Stance stability with unilateral and bilateral light touch of an external stationary object

Unilateral light fingertip touch of a stationary object has a significant stabilizing effect on postural sway during stance. The purpose of this study was to find out if this effect is enhanced by bilateral light touch of parallel stationary objects. The postural sway of 54 healthy subjects was tested in four stance conditions: no touch; unilateral left light touch of the left handle of a walker; unilateral right light touch of the right handle of the same walker; and bilateral light touch of the two handles. During testing, subjects stood blindfolded on two foam pads placed on the left and right force plates of the Tetrax balance system. Testing in each condition lasted 45?s and was executed twice in a random order. As expected, postural sway was significantly reduced by unilateral left or right light fingertip touch. It was significantly further decreased by bilateral light touch. In addition, light touch conditions were associated with a reduction in pressure fluctuations between the heel and forefoot of the same foot as well as those of the contralateral foot, with a concomitant increase in weight shift fluctuations between the two feet. The decrease in postural sway with bilateral light touch suggests cortical modulation of the bilateral touch inputs, with enhancement of the stabilizing response.     

Modulation of soleus H reflex due to stance pattern and haptic stabilization of posture

The quiet stance is a complicated motor act requiring sophisticated sensorimotor integration to balance an artificial inverted pendulum with the ankle musculature. The objective of this study was to characterize the effects of stance pattern (bilateral stance vs. unilateral stance) and directional influence of light finger touch (medial–lateral vs. anterior–posterior) in unilateral stance upon responsiveness of the soleus H reflex. Sixteen healthy volunteers (mean age, 24.25 ± 1.77 years) participated in four postural tasks with the eyes open, including the bilateral stance (BS), the unilateral stance without finger touch (USNT), and with finger touch in the medial–lateral direction (USML) and anterior–posterior direction (USAP). Meanwhile, the soleus H reflex, the pre-stimulus background activity of ankle antagonist pairs, and center of pressure (CoP) sway were measured. In reference to the BS, the USNT resulted in a significant stance effect on suppression of the soleus H reflex (H/M_max) associated with enhancement of CoP sway. Among the conditions of unilateral stance, there was a marked directional effect of finger touch on modulation of the H/M_max. A greater disinhibition of the H/M_max in consequence to light touch in the ML direction than in the AP direction was noted (H/M_max: USML > USAP > USNT). This directional modulation of the soleus H reflex concurred with haptic stabilization of posture in unilateral stance, showing a more pronounced reduction in CoP sway in the USML condition than in the USAP condition. However, alteration in postural sway and modulation of the soleus H reflex were not mutually correlated when stance pattern or touch vector varied. In conclusion, gating of the soleus H reflex indicated adaptation of an ankle strategy to stance pattern and haptic stabilization of posture. Relative to bilateral stance, postural maintenance in unilateral stance relied less on reflexive correction of the soleus. When finger touch was provided in line with prevailing postural threat in the lateral direction, postural stability in unilateral stance was better secured than finger touch in anterior–posterior direction, resulting in more pronounced disinhibition of the monosynaptic reflex pathway.     

Reciprocal influences on performances of a postural–suprapostural task by manipulating the level of task-load

The objective of this study was to investigate the reciprocal influences of stance pattern (bilateral stance vs. unilateral stance) and thumb-index precision grip task (static target vs. dynamic target) on postural–suprapostural tasks by manipulating task-load. Fifteen healthy volunteers participated in four postural–suprapostural tasks, including static force-matching in bilateral/unilateral stance (BS_static; US_static), dynamic force-matching in bilateral/unilateral stance (BS_dynamic; US_dynamic), and two control tasks in bilateral and unilateral stances without a finger task. The normalized force error (NFE), reaction time (RT) of the finger tasks, and normalized change in center of pressure sway (ΔNCoP) were measured. For suprapostural task performance, a significant interaction effect between postural and suprapostural tasks on NFE of the finger tasks was noted (static: BS < US; dynamic: BS > US), but RT was not different among the four tasks. For postural task performance, negative ΔNCoP during unilateral stance indicated a spontaneous reduction in postural sway due to added force-matching. In contrast, addition of force-matching tended to increase postural sway during bilateral stance, but postural fluctuations decreased as task-load of suprapostural task increased (BS_dynamic < BS_static). In conclusion, performance of postural–suprapostural tasks was differently modulated by task-load increment. Our observations favored adaptive resource-sharing and implicit expansion of resource capacity for a postural task with a motor suprapostural goal.     

Age-related changes of human balance during quiet stance

Certain aspects of balance control change with age, resulting in a slight postural instability. We examined healthy subjects between 20-82 years of age during the quiet stance under static conditions: at stance on a firm surface and/or on a compliant surface with eyes either open or closed. Body sway was evaluated from centre of foot pressure (CoP) positions during a 50 sec interval. The seven CoP parameters were evaluated to assess quiet stance and were analyzed in three age groups: juniors, middle-aged and seniors. The regression analysis showed evident increase of body sway over 60 years of age. We found that CoP parameters were significantly different when comparing juniors and seniors in all static conditions. The most sensitive view on postural steadiness during quiet stance was provided by CoP amplitude and velocity in AP direction and root mean square (RMS) of statokinesigram. New physiological ranges of RMS parameter in each condition for each age group of healthy subjects were determined. Our results showed that CoP data from force platform in quiet stance may indicate small balance impairment due to age. The determined physiological ranges of RMS will be useful for better distinguishing between small postural instability due to aging in contrast to pathological processes in the human postural control.     

Sex and age differences of relationships among stepping parameters for evaluating dynamic balance in the elderly

This study aimed to examine the relationships among various stepping parameters, sex, and age in the elderly. Healthy elderly Japanese individuals 60-85 years old (50 males and 61 females) performed 4 types of stepping motions for 20 s. Stepping motions included bilateral stepping (back/forth and right/left) and unilateral stepping (back/forth and right/left). The number of steps, the average connecting time of a foot during one step, and the average time of both feet touching the floor at the same time (bilateral connecting time) were measured with a foot switch sheet. The trial-to-trial reliability was very high (above 0.86) except for the bilateral connecting time in the bilateral stepping back/forth test for 70-85 year olds (males: 0.67, females: 0.68). With age, the number of steps was significantly smaller, and the average connecting time and the bilateral connecting time were shorter in all stepping tests. There were significant sex differences in bilateral connecting time for bilateral stepping right and left and the number of steps for the bilateral stepping back and forth and the unilateral stepping right and left tests. The number of steps and average connecting time showed high correlations between bilateral stepping right/left and back/forth (r=0.71-0.94) and between unilateral stepping back/forth and right/left (r=0.87-0.99). There were significant correlations of the average connecting time between bilateral and unilateral stepping motions (r=0.51-0.83), but both stepping motions are considered to have different motion properties from the viewpoint of center of gravity sway. The correlations between the bilateral connecting time and the number of steps in bilateral stepping were relatively low (males: /r/<0.70, females: /r/<0.57). The bilateral connecting time was near 0 s in many males; thus, it may depend greatly on individual or sex differences in stepping strategy. These results suggest that the stepping motions used in this study can evaluate dynamic balance ability, and that the unilateral test may be useful for the elderly who cannot walk independently with ease.     

Effects of Additional Support on the Maintenance of Human Vertical Posture

Effects of contact of a hand or fingertip with an additional support on human balance on stationary and movable surfaces were studied. Contact with a fixed or free vertical bar was established either by a handgrip or a touch with the tip of the index finger. Amplitudes and lengths of posturograms under conditions of free standing and standing with additional proprioceptive information were compared. It was shown that contact with an additional support during standing on a stationary surface with closed eyes decreases the amplitude of sagittal sway of the center of gravity by 1.3- to 2-fold as compared to standing without such a contact, independently of the contact type and the degree of bar mobility. During standing on a movable platform (which resulted in a three- to fourfold increase in the amplitude of sway as compared to standing on the floor), the grasp of the fixed bar decreased the amplitude of sagittal sway by five- to ninefold and the touch led to a three- to fourfold decrease. The sway of the common center of gravity upon contact with the movable bar during standing on the unstable platform was reduced by half on both planes independently of the contact type. The results suggest that sensory information from receptors of the hand contacting with a stationary or movable support substantially supplements the current neural representation of the spatial position of the body, correcting and changing the direction of postural reactions and the perception of the location of external objects, which ensures the ability of the CNS to maintain the balance under complicated conditions and to provide highly stable standing.     

Enhancing human balance control with galvanic vestibular stimulation

 With galvanic vestibular stimulation (GVS), electrical current is delivered transcutaneously to the vestibular afferents through electrodes placed over the mastoid bones. This serves to modulate the continuous firing levels of the vestibular afferents, and causes a standing subject to lean in different directions depending on the polarity of the current. Our objective in this study was to test the hypothesis that the sway response elicited by GVS can be used to reduce the postural sway resulting from a mechanical perturbation. Nine subjects were tested for their postural responses to both galvanic stimuli and support-surface translations. Transfer-function models were fit to these responses and used to calculate a galvanic stimulus that would act to counteract sway induced by a support-surface translation. The subjects' responses to support-surface translations, without and with the stabilizing galvanic stimulus, were then measured. With the stabilizing galvanic stimulus, all subjects showed significant reductions in both sway amplitude and sway latency. Thus, with GVS, subjects maintained a more erect stance and followed the support-surface displacement more closely. These findings suggest that GVS could possibly form the basis for a vestibular prosthesis by providing a means through which an individual's posture can be systematically controlled. Received: 11 May 2000 / Accepted in revised form: 20 November 2000     

Static Postural Stability in Women during and after Pregnancy: A Prospective Longitudinal Study

This longitudinal study aimed to compare static postural stability in women between early pregnancy, advanced pregnancy, and at 2 and 6 months postpartum. Forty-five pregnant women were enrolled and 31 completed the protocol. Data were collected at 7–16 and 34–39 weeks gestation, and at 6–10 and 26–30 weeks postpartum. For each subject, the center of foot pressure path length and mean velocity (with directional subcomponents) were computed from 30-s long quiet-standing trials on a stationary force plate with eyes open or closed. The body mass, stance width, and sleep duration within 24 h before testing were also recorded. Static postural stability was not different between pregnancy and postpartum, except for the anterior posterior sway tested in the eyes-closed condition, which was significantly increased in late pregnancy compared to that at 2 and 6 months postpartum. Pregnant/postpartum women’s body mass weakly positively correlated with anterior-posterior sway in the eyes-closed condition and their stance width weakly positively correlated with the anterior-posterior sway in the eyes-open condition. No effect of sleep duration on postural sway was found. Our findings indicate that under visual deprivation conditions women in advanced pregnancy may have decreased static stability compared to their non-pregnant state.     

Effects of excessive body weight on postural control

Research that evaluated both static and dynamic stability was performed, to clarify the impact of excessive body weight on postural control. The spontaneous center of foot pressure (CP) motion during quiet stance and a range of forward voluntary CP displacements were studied in 100 obese, and 33 lean women. Characteristics of postural sway were acquired while the subjects were standing quiet on a force plate with eyes open (EO) and with eyes closed (EC). Their anterior range of CP voluntary displacements was assessed upon a range of maximal whole body leanings which were directed forward. A substantial reduction of postural sway was observed in all patients which had increased body weight. Main postural sway parameters i.e., the total path length as well as its directional components were negatively correlated with the body mass and body mass index (BMI). The range of a whole body voluntary forward leaning, did not exhibit any significant change in patients with an obesity grade of I and II. Such a deficit was, however, found in subjects with a body mass index above 40. In conclusion, the increased body weight imposed new biomechanical constraints, that resulted in functional adaptation of the control of the erect posture. This functional adaptation was characterized by a reduced postural sway associated with a substantial reduction of the dynamic stability range in subjects with BMI>40.     

Multisensory fusion and the stochastic structure of postural sway

 We analyze the stochastic structure of postural sway and demonstrate that this structure imposes important constraints on models of postural control. Linear stochastic models of various orders were fit to the center-of-mass trajectories of subjects during quiet stance in four sensory conditions: (i) light touch and vision, (ii) light touch, (iii) vision, and (iv) neither touch nor vision. For each subject and condition, the model of appropriate order was determined, and this model was characterized by the eigenvalues and coefficients of its autocovariance function. In most cases, postural-sway trajectories were similar to those produced by a third-order model with eigenvalues corresponding to a slow first-order decay plus a faster-decaying damped oscillation. The slow-decay fraction, which we define as the slow-decay autocovariance coefficient divided by the total variance, was usually near 1. We compare the stochastic structure of our data to two linear control-theory models: (i) a proportional–integral–derivative control model in which the postural system's state is assumed to be known, and (ii) an optimal-control model in which the system's state is estimated based on noisy multisensory information using a Kalman filter. Under certain assumptions, both models have eigenvalues consistent with our results. However, the slow-decay fraction predicted by both models is less than we observe. We show that our results are more consistent with a modification of the optimal-control model in which noise is added to the computations performed by the state estimator. This modified model has a slow-decay fraction near 1 in a parameter regime in which sensory information related to the body's velocity is more accurate than sensory information related to position and acceleration. These findings suggest that: (i) computation noise is responsible for much of the variance observed in postural sway, and (ii) the postural control system under the conditions tested resides in the regime of accurate velocity information. Received: 20 March 2001 / Accepted: 17 April 2002 Acknowledgements. We thank Tjeerd Dijkstra for bringing the slow-decay component of postural sway to our attention. Funding for this research was provided by National Institutes of Health grant R29 N35070–01A2, John J. Jeka, PI. Correspondence to: T. Kiemel (Tel.: +1-301-4056176, Fax: +1-301-3149358 e-mail: kiemel@glue.umd.edu)     

Characteristic Features of Disorders of the Upright Posture in Patients with Poststroke Hemipareses

Characteristic features of upright posture maintenance and mechanisms of postural disorders in poststroke hemiparetic patients were studied using a bilateral force platform. The following features of postural disorders were revealed in the patients tested: an increase in the velocity and amplitude of the center-of-pressure (CP) sway as compared to in healthy subjects, an absolute decrease in the half-cycles of the CP sway, asymmetry of weight bearing by both feet, and a shift of the center of pressure of an affected foot towards the toe. The disturbance of stability of the vertical posture in such patients is to a greater extent associated with weight-bearing asymmetry. It was shown that the character of the CP sway is mainly determined by a disorder of the sensory motor control, whereas damage to the efferent pathways is responsible for the postural asymmetry. Increase in the muscle tone restricts the sway amplitude. Thus, several forms of postural instability are characteristic of hemiparetic patients. Predominantly sensory, motor, or tonic disorders are responsible for these disturbances of stability.     

Relationship between Spectral Characteristics of Spontaneous Postural Sway and Motion Sickness Susceptibility

Motion sickness (MS) usually occurs for a narrow band of frequencies of the imposed oscillation. It happens that this frequency band is close to that which are spontaneously produced by postural sway during natural stance. This study examined the relationship between reported susceptibility to motion sickness and postural control. The hypothesis is that the level of MS can be inferred from the shape of the Power Spectral Density (PSD) profile of spontaneous sway, as measured by the displacement of the center of mass during stationary, upright stance. In Experiment 1, postural fluctuations while standing quietly were related to MS history for inertial motion. In Experiment 2, postural stability measures registered before the onset of a visual roll movement were related to MS symptoms following the visual stimulation. Study of spectral characteristics in postural control showed differences in the distribution of energy along the power spectrum of the antero-posterior sway signal. Participants with MS history provoked by exposure to inertial motion showed a stronger contribution of the high frequency components of the sway signal. When MS was visually triggered, sick participants showed more postural sway in the low frequency range. The results suggest that subject-specific PSD details may be a predictor of the MS level. Furthermore, the analysis of the sway frequency spectrum provided insight into the intersubject differences in the use of postural control subsystems. The relationship observed between MS susceptibility and spontaneous posture is discussed in terms of postural sensory weighting and in relation to the nature of the provocative stimulus.     

Somatosensory impairments in patients with multiple sclerosis: association with dynamic postural control and upper extremity motor function

Abstract

Purpose: We planned this study to bring attention to the somatosensory impairments in patients with multiple sclerosis (PwMS) and to investigate relationship of somatosensory impairments with dynamic postural stability and upper extremity motor function.

Methods: Seven males and 23 females, 30 patients with mean EDSS 2.9 (SD = 1.4), aged between 18 and 65 years (mean = 41.43?±?14.90 years) were included in this clinical study. Light touch sensorial assessment was made with Semmes Weinstein monofilament test and proprioception by distal proprioception test. Hand strength was measured by the Jamar dynamometer, fine motor skill was examined with nine-hole peg test, functional reach test in sitting and standing position was applied. Nottingham Extended Activities of Daily Living Scale (NEADLS) was used to measure everyday activities.

Results: We found a negative and moderate correlation between FRT in standing and light touch of the middle of the heel (right: –0.515), metatarsal bone (right r: 0.453, left r: –0.426), and medial of the foot (right r: –0.462). There was a negative and moderate correlation between NEADLS and light touch of the metatarsal bone (right r: –0.564, left r: –0.472), medial of the foot (right r: –0.531, left r: –0.479), and lateral of the foot (right r: –0.526). We found a positive and moderate correlation between proprioception of the ankle (right r: 0.421 left r: 0.588) and NEADLS.

Conclusions: We found impairment in light touch and proprioception and, associations between sensorial functions and dynamic postural stability in PwMS. Also impaired sensorial functions cause dependent patients in daily living activities. In the assessment of balance and falling risk, independency in daily living activities; foot light touch and proprioception sense should be taken into account, hence it may provide guidance in planning rehabilitation programmes.

Abbreviations: MS: multiple sclerosis; PwMS: patients with multiple sclerosis; VAS: visual analogue scale; FRT: functional reach test; 9-HPT: Nine-hole peg test; EDSS: The Expanded Disability Status Scale; NEADLS: Nottingham Extended Activities of Daily Living Scale     

Diabetic neuropathy and surface sway-referencing disrupt somatosensory information for postural stability in stance

In order to determine the type of somatosensory information for postural control that is most affected by neuropathy, we compared the relative effects of three methods of sway-referencing the surface in a group of subjects with profound loss of somatosensory function associated with sensory polyneuropathy from diabetes with age-matched control subjects. Sway-referencing disrupted somatosensory feedback for postural control by servo-controlling the dorsi- and plantar-flexion rotation of the support surface in proportion to anterior-posterior excursion of (1) ankle angle, (2) center of body mass (CoM) angle or (3) filtered center of pressure (CoP). Postural sway in subjects with somatosensory loss was significantly larger than normal on a firm surface but not on the sway-referenced surfaces, suggesting that sway-referencing disrupts somatosensory information for postural control already disrupted by neuropathy. Control subjects standing on any sway-referenced surface swayed significantly more than neuropathy subjects who stood on a firm surface, suggesting that sway-referencing disrupts more somatosensory information than disrupted by severe neuropathy. CoP sway-referencing was less sensitive than ankle or CoM sway-referencing for distinguishing postural sway in subjects with somatosensory loss from age-matched control subjects. Given that filtered CoP sway-referencing disrupts the ability to utilize somatosensory information related to surface reactive force to a greater extent than the other two methods of sway-referencing, then these results support the hypothesis that subjects with diabetic peripheral neuropathy have lost more CoP information, than ankle or CoM angle information, for controlling postural sway in stance.     

Diabetic neuropathy and surface sway-referencing disrupt somatosensory information for postural stability in stance

In order to determine the type of somatosensory information for postural control that is most affected by neuropathy, we compared the relative effects of three methods of sway-referencing the surface in a group of subjects with profound loss of somatosensory function associated with sensory polyneuropathy from diabetes with age-matched control subjects. Sway-referencing disrupted somatosensory feedback for postural control by servo-controlling the dorsi- and plantar-flexion rotation of the support surface in proportion to anterior-posterior excursion of (1) ankle angle, (2) center of body mass (CoM) angle or (3) filtered center of pressure (CoP). Postural sway in subjects with somatosensory loss was significantly larger than normal on a firm surface but not on the sway-referenced surfaces, suggesting that sway-referencing disrupts somatosensory information for postural control already disrupted by neuropathy. Control subjects standing on any sway-referenced surface swayed significantly more than neuropathy subjects who stood on a firm surface, suggesting that sway-referencing disrupts more somatosensory information than disrupted by severe neuropathy. CoP sway-referencing was less sensitive than ankle or CoM sway-referencing for distinguishing postural sway in subjects with somatosensory loss from age-matched control subjects. Given that filtered CoP sway-referencing disrupts the ability to utilize somatosensory information related to surface reactive force to a greater extent than the other two methods of sway-referencing, then these results support the hypothesis that subjects with diabetic peripheral neuropathy have lost more CoP information, than ankle or CoM angle information, for controlling postural sway in stance.     

Chaos in Balance: Non-Linear Measures of Postural Control Predict Individual Variations in Visual Illusions of Motion

Visually-induced illusions of self-motion (vection) can be compelling for some people, but they are subject to large individual variations in strength. Do these variations depend, at least in part, on the extent to which people rely on vision to maintain their postural stability? We investigated by comparing physical posture measures to subjective vection ratings. Using a Bertec balance plate in a brightly-lit room, we measured 13 participants'' excursions of the centre of foot pressure (CoP) over a 60-second period with eyes open and with eyes closed during quiet stance. Subsequently, we collected vection strength ratings for large optic flow displays while seated, using both verbal ratings and online throttle measures. We also collected measures of postural sway (changes in anterior-posterior CoP) in response to the same visual motion stimuli while standing on the plate. The magnitude of standing sway in response to expanding optic flow (in comparison to blank fixation periods) was predictive of both verbal and throttle measures for seated vection. In addition, the ratio between eyes-open and eyes-closed CoP excursions during quiet stance (using the area of postural sway) significantly predicted seated vection for both measures. Interestingly, these relationships were weaker for contracting optic flow displays, though these produced both stronger vection and more sway. Next we used a non-linear analysis (recurrence quantification analysis, RQA) of the fluctuations in anterior-posterior position during quiet stance (both with eyes closed and eyes open); this was a much stronger predictor of seated vection for both expanding and contracting stimuli. Given the complex multisensory integration involved in postural control, our study adds to the growing evidence that non-linear measures drawn from complexity theory may provide a more informative measure of postural sway than the conventional linear measures.     

Human postural response to lower leg muscle vibration of different duration

Body lean response to bilateral vibrations of soleus muscles were investigated in order to understand the influence of proprioceptive input from lower leg in human stance control. Proprioceptive stimulation was applied to 17 healthy subjects by two vibrators placed on the soleus muscles. Frequency and amplitude of vibration were 60 Hz and 1 mm, respectively. Vibration was applied after a 30 s of baseline. The vibration duration of 10, 20, 30 s respectively was used with following 30 s rest. Subjects stood on the force platform with eyes closed. Postural responses were characterized by center of pressure (CoP) displacements in the anterior-posterior (AP) direction. The CoP-AP shifts as well as their amplitudes and velocities were analyzed before, during and after vibration. Vibration of soleus muscles gradually increased backward body tilts. There was a clear dependence of the magnitude of final CoP shift on the duration of vibration. The amplitude and velocity of body sway increased during vibration and amplitude was significantly modulated by duration of vibration as well. Comparison of amplitude and velocity of body sway before and after vibration showed significant post-effects. Presented findings showed that somatosensory stimulation has a long-term, direction-specific influence on the control of postural orientation during stance. Further, the proprioceptive input altered by soleus muscles vibration showed significant changes in postural equilibrium during period of vibration with interesting post-effects also.     

Lateral dynamic balance reactions to circular translation of the visual field

Lateral sway of subjects in spontaneous dynamic balance conditions on a seesaw platform was measured during a visual stimulation monocularly produced by a rotating glass covered with a prism membrane. Prism rotation induced the perception of a circular translation of the whole visual field and an ocular pursuit movement. Therefore, the retinal slip that occurs in normal pursuit was cancelled. Strong stereo-typed postural reactions were observed in a direction that depended upon both the vertical visual field deviation and the eye stimulated: upper position of the right visual field induced a leftward sway resulting from an extension of the right hemibody; symmetrical reactions occurred for the left stimulation. The results suggest that the postural reactions recorded depend on the isolated oculomotor activity and, in addition, on retinal afferences corresponding to the temporal crescent of the stimulated side, which orientates the postural reaction on the homolateral lower limb muscles.     

Effects of stance width on postural movement pattern and anticipatory postural control associated with unilateral arm abduction

We investigated the effects of stance width on postural movement pattern and activation timing of postural muscles during unilateral arm abduction. Thirty-two healthy subjects abducted the right arm at their own timing. Stance width was 0, 9, 18 or 27 cm. Movement angles of leg lateral inclination and trunk lateral flexion to the leg in the frontal plane were analyzed. Based on movement angles at 0 cm width, subjects were classified into three groups: contralateral whole body leaning (CWBLg); ipsilateral trunk flexion (ITFg); and contralateral trunk flexion (CTFg). A high correlation between the movement angles was obtained at 0 cm width (r = 0.82). With increasing stance width, postural movement pattern in the ITFg shifted to patterns characterized by lateral flexion of the trunk toward the side opposite to arm movement, and movement angle of leg-inclination in ITFg and CWBLg decreased. At 0 cm width, left gluteus medius and tensor fascia latae were activated significantly about 40 ms ahead of the right middle deltoid in CWBLg and CTFg, but not in ITFg. However, preceding activation became prominent (about 20 ms) in ITFg for wide stances. Moreover, bilateral activation of the tensor fascia latae was observed in CTFg for all widths.     

Effect of ageing and vision on limb load asymmetry during quiet stance

Although the identification and characterization of limb load asymmetries during quiet standing has not received much research attention, they may greatly extend our understanding of the upright stance stability control. It seems that the limb load asymmetry factor may serve as a veridical measure of postural stability and thus it can be used for early diagnostic of the age-related decline in balance control. The effects of ageing and of vision on limb load asymmetry (LLA) during quiet stance were studied in 43 healthy subjects (22 elderly, mean age 72.3+/-4.0 yr, and 21 young, mean age 23.9+/-4.8 yr). Postural sway and body weight distribution were recorded while the subject was standing on two adjacent force platforms during two 120 s trials: one trial was performed with the eyes open (EO), while the other trial was with the eyes closed (EC). The results indicate that LLA was greater in the old adults when compared with the young control subjects. The LLA values were correlated with the postural sway magnitudes especially in the anteroposterior direction. Eyes closure which destabilized posture resulted in a significant increase of body weight distribution asymmetry in the elderly but not in the young persons. The limb load difference between EO and EC conditions showed a significantly greater effect of vision on LLA in the elderly compared to the young subjects. The observed differences in the LLA may be attributed to the decline of postural stability control in the elderly. Ageing results in the progressive decline of postural control and usually the nervous system requires more time to complete a balance recovery action. To compensate for such a deficiency, different compensatory strategies are developed. One of them, as evidenced in our study, is preparatory limb unload strategy (a stance asymmetry strategy) which could significantly shorten reaction time in balance recovery.