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.     

Rhythmic movement and rhythmic auditory cues enhance anticipatory postural adjustment of gait initiation

Abstract

The purpose of this study was to determine whether the rhythmic movements or cues enhance the anticipatory postural adjustment (APA) of gait initiation. Healthy humans initiated gait in response to an auditory start cue (third cue). A first auditory cue was given 8?s before the start cue, and a second auditory cue was given 3?s before the start cue. The participants performed the rhythmic medio-lateral weight shift (ML-WS session), rhythmic anterior-posterior weight shift (AP-WS session), or rhythmic arm swing (arm swing session) in the time between the first and second cues. In the rhythmic cues session, rhythmic auditory cues with a frequency of 1?Hz were given in this time. In the stationary session, the participants maintained stationary stance in this time. The APA and initial step movement preceded by those rhythmic movements or cues were compared with those in the stationary session. The temporal characteristics of the initial step movement of the gait initiation were not changed by the rhythmic movements or cues. The medio-lateral displacement of the APA in the ML-WS and arm swing sessions was significantly greater than that in the stationary session. The anterior–posterior displacement of the APA in the rhythmic cues and arm swing sessions was significantly greater than that in the stationary session. Taken together, the rhythmic movements and cues enhance the APA of gait initiation. The present finding may be a clue or motive for the future investigation for using rhythmic movements or cues as the preparatory activity to enlarge the small APA of gait initiation in the patients with Parkinson’s disease.     

Anticipatory postural adjustments associated with lateral and rotational perturbations during standing.

We studied the role of different leg and trunk muscle groups in the generation of anticipatory postural adjustments (APAs) prior to lateral and rotational perturbations associated with predictable and self-triggered postural perturbations during standing. Postural perturbations were induced by a variety of manipulations including catching and releasing a load with the right hand extended either in front of the body or to the right side, performing bilateral fast shoulder movements in different directions, and applying brief force pulses with a hand against the wall. Perturbations in a frontal plane ("lateral perturbations") were associated with significant asymmetries in APAs seen in the right and left distal (soleus and tibialis anterior) muscles; these asymmetries dependent on the direction of the perturbation. Rotational perturbations about the vertical axis of the body generated by fast movements of the two shoulders in the opposite directions were also associated with direction-dependent asymmetries in the APAs in soleus muscles. However, rotational perturbations generated by an off-body-midline force pulse application were accompanied by direction-dependent asymmetries in proximal muscle groups, but not in the distal muscles. We conclude that muscles controlling the ankle joint play an important role in the compensation of lateral and rotational perturbations. The abundance of muscles participating in maintaining vertical posture allows the control system to use different task-dependent strategies during the generation of APAs in anticipation of rotational perturbation.     

Standing on wedges modifies side-specific postural control in the presence of lateral external perturbations

Standing on wedges changes the position in the ankle joints and affects postural stability in the medial-lateral direction. The objective of the study was to investigate the role of wedges and external lateral perturbations on anticipatory (APA) and compensatory postural adjustments (CPA). Ten healthy young participants were exposed to perturbations applied to the lateral part of their right shoulder when standing on a planar surface, on a medial or lateral wedges. Bilateral electromyographic activity of dorsal and ventral postural muscles and the center of pressure (COP) displacement were recorded and analyzed during the APA and CPA phases. When exposed to the lateral perturbation, reciprocal activation of shank muscles was seen on the side of the perturbation while co-contraction of shank muscles was seen on the contralateral side during the APA and CPA phases. Standing on a wedge was associated with decreased magnitudes of co-contraction and reciprocal activation of shank muscles. The COP displacements were smaller in the APA phase and larger in the CPA phase while standing on wedges compared to standing on the planar surface. The outcome of the study provides a basis for future investigations of incorporating wedges in balance re-training paradigms for the elderly or individuals with neurological impairment.     

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.     

Effects of neck flexion on contingent negative variation and anticipatory postural control during arm movement while standing

We investigated the effects of neck flexion on contingent negative variation (CNV) and anticipatory postural control using an arm flexion task in standing. CNV was adopted to evaluate the state of activation of brain areas related to anticipatory postural control. Subjects were required to flex the arms in response to a sound stimulus preceded by a warning sound stimulus. Two different intervals (2.0 and 3.5 s) between these two stimuli were used in neck position in quiet standing (neck resting) and neck position at 80% angle of maximal neck flexion. The mean amplitude of CNV 100-ms before the response stimulus, recorded from a Cz electrode, was calculated. Onset timing of activation of the postural muscles (lumbar paraspinal, biceps femoris and gastrocnemius) with respect to the anterior deltoid was analyzed. Reaction time at the anterior deltoid was significantly shorter in the 2.0 s period than in the 3.5 s period, and in the neck flexion than in the neck resting in both periods. In the 2.0 s, but not in the 3.5 s period, neck flexion resulted in an increased CNV amplitude and an increased duration of preceding activation of the postural muscles, and the correlation between these increases was significant.     

Effects of amplitude and predictability of perturbations to the arm on anticipatory and reactionary muscle responses to maintain balance

Disturbances to balance arising from forces applied to the upper limb have received relatively little attention compared to disturbances arising from support surface perturbations. In this study we applied fast ramp perturbations to the hand in anterior, posterior, medial and lateral directions. The effects of perturbation predictability and amplitude on the postural response of upper limb, trunk and lower limb muscles were investigated. Perturbations were applied either in blocks of constant amplitude and direction (predictable) or with direction and amplitude varying randomly (random) from trial to trial. The spatial-temporal patterns of anticipatory muscle activation under the predictable condition and the reactionary responses following the perturbation under both conditions were similarly organized. The size of the response increased systematically with the perturbation magnitude for both anticipatory and reactionary changes in muscle activation. However, the slope of the relation between perturbation amplitude and the magnitude of the change in muscle activation was greater when perturbations were predictable than when they were randomly selected. The timing of both the anticipatory and reactionary increases in muscle activation was invariant across perturbation amplitudes. The characteristics of the reactionary responses have a similar organization to the long latency muscle responses to support surface perturbations.     

Effects of limiting anterior displacement of the center of foot pressure on anticipatory postural control during bilateral shoulder flexion

In bilateral shoulder flexion with the arms moving from the sides of the body to the horizontal level while standing, no preceding activation of the triceps surae (TS) with respect to focal muscles has been found. Considering that preceding activation would offer a useful indicator of anticipatory postural control, it was attempted to induce preceding activation by limiting the anterior displacement range of the center of foot pressure in the anteroposterior direction (CoPap). Subjects were 13 healthy young adults. The 50% anterior range of CoPap displacement caused by shoulder flexion was calculated, and the floor inclined by the subject’s weight when CoPap extended beyond that range. Subjects were instructed not to incline the floor during shoulder flexion. Under the limitation condition, the ankle and knee joints plantarflexed and extended at 1.1°, respectively, with no hip movement; that is, the whole body inclined backward by pivoting at the ankle. This limitation resulted in preceding muscle activation of TS as well as erector spinae and biceps femoris, and no significant differences in onset time were seen between these muscles. These results demonstrated that by limiting CoPap anterior displacement, preceding activation of TS could be induced with backward inclination of the whole body.     

The effect of the amplitude of motor action on anticipatory postural adjustments.

The purpose of this study was to determine whether changes in the amplitude of a motor action triggering the same perturbation affect anticipatory postural adjustments (APAs). Healthy subjects performed releases of the same load with shoulder abduction movements of different amplitudes. Changes in the electrical activity of trunk and leg muscles, as well as displacements of the center of pressure were recorded. Generally, there were no differences in anticipatory activity of muscles and displacements of the center of pressure between series of load releases induced by motor actions of different amplitudes. We suggest that the CNS arranges APAs based on the magnitude of the perturbation if the same muscle groups generate motor actions of different amplitudes.     

Influences of illusionary position perception on anticipatory postural control associated with arm flexion

We examined the effect of illusionary perception on anticipatory postural control associated with arm flexion with subjects in a standing position, using vibration stimulation of the Achilles’ tendon. Arm flexion was performed five times under each of the following conditions: (1) quiet standing, (2) vibration of the Achilles’ tendon at 100 Hz frequency and 1.5 mm amplitude with the trunk fixed by a stopper during quiet standing, and (3) a perceived standing position during vibration. The reproduced positions were located forward by about 20% of the foot length compared with the quiet standing position; these positions showed no significant differences among the five trials. In the first trial of arm flexion during vibration, the biceps femoris began activating approximately 40 ms before the anterior deltoid. The same time difference between activation of the two muscles was observed in the reproduced condition. As the vibration trials were repeated, this activation timing approached the value in the quiet standing condition. In both the biceps femoris and erector spinae, the mean amplitude of electromyogram for the first 50 ms after the start of activation did not differ significantly among the three conditions.     

Effect of long-duration spaceflight on postural control during self-generated perturbations.

This report is the first systematic evaluation of the effects of prolonged weightlessness on the bipedal postural control processes during self-generated perturbations produced by voluntary upper limb movements. Spaceflight impacts humans in a variety of ways, one of which is compromised postflight postural control. We examined the neuromuscular activation characteristics and center of pressure (COP) motion associated with arm movement of eight subjects who experienced long-duration spaceflight (3--6 mo) aboard the Mir space station. Surface electromyography, arm acceleration, and COP motion were collected while astronauts performed rapid unilateral shoulder flexions before and after spaceflight. Subjects generally displayed compromised postural control after flight, as evidenced by modified COP peak-to-peak anterior-posterior and mediolateral excursion, and pathlength relative to preflight values. These changes were associated with disrupted neuromuscular activation characteristics, particularly after the completion of arm acceleration (i.e., when subjects were attempting to maintain upright posture in response to self-generated perturbations). These findings suggest that, although the subjects were able to assemble coordination modes that enabled them to generate rapid arm movements, the subtle control necessary to maintain bipedal equilibrium evident in their preflight performance is compromised after long-duration spaceflight.     

Organization of physiological tremors and coordination solutions to postural pointing on an uneven stance surface

The study investigated the destabilization effect on multi-segment physiological tremors and coordinative control for a postural-suprapostural task under different stance conditions. Twenty volunteers executed postural pointing from a level surface and a seesaw balance board; meanwhile, physiological tremors of the whole postural system and fluctuation movements of fingertip/stance surface were recorded. In reference to level stance, seesaw stance led to much fewer tremor increments of the upper limb and less fluctuation movement of the fingertip than tremor increment of the lower limb and rolling movement of the stance surface. Tremor coupling between the adjacent segments organized differentially with stance surface. In reference to level stance, seesaw stance reinforced tremor coupling of the upper limb but enfeebled the coupling in the arm-lumbar and calf-foot complexes. Stance-related differences in physiological tremors could be explained by characteristic changes in the primary and secondary principal components (PC1 and PC2), with relatively high communality with segment tremors of the lower and upper limbs, respectively. Seesaw stance introduced a prominent 4-8Hz spectral peak in PC1 and potentiated 1-4Hz and 8-12Hz spectral peaks of PC2. Structural reorganization of physiological tremors with stance configuration suggests that seesaw stance involves distinct suprapostural and postural synergies for regulating degree of freedom in joint space.     

The effects of total ankle arthroplasty on postural stability and loading symmetry in quiet stance

Ankle osteoarthritis is a debilitating condition affecting about 1% of the population with approximately 50,000 new instances annually. One treatment is total ankle arthroplasty (TAA), however, its effects on balance are not well understood. This study analyzed balance over a two-year period following TAA. 408 subjects (177 left, 231 right ankles) diagnosed with end-stage ankle osteoarthritis performed quiet standing trials while center of pressure (COP) data were collected. Data were compared across three time points (pre-op, 1-year, and 2-years post-op) and between surgical and non-surgical limbs using a linear mixed model with significance set at P = 0.05. COP excursions in the feet-together condition were not significantly different between limbs after 2 years in anteroposterior or mediolateral directions (P = 0.06, 0.08) after being significantly different between limbs in the anteroposterior (P = 0.014) and mediolateral direction (P < 0.001) pre-op. The vertical ground reaction force significantly decreased across time in the non-surgical limb, while reciprocally increasing in the surgical limb (P < 0.001). After 2 years, no significant difference in vertical ground reaction force between limbs existed (P = 0.20). Limb asymmetry indices decreased at each time point in both conditions (all P < 0.001) and were not significantly different from zero after 2 years in the feet-together condition (P = 0.290). In conclusion, surgical limb balance improved compared to pre-op, resulting in increased symmetry between limbs after 2 years. Vertical ground reaction forces on both limbs converge and limb asymmetry indices approach zero two years post-op. Differences in the COP excursion-loading symmetry relationship between limbs could be useful for identifying instability in other pathologies.     

Human stability in the erect stance: Alcohol effects and audio-visual perturbations

AimIn this article, we discuss the connection between alcohol and the control strategies carried out by the central nervous system to maintain the erect stance. Audio-visual perturbations were coupled with the consumption of an alcoholic beverage to simulate the possible perturbation affecting people at disco clubs, and the effects measured with a stabilometric platform.MethodsWe studied the statokinesigrams (SKG) of 14 volunteers; 11 of them were healthy, 3 were injured. We made a series of numerical tests using a stabilometric platform to record the statokinesigrams.The tests were carried out using statistical methods, time-series analysis, and applying the “p” parameter, recently proposed by Pascolo and Marini [2006. On the introduction of a new parameter for the analysis of posture. Europa Medicophysica, 42, 145–149] as a new tool to evaluate the reactions of the central control system with respect to posture-affecting diseases (for instance Parkinson) and perturbations.ConclusionThis work shows that it is theoretically possible to define non-invasive parameters able to distinguish sober subjects from drunk subjects, with an evaluation that only uses a stabilometric platform.     

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.     

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.     

Biomechanical study of the programming of anticipatory postural adjustments associated with voluntary movement

The present research concerns anticipatory postural adjustments (APA), with the purpose of determining whether they are preprogrammed and of specifying their biomechanical finality. The experimental situation allowed us to distinguish between the voluntary movement itself (an upper limb elevation) and the postural adjustments associated with it. To this aim, the upper limb kinematics, evaluated from an accelerometer fixed at wrist level, were compared to the whole body dynamics, recorded by means of a force platform. Movements, executed in series of five, were studied according to three conditions: bilateral flexions (BF) and unilateral flexions (UF), with (IUF) and without (OUF) an additional inertia, of the stretched upper limb(s). Six right handed adults were tested twice. Results showed that the ground reaction resultant forces as well as the ground reaction resultant moment about the vertical axis presented reproducible variations before and after the onset of upper limb acceleration. The biomechanical organization of APA corresponded, for the three experimental conditions, to an upward and forward acceleration of the body center of gravity, and also, for UF, to a resultant moment directed towards the contralateral side. The duration of APA varied with the characteristics of the forthcoming voluntary movement, increasing significantly from BF to OUF and from OUF to IUF. It is concluded that APA correspond to dynamic phenomena which are centrally preprogrammed. The inertia forces associated with APA may, when the time comes, balance the inertia forces due to the movement of the mobile limb therefore counteracting the disturbance to postural equilibrium.(ABSTRACT TRUNCATED AT 250 WORDS)