favourable to the faster setting up of operational anticipated control.

Adult↗

Postural sway under muscle vibration and muscle fatigue in humans.

Separate studies have demonstrated that vibration and fatigue of ankle muscles alter postural control. The purpose of the present experiment was to investigate the effect of ankle muscle vibration on the regulation of postural sway in bipedal stance following ankle muscle fatigue. Center of foot pressure displacements were recorded using a force platform. Results showed a similar increase in postural sway under muscle fatigue as well as under muscle vibration. Interestingly, under muscle fatigue muscle vibration did not induce a further increase in postural sway. Two hypotheses could, at least, account for this observation: (1). fatigued muscles are less sensitive to muscle vibration and (2). the central nervous system relies less upon proprioceptive information originating from fatigued muscles for regulating postural sway.

Adult↗

3D analysis of posturo-kinetic coordination associated with a climbing task in children and teenagers.

The aim of this study was to characterize the modifications of the posturo-kinetic coordination during a climbing task as a function of postural and/or movement constraints in children (8-10 years) and adolescents (10-15 years). A 3D-analysis of forces was recorded for different movement amplitudes and types of holds. The results show the involvement of horizontal and vertical forces to maintain equilibrium during the steady state changes for different experimental groups. The contribution of horizontal and vertical forces changes in the course of movement realization. The vertical momentum (Iz) is mainly involved in the movement initiation: this role is mostly meaning for children. The horizontal momentum (Ih) is mainly involved in controlling equilibrium: this role is mostly meaning for adolescents.

Adolescent↗

Effects of local fatigue of the lower limbs on postural control and postural stability in standing posture.

Postural stability and postural control were studied before and after a fatigue protocol of soleus muscles. Postural stability was assessed by the centre of gravity motion, which was computed from the motion of the centre of pressure, evaluating the postural control. Ten healthy male subjects were asked to stand as still as possible with eyes open before and after the fatigue protocol, performed in a sitting position. Fatigue was assumed on the basis of a shortening of the exertion time of the soleus muscles at 60% of their maximal voluntary contraction. Results of the whole group showed that fatigue modified postural control but did not change postural stability. The same results were observed only for some subjects. However, these results indicate an increase of the neuromuscular activity in high frequencies.

Adult↗

Recurrence analysis of human postural sway during the sensory organization test.

The present study examined how the availability of and alterations in sensory information during the sensory organization test (SOT) influenced the amount, variability, and temporal structure of spontaneous postural sway in young, healthy adults. Findings indicated that postural sway tended to increase in amount and variability as the SOT condition became increasingly difficult (i.e. as the SOT condition moved from eyes open to eyes closed, to sway-referenced visual surround or support surface, and to sway-reference surface and visual surround). In addition, recurrence quantification analysis revealed that the temporal structure of postural sway tended to become increasingly regular as the SOT condition increased in difficulty. The functional utility of the observed changes in the temporal structure of postural sway across sensory conditions was discussed.

Adult↗

Motor control and children with autism: deficit of anticipatory function?

This study aims at investigating how do anticipatory postural adjustments develop in children with autism, during a bimanual load-lifting task that required maintaining the stabilisation of the forearm despite imposed or voluntary unloading. Elbow angle and electromyographic were recorded on the child forearm supporting the load. The forearm stabilisation was as good in children with autism as in the control group. However, in children with autism, the latencies for both kinematics and muscular events indicated an increase of the duration of unloading. These results indicate the use of a feedback rather than a feed-forward mode of control. Impairments in both the building of internal representations and the mastering of timing parameters, could explain the deficient postural anticipation reported in children with autism.

Autistic Disorder↗

Human stance stability improves with the repetition of the task: effect of foot position and visual condition.

The effects of repetition of quiet stance trials on body sway, recorded through a stabilometric platform, were studied in 12 normal subjects. With feet together, both with eyes open (EO) and closed (EC), a progressive shift forward of the centre of foot pressure (CFP) occurred with repetition. In addition, with EC, but not with EO, a significant progressive reduction in sway area (SA) and sway path (SP) occurred. With feet 10 cm apart, initial SA and SP values were significantly smaller than with feet together, regardless of the visual condition, but repetition of trials induced no significant effects on either position of CFP or body sway under either visual condition. Results indicate the occurrence of a learning phenomenon in this simple postural task, whereby the body shifts towards a 'safer' position with a minimum energy expenditure due to reduced corrections of sway. Forward leaning and decrease in sway are two independently-occurring processes, each possibly due to a better central integration of proprioceptive input with repetition of trials.

Adolescent↗

Fitts' law in human standing: the effect of scaling.

Fitts' law states that the movement time (MT) of an aiming movement is a linear function of the index of difficulty (ID), where ID = log2(2A/W, A is the movement amplitude, and W is the target width. This law implies that MT should remain unchanged as long as A/W remains constant (i.e. the absence of a scaling effect). The goal of this study was to investigate whether, during upright posture, reciprocal-pointing movements with the center of pressure location follow Fitts' law. Six subjects performed the task with six IDs factorially combined with four As. The results showed that for each A, MT was a linear function of ID. However, the slopes of the linear-regression lines increased with decreases in A. These findings indicate the presence of a scaling effect which violates Fitts' law.

Adult↗

Autonomic nervous system activity associated with postural disturbances in patients with perilymphatic fistula: sympathetic or vagal origin?

The study focused on patients suffering from perilymphatic fistula (PLF), whether they had undergone surgery or not. Vestibular disturbances can be harmless but are associated with varying symptoms, demonstrating disorders within the autonomic nervous system (ANS). The aim was to test whether the orthosympathetic is involved as the vagal part is often suspected of eliciting a feeling of sickness. Non-invasive and uninterrupted recording of ANS activity represents an objectivation technique to evidence such disturbances. Electrodermal activity, thermovascular variables, instantaneous cardiac rate and blood pressure were recorded. Discomfort was triggered experimentally by applying various stimulations successively to the intact ear then to the PLF (or operated) side. Twelve subjects took part in the experiment. Two types of ANS activity were distinguished: (1) phasic responses during stimulation and (2) tonic evolution thereafter. Results show strong activation in orthosympathetic variables when the PLF side was stimulated. No further significant difference between the two sides was to be observed following surgery. After stimulation, a sudden increase in skin resistance was observed, associated with slight bradycardia. No vagal signs having been evidenced, actual nausea may result from brief inhibition of sympathetic activation resulting, in turn from primary over-activation of this system.

Adult↗

Examination of sensorimotor performance following middle cerebral artery occlusion in rats.

Middle cerebral artery occlusion (MCAO) in rats is the most commonly used stroke model. Besides the infarct size, assessment of sensorimotor performance has become increasingly important in neuroprotective drug research. However, contradictions exist about procedures for testing functional outcome following MCAO. The aim of the present study was to evaluate a relatively simple set of neurological tests based on the most commonly used scoring systems, and to describe the functional recovery and correlation with the infarct size in rats sacrificed 2 or 14 days after permanent or transient MCAO. The smaller infarct size of rats with transient occlusion was reflected in the neurological scores only during the first 6h. By day 14, no recovery occurred in postural signs, lateral resistance and spontaneous activity, other signs showed different degrees of recovery. Correlation with the infarct size was found only on certain days in gait disturbance, placing reactions, daily body weight and spontaneous activity. According to our observations, the most commonly used sensorimotor tests provide a useful initial screening of functional deficits, but these tests most probably measure deficits caused by infarction of the core area. It is suggested that these tests should be completed by more refined tests when testing a neuroprotective drug which reduces the infarct size in penumbral areas.

Animals↗

Relationship between head sway and center of foot pressure sway.

We investigated the correlation between body sway and head sway in 64 healthy subjects who stood on a force-measuring platform. Each subject wore a helmet attached to a cephalograph and was asked to stand as still as possible on a platform with his feet close together for 60 sec. Subjects were asked to do this three times with their eyes closed and three times with their eyes open. We selected the test with the minimum sway for computer analysis of the sway path, sway area, ratio of anteroposterior/lateral components, sway velocity in each direction, averaged divisional frequency, and Romberg quotient. The movement of the head was significantly correlated with the center of foot pressure (COF) for the sway path, sway area, sway velocity, averaged divisional frequency, and the Romberg quotient. Our findings suggest that COF sway can be used instead of head sway to assess those five parameters.

Adolescent↗

Postural deviation evoked by caloric stimulation during upright standing in man.

To understand a disequilibrium of the peripheral vestibular disorders, we tried to analyze the body sway evoked by unilateral or bilateral caloric stimulation with warm and cold water systematically. As for postural deviation, the results of our study are summarized as follows. Unilateral warm stimulation evokes heterolateral and anterior postural deviation. Unilateral cold stimulation evokes homolateral and anterior postural deviation. Bilateral warm stimulation evokes posterior postural deviation. Bilateral cold stimulation evokes anterior postural deviation. Therefore we consider that there are several patterns of static disequilibrium of upright posture in the peripheral vestibular disorders.

Adult↗

The influence of eye movements and tactile information on postural sway in patients with peripheral vestibular lesions.

The statokinesigram of the 16 benign paroxysmal positional vertigo (BPPV) patients and the 28 vestibular deficits (VDS) patients were analyzed in comparison with the 20 normal subjects (NS). Velocity of the track (LNG/T), root mean square (RMS), and standard deviation area (SD-Area) were used as parameters. Fourteen different tests were done. When the result for each subject group were analyzed there were interesting differences between the compensated VDS and BPPV patients and between the untreated period and the compensated stage in each patient group. Comparing the data between NS and BPPV at the compensated stage, the latter group was unstable while watching LED with OKN on the tactile information plate (S-G plate). The significant differences were for RMS and SD-Area. The data of the NS and the untreated VDS show that the latter group was more unstable while watching LED with OKN than in the dark on the S-G plate. According to the data of the NS and the VDS at the compensated stage, the latter group was more unstable during OKN or watching LED which was almost the same as in the dark on both plate conditions. And it was more unstable while watching LED than during OKN on the S-G plate. The significant differences were for velocity of body sway (LNG/T). The neural region for compensation in BPPV patients might be on the visuo-oculomotor pathway through the peripheral retina. One of the most important regions for compensation in VDS patients might be in the rombencephalic reticular formation.

Eye Movements↗

Does articulation contribute to modifications of postural control during dual-task paradigms?

Many studies have been carried out to investigate the attentional resources required for postural control, using a 'dual-task' methodology in which performance on mental and postural control tasks is compared when these are carried out separately and concurrently. Most mental tasks used in these dual-task studies have employed verbal responses. However, changes in respiration during speech production are known to produce changes in postural control. Hence, the goal of this study was to determine whether articulation might contribute to the changes found in postural sway when a spoken mental task is being performed and to determine if the type of postural control measurement might also have an impact on the outcome of the study. Twenty young healthy participants were asked to stand on a force platform while executing secondary tasks that were performed silently or required a verbal response, and that required high or low levels of attention. Vision and postural task difficulty were manipulated. Performance of all tasks produced an increased sway frequency and decreased sway amplitude relative to the no task baseline. However, tasks that required articulation resulted in a more pronounced increase in postural sway frequency and sway path than did the tasks that did not require any articulation. These findings could imply that the addition of a secondary task results in increased stiffness, whereas articulation results in a further increased frequency of sway, which leads to an increase in sway path. We conclude that changes in the various parameters of sway that accompany performance of secondary tasks are complex, and are not always wholly attributable to attentional load, but may also be partly due to the motor requirements of the task, such as those involved in articulation.

Adult↗

Prism adaptation to rightward optical deviation improves postural imbalance in left-hemiparetic patients.

Left-hemiparetic patients show predominant postural imbalance as compared to right-hemiparetic patients. The right hemisphere is crucial for generating internal maps used for perceptual and premotor processing of spatial information. Predominant postural imbalance with right-brain damage could thus result from a distortion of an internal postural map. Well-known manifestations of distorted internal maps due to right-hemisphere lesions, such as hemineglect, may show improvement following prism adaptation shifting the visual field to the right. We therefore investigated the effect of prism adaptation on postural imbalance in left-hemiparetic patients. Three groups of five patients were either adapted to prisms deviating the visual field to the right or left or exposed to neutral prisms while performing reaching movements of the right arm. Postural imbalance was reduced only following prism adaptation to the right. Thus, brief adaptation (i.e., 3 min) to rightward-shifting prisms can dramatically improve postural imbalance. This result shows that the effect of exposure to prisms that horizontally shift the visual field to the right in a reaching task generalizes to the postural system, and it suggests an interaction between horizontal and vertical reference frames. This also supports the theory that predominant postural imbalance in patients with right-brain damage may be partly related to a distortion of an internal postural map.

Adult↗

Postural control is scaled to level of postural threat.

This study investigated control of posture when standing at different surface heights above ground level. Alterations in surface height were used to modify threat to postural control. Sixty-two healthy adults (mean+/-S.D.=20.3+/-1.3 years) stood quietly on a force plate 40 cm (LOW threat), 100 cm (MEDIUM threat) or 160 cm (HIGH threat) above ground level. Each standing trial was performed with eyes open for 120 s. Postural threat was presented in ascending (n=31) or descending (n=31) order with the first threat condition in each series (LOW threat for ascending group, HIGH threat for descending group) repeated. This manipulation allowed for an examination of set effects (i.e. prior experience of postural threat) on postural control. The results demonstrated scaling of postural control variables to level of postural threat. Amplitude of centre of pressure (COP) displacement decreased and frequency of COP displacement increased linearly as postural threat increased from LOW to HIGH. The central nervous system progressively tightened control of posture as postural threat increased. Initial exposure to the HIGH or LOW threat condition influenced postural control differently. The group who received the HIGH threat condition first (descending) demonstrated increased amplitude of COP displacement in the anterior-posterior direction compared with the group who received the LOW threat condition first (ascending). A 'first trial' effect was observed when standing for two consecutive trials but only at the LOW threat condition. Decreased amplitude and increased frequency of COP displacement were observed on the first trial compared to the second trial. The results of this study demonstrated that control of posture is influenced not only by the threat to posture but also by the order in which the threat to posture is experienced.

Accidental Falls↗

Postural activity of constrained subject in response to disturbance in sagittal plane.

This study examines the postural activity of partially constrained subjects for three different initial standing postures in response to disturbances in the sagittal plane. When the ankle strategy suffices for disturbance rejection in response to anterior disturbances, a mostly linear relationship between the ankle torque and ankle angle was observed, resulting in a constant stiffness at the ankles. However, when the ankle torque saturation was reached, a combined ankle-trunk postural strategy was utilized mainly in response to posterior perturbations due to the properties of the base-of-support. This caused a nonlinear scaling of ankle responses, thereby increasing variability of ankle stiffness. Distinctions in the ankle responses were also observed for different initial standing postures. The anterior initial stance generally increases the overall postural stability and renders the utilization of ankle strategy feasible, even for the rejection of posterior disturbances. Therefore, a linear torque-angle relationship at the ankles was observed for the anterior initial stance, regardless of the perturbation parameters.

Adult↗