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Water balance in the Brattleboro rat: single or multiple defects?

The total restoration of urinary concentrating ability of the DI rat given daily injections of vasopressin takes several weeks, although complete osmotic equilibrium across the collecting duct is manifest within hours. This suggests that there may be other deficiencies of the renal concentrating mechanism that, if corrected by vasopressin treatment, are corrected more slowly. I have focussed on just three possibilities. First, the morphology of the medullary interstitium is different from normal rats. Perhaps associated with this finding are alterations in the levels of medullary glycosaminoglycans which may have a role to play in water balance. Functional and morphological changes in the juxtamedullary nephrons are also evident. Second, the possibility exists that the countercurrent multiplier of the DI rat operates less efficiently than in the normal animal. Finally, reduced synthesis of PGs in the renal medulla of DI rats may also influence the concentrating mechanism, although in a favorable direction. While most (if not all) of these differences are secondary to the lack of vasopressin, in some instances it appears that it is the high water turnover (possibly the altered chemical composition of the medullary interstitium) that is the primary culprit. While the DI rat remains an excellent model for the study of water balance and the action of vasopressin, the presence of multiple defects within the system should be borne in mind. This is particularly true when comparing data obtained following acute treatment with vasopressin versus that following chronic treatment.

Adenylyl Cyclases↗

Granal stacking of thylakoid membranes in higher plant chloroplasts: the physicochemical forces at work and the functional consequences that ensue.

The formation of grana in chloroplasts of higher plants is examined in terms of the subtle interplay of physicochemical forces of attraction and repulsion. The attractive forces between two adjacent membranes comprise (1) van der Waals attraction that depends on the abundance and type of atoms in each membrane, on the distance between the membranes and on the dielectric constant, (2) depletion attraction that generates local order by granal stacking at the expense of greater disorder (i.e. entropy) in the stroma, and (3) an electrostatic attraction of opposite charges located on adjacent membranes. The repulsive forces comprise (1) electrostatic repulsion due to the net negative charge on the outer surface of thylakoid membranes, (2) hydration repulsion that operates at small separations between thylakoid membranes due to layers of bound water molecules, and (3) steric hindrance due to bulky protrusions of Photosystem I (PSI) and ATP synthase into the stroma. In addition, specific interactions may occur, but they await experimental demonstration. Although grana are not essential for photosynthesis, they are ubiquitous in higher plants. Grana may have been selected during evolution for the functional advantages that they confer on higher plants. The functional consequences of grana stacking include (1) enhancement of light capture through a vastly increased area-to-volume ratio and connectivity of several PSIIs with large functional antenna size, (2) the ability to control the lateral separation of PSI from PSII and, therefore, the balanced distribution of excitation energy between two photosystems working in series, (3) the reversible fine-tuning of energy distribution between the photosystems by State 1-State 2 transitions, (4) the ability to regulate light-harvesting via controlled thermal dissipation of excess excitation energy, detected as non-photochemical quenching, (5) dynamic flexibility in the light reactions mediated by a granal structure in response to regulation by a trans-thylakoid pH gradient, (6) delaying the premature degradation of D1 and D2 reaction-centre protein(s) in PSII by harbouring photoinactived PSIIs in appressed granal domains, (7) enhancement of the rate of non-cyclic synthesis of adenosine triphosphate (ATP) as well as the regulation of non-cyclic vs. cyclic ATP synthesis, and (8) the potential increase of photosynthetic capacity for a given composition of chloroplast constituents in full sunlight, concomitantly with enhancement of photochemical efficiency in canopy shade. Hence chloroplast ultrastructure and function are intimately intertwined.

Alocasia↗

Clinical care of the aging hypertensive patient.

That elderly hypertensive patients need to be treated is now well established, as major clinical trials have confirmed the reduction in serious complications and organ damage in the treated patient. However, the concomitant findings on the high rates of adverse side effects of drug therapies to lower blood pressure are of concern. The physiologic and disease changes that occur with aging may explain some of the adverse drug responses encountered in this population. Nondrug treatment of hypertension, including sodium restriction and weight reduction, would be desirable in the elderly, but there are no trials of the efficacy and safety of these methods in this population. Homeostatic fragility in the elderly is the loss of the ability to regulate cardiovascular and respiratory function, and fluid and electrolyte balance under conditions of stress. Introduction of antihypertensive agents with their global effects on these homeostatic processes leads to frequent complications such as orthostatic hypotension, cardiac depression, reduced cerebral blood flow, and abnormalities in metabolic, volume, and electrolyte control. Although these adverse reactions explain some of the compliance problems in the elderly, several psychosocial factors also hinder the ability of older patients to follow therapeutic protocols. The need for alternative and more appropriate therapies tailored to fit these problems associated with aging is the desired goal of future blood pressure intervention policies.

Aged↗

Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study.

OBJECTIVE: To identify and interrelate static and dynamic characteristics of the restoration of quiet standing balance in a representative sample of stroke survivors in the Netherlands during their inpatient rehabilitation. DESIGN: Exploratory study using an inception cohort with findings related to reference values from healthy elderly persons. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-seven inpatients (mean age, 61.6y; mean time poststroke, 10.0wk) with a first hemispheric intracerebral infarction or hematoma who were admitted to retrain standing balance and walking. INTERVENTION: Individualized therapy. MAIN OUTCOME MEASURES: Center of pressure fluctuations were registered under each foot and in the sagittal and frontal planes separately by using a dual-plate force platform. The first balance measurements took place as soon as patients were able to stand unassisted for at least 30 seconds as well as 2, 4, 8, and, 12 weeks later. Quiet standing was assessed under 4 conditions: with and without a visual midline reference, with the eyes closed, and while performing a concurrent arithmetic task. RESULTS: The stroke patients showed excessive postural sway and instability, particularly in the frontal plane, compared with reference values. Frontal plane balance was, however, also most responsive to the effects of balance training and recovery (P<.001). The degree of visual dependency for frontal plane balance control showed a significant reduction in time (P<.02). Weight-bearing asymmetry, which was most pronounced in patients with disturbed sensibility or ankle clonus, diminished considerably during the first 4 weeks of the follow-up period (P<.02). Yet, a substantial degree of weight-bearing asymmetry persisted during the 8 weeks thereafter, and it continued to be aggravated by attentional distraction (P<.001). During the same period, static asymmetry (ie, the degree of pes equinovarus loading at the paretic side) and dynamic asymmetry (ie, the extent to which compensatory ankle moments are applied at the nonparetic side) did not show normalization at all, although motor selectivity of the paretic leg improved by 1 stage on the 6-stage Brunnstrom scale (P<.001) and the independency level of balance and walking skills improved by 2 points on the 6-point Functional Ambulation Categories (P<.001). CONCLUSIONS: Balance recovery in postacute stroke inpatients is characterized by a reduction in postural sway and instability as well as by a reduction in visual dependency, particularly with regard to frontal plane balance. These restoration characteristics may be important factors underlying the relearning of independent standing and walking abilities. The clear lack of normalization for measures reflecting static and dynamic aspects of postural asymmetry suggests that the functional improvements in balance and gait must be more related to other mechanisms than to the restoration of support functions and equilibrium reactions of the paretic leg.

Adult↗

Shoe sole thickness and hardness influence balance in older men.

OBJECTIVE: To test the hypothesis that shoes with thick, soft midsoles, such as modern running shoes, provide better stability in older individuals than those with thin-hard midsoles. In addition, we examined the relation between footwear comfort and stability and stability when barefoot. DESIGN: Randomized-order, cross-over, controlled comparison. SETTING: Subjects were drawn from an internal medicine practice. PARTICIPANTS: A random sample of 25 healthy men, minimum age 60 years. Additional selection criteria were absence of disabilities influencing ability to walk and lack of history of frequent falls. MEASUREMENTS: Balance failure frequency, which was defined as falls from the beam per 100 meters of beam walking when 10 passes were made down a 9 M long balance beam. Comfort rating was based on an ordinal scale. RESULTS: Contrary to the hypothesis: (1) midsole softness was associated with poor stability (F(2,48) = 17.9, P < 0.0001); (2) thick midsoles also provided poor stability (F(1,24) = 7.36, P < 0.01). When barefoot, subjects showed 19% higher balance failure frequency than with the poorest shoe and 171% greater than the best shoe (t = 5.33, P < 0.0001). Higher comfort was generally found in shoe types associated with higher balance failure frequency. CONCLUSIONS: For optimal stability, shoes with thin, hard soles are preferable for older individuals. Health professionals should exercise caution when recommending shoes with thick, yielding midsoles, such as running shoes, to unstable elderly individuals. Older men and women with a history of falls or who are obviously unstable, should avoid barefoot locomotion.

Accidental Falls↗

Isolation and characterization of a MHC class II DRB locus in the European water vole (Arvicola terrestris).

In so-called model species, such as human and mouse, genes of the major histocompatibility complex (MHC) are characterized by extremely high levels of polymorphism, and it is considered that such diversity is maintained by balancing selection. ;There is now a recognized need to expand studies into nonmodel species to examine whether high MHC diversity is mirrored in natural populations, and to determine the ecological, ethological, and evolutionary processes that underpin balancing selection. To address such issues, a necessary prerequisite is the ability to characterize diversity at a single, expressed, polymorphic MHC locus on which selection may be acting. Here, we provide the first description of allelic diversity at exon 2 of an MHC class II DRB locus in the European water vole (Arvicola terrestris), characterize variation across four natural populations, and test whether the patterns of variation are consistent with the effects of balancing selection. Using single-strand conformation polymorphism analysis and subsequent DNA sequencing of gel excisions, five DRB alleles were resolved, each with a unique amino acid sequence, among 100 individuals from four geographically distinct populations. Reverse transcription polymerase chain reaction confirmed that the alleles were products from an expressed locus. Intra-allelic amino acid differences were high (10.5-33.3%), and the nonsynonymous substitution rate exceeded the synonymous substitution rate for the functional peptide-binding region (d (N):d (S)=3.91 and P<0.005). Phylogenetic comparison of resolved alleles with closely related homologues indicated that each allele represented a unique lineage preserved across speciation events. These results indicate that balancing selection has maintained diversity of DRB allelic lineages and amino acid function over evolutionary time scales, but may be less effective at preserving alleles in contemporary populations where stochastic microevolutionary processes may dominate.

Alleles↗

Late side effects of lithium treatment.

Many patients have now been given lithium for 10-15 years, and the overall picture as regards late side effects is not alarming. Changes of renal morphology and function currently attract interest. Histologically demonstrate interstitial nephropathy may be observed in 10-15% of patients, but glomerular filtration rate is little affected or unaffected, and the risk of progressive renal failure with terminal azotemia is remote even in patients given lithium for many years. Renal water reabsorption is often impaired, and the patients may develop polyuria or lowered concentrating ability. These changes are not in themselves dangerous, but since dehydration may lead to lithium poisoning, the patients should drink extra water during situations with risk of a negative water balance.

Bipolar Disorder↗

[Decreased ATP-synthesis ability of brain mitochondria in spontaneously hypertensive rats].

UNLABELLED: It has been shown previously that a decrease of ATP amount and changed balance of other macroergic phosphates occurs in different tissues of spontaneously hypertensive rats (SHR) compared with control normotensive rats (WKY). AIM: To assess the ability of SHR brain isolated mitochondria to synthesize ATP and to elucidate its relation to extramitochondrial calcium concentration. RESULTS: The present work shows for the first time that SHR brain mitochondria initially differ from WKY ones by decreased (by 30%) ATP synthesis rate. When calcium concentration is increased up to 20 or 40 micromole/l ATP synthesis rates in WKY and SHR mitochondria are about one half compared with the condition when the medium does not contain calcium, but the differences between SHR and WKY remain the same. CONCLUSION: Decreased ATP synthesis rate in SHR mitochondria may be considered as the main cause of cell energy deficiency observed in experimental variant of primary arterial hypertension.

Adenosine Triphosphate↗

[Postoperative pulmonary function after lung surgery. Total intravenous anesthesia with propofol in comparison to balanced anesthesia with isoflurane].

After lung resection, early extubation and the rapid return of the patients ability to cooperate is the predominant goal. Propofol anaesthesia is characterised by rapid awakening and recovery of cognitive and psychomotor functions and is consequently desirable for such operations. Experience so far in lung surgery, however, is limited. Besides the level of consciousness we investigated various spirometric parameters after lung resection. Total intravenous anaesthesia was performed with propofol, while balanced anaesthesia was performed with isoflurane. METHODS. A total of 93 patients evaluated electively for wedge excision or lobectomy were enrolled in an open, prospective, randomised, interindividual comparative study. Sixty-three patients could be evaluated with complete data sets. In the evening and the morning before the operation the patients were premedicated orally with clorazepate 0.5-0.7 mg/kg. Anaesthesia was induced in group 1 with propofol (1.0-2.5 mg/kg) and maintained with propofol (4-12 mg/kg) in 50% O2/air. The patients in group 2 received methohexital (1-2 mg/kg) for induction and isoflurane (0.4-2.0 vol%) in 50% O2/air for the maintenance of general anaesthesia. In both groups analgesia was achieved by using fentanyl (up to 10 micrograms/kg) and muscle relaxation by using atracurium. Psychomotor tests (minimal mental state, reaction time) were performed the day before the operation (t1), immediately prior to induction of anaesthesia (t2) and 5 min, 30 min, 60 min, 90 min, 24 h, and 7 days after extubation (t3-t8). Spirometry (forced expiratory volume in 1 s, FEV1; forced vital capacity, FVC; peak expiratory flow, PEF) was carried out at times t1, t2 and t5-t8. RESULTS. The two groups were comparable regarding preoperative status (age, sex, preoperative risk score, psychomotor tests, and spirometric values) and the operation performed (wedge excision/lobectomy, duration of anaesthesia). The extubation time was slightly shorter in the propofol group (18 +/- 8 min) than in the isoflurane group (20 +/- 6 min). Also, the results of the psychomotor tests were somewhat better in the propofol group than those in the isoflurane group. The clearest differences were found in the early postoperative period, but not all differences were significant. Statistically highly significant differences between the two groups were found for the three spirometric parameters. Based on the FEV1 value of the 7th postoperative day, FEV1 taken 60 min after extubation declined by 27.9% in the propofol group vs. 51.7% in the isoflurane group (P = 0.01). At 90 min after extubation the corresponding decline in the propofol group was 26.6%, in the isoflurane group 51.1% (P = 0.003). In addition, the decline of FVC and PEF measured 60 min and 90 min after extubation was significantly smaller in the propofol group than in the isoflurane group. CONCLUSION. The postoperative impairment of lung function after lung resection under propofol anaesthesia is statistically significantly smaller than under isoflurane anaesthesia. Total intravenous anaesthesia with propofol is particularly suitable for this kind of operation.

Adult↗

The Community Balance and Mobility Scale--a balance measure for individuals with traumatic brain injury.

OBJECTIVE: To provide evidence for the validity and reliability of a new outcome measure of balance, the Community Balance and Mobility Scale, developed for the ambulatory individual with traumatic brain injury. DESIGN: A validity and reliability study. SETTING: Acute care, in- and outpatient rehabilitation and day hospital settings. SUBJECTS: Two convenience samples (n=36, 32) of ambulatory patients with traumatic brain injury. MAIN MEASURES: The content and construct validity, test-retest, inter- and intra-rater reliability and internal consistency of the Community Balance and Mobility Scale. RESULTS: Content validity was demonstrated by the involvement of patients with traumatic brain injury (n=7) and clinicians (n=17) in the process of item generation and by physical therapists' ratings of item relevance. Further support is the correlation of the Community Balance and Mobility Scale scores with physical therapists' global balance ratings of the patient (r=0.62). Construct validity was supported by the ability of the measure to differentiate between patients along the continuum of care and also by comparisons with maximal walking velocity (r=0.64). Patients who scored greater than or less than 50 on the balance measure demonstrated significantly different Community Integration Questionnaire scores (P=0.004). The Community Balance and Mobility Scale demonstrated intraclass correlation coefficients (ICCs) of 0.977, 0.977, 0.975 and Cronbach's alpha of 0.96 for intra-, inter-, test-retest reliability and internal consistency, respectively. CONCLUSION: The Community Balance and Mobility Scale is a valid and reliable outcome measure for the ambulatory individual with traumatic brain injury.

Adult↗

Differential effects of ethanol on motor coordination in adolescent and adult rats.

Recent evidence suggests that adolescence represents a unique period of sensitivity to the effects of ethanol. Adolescent animals are more sensitive than adults to many of the effects of ethanol, including ethanol-induced learning and memory impairments, while being less sensitive to others, including ethanol-induced sedation. It is well known that ethanol produces dramatic impairments in balance and motor coordination. While previous research suggests that adolescents and adults do not differ in their sensitivity to the effects of relatively low doses of ethanol on motor coordination, it is not known whether differences in performance would emerge at higher doses. The present study compared the impact of a range of ethanol doses (1.0, 2.0 and 3.0 g/kg) on motor coordination in adolescent [postnatal day (PD) 35-40] and adult (PD 70-75) rats. Motor coordination was assessed using the tilting plane test before ethanol administration (baseline) and at 15, 30, 60, 120 and 180 min after ethanol administration. Performance was not affected by 1.0 g/kg ethanol in either age group. However, adults were more impaired than adolescents at nearly every time point following administration of both 2.0 and 3.0 g/kg ethanol. The results provide further evidence that adolescents and adults are differentially sensitive to the behavioral effects of ethanol. Given the critical role of motor coordination in the ability to operate motor vehicles and the central role of balance and coordination in field sobriety tests, these data could have important implications if extended to human subjects.

Aging↗

Regulators of apoptosis on the road to persistent alphavirus infection.

Alphavirus infection can trigger the host cell to activate its genetically programmed cell death pathway, leading to the morphological features of apoptosis. The ability to activate this death pathway is dependent on both viral and cellular determinants. The more virulent strains of alphavirus induce apoptosis with increased efficiency both in animal models and in some cultured cells. Although the immune system clearly plays a central role in clearing virus, the importance of other cellular factors in determining the outcome of virus infections are evident from the observation that mature neurons are better able to resist alphavirus-induced apoptosis than immature neurons are, both in culture and in mouse brains. These findings are consistent with the age-dependent susceptibility to disease seen in animals. Cellular genes that are known to regulate the cell death pathway can modulate the outcome of alphavirus infection in cultured cells and perhaps in animals. The cellular bax and bak genes, which are known to accelerate cell death, also accelerate virus-induced apoptosis. In contrast, inhibitors of apoptotic cell death such as bcl-2 suppress virus-induced apoptosis, which can facilitate a persistent virus infection. Thus, the balance of cellular factors that regulate cell death may be critical in virus infections. Additional viral factors also contribute to this balance. The more virulent strains of alphavirus have acquired the ability to induce apoptosis in mature neurons, while mature neurons are resistant to cell death upon infection with less virulent strains. Here we discuss a variety of cellular and viral factors that modulate the outcome of virus infection.

Alphavirus↗

Inventory of interpersonal problems: a three-dimensional balanced and scalable 48-item version.

Interpersonal relating has been a focus of attention in psychiatry for decades. To address this domain, a self-rating scale, the Inventory of Interpersonal Problems (IIP; Horowitz, Rosenberg, Baer, Ureño, & Villaseñor, 1988), was developed. Analysis of the psychometric properties of IIP presented in this article was performed by principal component analysis (PCA) for the purpose of obtaining subscales with a balanced, bipolar dimensionality. The model was validated by the resulting dimensions' ability to discriminate among different categories of personality disorders (PDs). The problem of a General Complaint factor affecting PCAs of questionnaires such as the IIP is discussed thoroughly, and ways of avoiding the problem are outlined. We present a three-dimensional structure of the IIP with both theoretically appealing and statistically robust dimensions of Assertiveness, Sociability, and Interpersonal Sensitivity based on 48 (out of 127) items. Balanced, additive indexes using the subset of 48 items appeared psychometrically sound by showing much lower correlations internally and less confounding from the General Complaint factor than extant indexes derived from the IIP. External validity seemed to be bolstered by all subscales' discriminating significantly between different PDs versus no PDs, on both cluster and single diagnosis levels. Our analysis seemed to substantiate the reliability (scalability) of three dimensions of the IIP tapping different areas of the interpersonal relational field.

Adolescent↗

Stepping before standing: hip muscle function in stepping and standing balance after stroke.

OBJECTIVE: To compare the pattern of pelvic girdle muscle activation in normal subjects and hemiparetic patients while stepping and maintaining standing balance. DESIGN: Group comparison. METHOD: Seventeen patients who had regained the ability to walk after a single hemiparetic stroke were studied together with 16 normal controls. Median interval between stroke and testing was 17 months. Amplitude and onset latency of surface EMG activity in hip abductors and adductors were recorded in response to sideways pushes in either direction while standing. Similar recordings were made in the same subjects during gait initiation and a single stride. RESULTS: In the standing balance task, normal subjects resisted a sideways push to the left with the left gluteus medius (74 ms) and with the right adductor (111 ms), and vice versa. In hemiparetic patients, the amplitude of activity was reduced in the hemiparetic muscles, the onset latencies of which were delayed (gluteus medius 96 ms, adductor 144 ms). Contralateral, non-paretic, adductor activity was increased after a push towards the hemiparetic side of patients with stroke and the latency was normal (110 ms). During self initiated sideways weight shifts at gait initiation, hemiplegic muscle activation was impaired. By contrast, the pattern and peak amplitude of hip muscle activation in stepping was normal in both hemiparetic and non-hemiparetic muscles of the subjects with stroke. CONCLUSIONS: In ambulant patients with stroke, a normal pattern of activation of hemiparetic muscles is seen in stepping whereas the response of these muscles to a perturbation while standing remains grossly impaired and is compensated by increased activity of the contralateral muscles. This suggests that hemiparetic patients should be able to step before regaining standing balance.

Electromyography↗

Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial.

In controlled clinical trials there are usually several prognostic factors known or thought to influence the patient's ability to respond to treatment. Therefore, the method of sequential treatment assignment needs to be designed so that treatment balance is simultaneously achieved across all such patients factor. Traditional methods of restricted randomization such as "permuted blocks within strata" prove inadequate once the number of strata, or combinations of factor levels, approaches the sample size. A new general procedure for treatment assignment is described which concentrates on minimizing imbalance in the distributions of treatment numbers within the levels of each individual prognostic factor. The improved treatment balance obtained by this approach is explored using simulation for a simple model of a clinical trial. Further discussion centers on the selection, predictability and practicability of such a procedure.

Carmustine↗

Correlation between two clinical balance measures in older adults: functional mobility and sensory organization test.

BACKGROUND: Functional mobility of older adults has been shown to correlate with stance stability to various extents. This variability could be due to the difference in the way sensory information is processed in these two types of balance tests. Correlations between functional mobility and stance stability under altered sensory conditions, such as those in the Sensory Organization Test (SOT), are needed to test this possibility. The present study investigated the correlation between the performance of older adults on a newly developed Sensory-Oriented Mobility Assessment Instrument (SOMAI) and on the various sensory conditions of the SOT. METHODS: Twenty-seven community-dwelling older adults (76 +/- 7 years) underwent tests of the six SOT conditions and 10 SOMAI mobility maneuvers performed under normal- and focal-vision (peripheral vision eliminated) conditions. Behavioral performance in the two SOMAI conditions and the amounts of postural sway in the six SOT conditions were ranked among the subjects. Correlations of performance rankings on these two tests were analyzed. RESULTS: Performance on the two SOMAI conditions significantly correlated with that on the SOT conditions in which accurate visual, vestibular, and somatosensory inputs were all present (p < .05). Performance on the focal-vision SOMAI condition was also significantly correlated with that on the SOT condition in which somatosensory input was unreliable for orientation while visual and vestibular inputs were reliable (p < .05). There were no correlations between the SOMAI performance and performance on the no-vision or unreliable-vision SOT conditions. CONCLUSIONS: The ability to use all visual, somatosensory, and vestibular inputs for balance was correlated with functional mobility. The moderate correlations between the performance on the normal-sensory SOT condition and the SOMAI conditions suggest that body systems other than balance senses also contribute to mobility performance.

Aged↗

Developmental changes in compensatory responses to unexpected resistance of leg lift during gait initiation.

The development of the ability to integrate postural adjustments into the gait initiation process was investigated in children, using both kinematic and electromyographic (EMG) analysis. Subjects included children of 1 year of age (1-4 months' walking experience), 2-3 years of age (9-17 months' walking experience), 4-5 years of age (3-4 years' walking experience), and adults. We perturbed the balance of the children during gait initiation to determine the point at which infants begin to develop and finally master the ability to respond to external threats to balance during the gait initiation process. A magnet attached to the force platform on which the child stood was activated and served to resist the child's gait initiation (metal plaques on the soles of the shoes were attracted by the magnet) and thus served as an external perturbation during the gait initiation process. Kinematic and EMG analysis indicated that, while the ability to use preparatory postural adjustments in the gait initiation process emerges early in development, the ability to react efficiently to perturbations during gait initiation does not develop until after about 4-5 years of age. Though even the youngest age groups showed some response to the perturbation, it was highly variable, indicating its primitive form. The main response to the perturbation was a slight decrease in latency and increase in amplitude in the muscles used for push-off for gait initiation. Interestingly there was a shift in response pattern at 4-5 years of age, in both kinematic and EMG patterns. The amplitudes of the lateral and anteroposterior trunk and stance leg oscillations were significantly increased. In addition, the muscle response amplitudes (hamstrings and second quadriceps burst) of the swing leg were significantly increased and delayed (hamstring and gastrocnemius), with coactivation of agonist and antagonist muscles at the knee and ankle joint, concomitant with an exaggerated foot height of the first step.

Adaptation, Physiological↗