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At least 1,117 records · Page 62Linked to original sources

PubMed1994

Effects of resistive and balance exercises on isokinetic strength in older persons.

OBJECTIVE: To determine the safety and efficacy of 3 months of resistive training of multiple lower extremity muscle groups compared with balance training in persons over 75 years. DESIGN: Randomized 3-month clinical trial. Subjects (n = 110, mean age 80) were randomized to 4 groups in a 2 x 2 design (control, resistive, balance, combined resistive/balance). INTERVENTIONS: Resistive training involved knee extension and flexion, hip abduction and extension, and plantar and dorsiflexion using simple resistive machines and sandbags. Balance training consisted of exercises to improve postural control. The control group attended 5 health-related discussion sessions. MEASUREMENTS: Summed isokinetic moments (N m) of 8 leg movements: hip, knee and ankle flexion/extension, and hip abduction/adduction. Secondary outcomes were gait velocity and chair rise time. MAIN RESULTS: Summed peak moment increased in both resistive exercise-trained groups (13% increase in the resistive group and 21% in the combined training group, P < 0.001). The effect of resistance training was significant (MANOVA F = 21.1, P < 0.001), but balance training did not improve strength, and there was no interaction (positive or negative) between balance and resistive training. Maximal gait velocity and chair rise time did not improve. Eleven subjects (20%) had musculoskeletal complaints related to resistive training, but all were able to complete the program with modifications. CONCLUSION: Resistive training using simple equipment is an effective and acceptable method to increase overall leg strength in older persons. Resistive or balance training did not improve maximal gait velocity or chair rise time in this sample of relatively healthy older persons.

Aged↗

PubMedDate not supplied

Motor control alteration in posturography in learning-disabled children.

BACKGROUND: Some authors have mentioned that intersensory integration is damaged in children with learning disabilities (LDs), and other investigators point to motor control alterations in the same patients. Thus, we decided to study these hypotheses by means of posturographic recordings. METHODS: A highly selected group of 27 children with LDs was compared with 27 children of control group without LDs. Patients and controls were placed on the Equitest equipment platform. Sensory organization tests evaluated different test conditions that systematically vary visual, vestibular, and foot somatosensory cues available to subjects while they attempt to maintain a stable, quiet stance. Movement coordination test involved sudden posterior and anterior translations of the patient support surface. RESULTS: No significant correlations between scholastics and posturographic performance were observed. No difference in the six conditions and in sensory organization ratios or in visual preference between both groups was disclosed. Motor control test on children with LDs showed significant higher values in latencies in averages of large translations. CONCLUSIONS: Our data suggest that vestibular-visual-somatosensory organization for posture control are not abnormal in children with LDs; instead, motor controls show higher latencies with large translation movements, which suggest abnormal rate and timing precision motor coordination.

Child↗

PubMed1991

[Visual contribution to the postural system: a clinical approach to the study of vision].

The clinician posturologist studies vision as one of the sources of informations about the small movements of the body relative to its environment, informations which enable controlling postural stability. But this way of working, very restrictive indeed, acquires a great clinical dimension because visual information must be integrated with all the other postural informations, and it appears that this integration is not always satisfactory and that its disorders can be detected and cured in many illnesses.

Humans↗

PubMed1998

Effect of posture change on control of ventilation.

To clarify the control mechanism of ventilation during posture change, ventilatory parameters, PETCO2, and ventilatory response to CO2 were examined in 11 healthy male subjects at supine (0 degrees) and 75 degrees head-up tilt positions. Minute expiratory ventilation (V.E), tidal volume (VT), respiratory frequency (f), end-tidal and transcutaneous PCO2 and CO2 output (V.CO2), and ventilatory response to CO2 were measured during a steady state condition. V.E (V.A) and VT increased significantly at 75 degrees tilt with significant decrease in PETCO2 from 40.1 mmHg (0 degrees) to about 36.1 mmHg (75 degrees). Transcutaneous PCO2 also decreased during tilt, by 3.3 mmHg. Physiological dead space (VD/VT) and V.CO2, however, remained unchanged, and ventilatory equivalent (V.E/V.CO2, V.A/V.CO2) increased significantly. The CO2-ventilatory response curve shifted upward (or leftward) without significant change in the response slope. At 75 degrees tilt, EMG activity of gastro-cnemius muscle increased. These findings suggested that PETCO2 decreased because of increased V.E (V.A) with a leftward shift of CO2-ventilatory response curve. Various signals such as afferents from lower extremities might have net stimulatory effects on a CO2-ventilation control system to reset the controlled level of PETCO2 to a lower range, but without significant change in CO2-ventilatory response during upright position.

Adult↗

PubMed1996

[Effects of aging on standing up and sitting down. Kinematic analysis].

Standing up from and sitting down to a chair are a challenging task for many elderly persons. The purpose of this study was to analyse the effects of ageing in kinematic features of each phase of motion. The study was performed on 7 young subjects (22.8 +/- 1.5 years) and 5 healthy elderly subjects (73.2 +/- 5.5 years). The kinematics of the movement were analysed by mean of an optical automatic TV processor (Elite system). Eight reflective markers were placed on left side of body. The elderly subjects showed modifications of velocity profiles of trunk and knee during the two phases of movement, an important need for an adjustment of velocity before seat-on and an inability to increase the velocity of trunk displacement in space. We suggested that these differences between young and elderly subjects, well seen during standing to sitting down, were related to deficits in postural control ability.

Adult↗

PubMed2005

Increased postural sway in control subjects with poor orthostatic tolerance.

OBJECTIVES: This study sought to evaluate postural sway in control subjects with good and poor orthostatic tolerance (OT). BACKGROUND: Some asymptomatic volunteers, when subjected to a progressive orthostatic stress test, show early presyncope. We hypothesized that normal subjects with poor OT do not usually faint because they adopt a strategy of increased lower limb movement, which helps maintain venous return. METHODS: In 12 asymptomatic subjects with good OT and 11 with poor OT, assessed by the combined orthostatic stress of head-up tilting and lower body suction, we determined postural sway using a force platform after 1, 5, and 10 min of motionless standing. RESULTS: The subjects with poor tolerance had greater distances and velocities of sway in the anteroposterior direction but not the mediolateral direction. There was a significant negative correlation between postural sway and orthostatic tolerance. CONCLUSIONS: We have shown that in normal subjects with poor OT during a passive orthostatic stress test, their leg movements tend to be greater when standing. These movements are likely to enhance venous return and may at least partly explain why, despite their poor test results, they do not normally faint.

Adult↗

PubMed2002

Selectivity of the central control of sensory information in the mammalian spinal cord.

Afferent feedback from muscle proprioceptors, as well as movement-induced activation of skin receptors plays an important role in the patterning of motor activity for stepping and postural control. An important component in this control is the presynaptic GABAergic modulation of the synaptic effectiveness of muscle and cutaneous afferents, known to change in phase with the locomotor cycle, during the execution of voluntary movements, or after a peripheral nerve injury. Recent electrophysiological studies, together with ultrastructural observations, indicate that the distribution of GABAa synapses in the intraspinal arborizations of muscle spindle and tendon organ afferents is not homogeneous. Namely, that some collaterals are the targets of one, or more, GABAergic interneurones, while other collaterals of the same fibre receive no GABAergic connections. In addition, both PAD and inhibition of PAD have a local character. This allows, at least in principle, decoupling the information arising from common sensory inputs. A spatially restricted modulation of PAD could play a significant role in the adjustment of the synaptic effectiveness of Ia afferents at the onset of voluntary contractions in humans, during movement-induced stimulation of the skin, or during the compensation of motor activity following partial denervation of muscles. Changes in the synchronization of the PAD-mediating interneurones can also have a profound effect on the information transmitted by a given set of afferent fibres. Data are presented that in the anesthetized cat, variation in the spontaneous activity of a population of dorsal horn neurones in laminae III-VI, that respond to stimulation of low-threshold cutaneous afferents, produce correlated fluctuations of monosynaptic reflexes by means of pre- and postsynaptic mechanisms. It is suggested that correlated changes in the level of PAD can also play a significant role in the presynaptic adjustment of the synaptic effectiveness of the afferent fibres during specific motor tasks.

Animals↗

PubMed1999

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↗

PubMed2005

Speed-accuracy trade-off in voluntary postural movements.

We investigated the speed and accuracy of fast voluntary movements performed by the whole body during standing. Adults stood on a force plate and performed rhythmic postural movements generating fore and back displacements of the center of pressure (shown as online visual feedback). We observed that for the same target distance, movement time increased with the ratio between target distance and target width, as predicted by Fitts'-type relationships. For different target distances, however, the linear regressions had different slopes. Instead, a single linear relation was observed for the effective target width versus mean movement speed. We discuss this finding as a result of the pronounced inherent variability of the postural control system and when such a source of variability is considered, the observed relationship can be explained. The results reveal that the accuracy of fast voluntary postural movements is deteriorated by the variability due to sway during standing.

Adult↗

PubMed1996

Postural corrections after standardised perturbations of single limb stance: effect of training and orthotic devices in patients with ankle instability.

OBJECTIVE: Soccer players with functional instability of the ankle joint have shown impairment of postural control in single limb stance. The aim of this study was to examine the effect of stance perturbation. METHODS: A standardised method for the study of postural corrections after perturbation (Equitest) was used. Female soccer players with and without functional instability were examined. RESULTS: The subjects showed a relative change from ankle to hip synergy at medially directed translations of the support surface. This impairment was restored after eight weeks of ankle disk training. The effect of a shoe and brace did not exceed the effect of the shoe alone. CONCLUSIONS: Functional instability seems to be related to impaired ability to retain equilibrium in single limb stance by means of ankle corrections. A positive effect of ankle disk training leading to functional restoration was confirmed.

Ankle Injuries↗

PubMed2006

Transcriptional response to alcohol exposure in Drosophila melanogaster.

BACKGROUND: Alcoholism presents widespread social and human health problems. Alcohol sensitivity, the development of tolerance to alcohol and susceptibility to addiction vary in the population. Genetic factors that predispose to alcoholism remain largely unknown due to extensive genetic and environmental variation in human populations. Drosophila, however, allows studies on genetically identical individuals in controlled environments. Although addiction to alcohol has not been demonstrated in Drosophila, flies show responses to alcohol exposure that resemble human intoxication, including hyperactivity, loss of postural control, sedation, and exposure-dependent development of tolerance. RESULTS: We assessed whole-genome transcriptional responses following alcohol exposure and demonstrate immediate down-regulation of genes affecting olfaction, rapid upregulation of biotransformation enzymes and, concomitant with development of tolerance, altered transcription of transcriptional regulators, proteases and metabolic enzymes, including biotransformation enzymes and enzymes associated with fatty acid biosynthesis. Functional tests of P-element disrupted alleles corresponding to genes with altered transcription implicated 75% of these in the response to alcohol, two-thirds of which have human orthologues. CONCLUSION: Expression microarray analysis is an efficient method for identifying candidate genes affecting complex behavioral and physiological traits, including alcohol abuse. Drosophila provides a valuable genetic model for comparative genomic analysis, which can inform subsequent studies in human populations. Transcriptional analyses following alcohol exposure in Drosophila implicate biotransformation pathways, transcriptional regulators, proteolysis and enzymes that act as metabolic switches in the regulation of fatty acid metabolism as important targets for future studies of the physiological consequences of human alcohol abuse.

Alcoholism↗

PubMed1985

Sensorimotor deficits related to postural stability. Implications for falling in the elderly.

The effects of age-related sensorimotor and central processing deficits on postural control are reviewed, and the paucity of knowledge about proprioceptive changes with age is noted. A model of processing stages in the production of responses to postural instability is outlined. Even slight response slowing produces disproportionate increases in clinically slow responses. Many aspects of postural responses are "cognitively penetrable". Research on falls should examine learned as well as automated behaviors.

Accidents↗

PubMed1999

Neuronal mechanisms for the control of body orientation in Clione I. Spatial zones of activity of different neuron groups.

The marine mollusk Clione limacina, when swimming, can stabilize different body orientations in the gravitational field. Here we describe one of the modes of operation of the postural network in Clione-maintenance of the vertical, head-up orientation. Experiments were performed on the CNS-statocyst preparation. Spike discharges in the axons of different types of neurons were recorded extracellularly when the preparation was rotated in space through 360 degrees in different planes. We characterized the spatial zones of activity of the tail and wing motor neurons as well as of the CPB3 interneurons mediating the effects of statocyst receptor cells on the tail motor neurons. It was found that the activity of the tail motor neurons increased with deviation of the preparation from the normal, rostral-side-up orientation. Their zones of activity were very wide ( approximately 180 degrees ). According to the zone position, three distinct groups of tail motor neuron (T1-T3) could be distinguished. The T1 group had a center of the zone near the ventral-side-up orientation, whereas the zones of T2 and T3 had their centers near the left-side-up and the right-side-up positions, respectively. By comparing the zone of activity with the direction of tail bending elicited by each of the groups, one can conclude that gravitational reflexes mediated by the T1, T2, and T3 groups will evoke turning of the animal toward the head-up orientation. Two identified wing motor neurons, 1A and 2A, causing the wing beating, were involved in gravitational reactions. They were activated with the downward inclination of the ipsilateral side. Opposite reactions were observed in the motor neurons responsible for the wing retraction. A presumed motor effect of these reactions is an increase of oscillations in the wing that is directed downward and turning of Clione toward the head-up orientation. Among the CPB3 interneurons, at least four groups could be distinguished. In three of them (IN1, IN2, and IN3), the zones of activity were similar to those of the three groups (T1, T2, and T3) of the tail motor neurons. The group IN4 had the center of its zone in the dorsal-side-up position; a corresponding group was not found among the tail motor neurons. In lesion experiments, it was found that gravitational input mediated by a single CPB3 interneuron produced activation of its target tail motor neurons in their normal zones, but the strength of response was reduced considerably. This finding suggests that several interneurons with similar spatial zones converge on individual tail motor neurons. In conclusion, because of a novel method, activity of the neuronal network responsible for the postural control in Clione was characterized in the terms of gravitational responses in different neuron groups comprising the network.

Animals↗

PubMedDate not supplied

Vestibular loss disrupts control of head and trunk on a sinusoidally moving platform.

Twelve subjects, 6 bilateral vestibular-loss (3 well compensated and 3 poorly compensated) and 6 controls, attempted to maintain balance during anterior-posterior sinusoidal surface translation at 6 different frequencies. For frequencies or= 0.75 Hz, these subjects fixed their head/upper-trunk in space. Poorly compensated vestibular subjects showed large head and center of mass variability and were unable to balance at frequencies requiring a head fixed in space pattern. All vestibular subjects were less stable with vision than the controls. Without vision, vestibular subjects experienced more falls than the controls at all frequencies, with falls observed in 61% of the vestibular subjects trials and 16% of the control subjects trials. Vestibular information is important in stabilizing head and upper-trunk motion in space. Visual and somatosensory information can compensate, in part, for vestibular-loss. The results are discussed in light of models that characterize postural control in a vestibular/visual top-down and somatosensory bottom-up manner.

Accidental Falls↗

PubMed2005

Treatment of phobic postural vertigo. A controlled study of cognitive-behavioral therapy and self-controlled desensitization.

In balance clinic practice, phobic postural vertigo is a term used to define a population with dizziness and avoidance behavior often as a consequence of a vestibular disorder. It has been described as the most common form of dizziness in middle aged patients in dizziness units. Anxiety disorders are common among patients with vestibular disorders. Cognitive-behavioral therapy is an effective treatment for anxiety disorders, and vestibular rehabilitation exercises are effective for vestibular disorders. This study compared the effect of additional cognitive-behavioral therapy for a population with phobic postural vertigo with the effect of self-administered vestibular rehabilitation exercises. 39 patients were recruited from a population referred for otoneurological investigation. Treatment effects were evaluated with the Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale. All patients had a self treatment intervention based on education about the condition and recommendation of self exposure by vestibular rehabilitation exercises. Every second patient included was offered additional cognitive behavioral therapy. Fifteen patients with self treatment and 16 patients with cognitive- behavioral treatment completed the study. There was significantly larger effect in the group who received cognitive behavioral therapy than in the self treatment group in Vertigo Handicap Questionnaire and the Hospital Anxiety and Depression scale and its subscales. Cognitive-behavioral therapy has an additional effect as treatment for a population with phobic postural vertigo. A multidisciplinary approach including medical treatment, cognitive-behavioral therapy and physiotherapy is suggested.

Adult↗

PubMed2006

Optimal movement variability: a new theoretical perspective for neurologic physical therapy.

Variability is a natural and important feature of human movement. Using existing theoretical frameworks as a foundation, we propose a new model to explain movement variability as it relates to motor learning and health. We contend that mature motor skills and healthy states are associated with an optimal amount of movement variability. This variability also has form and is characterized by a chaotic structure. Less than optimal movement variability characterizes biological systems that are overly rigid and unchanging, whereas greater than optimal variability characterizes systems that are noisy and unstable. Both situations characterize systems that are less adaptable to perturbations, such as those associated with abnormal motor development or unhealthy states. From our perspective, the goal of neurologic physical therapy should be to foster the development of this optimal amount of movement variability by incorporating a rich repertoire of movement strategies. The development of such a repertoire can be enhanced by incorporating a multitude of experiences within the therapeutic milieu. Promoting complex variation in human movement allows either motor development or the recovery of function after injury not to be hard coded, but determined instead by the active engagement of the individual within their environment. Measurement tools derived from nonlinear dynamics that characterize the complexity of movement variability provide useful means of testing these propositions. To illustrate, we present 2 clinical case studies, one pediatric and one adult, where we applied our theoretical framework to measuring change in postural control.

Adolescent↗

PubMed1998

Stretch reflex sensitivity: effects of postural and muscle length changes.

In this study, a combination of clinical evaluation, laboratory testing, and model simulation of spasticity is performed under various postural conditions to investigate the changes in the sensitivity and specific mechanisms of spasticity. Fifty-nine multiple sclerosis patients participated in the study and received spasticity evaluation based on both the Ashworth scale and the pendulum test. Spasticity was found to increase in the pendulum test when the subjects were tested in a supine posture, compared to when they were sitting. Three patterns of stretch reflex response were seen for similar leg swing trajectories. While it was clear that the increased stretch of rectus femoris in the supine posture contributed to the increased spasticity, the results of modeling showed that other more complex factors were also involved. The supraspinal descending modulation associated with postural control may play a more dominant role in the severity of spasticity. The results suggest that the biomechanical test of spasticity should be performed for several different postures or ranges of movement with muscle activities monitored simultaneously, so that the effect of various factors can be examined. The work also indicates that a neuromusculoskeletal model with detailed muscle dynamics and stretch reflex loops is a valuable tool for investigating the neural mechanisms of spasticity.

Adult↗

PubMed2004

Vision preference in dynamic posturography analysed according to vestibular impairment and handicap.

OBJECTIVE: The objective of this work was to characterise the implications of vision preference derived from the sensory organisation test of computerised dynamic posturography, in terms of impairment, disability and handicap. MATERIAL AND METHOD: This was a prospective assessment of 88 patients suffering from dizziness who denied experiencing any visually induced vertiginous symptoms. The level of impairment of each patient was estimated by performing a complete analysis of vestibular function by means of the caloric and rotatory stimulation tests. Disability and handicap were determined with the Dizziness Handicap Inventory questionnaire (DHI). RESULTS: The results of the caloric test in patients were independent of vision preference although canal paresis was more frequently abnormal in patients without visual preference. No differences were found in the results of rotatory stimulation by means of impulse and sinusoidal tests, both at high velocities of stimuli, in between patients with and without vision preference. Similarly, the responses in the DHI, a common questionnaire for vestibular disability and handicap and, specifically to questions addressing the problem of visual and vestibular disability, were not able to differentiate either group of patients. Nevertheless, we have found that patients with vision preference tend to have poorer balance. CONCLUSION: We consider that in the patients studied here, vision preference must be considered as a normal finding as this represents a normal strategy in a subject that relies more heavily on visual cues for his or her postural control.

Adult↗