Effects of two passive back-support exoskeletons on postural balance during quiet stance and functional limits of stability

While occupational back-support exoskeletons (BSEs) are considered as potential workplace interventions, BSE use may compromise postural control. Thus, we investigated the effects of passive BSEs on postural balance during quiet upright stance and functional limits of stability. Twenty healthy adults completed trials of quiet upright stance with differing levels of difficulty (bipedal and unipedal stance; each with eyes open and closed), and executed maximal voluntary leans. Trials were done while wearing two different BSEs (SuitX™, Laevo™) and in a control (no-BSE) condition. BSE use significantly increased center-of-pressure (COP) median frequency and mean velocity during bipedal stance. In unipedal stance, using the Laevo™ was associated with a significant improvement in postural balance, especially among males, as indicated by smaller COP displacement and sway area, and a longer time to contact the stability boundary. BSE use may affect postural balance, through translation of the human + BSE center-of-mass, restricted motion, and added supportive torques. Furthermore, larger effects of BSEs on postural balance were evident among males. Future work should further investigate the gender-specificity of BSE effects on postural balance and consider the effects of BSEs on dynamic stability.     

A balance control model of quiet upright stance based on an optimal control strategy

Models of balance control can aid in understanding the mechanisms by which humans maintain balance. A balance control model of quiet upright stance based on an optimal control strategy is presented here. In this model, the human body was represented by a simple single-segment inverted pendulum during upright stance, and the neural controller was assumed to be an optimal controller that generates ankle control torques according to a certain performance criterion. This performance criterion was defined by several physical quantities relevant to sway. In order to accurately simulate existing experimental data, an optimization procedure was used to specify the set of model parameters to minimize the scalar error between experimental and simulated sway measures. Thirty-two independent simulations were performed for both younger and older adults. The model's capabilities, in terms of reflecting sway behaviors and identifying aging effects, were then analyzed based on the simulation results. The model was able to accurately predict center-of-pressure-based sway measures, and identify potential changes in balance control mechanisms caused by aging. Correlations between sway measures and model parameters are also discussed.     

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.     

Postural control model interpretation of stabilogram diffusion analysis

Collins and De Luca [Collins JJ, De Luca CJ (1993) Exp Brain Res 95: 308–318] introduced a new method known as stabilogram diffusion analysis that provides a quantitative statistical measure of the apparently random variations of center-of-pressure (COP) trajectories recorded during quiet upright stance in humans. This analysis generates a stabilogram diffusion function (SDF) that summarizes the mean square COP displacement as a function of the time interval between COP comparisons. SDFs have a characteristic two-part form that suggests the presence of two different control regimes: a short-term open-loop control behavior and a longer-term closed-loop behavior. This paper demonstrates that a very simple closed-loop control model of upright stance can generate realistic SDFs. The model consists of an inverted pendulum body with torque applied at the ankle joint. This torque includes a random disturbance torque and a control torque. The control torque is a function of the deviation (error signal) between the desired upright body position and the actual body position, and is generated in proportion to the error signal, the derivative of the error signal, and the integral of the error signal [i.e. a proportional, integral and derivative (PID) neural controller]. The control torque is applied with a time delay representing conduction, processing, and muscle activation delays. Variations in the PID parameters and the time delay generate variations in SDFs that mimic real experimental SDFs. This model analysis allows one to interpret experimentally observed changes in SDFs in terms of variations in neural controller and time delay parameters rather than in terms of open-loop versus closed-loop behavior. Received: 13 August 1998 / Accepted in revised form: 12 November 1999     

Kinematic, kinetic and EMG patterns during downward squatting.

The aim of this study was to investigate the kinematic, kinetic, and electromyographic pattern before, during and after downward squatting when the trunk movement is restricted in the sagittal plane. Eight healthy subjects performed downward squatting at two different positions, semisquatting (40 degrees knee flexion) and half squatting (70 degrees knee flexion). Electromyographic responses of the vastus medialis oblique, vastus medialis longus, rectus femoris, vastus lateralis, biceps femoris, semitendineous, gastrocnemius lateralis, and tibialis anterior were recorded. The kinematics of the major joints were reconstructed using an optoelectronic system. The center of pressure (COP) was obtained using data collected from one force plate, and the ankle and knee joint torques were calculated using inverse dynamics. In the upright position there were small changes in the COP and in the knee and ankle joint torques. The tibialis anterior provoked the disruption of this upright position initiating the squat. During the acceleration phase of the squat the COP moved posteriorly, the knee joint torque remained in flexion and there was no measurable muscle activation. As the body went into the deceleration phase, the knee joint torque increased towards extension with major muscle activities being observed in the four heads of the quadriceps. Understanding these kinematic, kinetic and EMG strategies before, during and after the squat is expected to be beneficial to practitioners for utilizing squatting as a task for improving motor function.     

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   

Virtual slope control of a forward dynamic bipedal walker

Active joint torques are the primary source of power and control in dynamic walking motion. However the amplitude, rate, timing and phasic behavior of the joint torques necessary to achieve a natural and stable performance are difficult to establish. The goal of this study was to demonstrate the feasibility and stable behavior of an actively controlled bipedal walking simulation wherein the natural system dynamics were preserved by an active, nonlinear, state-feedback controller patterned after passive downhill walking. A two degree-of-freedom, forward-dynamic simulation was implemented with active joint torques applied at the hip joints and stance leg ankle. Kinematic trajectories produced by the active walker were similar to passive dynamic walking with active joint torques influenced by prescribed walking velocity. The control resulted in stable steady-state gait patterns, i.e. eigenvalue magnitudes of the stride function were less than one. The controller coefficient analogous to the virtual slope was modified to successfully control average walking velocity. Furture developments are necessary to expand the range of walking velocities.     

Predicting the influence of hip and lumbar flexibility on lifting motions using optimal control

Computational models of the human body coupled with optimization can be used to predict the influence of variables that cannot be experimentally manipulated. Here, we present a study that predicts the motion of the human body while lifting a box, as a function of flexibility of the hip and lumbar joints in the sagittal plane. We modeled the human body in the sagittal plane with joints actuated by pairs of agonist-antagonist muscle torque generators, and a passive hamstring muscle. The characteristics of a stiff, average and flexible person were represented by co-varying the lumbar range-of-motion, lumbar passive extensor-torque and the hamstring passive muscle-force. We used optimal control to solve for motions that simulated lifting a 10 kg box from a 0.3 m height. The solution minimized the total sum of the normalized squared active and passive muscle torques and the normalized passive hamstring muscle forces, over the duration of the motion. The predicted motion of the average lifter agreed well with experimental data in the literature. The change in model flexibility affected the predicted joint angles, with the stiffer models flexing more at the hip and knee, and less at the lumbar joint, to complete the lift. Stiffer models produced similar passive lumbar torque and higher hamstring muscle force components than the more flexible models. The variation between the motion characteristics of the models suggest that flexibility may play an important role in determining lifting technique.     

Paired nonlinear behavior of active and passive joint torques associated with preparation for walk-to-run gait transition

This study investigated the lower extremity torque's active and passive features during the walk-to-run gait transition with continuously increased walking speed. Fourteen volunteers participated in the experiment. Kinematic and kinetic data were collected synchronously. Five strides leading up the gait transition were examined. Peaks of the passive (e.g., contact) and active (e.g., generalized muscle torques), along with net joint torque, and time to peak torques exhibited significant differences at the last stride before gait transition, compared to the first four strides, at the ankle, knee, and hip joints, respectively. Selected peak joint active and passive torques showed significant and opposite trends at critical events within a stride cycle: such ankle joint right after heel-contact, knee joint during weight acceptance, and both hip and knee joints right before toe-off. The magnitude and the corresponding time to active and passive peak torque changed in a nonlinear pattern before the transition from walk to run. The lower extremity segment-interaction during gait transition appeared to be an active reorganization exemplified by the interaction between the lower extremity's active and passive torque components.     

Low-level noise affects balance control differently when applied at different body parts

The main purpose of this study was to determine which body part is the best position to apply noise at so that balance control can be improved most. Twelve young healthy participants were recruited in this study. Balance control was assessed by center of pressure (COP) measures, which were collected when participants were blindfolded and stood upright quietly on a force platform. Low-level mechanical noise was separately applied at seven body parts during quiet upright stance, including the forehead, neck, shoulder, finger, abdomen, knee, and ankle. Results showed that dependent COP measures as a whole were not improved when noise was at the finger, shoulder, abdomen, knee, and ankle. In contrast, with the application of noise at the forehead and neck, the dependent COP measures as a whole significantly changed. The forehead appeared to be the better position at which noise should be applied, since the ANOVAs revealed that body sway significantly decreased with the application of noise at the forehead. Findings from this study can aid in the development of noise-based intervention strategies aimed at improving balance. A possible intervention solution might be embedding noise-based devices into head belt.     

Evaluation of a subject-specific female gymnast model and simulation of an uneven parallel bar swing

A gymnast model and forward dynamics simulation of a dismount preparation swing on the uneven parallel bars were evaluated by comparing experimental and predicted joint positions throughout the maneuver. The bar model was a linearly elastic spring with a frictional bar/hand interface, and the gymnast model consisted of torso/head, arm and two leg segments. The hips were frictionless balls and sockets, and shoulder movement was planar with passive compliant structures approximated by a parallel spring and damper. Subject-specific body segment moments of inertia, and shoulder compliance were estimated. Muscles crossing the shoulder and hip were represented as torque generators, and experiments quantified maximum instantaneous torques as functions of joint angle and angular velocity. Maximum torques were scaled by joint torque activations as functions of time to produce realistic motions. The downhill simplex method optimized activations and simulation initial conditions to minimize the difference between experimental and predicted bar-center, shoulder, hip, and ankle positions. Comparing experimental and simulated performances allowed evaluation of bar, shoulder compliance, joint torque, and gymnast models. Errors in all except the gymnast model are random, zero mean, and uncorrelated, verifying that all essential system features are represented. Although the swing simulation using the gymnast model matched experimental joint positions with a 2.15cm root-mean-squared error, errors are correlated. Correlated errors indicate that the gymnast model is not complex enough to exactly reproduce the experimental motion. Possible model improvements including a nonlinear shoulder model with active translational control and a two-segment torso would not have been identified if the objective function did not evaluate the entire system configuration throughout the motion. The model and parameters presented in this study can be effectively used to understand and improve an uneven parallel bar swing, although in the future there may be circumstances where a more complex model is needed.     

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.     

All leg joints contribute to quiet human stance: A mechanical analysis

According to the state of the art model (single inverted pendulum) the regulation of quiet human stance seems to be dominated by ankle joint actions. Recent findings substantiated both in-phase and anti-phase fluctuations of ankle and hip joint kinematics can be identified in quiet human stance. Thus, we explored in an experimental study to what extent all three leg joints actually contribute to the balancing problem of quiet human stance. We also aimed at distinguishing kinematic from torque contributions. Thereto, we directly measured ankle, knee, and hip joint kinematics with high spatial resolution and ground reaction forces. Then, we calculated the six respective joint torques and, additionally, the centre of mass kinematics. We searched for high cross-correlations between all these mechanical variables. Beyond confirming correlated anti-phase kinematics of ankle and hip, the main results are: (i) ankle and knee joint fluctuate tightly (torque) coupled and (ii) the bi-articular muscles of the leg are well suited to fulfil the requirements of fluctuations around static equilibrium. Additionally, we (iii) identified high-frequency oscillations of the shank between about 4 and 8 Hz and (iv) discriminated potentially passive and active joint torque contributions. These results demonstrate that all leg joints contribute actively and concertedly to quiet human stance, even in the undisturbed case. Moreover, they substantiate the single inverted pendulum paradigm to be an invalid model for quiet human stance.     

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.     

Difference in Postural Control during Quiet Standing between Young Children and Adults: Assessment with Center of Mass Acceleration

The development of upright postural control has often been investigated using time series of center of foot pressure (COP), which is proportional to the ankle joint torque (i.e., the motor output of a single joint). However, the center of body mass acceleration (COM_acc), which can reflect joint motions throughout the body as well as multi-joint coordination, is useful for the assessment of the postural control strategy at the whole-body level. The purpose of the present study was to investigate children’s postural control during quiet standing by using the COM_acc. Ten healthy children and 15 healthy young adults were instructed to stand upright quietly on a force platform with their eyes open or closed. The COM_acc as well as the COP in the anterior–posterior direction was obtained from ground reaction force measurement. We found that both the COM_acc and COP could clearly distinguish the difference between age groups and visual conditions. We also found that the sway frequency of COM_acc in children was higher than that in adults, for which differences in biomechanical and/or neural factors between age groups may be responsible. Our results imply that the COM_acc can be an alternative force platform measure for assessing developmental changes in upright postural control.     

The contribution of body weight distribution and center of pressure location in the control of mediolateral stance

The study investigated the mediolateral control of upright stance in 16 healthy, young adults. The model analyzed the body weight distribution and center of pressure location mechanisms under three stance width conditions (feet close, under standard condition, and apart). Our first objective was to discuss some methodological requirements to investigate the contribution of both mechanisms by means of two platforms. It is proposed that both the amplitude contribution (in variability analyses) and active contribution (in cross-correlation analyses) need to be studied distinctively. These analyses may be concerned with the strength and the degree of active contributions, respectively. Based on this theoretical proposition, we expected and found that the amplitude contribution of both mechanisms was higher and lower in wide and narrow stances compared with that in the standard stance, respectively. Indeed, the closer the two reaction forces, the lower their mechanical contribution. As expected, the active contribution of both mechanisms was significantly lower and higher in wide and narrow stances, respectively. Indeed, the further the feet apart, the less active both mechanisms needed to be to control mediolateral stance. Overall, only the center of pressure location mechanism really changed its significant contribution to control mediolateral stance under the three conditions. The result is important because this mechanism is known to be secondary, weaker than the body weight distribution mechanism to control mediolateral stance. In practical terms, these findings may explain why the mediolateral variability of center of pressure displacement was significantly higher in narrow stance but not lower in wide stance.     

Vestibular humanoid postural control

Many of our motor activities require stabilization against external disturbances. This especially applies to biped stance since it is inherently unstable. Disturbance compensation is mainly reactive, depending on sensory inputs and real-time sensor fusion. In humans, the vestibular system plays a major role. When there is no visual space reference, vestibular-loss clearly impairs stance stability. Most humanoid robots do not use a vestibular system, but stabilize upright body posture by means of center of pressure (COP) control. We here suggest using in addition a vestibular sensor and present a biologically inspired vestibular sensor along with a human-inspired stance control mechanism. We proceed in two steps. First, in an introductory review part, we report on relevant human sensors and their role in stance control, focusing on own models of transmitter fusion in the vestibular sensor and sensor fusion in stance control. In a second, experimental part, the models are used to construct an artificial vestibular system and to embed it into the stance control of a humanoid. The robot’s performance is investigated using tilts of the support surface. The results are compared to those of humans. Functional significance of the vestibular sensor is highlighted by comparing vestibular-able with vestibular-loss states in robot and humans. We show that a kinematic body-space sensory feedback (vestibular) is advantageous over a kinetic one (force cues) for dynamic body-space balancing. Our embodiment of human sensorimotor control principles into a robot is more than just bionics. It inspired our biological work (neurorobotics: ‘learning by building’, proof of principle, and more). We envisage a future clinical use in the form of hardware-in-the-loop simulations of neurological symptoms for improving diagnosis and therapy and designing medical assistive devices.     

Effect of hip flexibility on optimal stalder performances on high bar

In the optimisation of sports movements using computer simulation models, the joint actuators must be constrained in order to obtain realistic results. In models of a gymnast, the main constraint used in previous studies was maximum voluntary active joint torque. In the stalder, gymnasts reach their maximal hip flexion under the bar. The purpose of this study was to introduce a model of passive torque to assess the effect of the gymnast's flexibility on the technique of the straddled stalder. A three-dimensional kinematics driven simulation model was developed. The kinematics of the shoulder flexion, hip flexion and hip abduction were optimised to minimise torques for four hip flexion flexibilities: 100°, 110°, 120° and 130°. With decreased flexibility, the piked posture period is shorter and occurs later. Moreover the peaks of shoulder and hip torques increase. Gymnasts with low hip flexibility need to be stronger to achieve a stalder; hip flexibility should be considered by coaches before teaching this skill.     

Incorporating the length-dependent passive-force generating muscle properties of the extrinsic finger muscles into a wrist and finger biomechanical musculoskeletal model

Dynamic movement trajectories of low mass systems have been shown to be predominantly influenced by passive viscoelastic joint forces and torques compared to momentum and inertia. The hand is comprised of 27 small mass segments. Because of the influence of the extrinsic finger muscles, the passive torques about each finger joint become a complex function dependent on the posture of multiple joints of the distal upper limb. However, biomechanical models implemented for the dynamic simulation of hand movements generally don’t extend proximally to include the wrist and distal upper limb. Thus, they cannot accurately represent these complex passive torques. The purpose of this short communication is to both describe a method to incorporate the length-dependent passive properties of the extrinsic index finger muscles into a biomechanical model of the upper limb and to demonstrate their influence on combined movement of the wrist and fingers. Leveraging a unique set of experimental data, that describes the net passive torque contributed by the extrinsic finger muscles about the metacarpophalangeal joint of the index finger as a function of both metacarpophalangeal and wrist postures, we simulated the length-dependent passive properties of the extrinsic finger muscles. Dynamic forward simulations demonstrate that a model including these properties passively exhibits coordinated movement between the wrist and finger joints, mimicking tenodesis, a behavior that is absent when the length-dependent properties are removed. This work emphasizes the importance of incorporating the length-dependent properties of the extrinsic finger muscles into biomechanical models to study healthy and impaired hand movements.     

Postural dynamics in the standing human

The purpose of this study was to develop a mathematical model of the linkage dynamics in upright standing, and to use this model to study output principles for postural control. The standing human was modelled in the sagittal plane as a three-segment linkage. Mechanical disturbances were simulated as forces which could be applied at various points in this linkage. An iterative approach was used to find joint torque combinations which would restore balance within 80 ms of these mechanical disturbances. The model predicted that a specific proportional relationship was necessary between the hip, knee and ankle torques in order for balance to be restored. This proportional relationship was shown to be a function of the model structure, but independent of the location, direction and amplitude of the disturbance. These predictions were tested experimentally. A disturbance apparatus was designed to apply an impulsive force to the subjects. The joint torque responses of the subjects were in quantitative agreement with the predictions of the model. The results suggest that a fixed relationship between joint torques may be required to restore balance, and this fixed relationship may make the task of postural control simpler for the nervous system.