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The contribution of motion, the visual frame, and visual polarity to sensations of body tilt.

Three types of visual information contribute to the sense of self orientation with respect to gravity: visual polarity of objects with a distinct top and bottom, the principal vertical and horizontal lines of the visual environment, and visual motion. Three visual displays were designed to investigate the contribution of each visual feature to illusory self tilt: a large sphere lined with dots, a cubic room lined with dots, and a furnished room with floor and ceiling. In experiment 1 the dotted room and the furnished room were tilted to various angles about the roll axis of the erect subject who set a visual line and an unseen rod to the apparent vertical. In the dotted room, settings were made either with respect to the nearest surface to the horizontal or with respect to the nearest diagonal of the room. In the furnished room, settings were made with respect to the nearest horizontal wall but not with respect to diagonals. In experiment 2 each of the three displays was rotated at constant velocity and subjects' responses were classified into four categories: illusory self tilt at a constant angle, alternating self tilt with the body becoming erect each time a surface became horizontal, continuous head-over-heels self rotation, and a feeling that the body was supine. Almost all responses were of constant tilt in the sphere. Constant and alternating tilt were the most common responses in the dotted room. In the furnished room 60% of subjects experienced full head-over-heels self rotation.

Attention↗

Respective contribution of orientation contrast and illusion of self-tilt to the rod-and-frame effect.

The visual angle subtended by the frame seems to be an important determinant of the contribution of orientation contrast and illusion of self-tilt (ie vection) to the rod-and-frame effect. Indeed, the visuovestibular factor (which produces vection) seems to be predominant in large displays and the contrast effect in small displays. To determine how these two phenomena are combined to account for the rod-and-frame effect, independent estimates of the magnitude of each component in relation to the angular size subtended by the display were examined. Thirty-five observers were exposed to three sets of experimental situations: body-adjustment test (illusion of self-tilt only), the tilt illusion (contrast only) and the rod-and-frame test, each display subtending 7, 12, 28, and 45 deg of visual angle. Results showed that errors recorded in the three situations increased linearly with the angular size. Whatever the size of the frame, both mechanisms, contrast effect (tilt illusion) and illusory effect on self-orientation (body-adjustment test), are always present. However, rod-and-frame errors became greater at a faster rate than the other two effects as the size of teh stimuli became larger. Neither one nor the other independent phenomenen, nor the combined effect could fully account for the rod-and-frame effect whatever the angular size of the apparatus.

Adult↗

Automatic determination of the transition between successive control mechanisms in upright stance assessed by modelling of the centre of pressure.

A recently introduced concept models the trajectory of the centre of pressure as a fractional Brownian motion and reveals that two successive scaling regimes, acting hypothetically as open and closed loop mechanisms, are implicated in posture control. Objectivity is obviously required in the determination of the transition point, i.e. the point at which an open-loop control mechanism would switch to a closed-loop one, in order to provide reproducibility and automatism in the processing of data. In the method proposed herein, the transition point corresponds to the maximal distance separating a diffusion curve in a double logarithmic plot (mean square distances MSD calculated on each axis versus increasing time intervals Deltat) from a straight line characterising a pure stochastic behaviour. In closed eye conditions, the switch appears medio-laterally in a 0. 26-0.52 s range for Deltat, the corresponding MSD being in the range of 1.86-10.50 mm(2). In the forward-backward direction, the transition is in a 0.28-0.42 s range and the corresponding MSD is between 3.60 and 15.17 mm(2). Finally, these co-ordinates induce scaling exponents over 0.50 for the shortest Deltat, thus suggesting open-loop control, whereas those of longest Deltat, ranged between 0 and 0.20, give evidence of close-loop control. This data is compared to previous data based upon empirical methods.

Algorithms↗

Postural behaviour responses to visual stimulation in patients with vestibular disorders.

Patients with different vestibular disorders exhibit changes in postural behaviour when they receive visual stimuli, reproducing environmental stimulation. Postural control was studied using an AMTI Accusway platform, measuring the confidential ellipse (CE) and sway velocity (SV). Postural responses were recorded according to the following stimulation paradigm: i) without specific stimuli; ii) smooth pursuit with pure sinusoids of 0.2 Hz (foveal stimulation); and iii) optokinetic stimulation (retinal stimuli). Patients with central vestibular disorders (CVD), cerebellar damage and unilateral peripheral vestibular lesions (UPVL) in asymptomatic periods were studied. A group of normal subjects was studied as control. Signal processing was done with a scalogram by wavelets in order to observe the relation between time and frequency in postural control. While patients with CVD and cerebellar disease showed a significant increase in CE and SV in the three conditions of the paradigm compared to the normal group, the patients with UPVL showed no change. Wavelets processing showed that the main sway occurs in the Y axis (antero-posterior) and below at 0.4 Hz in normal subjects, while the CVD and cerebellar patients showed sway frequencies in both the X and Y axes. The clinical implications of these findings are discussed.

Adult↗

Assessment of the risk of fall, related to visual stimulation, in patients with central vestibular disorders.

In order to assess the influence of visual stimulation in the triggering of imbalance and falls in the elderly population, the postural responses of 18 elderly patients with central vestibular disorders and clinical evidence of instability and falls were studied while receiving different types of visual stimuli. The stimulation conditions were: (i) no specific stimuli; (ii) smooth pursuit with pure sinusoids of 0.2 Hz as foveal stimulation; and (iii) optokinetic stimulation (OK) as retinal stimuli. Using a platform AMTI Accusway platform, the 95% confidence ellipse (CE) and sway velocity (SV) were evaluated with a scalogram using wavelets in order to assess the relationship between time and frequency in postural control. Velocity histograms were also constructed in order to observe the distribution of velocity values during the recording. A non-homogeneous postural behavior after visual stimulation was found among this population. In five of the patients the OK stimulation generated: (i) significantly higher average values of CE ( > 3.4+/-0.69 cm2); (ii) a significant increase in the average values of the SV ( > 3.89+/-1.15 cm/s) and a velocity histogram with a homogeneous distribution between 0 and 18 cm/s; and (iii) a scalogram with sway frequencies of up to 4 Hz distributed in both the X and Y directions (backwards and forwards and lateral) during visual stimulation with arbitrary units of energy density > 5. These three qualitative and quantitative aspects could be "markers" of visual dependence in the triggering of the mechanism of lack of equilibrium and hence falls in some elderly patients and should be considered in order to prevent falls and also to assist in the rehabilitation program of these patients.

Accidental Falls↗

Background on methods of stimulation in galvanic-induced body sway in young healthy adults.

The aim of this study was to develop a standardized procedure for reproducible quantification of galvanic-induced body sway (GBS). This was a prospective experimental study conducted in a tertiary referral centre. An exploratory study was first conducted to define the galvanic vestibular stimulation (GVS) method that resulted in the best reproducible responses. Ten subjects underwent computer-controlled GVS using five different types of monaural and binaural stimulation with 2-mA currents. Cosinusoidal stimulation gave the most reproducible responses. The frequency and current variability of this stimulus type were then tested in the same 10 subjects. A monaural continuous 1-cosinusoidal current of 0.5 Hz and 2 mA gave the most reproducible responses (< 20% test-retest variation) and the largest GBS amplitude. The other (sinusoidal) stimuli resulted in variabilities exceeding 50%. This stimulus was thus used for further testing in our normative study. In this study we measured GBS amplitude at 0.5 Hz in 60 subjects, with eyes closed and an inter-feet distance of 0 cm, using a force platform. In addition to body sway, responses included slight dizziness, taste sensations and a tingling sensation at the site of stimulation. Habituation to the applied stimulus was seen. Binaural prestimulation, performed in 50/60 test subjects, is necessary to reduce habituation and achieve optimal reproducibility in order to be able to compare the sensitivity of the left and right vestibular systems. The test-retest variability was determined in detail in 12 additional subjects. Prestimulation reduced habituation, but improved the sensitivity of the method; some test-retest variability persisted (< 20%).

Adult↗

A new translational platform for evaluating aging or pathology-related postural disorders.

CONCLUSIONS: Dynamic posturography using a translational platform and new parameters for quantifying postural reactions to linear displacements were suitable for differentiating between aging and pathological effects in upright postural control. These tools should be used on a wider scale in the near future for both routine tests and rehabilitation purposes, including the prevention of falls in elderly people. OBJECTIVE: To demonstrate that dynamic posturography using a translational platform and new parameters for quantifying postural reactions to linear displacements constitute a more suitable way of discriminating age and/or pathology-induced postural effects. MATERIAL AND METHODS: Three groups of young healthy, elderly healthy and elderly unstable patients were tested on a translational platform using ramp (0.03, 0.07 and 0.1 m/s) and sinusoidal (0.25 and 0.5 Hz) stimulations. Their dynamic performances were compared to their postural evaluation on a static platform using classical stabilometric parameters (surface, length, etc.) and stabilogram-diffusion analysis (critical point coordinates and short-term diffusion coefficient). RESULTS: The translational platform, the new parameters elaborated for quantifying postural reactions (energy and time for postural stabilization, phase and gain of the postural response) and the visual condition under which the subjects were tested (eyes open versus eyes closed) discriminated all groups better than the classical methods.

Adult↗

Head and body sway in response to vertical visual stimulation.

CONCLUSIONS: Postural responses differed according to the stimulus direction, i.e. vertical visual stimulation induced head rather than trunk displacements. Accordingly, it could be that center of foot pressure (COP) responses tended to underestimate the postural sway during visual stimulation. OBJECTIVES: To investigate head and body sway in response to vertical visual surround motion, and to examine the correlation between the displacements of head and body segments derived from video-motion analysis and COP measurements. MATERIAL AND METHODS: Postural sway was assessed in 10 young female subjects by video-motion analysis of four different head and body segments, and by use of force-plate posturography. Head and body sway in the pitch plane was induced by rotating a random pattern of dots about the subject's inter-aural axis at a constant acceleration of 1 degree/s(2) or a constant velocity of 60 degrees/s in darkness. RESULTS: Generally, head displacement was greater than that of other body parts during vertical optokinetic stimulation (OKS). In most subjects, maximum head displacements were induced in the same direction as the visual motion. Downward OKS induced a forward head and body sway. The COP trajectory correlated well with the displacements of each head and body segment during downward OKS. In contrast, postural responses to upward OKS were complicated in terms of their time course. The correlation coefficient between each head and body segment and the COP varied among individuals for upward OKS.

Adult↗

Cristospinal reflex in circular walking.

This study comprised 22 normal adults, 12 males and 10 females. Electromyograms of the bilateral gastrocnemius muscle were recorded during circular walking under two conditions: no caloric stimulation and immediately after irrigating the right auditory canal with 20 degrees C water for 20 s with the horizontal semicircular canal maintained in vertical position. With no caloric stimulation, gastrocnemius muscle activity on the right side exceeded that on the left during dextrorotation and vice versa during sinistrorotation. Following irrigation of the right auditory canal, the activity was greater on the left side than on the right during sinistrorotation, but no consistent differences in muscle activity were observed during dextrorotation. Dextrorotation was associated with ataxic gait in all cases. Thus ampullopetal lymphatic flow in the semicircular canal due to circular walking causes increased antigravity muscle tonus of the ipsilateral leg. This gives the ipsilateral leg assistance for supporting body weight which shifts to the inner side of circular walking.

Adult↗

Validity of visual stabilization conditions used with computerized dynamic platform posturography.

Temporal and spatial relationships between head motion and tilt of a visual surround were evaluated in conditions 3 and 6 of the sensory organization test (SOT) to determine the validity of visual stabilization during computerized dynamic platform posturography (CDP). Seven healthy subjects participated (mean age 42.4 years, SD = 19 years, range 25-72 years). Sagittal head translation and head pitch were evaluated separately with respect to displacement of the visual surround. Overall, the mean correlation between sagittal head motion and surround tilt was r = 0.68 for C3 and r = 0.93 for C6. The average phase (aggregate findings supported with trial-by-trial analysis), however, showed that sagittal head displacement leads motion of the visual surround ( + 452 ms for C3 and + 250 ms for C6). The mean correlation between head pitch and surround tilt was r = -0.30 for C3 and r = -0.72 for C6. Head pitch also leads visual surround motion (+567 ms for C3 and +539 ms for C6), but with greater variability than sagittal head translation. The results showed that visual stabilization was not consistently achieved during SOT conditions 3 and 6. The fundamental assumption that posture behaves as an inverted pendulum, with control of equilibrium originating in the lower extremities, does not appear to be applicable to the voluntary corrections of sway required during the SOT.

Adult↗

Biomechanics of slips.

The biomechanics of slips are an important component in the prevention of fall-related injuries. The purpose of this paper is to review the available literature on the biomechanics of gait relevant to slips. This knowledge can be used to develop slip resistance testing methodologies and to determine critical differences in human behaviour between slips leading to recovery and those resulting in falls. Ground reaction forces at the shoe-floor interface have been extensively studied and are probably the most critical biomechanical factor in slips. The ratio of the shear to normal foot forces generated during gait, known as the required coefficient of friction (RCOF) during normal locomotion on dry surfaces or 'friction used/achievable' during slips, has been one biomechanical variable most closely associated with the measured frictional properties of the shoe/floor interface (usually the coefficient of friction or COF). Other biomechanical factors that also play an important role are the kinematics of the foot at heel contact and human responses to slipping perturbations, often evident in the moments generated at the lower extremity joints and postural adaptations. In addition, it must be realized that the biomechanics are dependent upon the capabilities of the postural control system, the mental set of the individual, and the perception of the environment, particularly, the danger of slipping. The focus of this paper is to review what is known regarding the kinematics and kinetics of walking on surfaces under a variety of environmental conditions. Finally, we discuss future biomechanical research needs to help to improve walkway-friction measurements and safety.

Accidental Falls↗

Free shoulder space requirements in the design of high backrests.

The objective of this study was to determine the influence of scapular support on the effects of lumbar support and to prove that a high and straight backrest is inappropriate. In literature the importance of a lumbar support is noted, although data about optimal dimensions is an under-researched topic and in earlier studies on force distribution and muscle activity the backrest had a fixed form. The lumbar support is needed to maintain the lumbar lordosis but no studies deal with the question of the precise dimensions of the backrest at shoulder level. With a specially designed apparatus, forces on shoulder and seat were measured separately, and the force on the pelvis calculated, while varying seat and backrest inclination within the range from 0 degrees to 17 degrees. Seat-to-backrest angle (at the level of lumbar support) was kept constant at 90 degrees. The distance between the tangent to the lumbar support and the parallel tangent to the scapular support was varied from 0, 2, 4, 6 and 8 cm. This distance is called the free shoulder space. Electromyography was measured at the erector spinae at the levels of the L1, T8 and T5 vertebrae. For all seat angles, a free shoulder space of d=0 cm resulted in the highest back muscle activity. In agreement with the biomechanical model, EMG activity reduced with an increase of seat tilt and increase of free shoulder space. With increasing free shoulder space, a larger part of the total backrest force was carried by the lumbar support. This study shows that a high and straight backrest overrules lumbar support. Offering free shoulder space of at least 6 cm reduces back muscle activity and allows for lumbar support.

Adult↗

Human push capability.

Use of unassisted human push capability arises from time to time in the areas of crowd and animal control, the security of locked doors, the integrity of railings, the removal of tree stumps and entrenched vehicles, the manoeuvering of furniture, and athletic pursuits such as US football or wrestling. Depending on the scenario, human push capability involves strength, weight, weight distribution, push angle, footwear/floor friction, and the friction between the upper body and the pushed object. Simple models are used to establish the relationships among these factors.

Anthropometry↗

Interface stability influences torso muscle recruitment and spinal load during pushing tasks.

Handle or interface design can influence torso muscle recruitment and spinal load during pushing tasks. The objective of the study was to provide insight into the role of interface stability with regard to torso muscle recruitment and biomechanical loads on the spine. Fourteen subjects generated voluntary isometric trunk flexion force against a rigid interface and similar flexion exertions against an unstable interface, which simulated handle design in a cart pushing task. Normalized electromyographic (EMG) activity in the rectus abdominus, external oblique and internal oblique muscles increased with exertion effort. When using the unstable interface, EMG activity in the internal and external oblique muscle groups was greater than when using the rigid interface. Results agreed with trends from a biomechanical model implemented to predict the muscle activation necessary to generate isometric pushing forces and maintain spinal stability when using the two different interface designs. The co-contraction contributed to increased spinal load when using the unstable interface. It was concluded that handle or interface design and stability may influence spinal load and associated risk of musculoskeletal injury during manual materials tasks that involve pushing exertions.

Adult↗

Effects of age and gender on maximum voluntary range of motion of the upper body joints.

The maximum voluntary range of motion (ROM) of the major joints of the upper body was studied in a seated position and compared between young and elderly subjects. A total of 41 subjects (22 young male and female subjects aged 25 to 35 years, 19 elderly male and female subjects aged 65 to 80 years) took part in the experiment. In total, 13 maximum voluntary joint motions were performed by each subject. Age was found to have a non-uniform effect on the ROM of the joints investigated in this study. Its effect on ROM was joint specific and motion specific. The highest loss in ROM was observed in the neck and trunk, especially for neck extension, lateral flexion and axial rotation as well as for trunk lateral flexion and axial rotation. No significant age differences were observed in the elbow and wrist joint ROMs. The effect of gender on joint ROM was much weaker than that of age. Only four among the 26 joint ROMs investigated in this study were significantly different between the two gender groups.

Adult↗

The feasibility of repositioning ability as a tool for ergonomic evaluation: effects of chair back inclination and fatigue on head repositioning.

Poor posture has been suggested as one of the main factors contributing to the high prevalence of neck pain in video display unit (VDU) users, but no clear association between pain and any particular resting neck posture has been found. Postural awareness of the neck, as indicated by the repositioning accuracy, may therefore be an appropriate measure and potentially useful assessment tool. The objective of this study is to examine whether posture and fatigue affect the head repositioning ability in typical VDU usage. A group of 20 healthy participants reproduced a normal comfortable posture for forward, upright and backward chair back inclinations in random order both before and after fatigue of the upper trapezius muscles. Ten repetitions of the posture were recorded for 2 s each, and the angular and translational deviations from the original head position were measured with regard to the external environment (head in space repositioning) and with regard to the trunk (head on trunk repositioning). Analysis by repeated measures ANOVA showed significant effects and interactions of fatigue and chair back inclination on the repositioning errors in the sagittal plane, which typically showed systematic trends towards certain postures rather than random errors around a mean position. While further work is required to examine the ergonomic impact of impaired repositioning ability, head repositioning is sensitive to ergonomic factors such as seating configuration and fatigue, and may therefore be a useful tool for evaluation of static working postures.

Adult↗

Stability of sitting postures: the influence of degrees of freedom.

Observational studies of sitting have shown that, during spontaneous sitting, people adopt a variety of postures. Various researchers have formulated theories to explain why people adopt their sitting postures. Branton (1969) hypothesized that there is continual need for postural stability while sitting. Dempster (1955) stated that additional stability could be obtained through temporarily closing chains of body segments, or, in other words, through decreasing the number of degrees of freedom of the body. The present study elaborates on Dempster's theory. The aim of this study was to determine the influence of the degrees of freedom of the body on postural stability in sitting postures. For 21 different sitting postures, the total number of degrees of freedom was determined. Postural sway, a measure for postural stability, was determined using a 3D motion and position measurement system with ten healthy subjects. This study shows that the mean path length at the level of the second thoracic vertebra (PL0.05), a measure derived from postural sway, increases significantly (p < 0.0001) with an increase of the number of degrees of freedom of the body (DoFB). Closer examination of the data showed that a model taking into account only the degrees of freedom of the lumbar and thoracic spine and pelvis seems to be a better predictor of postural sway than the total number of degrees of freedom of the body.

Biomechanical Phenomena↗

Influence of fatigue time and level on increases in postural sway.

The purpose of this study was to investigate the influence of fatigue time and fatigue level on the increases in postural sway during quiet standing. Centre of pressure-based measures of postural sway were collected both before and after fatiguing participants using three different fatigue levels and two different fatigue times. Results showed increasing fatigue time increased sway velocity and sway area, and increasing fatigue level increased sway velocity. Fatigue time effects are important to consider when applying laboratory-based findings to the field given that the fatigue time can differ substantially between the two. Fatigue level effects imply a dose - response relationship between localized muscle fatigue and risk of falling that can have important implications in work/rest cycle scheduling for occupations at risk of injurious falls.

Accidental Falls↗