Musculature and biomechanics of the trunk in the maintenance of upright posture

Surface perturbation has been used for decades to study balance and postural control; however the behavior of the trunk in these postural responses has been largely overlooked. Thirteen healthy males (18–23 yrs) were exposed to horizontal support surface translations delivered randomly in one of eight different horizontal directions in both sitting and standing. A 4-segment model of the trunk was used to estimate the kinematics and kinetics associated with the postural response, while surface EMG was acquired, bilaterally, from seven trunk muscles and one hip muscle. Multi-segmental movement was observed in the trunk in both test postures. Both the biomechanical and neuromuscular aspects of the trunk response were significantly affected by translation direction and test posture, with an interaction effect between these variables. The response in sitting was closely tied to the movement of the support surface, while the response in standing occurred in two phases: the first related to the dynamic response in the lower limbs, and the second tied to the movement of the support surface. As such, the observed postural responses could be largely explained by the biomechanical constraints of the system, such that the neural control of trunk equilibrium is simplified.     

Greater sensitivity of the vestibulosympathetic reflex in the upright posture in humans.

Otolith organs have been shown to activate the sympathetic nervous system in the prone position by head-down rotation (HDR) in humans. To date, otolithic stimulation by HDR has not been comprehensively studied in the upright posture. The purpose of the present study was to determine whether otolithic stimulation increases muscle sympathetic nerve activity (MSNA) in the upright posture. It was hypothesized that stimulation of the otolith organs would increase MSNA in the upright posture, despite increased baseline sympathetic activation due to unloading of the baroreceptors. MSNA, arterial blood pressure, heart rate, and degree of head rotation were measured during HDR in 18 volunteers (23 +/- 1 yr) in different postures. Study 1 (n = 11) examined HDR in the prone and sitting positions and study 2 (n = 7) examined HDR in the prone and 60 degrees head-up tilt positions. Baseline MSNA was 8 +/- 4, 15 +/- 4, and 33 +/- 2 bursts/min for prone, sitting, and head-up tilt, respectively. HDR significantly increased MSNA in the prone (Delta4 +/- 1 and Delta105 +/- 37% for burst frequency and total activity, respectively), sitting (Delta5 +/- 1 and Delta43 +/- 12%), and head-up tilt (Delta7 +/- 1 and Delta110 +/- 41%; P < 0.05). Sensitivity of the vestibulosympathetic reflex (%DeltaMSNA/DeltaHDR; degree of head rotation) was significantly greater in the sitting and head-up tilt than prone position (prone = 74 +/- 22; sitting = 109 +/- 30; head-up tilt = 276 +/- 103; P < 0.05). These data indicate that stimulation of the otolith organs can mediate increases in MSNA in the upright posture and suggest a greater sensitivity of the vestibulosympathetic reflex in the upright posture in humans.     

Mechanisms of reference posture correction in the system of upright posture control

It was earlier shown that ultraslow tilts of the support under quiet standing conditions evoke an unusual response reflecting the operation of compensatory mechanisms: postural sway is a superposition of postural oscillations typical of quiet standing and greater, slower inclinations of the body caused by the tilt. This may be explained by the presence of two hierarchical levels of upright posture control: real-time control compensates for small deviations of the body from the reference posture prescribed by presetting control. Mathematical simulation methods have been used to study the mechanisms of reference posture control. The results are compared with available experimental data. It is demonstrated that the reference posture can be corrected according to the gravitational vertical with the use of a kinesthetic reference alone. It is hypothesized that, when correcting the reference posture, the nervous system “assumes” the support to be immobile. The afferent input from sole pressure receptors is an important factor in reference posture correction. The advantages of the putative two-level control over control based on an explicit internal model are discussed.     

Enhanced stretch reflex excitability in the soleus muscle during passive standing posture in humans

The purpose of this study was to test whether the spinal reflex excitability of the soleus muscle is modulated as posture changes from a supine to a passive upright position. Eight healthy subjects (29.6 ± 5.4 yrs) participated in this study. Stretch and H-reflex responses were elicited while the subjects maintained passive standing (ST) and supine (SP) postures. The passive standing posture was accomplished by using a gait orthosis to which a custom-made device was mounted to elicit stretch reflex in the soleus muscle. This orthosis makes it possible to elicit stretch and H-reflexes without background muscle activity in the soleus muscle. The results revealed that the H-reflex amplitude in the ST was smaller than that in the SP condition, which is in good agreement with previous reports. On the other hand, the stretch reflex was significantly larger in the ST than in the SP condition. Since the experimental conditions of both the stretch and H-reflex measurements were exactly the same, the results were attributed to differences in the underlying neural mechanisms of the two reflex systems: different sensitivity of the presynaptic inhibition onto the spinal motoneuron pool and/or a change in the muscle spindle sensitivity.     

EEG markers of upright posture in healthy individuals

The EEG spectral-coherence parameters were analyzed in 10 healthy individuals (mean age, 22 ± 0.67 years) at different steps of verticalization, from the lying position to the sitting and standing positions. The maximal changes in all EEG parameters were revealed when the upright posture was maintained in the absence of visual control. Under these conditions, a power increase for the fast EEG components (the ??- and ??-bands) was observed, as was an additional increase when the conditions of maintaining the upright posture were complicated. According to the results of the EEG??s coherent analysis, human verticalization revealed a specific increase for most of the EEG rhythm ranges in the right hemisphere, especially in the frontocentral and occipitoparietal regions, as well as for the interhemispheric coherences for these leads reflecting the involvement of both cortical and subcortical structures in these processes. When the posture maintenance conditions were complicated, an additional coherence increase in the fast EEG bands (the ??-rhythm) was observed in the frontal cortical regions, which was evidence of the increase in the executive functions under these conditions.     

Characteristics of the maintenance of the upright posture in subjects touching an external object while standing on a moving or immobile platform

Postural sway was compared for humans touching an external object while standing on an immobile or slowly moving posturographic platform. When the platform moves, the central nervous system may interpret the movement of the point of the contact with the external object as the movement of the body relative to the support or as the movement of the support itself. Thus, the information concerning the body position that is provided by the touch becomes ambiguous. It was demonstrated that contact with an external object during standing on an unstable support leads to a decrease in support sway. When a subject stands on a moving platform, this decrease is smaller than in the case of an immobile platform. Contact with an external object causes a decrease in postural responses to shank muscle vibrations on an immobile platform. On a moving platform, this decrease is nonsignificant. The change in postural sway depending on the unambiguity of afferent information is discussed in terms of the interaction between afferent signals of different modalities on the basis of the body scheme in subjects maintaining balance.Translated from Fiziologiya Cheloveka, Vol. 31, No. 1, 2005, pp. 59–65.Original Russian Text Copyright © 2005 by Kazennikov, Shlykov, Levik.     

Intense exercise stimulates albumin synthesis in the upright posture.

We tested the hypothesis that an elevation in albumin synthetic rate contributes to increased plasma albumin content during exercise-induced hypervolemia. Albumin synthetic rate was measured in seven healthy subjects at 1-5 and 21-22 h after 72 min of intense (85% peak oxygen consumption rate) intermittent exercise and after 5 h recovery in either upright (Up) or supine (Sup) postures. Deuterated phenylalanine (d(5)-Phe) was administrated by a primed-constant infusion method, and fractional synthetic rate (FSR) and absolute synthetic rate (ASR) of albumin were calculated from the enrichment of d(5)-Phe in plasma albumin, determined by gas chromatography-mass spectrometry. FSR of albumin in Up increased significantly (P < 0.05) from 4.9 +/- 0.9%/day at control to 7.3 +/- 0.9%/day at 22 h of recovery. ASR of albumin increased from 87.9 +/- 17.0 to 141.1 +/- 16.6 mg albumin. kg body wt(-1). day(-1). In contrast, FSR and ASR of albumin were unchanged in Sup (3.9 +/- 0.4 to 4.0 +/- 1.4%/day and 74.2 +/- 8.9 to 85.3 +/- 23.9 mg albumin. kg body wt(-1). day(-1) at control and 22 h of recovery, respectively). Increased albumin synthesis after upright intense exercise contributes to the expansion of greater albumin content and its maintenance. We conclude that stimuli related to posture are critical in modulating the drive for albumin synthesis after intense exercise.     

Additional afferent signals in the human upright posture control system

Equilibrium maintenance was estimated in a subject standing with the eyes closed while holding a small weight. The experiments were performed on a movable platform in the form of a seesaw. Loads of 200, 500, and 1000 g were held by the subjects between the forefinger and the thumb, with the arm bent at the elbow. The rate of change in the length of the sagittal stabilogram and the root mean square deviation of the center of pressure from the equilibrium position were less when a subject was holding a load while standing on a movable support. The rate of change in the stabilogram length was the lowest (44.5 ± 6.8 mm/s) if the subject stood holding a 1000-g load and was 52.6 ± 9.2 mm/s without a load (p < 0.05, paired T-test). At the same time, when these loads were fixed on a mechanical holder attached to the trunk and simulating an arm bent at the elbow, there was no significant change in stabilogram parameters. Apparently, postural sway reduction is associated with the fact that the system of equilibrium maintenance can control the upright posture using an uncommon afferent input, namely, modulation of afferent signals induced by inertial interaction of an object and the fingers.     

Compensation effect of visual biofeedback in upright posture control

The effectivity of the compensatory role of visual biofeedback in cases of decreased stability of upright posture has been analysed. The deterioration of stance was modelled by a subject standing on a soft surface and with additional weight load on the body. The influence of visual biofeedback was positive only for the compensation of decreased stability of upright posture caused by artificially increased body weight of the subject. The compensatory effectivity of visual biofeedback in stabilization of upright posture during stance on a soft surface was practically negligible. The results have shown that effective compensation of the destabilizing effect by visual biofeedback in human upright posture was possible only when the activity and efficiency of efferent-action part of the postural system remained unchanged.     

Effects of stimulating surface during static upright posture in the elderly

Abstract

This study aimed to investigate the influence of three stimulating surfaces based on center of pressure (CoP), anteroposterior sway velocity (V_A/P), and medio-lateral sway velocity (V_M/L) of 40 elderly subjects. CoP and V_M/L showed a significant decrease in all visual conditions only in the stimulating surface whereas V_A/P showed a significant decrease only on the same surface with eyes open. Results confirm the importance of multisensory stimulation in postural control in the elderly.     

Human upright posture control in a virtual visual environment

The sagittal and frontal components of the stabilogram were monitored in 14 healthy subjects standing on a rigid or pliant support under three different conditions of visual control: with the eyes opened (EO), with the eyes closed (EC), or in a virtual visual environment (VVE). Under the VVE conditions, the subjects looked at a three-dimensional image of elements of a room (a 3-D artificial room) that was generated by a computer and locked to the fluctuations of the body center of gravity (CG) so that the visual connection between body sway and shifts of the visual environment typical of normal visual conditions was reproduced. Frequency filtration of the fluctuations of the foot’s center of pressure (FCP) was used to isolate the movements of the vertical projection of the CG and determine the difference between these two variables. The changes in the variables (CG and FCP-CG) were estimated using spectral analysis followed by the calculation of the root mean square (RMS) amplitudes of their spectral fluctuations. In subjects standing on a rigid support, the RMS amplitudes of the spectra of both variables were the highest under the VVE and EC conditions and the lowest under the EO conditions. In subjects standing on a pliant support, body sway was considerably enhanced, which was accompanied by a different pattern of visual influences. The RMS values were the highest under the EC conditions and were lower by a factor of 2–2.5 under the EO and VVE conditions. Thus, it has been demonstrated that the cerebral structures controlling posture ignore the afferent input from the eyes under VVE conditions, if the subject is standing on a rigid support and the CG fluctuations are relatively small; however, this afferentation is efficiently used for maintaining the posture on a pliable support, when the body sway is substantially enhanced.     

Characteristics of the pressure center movement under upright posture regulation

The hypothesis was put forward that, along with the regulation of mass center projection, the system of upright posture control stabilizes the deviation of pressure center from the position of the mass center projection. The regularities in the behavior of the trajectories of pressure center and mass center projection were analysed. Experimental evidence was obtained supporting the validity of the hypothesis. The structure of the control system that corresponds to the new understanding of the variables being regulated during the maintenance of vertical posture was considered.     

Influence of repeated passive body heating on subsequent night sleep in humans

Experiments were carried out on four healthy male subjects in two separate sessions: (a) A baseline period of two consecutive nights, one spent at thermoneutrality [operative temperature (To) = 30 degrees C, dew-point temperature (Tdp) = 7 degrees C, air velocity (Va) = 0.2 m.s-1] and the other in hot condition (To = 35 degrees C, Tdp = 7 degrees C, Va = 0.2 m.s-1). During the day, the subjects lived in their normal housing and were engaged in their usual activities. (b) An acclimation period of seven consecutive daily heat exposures from 1400 to 1700 hours (To = 44 degrees C, Tdp = 29 degrees C, Va = 0.3 m.s-1). During each night, the subjects slept in thermoneutral or in hot conditions. The sleep measurements were: EEG from two sites, EOG from both eyes, EMG and EKG. Esophageal and ten skin temperatures were recorded continuously during the night. In the nocturnal hot conditions, a sweat collection capsule recorded the sweat gland activity in the different sleep stages. Results showed that passive body heating had no significant effect on the sleep structure of subsequent nights at thermoneutrality. In contrast, during nights at To = 35 degrees C an effect of daily heat exposure was observed on sleep. During the 2nd night of the heat acclimation period, sleep was more restless and less efficient than during the baseline night. The rapid eye movement sleep duration was reduced, while the rate of transient activation phases observed in sleep stage 2 increased significantly. On the 7th night, stage 4 sleep increased (+68%) over values observed during the baseline night.(ABSTRACT TRUNCATED AT 250 WORDS)