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PubMed2000

An experimental controlled study on postural sway and therapeutic exercise in subjects with low back pain.

OBJECTIVES: To describe postural sway and its associations to background factors, low back pain and functional capacity. To evaluate the changes in postural sway after three months of therapeutic exercise in the gym or at home. DESIGN: A one-year randomized experimental trial evaluated postural sway in three study groups: intensive training, home exercise and control group. SETTING: Subjects were recruited from seven local occupational health care centres in Central Finland and were examined at Central Finland Hospital by medical doctors. Measurements and therapeutic exercise programmes were carried out in the Research Laboratory of Sport and Health Sciences at Jyväskylä University. SUBJECTS: Initially, 49 male and 41 female subjects (aged 20-55 years) with nonspecific and subacute low back pain were examined. MAIN OUTCOME MEASURES: Postural sway using a force platform, the Oswestry Index, as well as a measure of low back pain intensity were measured at the initial stage of the study, directly after interventions, as well as at three and nine months after the interventions. RESULTS: The background variables were not strongly correlated with postural sway. No changes occurred in the amplitude of sway during the study, but the sway velocity of the home exercise group increased. CONCLUSIONS: Postural sway measurements with a force platform may be suitable for detecting impairments of balance performance among subjects with pronounced functional or activity limitations and severe low back pain problems. In order to enhance balance performance, specific and customized exercise programmes are required.

Adult↗
PubMed2003

Biomechanical modeling and optimal control of human posture.

The present work describes the biomechanical modeling of human postural mechanics in the saggital plane and the use of optimal control to generate open-loop raising-up movements from a squatting position. The biomechanical model comprises 10 equivalent musculotendon actuators, based on a 40 muscles model, and three links (shank, thigh and HAT-Head, Arms and Trunk). Optimal control solutions are achieved through algorithms based on the Consistent Approximations Theory (Schwartz and Polak, 1996), where the continuous non-linear dynamics is represented in a discrete space by means of a Runge-Kutta integration and the control signals in a spline-coefficient functional space. This leads to non-linear programming problems solved by a sequential quadratic programming (SQP) method. Due to the highly non-linear and unstable nature of the posture dynamics, numerical convergence is difficult, and specific strategies must be implemented in order to allow convergence. Results for control (muscular excitations) and angular trajectories are shown using two final simulation times, as well as specific control strategies are discussed.

Algorithms↗
PubMed2004

Is postural tremor size controlled by interstitial potassium concentration in muscle?

OBJECTIVES: To determine whether factors associated with postural tremor operate by altering muscle interstitial K(+). METHODS: An experimental approach was used to investigate the effects of procedures designed to increase or decrease interstitial K(+). Postural physiological tremor was measured by conventional means. Brief periods of ischaemic muscle activity were used to increase muscle interstitial K(+). Infusion of the beta(2) agonist terbutaline was used to decrease plasma (and interstitial) K(+). Blood samples were taken for the determination of plasma K(+). RESULTS: Ischaemia rapidly reduced tremor size, but only when the muscle was active. The beta(2) agonist produced a slow and progressive rise in tremor size that was almost exactly mirrored by a slow and progressive decrease in plasma K(+). CONCLUSIONS: Ischaemic reduction of postural tremor has been attributed to effects on muscle spindles or an unexplained effect on muscle. This study showed that ischaemia did not reduce tremor size unless there was accompanying muscular activity. An accumulation of K(+) in the interstitium of the ischaemic active muscle may blunt the response of the muscle and reduce its fusion frequency, so that the force output becomes less pulsatile and tremor size decreases. When a beta(2) agonist is infused, the rise in tremor mirrors the resultant decrease in plasma K(+). Decreased plasma K(+) reduces interstitial K(+) concentration and may produce greater muscular force fluctuation (more tremor). Many other factors that affect postural tremor size may exert their effect by altering plasma K(+) concentration, thereby changing the concentration of K(+) in the interstitial fluid.

Adrenergic beta-Agonists↗
PubMed1985

The mechanics of multi-joint posture and movement control.

The dependence of muscle force on muscle length gives rise to a "spring-like" behavior which has been shown to play a role in the execution of single-joint posture and movement. This paper extends this concept and considers the influence of the apparent mechanical behavior of the neural, muscular and skeletal system on the control and coordination of multiple degree of freedom posture and movement. A rigorous definition of "spring-like" behavior is presented. From it a numerically quantifiable, experimental test of spring-like behavior is formulated. It is shown that if the steady-state force-displacement behavior of a limb is not spring-like, this can only be due to the action of inter-muscular feedback, and can not be due to intrinsic muscle properties. The directional character of the spring-like behavior of a multiple degree of freedom system is described. The unique way in which synergistic coactivation of polyarticular muscles may modulate the directional properties of the spring-like behavior of a multiple degree of freedom system is explained. Dynamic aspects of postural behavior are also considered. The concept of mechanical impedance is presented as a rigorous dynamic generalisation of the postural stiffness of the limb. The inertial behavior of the system is characterised by its mobility. As with the stiffness or impedance, in the multiple degree of freedom case it has a directional property. The way in which the apparent kinematic redundancy of the musculo-skeletal system may be used to modify its dynamic behavior is explained. Whereas the inertial behavior of a single limb segment is not modifiable, it is shown that the apparent inertial behavior of a multiple degree of freedom system may be modulated by repositioning the joints. A unified description of the posture and movement of a multi-joint system is presented by defining a "virtual trajectory" of equilibrium positions for the limb which may be specified by the neuro-muscular system. The way in which this approach may lead to a simplification of some the apparent computational difficulties associated with the control of multi-joint motion is discussed.

Arm↗
PubMed2003

Motor control of locomotor hindlimb posture in the American alligator (Alligator mississippiensis).

Crocodilians are unusual among quadrupedal tetrapods in their frequent use of a wide variety of hindlimb postures, ranging from sprawling to a more erect high walk. In this study, we use synchronized kinematic videos and electromyographic recordings to test how the activity patterns of hindlimb muscles in American alligators (Alligator mississippiensis Daudin) differ between sprawling and more upright postures. Previous force platform analyses suggested that upright posture in alligators would require greater activation by hindlimb extensors to counter increases in the flexor moments exerted about joints by the ground reaction force during upright stance. Consistent with these predictions, ankle extensors (gastrocnemius) and knee extensors (femorotibialis internus and iliotibialis 2) exhibit increases in signal intensity during the use of more upright stance. Bone loading data also predicted that activation patterns for hip adductors spanning the length of the femur would not differ between sprawling and more upright posture. Correspondingly, motor patterns of the adductor femoris were not altered as posture became more upright. However, the adductor puboischiofemoralis externus 3, which inserts far proximally on the femur, displays significant increases in burst intensity that could contribute to the greater femoral adduction that is integral to upright posture. In contrast to patterns in alligators, in mammals EMG burst intensity typically decreases during the use of upright posture. This difference in the motor control of limb posture between these taxa may be related to differences in the relative sizes of their feet. Alligator feet are large relative to the hindlimb and, as a result, the ground reaction force shifts farther from the limb joints during upright steps than in mammals, increasing flexor moments at joints and requiring alligator extensor muscles to exert greater forces to keep the limb in equilibrium. However, several alligator hindlimb muscles show no differences in motor pattern between sprawling and upright posture. The wide range of motor pattern modulations between different postures in alligators suggests considerable independence of neural control among the muscles of the alligator hindlimb.

Alligators and Crocodiles↗
PubMed2006

Effect of age and sex on maturation of sensory systems and balance control.

Maintenance of postural balance requires an active sensorimotor control system. Current data are limited and sometimes conflicting regarding the influence of the proprioceptive, visual, and vestibular afferent systems on posture control in children. This study investigated the development of sensory organization according to each sensory component in relation to age and sex. A total of 140 children (70 males, 70 females; mean age 10y [SD 4y]; age range 3y 5mo-16y 2mo) and 20 adults (10 males, 10 females; mean age 30y 6mo [SD 8y 4mo]; age range 17y 2mo-49y 1mo) were examined using the Sensory Organization Test. Participants were tested in three visual conditions (eyes open, blindfolded, and sway-referenced visual enclosure) while standing on either a fixed or a sway-referenced force platform. Mean equilibrium scores for the six balance conditions showed rapid increases and maturation ceiling levels for age-related development of the sensorimotor control system. Proprioceptive function seemed to mature at 3 to 4 years of age. Visual and vestibular afferent systems reached adult level at 15 to 16 years of age, revealing differences between young males and females. Characterizing balance impairments can contribute to the diagnostic evaluation of neuromotor disorders.

Adolescent↗
PubMed2005

Energy cost and cardiorespiratory adaptation in the "Get-Up-and-Go" test in frail elderly women with postural abnormalities and in controls.

BACKGROUND: This study investigated the hypothesis that postural abnormalities might increase energy expenditure during a clinical functional test in frail elderly persons. METHODS: Two groups of hospitalized women (aged 73 to 100 years) were recruited. Women who showed postural and gait abnormalities as described in the psychomotor disadaptation syndrome (PDS) were compared with control participants. The authors measured energy expenditure during the timed "up and go" test. For each participant, oxygen uptake, carbon dioxide output, expiratory minute ventilation, breathing frequency, heart rate, and alveolar ventilation were recorded 10 minutes before, during, and 10 minutes after exercise. The arterial pressure of carbon dioxide was estimated from expired gases. RESULTS: The mean oxygen uptake values were significantly higher in women with PDS than in the control group during exercise and recovery periods (4.89 +/- 1.68 vs 3.75 +/- 1.25 ml . kg(-1) . min(-1) and 4.69 +/- 1.45 vs 3.76 +/- 0.97 ml . kg(-1) . min(-1), respectively [p <.05]). Expiratory minute ventilation was always higher in women with PDS than in controls regardless of the period of the test (p <.05), and alveolar ventilation was higher in women with PDS only during the exercise period (p <.05). The estimated arterial pressure of carbon dioxide did not change significantly between the different phases of the test but was always lower (p <.05) in women with PDS compared with the control group. CONCLUSIONS: The significant increase in oxygen uptake during the exercise and recovery periods in women with PDS compared with controls suggests that postural abnormalities that characterize PDS may be associated with an increase in energy expenditure. In clinical practice, the low capacity to tolerate even moderate exercise must be considered when specific rehabilitation programs are offered to women with PDS.

Adaptation, Physiological↗
PubMed1995

Long latency postural reflexes are under supraspinal dopaminergic control.

Scaling of posturally stabilizing long latency (LL) reflexes in tibialis anterior muscles induced by "toe-up" rotational perturbations is abnormal in standing patients with Parkinson's disease. To investigate the contribution of dopaminergic pathways to abnormal scaling, we studied LL reflexes in 22 patients with selective hypodopaminergic syndromes: 10 psychiatric patients taking chronic neuroleptic medication (7 with mild parkinsonism), 8 patients with young-onset Parkinson's disease, and 4 patients with MPTP-induced parkinsonism. Results were compared with those of 10 healthy controls. Stimuli consisted of (a) 10 serial (predictable) perturbations of 4 degrees amplitude, (b) 10 serial (predictable) perturbations of 10 degrees amplitude, and (c) 20 randomly mixed (unpredictable) perturbations of either 4 or 10 degrees amplitude. In normal subjects, LL reflex amplitudes were adapted to match predictable variations in stimulus size, whereas under unpredictable conditions a "default" response emerged that anticipated the 10 degrees perturbation. LL reflex scaling under predictable conditions was intact in patients with neuroleptic-induced parkinsonism and young-onset Parkinson's disease, but the large default LL response under unpredictable conditions was absent. In patients with MPTP-induced parkinsonism, LL reflex scaling was absent during both predictable and unpredictable conditions. We conclude that abnormal scaling of posturally stabilizing LL reflexes is related to decreased supraspinal dopaminergic influence.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1993

Geometrical approach to neural net control of movements and posture.

In one approach to modeling brain function, sensorimotor integration is described as geometrical mapping among coordinates of non-orthogonal frames that are intrinsic to the system; in such a case sensors represent (covariant) afferents and motor effectors represent (contravariant) motor efferents. The neuronal networks that perform such a function are viewed as general tensor transformations among different expressions and metric tensors determining the geometry of neural functional spaces. Although the non-orthogonality of a coordinate system does not impose a specific geometry on the space, this "Tensor Network Theory of brain function" allows for the possibility that the geometry is non-Euclidean. It is suggested that investigation of the non-Euclidean nature of the geometry is the key to understanding brain function and to interpreting neuronal network function. This paper outlines three contemporary applications of such a theoretical modeling approach. The first is the analysis and interpretation of multi-electrode recordings. The internal geometries of neural networks controlling external behavior of the skeletomuscle system is experimentally determinable using such multi-unit recordings. The second application of this geometrical approach to brain theory is modeling the control of posture and movement. A preliminary simulation study has been conducted with the aim of understanding the control of balance in a standing human. The model appears to unify postural control strategies that have previously been considered to be independent of each other. Third, this paper emphasizes the importance of the geometrical approach for the design and fabrication of neurocomputers that could be used in functional neuromuscular stimulation (FNS) for replacing lost motor control.

Animals↗
PubMed2004

Controlling human upright posture: velocity information is more accurate than position or acceleration.

The problem of how the nervous system fuses sensory information from multiple modalities for upright stance control remains largely unsolved. It is well established that the visual, vestibular, and somatosensory modalities provide position and rate (e.g., velocity, acceleration) information for estimation of body dynamics. However, it is unknown whether any particular property dominates when multisensory information is fused. Our recent stochastic analysis of postural sway during quiet stance suggested that sensory input provides more accurate information about the body's velocity than its position or acceleration. Here we tested this prediction by degrading major sources of velocity information through removal/attenuation of sensory information from vision and proprioception. Experimental measures of postural sway were compared with model predictions to determine whether sway behavior was indicative of a deficit in velocity information rather than position or acceleration information. Subjects stood with eyes closed on a support surface that was 1) fixed, 2) foam, or 3) sway-referenced. Six measures characterizing the stochastic structure of postural sway behaved in a manner consistent with model predictions of degraded velocity information. Results were inconsistent with the effect of degrading only position or acceleration information. These findings support the hypothesis that velocity information is the most accurate form of sensory information used to stabilize posture during quiet stance. Our results are consistent with the assumption that changes in sway behavior resulting from commonly used experimental manipulations (e.g., foam, sway-referencing, eyes closed) are primarily attributed to loss of accurate velocity information.

Acceleration↗
PubMed2004

Does anticipation of back pain predispose to back trouble?

Limb movement imparts a perturbation to the body. The impact of that perturbation is limited via anticipatory postural adjustments. The strategy by which the CNS controls anticipatory postural adjustments of the trunk muscles during limb movement is altered during acute back pain and in people with recurrent back pain, even when they are pain free. The altered postural strategy probably serves to protect the spine in the short term, but it is associated with a cost and is thought to predispose spinal structures to injury in the long term. It is not known why this protective strategy might occur even when people are pain free, but one possibility is that it is caused by the anticipation of back pain. In eight healthy subjects, recordings of intramuscular EMG were made from the trunk muscles during single and repetitive arm movements. Anticipation of experimental back pain and anticipation of experimental elbow pain were elicited by the threat of painful cutaneous stimulation. There was no effect of anticipated experimental elbow pain on postural adjustments. During anticipated experimental back pain, for single arm movements there was delayed activation of the deep trunk muscles and augmentation of at least one superficial trunk muscle. For repetitive arm movements, there was decreased activity and a shift from biphasic to monophasic activation of the deep trunk muscles and increased activity of superficial trunk muscles during anticipation of back pain. In both instances, the changes were consistent with adoption of an altered strategy for postural control and were similar to those observed in patients with recurrent back pain. We conclude that anticipation of experimental back pain evokes a protective postural strategy that stiffens the spine. This protective strategy is associated with compressive cost and is thought to predispose to spinal injury if maintained long term.

Adult↗
PubMed1996

[The significance of visual analyzer in controlling the standing posture in individuals with the spastic form of child cerebral paralysis while wearing "Adel" suit].

The paper discussed the results of stabilographic examination of the children suffered from the spastic form of child cerebral paralysis (CCP) treated by means of graded wearing of "Adel" suit which is a modification of the "Penguin" spacesuit. There has been studied the state of 30 children before treatment with the use of "Adel" suit and after the treatment as well as following the several courses of wearing the suit. Besides the patients, eleven healthy volunteer subjects (control group) were examined. There have been obtained the results pointing to the fact that in the healthy persons when they try to achieve the standing posture the leading role pertains to visual analyzer, at the same time, in the patients with spastic form of CCP the realization of standing posture depends upon the severity of the motor function disorders. When in the process of control stabilographic examination the patients suffered from spastic form of CCP demonstrate the significant role of the visual analyzer in achieving the standing posture, the use of the "Adel" suit is most desirable. The use of the "Adel" suit in the CCP patients with a decreased role of visual analyzer in achieving the standing pose as it was found under control examination enhances its significance in controlling the position of the center of gravity of the body.

Cerebral Palsy↗
PubMed1979

Cerebral specialization, writing posture, and motor control of writing in left-handers.

It has been suggested that the inverted hand position of left-handers during writing indicates the left hemisphere of their brain is linguistically specialized and that the writing of these left-handers may be controlled via ipsilateral pathways. Electroencephalograph alpha asymmetry measures at central and parietal leads, as well as dichotic tests, differentiated right-handers from left-handers, but not inverters from noninverters. Electroencephalograph differences between hand posture groups did appear, but only at occipital leads during reading and writing tasks. Regardless of hand posture or speech lateralization, the right central region of the brain is significantly involved in the control of left-handed writing.

Auditory Perception↗
PubMedDate not supplied

Balancing acts: respiratory sensations, motor control and human posture.

1. The present brief review covers some novel aspects of integration between respiration and movement of the body. 2. There are potent viscerosomatic reflexes in animals involving small-diameter pulmonary afferents that, when excited, would limit exercise. However, recent studies using lobeline injections to excite pulmonary afferents in awake humans suggest that there is no evoked reflex motoneuronal inhibition. Instead, the noxious respiratory sensations generated by the vagal afferents may be crucial in the decision to stop exercise. 3. While respiratory movements may affect limb movements, the control of the trunk and limbs can involve interaction (and even interference) with key respiratory muscles, such as the diaphragm. Recent studies have revealed that not only does the diaphragm receive feed-forward drive prior to some limb movements, but that it also contracts both phasically and tonically during repetitive limb movements. 4. Thus, challenges to posture can indirectly challenge ventilation, while coordinated diaphragm contraction may contribute to control of the trunk.

Humans↗
PubMed1997

Postural perturbations: new insights for treatment of balance disorders.

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.

Biomechanical Phenomena↗
PubMed1996

The control of stable postures in the multijoint arm.

The stiffness that is measured at the hand of a multijoint arm emerges from the combined effects of the elastic properties of the muscles and joints, the geometry of the linkages and muscle attachments, and the neural control circuits that act on the arm. The effective stiffness of a nonlinear linkage such as a two-joint arm depends on the force acting on the system as well as the intrinsic stiffness of the actuators. This paper presents an analysis of the factors that affect limb stiffness, including the effects of external forces. Three potential strategies for controlling the stability of the limb are proposed and demonstrated by computer simulations. The predictions from the simulations are then compared experimentally with measured stiffness values for human subjects working against an external force. These experiments were directed toward understanding what strategies are used by the CNS to control limb stiffness and stability. The experimental evidence showed that human subjects must increase the stiffness at the joints in order to maintain limb stability in the presence of applied external forces at the hand. In the process we identified a precise role for muscles which span two or more joints in the control of over all limb stiffness. A local strategy may be used to achieve limb stability, in which the muscle stiffness increases with muscle force. Multijoint muscles are shown to provide mechanical couplings which are necessary for the maintenance of stability. By utilizing these muscles, the neuro-musculo-skeletal system can control a global property of the system (stability) with a passive local strategy.

Adult↗
PubMed2006

Interfering effects of multitasking on muscle activity in the upper extremity.

Multitasking, where workers are required to perform multiple physical tasks with various levels of cognitive load is common in today's workplace. Simultaneous physical and mental demands are thought to cause task interference and likely increase muscle activity. To test the interfering effects of multitasking, 16 healthy participants performed hand and shoulder exertions with combinations of four grip conditions (no grip, 30% grip with low precision, 30% grip with high precision, and maximal grip) and three shoulder conditions at 90 degrees abduction (maintaining posture, 40% force-controlled moment, 40% posture-controlled moment), with and without the Stroop test while surface EMG was recorded from eight upper extremity muscles. Both 40% MVC shoulder moments increased extrinsic forearm muscle activity by 2-4% MVE (p<0.01). Grip exertion at 30% MVC reduced anterior and middle deltoid activity by 2% MVE (p<0.01). Exerting a constant force against the transducer (force-controlled) required 3-4% MVE greater middle and posterior deltoid activity (p<0.001) compared to supporting an equivalent inertial load at the same shoulder angle (posture-controlled). Performing the mental task (Stroop test) concurrently with either 40% MVC shoulder moments significantly increased trapezius activity by nearly 2% MVE (p<0.05). Interestingly, the Stroop test also reduced all deltoid activity by 1% MVE (p<0.05). The addition of both the Stroop test and force-control shoulder exertion independently reduced maximal grip force by 7% and 10% MVC, respectively. These results suggest that more complex workplace tasks may act to increase muscle load or interfere with task performance. These small but significant findings may play a role in the development of long-term musculoskeletal disorders in the workplace.

Adult↗