Using Low Levels of Stochastic Vestibular Stimulation to Improve Balance Function

Low-level stochastic vestibular stimulation (SVS) has been associated with improved postural responses in the medio-lateral (ML) direction, but its effect in improving balance function in both the ML and anterior-posterior (AP) directions has not been studied. In this series of studies, the efficacy of applying low amplitude SVS in 0–30 Hz range between the mastoids in the ML direction on improving cross-planar balance function was investigated. Forty-five (45) subjects stood on a compliant surface with their eyes closed and were instructed to maintain a stable upright stance. Measures of stability of the head, trunk, and whole body were quantified in ML, AP and combined APML directions. Results show that binaural bipolar SVS given in the ML direction significantly improved balance performance with the peak of optimal stimulus amplitude predominantly in the range of 100–500 μA for all the three directions, exhibiting stochastic resonance (SR) phenomenon. Objective perceptual and body motion thresholds as estimates of internal noise while subjects sat on a chair with their eyes closed and were given 1 Hz bipolar binaural sinusoidal electrical stimuli were also measured. In general, there was no significant difference between estimates of perceptual and body motion thresholds. The average optimal SVS amplitude that improved balance performance (peak SVS amplitude normalized to perceptual threshold) was estimated to be 46% in ML, 53% in AP, and 50% in APML directions. A miniature patch-type SVS device may be useful to improve balance function in people with disabilities due to aging, Parkinson’s disease or in astronauts returning from long-duration space flight.     

Time-to-boundary measures of postural control during single leg quiet standing

A novel approach to quantifying postural stability in single leg stance is assessment of time-to-boundary (TTB) of center of pressure (COP) excursions. TTB measures estimate the time required for the COP to reach the boundary of the base of support if it were to continue on its instantaneous trajectory and velocity, thus quantifying the spatiotemporal characteristics of postural control. Our purposes were to examine: (a) the intrasession reliability of TTB and traditional COP-based measures of postural control, and (b) the correlations between these measures. Twenty-four young women completed three 10-second trials of single-limb quiet standing on each limb. Traditional measures included mean velocity, standard deviation, and range of mediolateral (ML) and anterior-posterior (AP) COP excursions. TTB variables were the absolute minimum, mean of minimum samples, and standard deviation of minimum samples in the ML and AP directions. The intrasession reliability of TTB measures was comparable to traditional COP based measures. Correlations between TTB and traditional COP based measures were weaker than those within each category of measures, indicating that TTB measures capture different aspects of postural control than traditional measures. TTB measures provide a unique method of assessing spatiotemporal characteristics of postural control during single limb stance.     

Relative contribution of the pressure variations under the feet and body weight distribution over both legs in the control of upright stance

The resultant centre of pressure (CP(Res)) trajectories are aimed at controlling body movements in upright stance. When standing on two legs, these trajectories are generated by exerting reaction forces under each foot and by loading-unloading mechanisms intervening at the hip level. To assess the respective contribution of each of these factors in stance maintenance, a group of healthy individuals were tested in several conditions including standing quietly and voluntarily producing under each foot larger CP displacements in phase and in opposite phase along medio-lateral (ML) and antero-posterior (AP) axes. The results, based on the computation of coefficients of correlation between CP(Res) trajectories and various time series including the relative body weight applied to one leg and plantar CP trajectories, highlight some differences according to the axes along which the displacements take place and the amplitudes of the movements. Furthermore, the comparison of the CP(Res) trajectories resulting from each one of these two factors reveals the predominant role played by the loading-unloading mechanisms intervening at the hip level for the movements along the ML axis and those of the plantar CP displacements along the AP axis. Increasing the plantar CP displacements in phase or in opposite phase substantially modifies these contributions although without inferring a shift to the benefit of the other mechanism. The specific morphology of the ankle and hip joints implicated in this postural task plainly explains this postural control organisation. In particular, the link between the segmental configuration of the lower limbs and these mechanisms are discussed.     

Dynamic stability of a human standing on a balance board

The neuromuscular system used to stabilize upright posture in humans is a nonlinear dynamical system with time delays. The analysis of this system is important for improving balance and for early diagnosis of neuromuscular disease. In this work, we study the dynamic coupling between the neuromuscular system and a balance board—an unstable platform often used to improve balance in young athletes, and older or neurologically impaired patients. Using a simple inverted pendulum model of human posture on a balance board, we describe a surprisingly broad range of divergent and oscillatory CoP/CoM responses associated with instabilities of the upright equilibrium. The analysis predicts that a variety of sudden changes in the stability of upright postural equilibrium occurs with slow continuous deterioration in balance board stiffness, neuromuscular gain, and time delay associated with the changes in proprioceptive/vestibular/visual-neuromuscular feedback. The analysis also provides deeper insight into changes in the control of posture that enable stable upright posture on otherwise unstable platforms.     

The effect of plantar flexor muscle fatigue on postural control

Objective

Previous studies have demonstrated that ankle muscle fatigue alters postural sway. Our aim was to better understand postural control mechanisms during upright stance following plantar flexor fatigue.

Method

Ten healthy young volunteers, 25.7 ± 2.2 years old, were recruited. Foot center-of-pressure (CoP) displacement data were collected during narrow base upright stance and eyes closed (i.e. blindfolded) conditions. Subjects were instructed to stand upright and as still as possible on a force platform under five test conditions: (1) non-fatigue standing on firm surface; (2) non-fatigue standing on foam; (3) ankle plantar flexor fatigue, standing on firm surface; (4) ankle plantar flexor fatigue, standing on foam; and (5) upper limb fatigue, standing on firm surface. An average of the ten 30-s trials in each of five test conditions was calculated to assess the mean differences between the trials. Traditional measures of postural stability and stabilogram-diffusion analysis (SDA) parameters were analyzed.

Results

Traditional center of pressure parameters were affected by plantar flexor fatigue, especially in the AP direction. For the SDA parameters, plantar flexor fatigue caused significantly higher short-term diffusion coefficients, and critical displacement in both mediolateral (ML) and anteroposterior (AP) directions. Long-term postural sway was different only in the AP direction.

Conclusions

Localized plantar flexor fatigue caused impairment to postural control mainly in the Sagittal plane. The findings indicate that postural corrections, on average, occurred at a higher threshold of sway during plantar flexor fatigue compared to non-fatigue conditions.     

How does cryotherapy effect ankle proprioception in healthy individuals?

Objectives To investigate how a 15-min cryotherapy intervention effects proprioception by measuring joint positional sense (JPS) and static single legged balance. Design Repeated measures design. Setting Laboratory. Participants Eighteen healthy university sports team students (11 males, 7 females) aged between 20 and 21?years old. Main outcome measures Participants were treated with 15?min of Aircast Cryo-cuff. The subject’s skin temperature was measured before and immediately after 15?min of cryotherapy treatment. Ankle active joint positional sense (A-JPS) and passive joint positional sense (P-JPS) were measured at pre-test, immediately post-test, and 5?min post-test. Static balance was measured by centre of pressure (CoP) mean path length, medial–lateral (ML) CoP mean deviation, and anterior–posterior (AP) CoP mean deviation and mean time-to-boundary (TtB) minima for AP and ML directions. Results No significant differences were found for the variables of JPS and static single balance testing after 15?min of cryotherapy treatment. However, mean differences for CoP mean path length and ML mean deviation were shown to improve following cryotherapy treatment, results not previously found in the literature. Conclusion Results suggest that 15?min of Cryo-cuff treatment does not significantly affect proprioception. Although the effect of cryotherapy on proprioception depends on cooling modality used, time frame applied, and joint applied to.     

Validating a low-cost,consumer force-measuring platform as an accessible alternative for measuring postural sway

The Zibrio SmartScale is a low-cost, portable force platform designed to perform an objective assessment of postural stability. The purpose of the present study was to validate the center of pressure (COP) measurements in the Zibrio SmartScale. Simultaneous COP data was collected by a Zibrio SmartScale and a laboratory-grade force platform (LFP) under the dynamic motion of an inverted pendulum device intended to mimic the sway of a standing human. The inverted pendulum was placed on the Zibrio SmartScale which was placed on the LFP. The pendulum was then displaced to angles of 3° and 5° in both the anterior-posterior (AP) and medial–lateral (ML) directions. The findings of this study show low mean average error (MAE) among the measures taken simultaneously upon the LFP and Zibrio SmartScale with no appreciable difference in error in either AP or ML COP directions. Averaged over repeated trials, the MAE did not surpass 0.5 mm. This represented 0.4% of the total range (±50 to 60 mm in 5° displacement trials) of simulated COP. The results of this study strongly indicate that the Zibrio SmartScale can perform adequately as a light-weight and low-cost alternative method of COP measurement in comparison to a traditional LFP.     

Alterations in Postural Control during the World's Most Challenging Mountain Ultra-Marathon

We investigated postural control (PC) effects of a mountain ultra-marathon (MUM): a 330-km trail run with 24000 m of positive and negative change in elevation. PC was assessed prior to (PRE), during (MID) and after (POST) the MUM in experienced ultra-marathon runners (n = 18; finish time = 126±16 h) and in a control group (n = 8) with a similar level of sleep deprivation. Subjects were instructed to stand upright on a posturographic platform over a period of 51.2 seconds using a double-leg stance under two test conditions: eyes open (EO) and eyes closed (EC). Traditional measures of postural stability (center of pressure trajectory analysis) and stabilogram-diffusion analysis (SDA) parameters were analysed. For the SDA, a significantly greater short-term effective diffusion was found at POST compared with PRE in the medio-lateral (ML; Dxs) and antero-posterior (AP) directions (Dys) in runners (p<0.05) The critical time interval (Ctx) in the ML direction was significantly higher at MID (p<0.001) and POST (p<0.05) than at PRE in runners. At MID (p<0.001) and POST (p<0.05), there was a significant difference between the two groups. The critical displacement (Cdx) in the ML was significantly higher at MID and at POST (p<0.001) compared with PRE for runners. A significant difference in Cdx was observed between groups in EO at MID (p<0.05) and POST (p<0.005) in the ML direction and in EC at POST in the ML and AP directions (p<0.05).Our findings revealed significant effects of fatigue on PC in runners, including, a significant increase in Ctx (critical time in ML plan) in EO and EC conditions. Thus, runners take longer to stabilise their body at POST than at MID. It is likely that the mountainous characteristics of MUM (unstable ground, primarily uphill/downhill running, and altitude) increase this fatigue, leading to difficulty in maintaining balance.     

Modelling 3D control of upright stance using an optimal control strategy

A 3D balance control model of quiet upright stance is presented, based on an optimal control strategy, and evaluated in terms of its ability to simulate postural sway in both the anterior-posterior and medial-lateral directions. The human body was represented as a two-segment inverted pendulum. Several assumptions were made to linearise body dynamics, for example, that there was no transverse rotation during upright stance. The neural controller was presumed to be an optimal controller that generates ankle control torque and hip control torque according to certain performance criteria. An optimisation procedure was used to determine the values of unspecified model parameters including random disturbance gains and sensory delay times. This model was used to simulate postural sway behaviours characterised by centre-of-pressure (COP)-based measures. Confidence intervals for all normalised COP-based measures contained unity, indicating no significant differences between any of the simulated COP-based measures and corresponding experimental references. In addition, mean normalised errors for the traditional measures were 相似文献   

Modelling 3D control of upright stance using an optimal control strategy

A 3D balance control model of quiet upright stance is presented, based on an optimal control strategy, and evaluated in terms of its ability to simulate postural sway in both the anterior–posterior and medial–lateral directions. The human body was represented as a two-segment inverted pendulum. Several assumptions were made to linearise body dynamics, for example, that there was no transverse rotation during upright stance. The neural controller was presumed to be an optimal controller that generates ankle control torque and hip control torque according to certain performance criteria. An optimisation procedure was used to determine the values of unspecified model parameters including random disturbance gains and sensory delay times. This model was used to simulate postural sway behaviours characterised by centre-of-pressure (COP)-based measures. Confidence intervals for all normalised COP-based measures contained unity, indicating no significant differences between any of the simulated COP-based measures and corresponding experimental references. In addition, mean normalised errors for the traditional measures were < 8%, and those for most statistical mechanics measures were ～3–66%. On the basis these results, the proposed 3D balance control model appears to have the ability to accurately simulate 3D postural sway behaviours.     

Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy

Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support. Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesized that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects. Seventeen UPVD patients and 17 healthy subjects performed six tasks on a force plate: forwards and backwards leaning, to determine limits of stability, and upright standing with and without Achilles tendon vibration, each with eyes open and closed (with blackout glasses). The COP displacement of the patients was significantly greater in the vibration tasks than the controls and came closer to the posterior base of support boundary than the controls in all tasks. Achilles tendon vibration led to a distinctly more backward sway in both subject groups. Five of the patients could not complete the eyes closed with vibration task. Due to the greater reduction in stance stability when the proprioceptive, compared with the visual, sensory system was disturbed, we suggest that proprioception may be more important for maintaining upright stance than vision. UPVD patients, in particular, showed more difficulty in controlling postural stability in the posterior direction with visual and proprioceptive sensory disturbance.     

Functional postural responses after perturbations in multiple directions in a standing man: a principle of decoupled control

The objective of this study was to assess functional postural responses by analyzing the net joint torques (NJT) in the ankles and the hips resulting from perturbations delivered in multiple directions to subjects standing quietly. A total of eight subjects were standing on two force platforms while an apparatus randomly delivered controlled perturbations at the level of the pelvis in eight directions: anterio-posterior (AP), medio-lateral (ML), and four combinations of these principal directions. Perturbations were repeated five times in each direction for six conditions (i.e., three different perturbation strengths and three different feet orientations). The comparison of the averaged ankle sum NJT (AP) responses showed that the time courses of the responses elicited by a perturbation acting only in the AP direction were identical to those elicited by a combination of two corresponding AP and ML perturbations. In contrast the observed averaged ankle NJT (ML) responses did not follow the same similarity. The comparison of the averaged ankle and hip sum NJT (ML) responses revealed that the time courses of the responses elicited by a perturbation acting only in the ML direction were identical to those elicited by a combination of two corresponding AP and ML perturbations. These findings were invariable of the experimental conditions and were consistent among all the eight subjects. Thereby, we conclude that the ankle sum NJT (AP) and the ankle and hip sum NJT (ML) are the global variables being controlled. This shows that CNS controls the recovery from the multiple direction perturbations of moderate strength by decoupling the AP-ML postural space into two orthogonal directions (AP and ML).     

Light touch for balance: influence of a time-varying external driving signal

Sensory information about body sway is used to drive corrective muscle action to keep the body's centre of mass located over the base of support provided by the feet. Loss of vision, by closing the eyes, usually results in increased sway as indexed by fluctuations (i.e. standard deviation, s.d.) in the velocity of a marker at C7 on the neck, s.d. dC7. Variability in the rate of change of centre of pressure (s.d. dCoP), which indexes corrective muscle action, also increases during upright standing with eyes closed. Light touch contact by the tip of one finger with an environmental surface can reduce s.d. dC7 and s.d. dCoP as effectively as opening the eyes. We review studies of light touch and balance and then describe a novel paradigm for studying the nature of somatosensory information contributing to effects of light touch balance. We show that 'light tight touch' contact by the index finger held in the thimble of a haptic device results in increased anteroposterior (AP) sway with entraining by either simple or complex AP sinusoidal oscillations of the haptic device. Moreover, sway is also increased when the haptic device plays back the pre-recorded AP sway path of another person. Cross-correlations between hand and C7 motion reveal a 176 ms lead for the hand and we conclude that light tight touch affords an efficient route for somatosensory feedback support for balance. Furthermore, we suggest that the paradigm has potential to contribute to the understanding of interpersonal postural coordination with light touch in future research.     

Stooping,crouching, and standing – Characterizing balance control strategies across postures

BackgroundWhile stooping and crouching postures are critical for many activities of daily living, little is known about the balance control mechanisms employed during these postures. Accordingly, the purpose of this study was to characterize the mechanisms driving net center of pressure (COP_Net) movement across three postures (standing, stooping, and crouching) and to investigate if control in each posture was influenced by time.MethodsTen young adults performed the three postures for 60 s each. Kinetic signals were collected via a force platform under each foot. To quantify mechanisms of control, correlations (Correl_LR) were calculated between the left and right COP trajectories in the anterior-posterior (AP) and medio-lateral (ML) directions. To examine the potential effects of time on balance control strategies, outcomes during the first 30 s were compared to the last 30 s.ResultsCorrel_LR values did not differ across postures (AP: p = 0.395; ML: p = 0.647). Further, there were no main effects of time on Correl_LR (AP: p = 0.976; ML: p = 0.105). A significant posture-time interaction was observed in the ML direction (p = 0.045) characterized by 35% decreases in Correl_LR over time for stooping (p = 0.022).ConclusionThe dominant controllers of sway (i.e., AP: ankle plantar/dorsi flexors; ML: hip load/unload mechanism) are similar across quiet stance stooping, and crouching. Changes in ML control strategies over time suggests that fatigue could affect prolonged stooping more so than crouching or standing.     

Age-related changes in the behavior of the muscle-tendon unit of the gastrocnemius medialis during upright stance

Mechanical properties of the muscle-tendon unit change with aging, but it is not known how these modifications influence the control of lower leg muscles during upright stance. In this study, young and elderly adults stood upright on a force platform with and without vision while muscle architecture and myotendinous junction movements (expressed relative to the change in the moment on the x-axis of the force platform) were recorded by ultrasonography and muscle activity by electromyography. The results show that the maximal amplitude of the sway in the antero-posterior direction was greater in elderly adults (age effect, P < 0.05) and was accompanied by an increase in lower leg muscle activity compared with young adults. Moreover, the data highlight that fascicles shorten during forward sway and lengthen during backward sways but more so for young (-4 ± 3 and -4 ± 3 mm/Nm, respectively) than elderly adults (-0.7 ± 3 and 0.8 ± 3 mm/Nm, respectively; age × sway, P < 0.001). Concurrently, the pennation angle increased and decreased during forward and backward sways, respectively, with greater changes in young than elderly adults (age × sway, P < 0.001). In contrast, no significant differences were observed between age groups for tendon lengthening and shortening during sways. The results indicate that, compared with young, elderly adults increase the stiffness of the muscular portion of the muscle-tendon unit during upright stance that may compensate for the age-related decrease in tendon stiffness. These observations suggest a shift in the control strategy used to maintain balance.     

Balance index score as a predictive factor for lower sports results or anterior cruciate ligament knee injuries in Croatian female athletes--preliminary study

Female athletes participating in high-risk sports suffer anterior cruciate ligament (ACL) knee injury at a 4- to 6-fold greater rate than do male athletes. ACL injuries result either from contact mechanisms or from certain unexplained non-contact mechanisms occurring during daily professional sports activities. The occurrence of non-contact injuries points to the existence of certain factors intrinsic to the knee that can lead to ACL rupture. When knee joint movement overcomes the static and the dynamic constraint systems, non-contact ACL injury may occur. Certain recent results suggest that balance and neuromuscular control play a central role in knee joint stability, protection and prevention of ACL injuries. The purpose of this study is to evaluate balance neuromuscular skills in healthy Croatian female athletes by measuring their balance index score, as well as to estimate a possible correlation between their balance index score and balance effectiveness. This study is conducted in an effort to reduce the risk of future injuries and thus prevent female athletes from withdrawing from sports prematurely. We analysed fifty-two female athletes in the high-risk sports of handball and volleyball, measuring for their static and dynamic balance index scores, using the Sport KAT 2000 testing system. This method may be used to monitor balance and coordination systems and may help to develop simpler measurements of neuromuscular control, which can be used to estimate risk predictors in athletes who withdraw from sports due to lower sports results or ruptured anterior cruciate ligament and to direct female athletes to more effective, targeted preventive interventions. The tested Croatian female athletes with lower sports results and ACL knee injury incurred after the testing were found to have a higher balance index score compared to healthy athletes. We therefore suggest that a higher balance index score can be used as an effective risk predictor for lower sports results and lesser sports motivation, anterior cruciate ligament injury and the ultimate decision to withdraw from active participation in sports. If the balance testing results prove to be effective in predicting the occurrence of ligament injuries during future sports activities, we suggest that prophylactic training programs be introduced during athlete training, since the prevention of an initial injury will be more effective than prevention of injury recurrence.     

Investigation of balance strategy over gait cycle based on margin of stability

This study was conducted to investigate the balance strategy of healthy young adults through a gait cycle using the margin of stability (MoS). Thirty healthy young adults participated in this study. Each performed walking five times at a preferred speed and at a fast speed. The MoS was calculated over a gait cycle by defining the base of support (BoS) changes during a gait cycle. The MoS was divided into medial/lateral and anterior/posterior components (ML MoS and AP MoS). The central values and the values at 12 gait events of the MoS were compared. Positive/negative integration of ML MoS (ML MoS_POS and ML MoS_NEG, respectively) and the average ML/AP MoS over a cycle (ML/AP MoS_mean) were significantly lower at a fast gait than at a preferred gait. ML/AP MoS were lower at a fast speed than at the preferred speed, except for the ML MoS immediately before left heel strike (pre left HS) and right and left heel strike (HS). ML/AP MoS were significantly lower immediately before heel strike (pre-HS) than in other gait events, regardless of walking speed. It was suggested that pre-HS is the most unstable moment in both ML/AP directions and a crucial moment in control of gait stability. The results presented above might be applicable as basic data regarding dynamic stability of healthy young adults through a gait cycle for comparisons with elderly people and patients with orthopedic disorders or neurological disorders.     

The influence of foot position on standing balance

To test the hypothesis that variations in foot position would significantly affect standing balance, we studied ten normal subjects on a Kistler force platform which measured the travel and center of pressure displacement. With the feet together there was substantially more mediolateral (ML) travel than with the axes of the feet 15, 30 or 45 cm apart and the mean ML position of the center of pressure was displaced toward the right; there was no consistent effect on anteroposterior (AP) travel or position. As the right foot was placed 10 and 30 cm forward or back, the least amount of ML and AP travel occurred with the feet even or at 10 cm either direction; the mean AP and ML position moved toward the foot which was placed more posteriorly. Of the five foot angles ranging from toes-out 45 degrees to toes-in 45 degrees, the extent of ML and AP travel was lowest in the toes-out 25 degrees position and greatest in the toes-in 45 degrees position; the mean AP and ML position was farthest forward and to the right with toes-in 45 degrees. These findings have implications for the prosthetic replacement of the lower limbs, sports, ergonomics and postural sway studies.     

One-legged stance as a representative static body position for calculation of hip contact stress distribution in clinical studies

It was shown in several clinical studies that static one-legged stance may be a relevant body position to describe the loads acting at the hip. However, the stress distribution averaged during movement may better describe hip load than hip contact stress distribution in the static body position. Using data on the resultant hip force during walking taken from the measurements of Bergmann (2001), spatial distribution of contact stress over the articular surface was calculated by the HIPSTRESS method and compared with the stress distribution in one-legged stance. It is shown, that the shape of the contact stress distribution during one-legged stance closely resembled the averaged contact stress distribution during the walking cycle (Pearson's correlation coefficient R2 equals; .986; p < .001). This finding presents a link between the hypothesis that the averaged contact stress distribution during a walking cycle is crucial for cartilage development and the results of clinical studies in which the calculated distribution of contact stress in one-legged stance was successfully used to predict the clinical status of the hip.     

Changes in center-of-pressure dynamics during upright standing related to decreased balance control in young adults: fractional Brownian motion analysis

We investigated the relationships between the ability to maintain balance in an upright stance and center-of-pressure (COP) dynamic properties in young adults. Included in this study were 10 healthy male subjects in each of two groups with respect to balance ability. Balance ability was evaluated according to the length of time a subject stood on one leg with his eyes closed. The means and ranges of this one-leg balancing time were 17.9 s (3-43 s) and 118.3 s (103-120 s) for the off-balance and balance groups, respectively. The time-varying displacements of the COP under a subject's feet during quiet two-leg (normal) standing were measured by an instrumented force platform. Each subject was tested in both the eyes-open and eyes-closed conditions. The COP trajectories were analyzed as fractional Brownian motions according to the procedure of 'stabilogram-diffusion analysis', proposed by Collins and De Luca (1993). The extracted parameters were the effective diffusion coefficients (D) for the short-term (less than about 1.0 s) and long-term intervals, respectively, as well as the Hurst exponents (H) for the short-term and long-term intervals, and some critical-point coordinates (i.e., critical mean square displacements and critical time intervals). The off-balance group showed significantly higher values for short-term D, short-term H, and critical mean square displacements than the balance group. No significant differences between the groups were found in the long-term D and H or in the critical time intervals. That is, for the off-balance subjects, an increase in the stochastic activity and positively correlated (persistent) behavior of the postural sway during shorter timescales may cause postural instability. These results suggest that the difference in balance ability for young adults is related to the open-loop (i.e., short-term) control mechanisms but not to the corrective feedback (i.e., long-term) mechanisms used to maintain balance in an upright stance.