Age-related changes in posture response under a continuous and unexpected perturbation

Aging is a critical factor to influence the functional performance during daily life. Without an appropriate posture control response when experiencing an unexpected external perturbation, fall may occur. A novel six-degree-of freedom platform with motion control protocol was designed to provide a real-life simulation of unexpected disturbance in order to discriminate the age-related changes of the balance control and the recovery ability. Twenty older adults and 20 healthy young adults participated in the study. The subjects stood barefoot on the novel movable platform, data of the center of mass (COM) excursion, joint rotation angle and electromyography (EMG) were recorded and compared. The results showed that the older adults had similar patterns of joint movement and COM excursion as the young adults during the balance reactive-recovery. However, larger proximal joint rotation in elderly group induced larger COM sway envelop and therefore loss of the compensatory strategy of posture recovery. The old adults also presented a lower muscle power. In order to keep an adequate joint stability preventing from falling, the EMG activity was increased, but the asymmetric pattern might be the key reason of unstable postural response. This novel design of moveable platform and test protocol comprised the computerized dynamic posturography (CDP) demonstrate its value to assess the possible sensory, motor, and central adaptive impairments to balance control and could be the training tool for posture inability person.     

A new measure for upright stability

The control of balance is a primary objective in most human movements. In many cases, research or practice, it is essential to quantitatively know how good the balance is at a body posture or at every moment during a task. In this paper we suggest a new measure for postural upright stability which assigns a value to a body state based on the probability of avoiding a fall initiation from that state. The balance recovery problem is solved for a population sample using a strength database, and the probability of successfully maintaining the balance is found over the population and called the probability of recovery (PoR). It, therefore, describes an attribute of a body state: how possible the control of balance is, or how safe being at that state is. We also show the PoR calculated for a 3-link body model for all states on a plane, compare it to that found using a 2-link model, and compare it to a conventional metric: the margin of stability (MoS). It is shown, for example, that MoS may be very low at a state from which most of the people will be able to easily control their balance.     

Gluteus maximus muscle function and the origin of hominid bipedality

Bipedality not only frees the hands for tool use but also enhances tool use by allowing use of the trunk for leverage in applying force and thus imparting greater final velocity to tools. Since the weight and acceleration of the trunk and forelimbs on the hindlimbs must be counteracted by muscles such as m. gluteus maximus that control pelvic and trunk movements, it is suggested that the large size of the cranial portion of the human gluteus maximus muscle and its unique attachment to the dorsal ilium (which is apparent in the Makapan australopithecine ilium) may have contributed to the effectiveness with which trunk movement was exploited in early hominid foraging activities. To test this hypothesis, the cranial portions of both right and left muscles were investigated in six human subjects with electromyography during throwing, clubbing, digging, and lifting. The muscles were found to be significantly recruited when the trunk is used in throwing and clubbing, initiating rotation of the pelvis and braking it as trunk rotation ceases and the forelimb accelerates. They stabilize the pelvis during digging and exhibit marked and prolonged activity when the trunk is maintained in partial flexion during lifting of heavy objects.     

Abdominal muscle activation changes if the purpose is to control pelvis motion or thorax motion

The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior–posterior translations, medial–lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial–lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior–posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired.     

How locomotion sub-functions can control walking at different speeds?

Inspired from template models explaining biological locomotory systems and Raibert׳s pioneering legged robots, locomotion can be realized by basic sub-functions: elastic axial leg function, leg swinging and balancing. Combinations of these three can generate different gaits with diverse properties. In this paper we investigate how locomotion sub-functions contribute to stabilize walking at different speeds. Based on this trilogy, we introduce a conceptual model to quantify human locomotion sub-functions in walking. This model can produce stable walking and also predict human locomotion sub-function control during swing phase of walking. Analyzing experimental data based on this modeling shows different control strategies which are employed to increase speed from slow to moderate and moderate to fast gaits.     

The effects of core muscle activation on dynamic trunk position and knee abduction moments: Implications for ACL injury

Anterior cruciate ligament (ACL) injury is one of the most common serious lower-extremity injuries experienced by athletes participating in field and court sports and often occurs during a sudden change in direction or pivot. Both lateral trunk positioning during cutting and peak external knee abduction moments have been associated with ACL injury risk, though it is not known how core muscle activation influences these variables. In this study, the association between core muscle pre-activation and trunk position as well as the association between core muscle pre-activation and peak knee abduction moment during an unanticipated run-to-cut maneuver were investigated in 46 uninjured individuals. Average co-contraction indices and percent differences between muscle pairs were calculated prior to initial contact for internal obliques, external obliques, and L5 extensors using surface electromyography. Outside tilt of the trunk was defined as positive when the trunk was angled away from the cutting direction. No significant associations were found between pre-activations of core muscles and outside tilt of the trunk. Greater average co-contraction index of the L5 extensors was associated with greater peak knee abduction moment (p=0.0107). Increased co-contraction of the L5 extensors before foot contact could influence peak knee abduction moment by stiffening the spine, limiting sagittal plane trunk flexion (a motion pattern previously linked to ACL injury risk) and upper body kinetic energy absorption by the core during weight acceptance.     

Are recruitment patterns of the trunk musculature compatible with a synergy based on the maximization of endurance?

To verify that maximization of endurance is important among the functional criteria determining trunk muscle activation patterns, symmetric and asymmetric exertions were simulated using a detailed model consisting of 114 muscle slips crossing the lumbosacral junction and employing a cost function which maximizes endurance. First, the question whether meaningful comparisons can be made between activity predictions for individual muscle slips and surface EMG data recorded from larger anatomical entities was addressed. This was answered affirmatively, since activation patterns predicted by a coarse and a middle version of the model, in which activation was constrained to be equal within 14 or 32 groups of muscle slips, were similar to those predicted with each muscle slip controlled independently. Median correlation coefficients between activity vectors predicted by the simplified models and the detailed model were 0.88 and 0.97, respectively. The coarse model underestimated the endurance capacity by a median of 21%, the middle model by only 0.7%. Second, predicted activities within anatomical entities defined at this level of detail were compared to reference data derived from the literature (Lavender et al. 1992, Human Factors 34, 239–247; 1992, Journal of Orthopaedic Research 10, 691–700; Vink et al., 1988, Electromyography and Clinical Neurophysiology 28, 517–525). The predicted activity patterns of the crector spinae, external oblique and rectus abdominis muscles closely resembled the EMG patterns (r² = 0.48–0.99). Furthermore, the observed distribution of activity between parts of the crector spinae muscle was adequately predicted.     

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.     

A surface electromyography based objective method to identify patients with nonspecific chronic low back pain,presenting a flexion related movement control impairment

Movement control impairments (MCI) are often present in patients with non-specific chronic low back pain (NS-CLBP). Therefore, movement control exercises are widely used to rehabilitate patients. However, the objective assessment remains difficult.The purpose of this study was to develop a statistical model, based on logistic regression analysis, to differentiate patients with NS-CLBP presenting a flexion-related MCI from healthy subjects. This model is based on trunk muscle activation patterns measured by surface electromyography (sEMG), during movement control exercises.Sixty-three healthy male subjects and 36 male patients with a flexion-related MCI participated in this study. Muscle activity of the internal obliques, the external obliques, the lumbar multifidus and the thoracic part of the iliocostalis was registered. Ratios of deep stabilizing to superficial torque producing muscle activity were calculated to examine trunk muscle recruitment patterns during 6 different exercises. Logistic regression analyses were performed (1) to define the ratios and exercises that were most discriminating between patients and non-patients, (2) to make a predictive model. K-Fold cross-validation was used to assess the performance of the predictive model.This study demonstrated that sEMG trunk muscle recruitment patterns during movement control tests, allows differentiating NSCLBP patients with a flexion-related MCI from healthy subjects.     

Effectiveness and recovery action of a perturbation balance test – a comparison of single-leg and bipedal stances

Abstract

Dynamic balancing abilities can be assessed with perturbation tests. The present study examined the effectiveness of balancing (damping ratio) and the recovery action (directional ratio) in bipedal and dominant single-leg stance in the young population. Twenty-four healthy young adult participants completed unidirectional lateral perturbations successfully using a Posturomed© platform (Haider Bioswing, Germany). Single-leg stances had similar damping scores (p?=?0.551) to and lower directional ratio values (p?=?0.002) than bipedal recoveries. This shows that different recovery actions can achieve similar effectiveness in the two stances. A test evaluation methodology that simultaneously utilises performance and motion characteristic parameters was demonstrated.     

Distributed moment histogram: A neurophysiology based method of agonist and antagonist trunk muscle activity prediction

A neurocortical-based technique of muscle recruitment is presented to solve the muscle indeterminacy problem for lumbar torso modeling. Cortical recordings from behaving primates have established motor cortex cells that respond to a wide range of task directions, but are tuned to a preferred direction. A characteristic activity pattern of these neurons seems to be associated with effort direction. It was hypothesized that a model which recruits muscles based on a similar distribution would predict antagonistic muscle activity with greater realism than a widely referenced optimization formulation. The predictions of the Distributed Moment Histogram (DMH) method were evaluated under common speed (<30^os⁻¹) sagittal plane lifting conditions using five subjects. The predicted forces showed high correspondence with agonist and antagonist myoelectric patterns. The mean coefficient of determination for the erector spinae was r²=0.91, and 0.41 for the latissimus. For the antagonistic muscles, the rectus abdominus was found to be electrically silent (<3% MVC) and no activity was predicted by the method. The external oblique muscle was observed to be minimally active (<16% MVC), and the DMH method predicted its mostly constant activity with a mean standard error of 1.6% MVC. The realistic antagonistic predictions supported the hypothesis and justify this cortical based technique as an alternative for muscle tension estimation in biomechanical torso modeling. A primary advantage of this method is its computational simplicity and direct physiologic analogy