Mechanical interaction of center of pressure and force direction in the upright human

Humans maintain upright bipedal posture by producing appropriate force against the environment through the interaction of neural controlled muscle force with the mechanics of the skeletal system. Characterizing these mechanics facilitates understanding of the neural control. We used a mechanical model of an upright human to analyze how the mechanical linkage aspects of the human body affect the force between the feet and the ground (F). Key parameters of F that directly regulate upright body posture are the direction of F (θ(F)) and its point of application (x(CP), anterior-posterior position of the center of pressure). Instantaneous analysis of the equations of motion demonstrated that θ(F) varied systematically with x(CP) such that the F vectors intersected at a point called the Posture-specific force Intersection point or PI (Π). The Π was located above the center of mass when the hip and knee joints were modeled as rigid and was located near the knee when the hip and knee torques were held constant. Limb posture and the knee torque affected the location of Π. This Π behavior quantifies the purely mechanical effect of anterior-posterior center of pressure shifts on the direction of F, which has consequences for the control of whole body posture.     

Posturographic analysis through markerless motion capture without ground reaction forces measurement

The ability of the central nervous system to control posture and balance has been used with increasing frequency for the diagnosis and/or treatment evaluation of various neuromuscular diseases. Typically this analysis (Posturographic Analysis) is based on tracking the motion of the center of mass (COM) during quiet standing, however direct measurement of the COM has been commonly approximated using the movement of the center of pressure (COP). The purpose of this study was to apply and validate a new method to track the COM (center of mass) and COP (center of pressure) from a visual hull measured using a markerless motion capture (MMC) method. The method was tested by comparing the calculation of the COP from direct measurements of the COP. The deviations between the methods, below 2 mm, were small relative to the average range of movement guaranteeing a satisfactory signal to noise ratio. This new method requires only kinematic data through MMC method and without the need of a force plate can identify the influence of individual body segments to motion of the COM.     

Exercise with and without gravitational gradient: evaluation with the new random access mass spectrometer (RAMS)

Gravity adds about 40-50 mmHg perfusion pressure to the arterial supply of the quadriceps muscles in the upright posture. This could have important implications in supply of blood flow during exercise. Recently, we have shown that when subjects exercise in the supine posture the rate of increase in VO2 is considerably slower then when cycling exercise takes place in the upright posture. The most probable explanation for this slower adaptation was the altered perfusion gradient. Indeed, when the perfusion gradient from heart to legs was restored by placing the lower part of the body of supine subjects in a negative pressure chamber, the rate of increase in VO2 returned to upright values. The hypothesis advanced from these studies was that skeletal muscle blood flow was reduced at the onset of supine exercise. Exercise in the microgravity environment of space should be similar to that in the supine posture. The only experiments conducted in space to this date that have addressed the question of cardiorespiratory adaptation to changing work rates were performed on the German D2 mission using the methodology proposed by Stegemann and colleagues. To conduct these experiments, it is necessary to utilize sensitive breath-by-breath technology. Recently, NASA and the Russian space programs have commissioned a new mass spectrometer based system as part of the GASMAP project. It was the purpose of this study to evaluate the new mass spectrometer under conditions in which the gravitational effects on the cardiorespiratory response were being challenged.     

Atrial distension, arterial pulsation, and vasopressin release during negative pressure breathing in humans

During an antiorthostatic posture change, left atrial (LA) diameter and arterial pulse pressure (PP) increase, and plasma arginine vasopressin (AVP) is suppressed. By comparing the effects of a 15-min posture change from seated to supine with those of 15-min seated negative pressure breathing in eight healthy males, we tested the hypothesis that with similar increases in LA diameter, suppression of AVP release is dependent on the degree of increase in PP. LA diameter increased similarly during the posture change and negative pressure breathing (-9 to -24 mmHg) from between 30 and 31 +/- 1 to 34 +/- 1 mm (P < 0.05). The increase in PP from 38 +/- 2 to 44 +/- 2 mmHg (P < 0.05) was sustained during the posture change but only increased during the initial 5 min of negative pressure breathing from 36 +/- 3 to 42 +/- 3 mmHg (P < 0.05). Aortic transmural pressure decreased during the posture change and increased during negative pressure breathing. Plasma AVP was suppressed to a lower value during the posture change (from 1.5 +/- 0.3 to 1.2 +/- 0.2 pg/ml, P < 0.05) than during negative pressure breathing (from 1.5 +/- 0.3 to 1.4 +/- 0.3 pg/ml). Plasma norepinephrine was decreased similarly during the posture change and negative pressure breathing compared with seated control. In conclusion, the results are in compliance with the hypothesis that during maneuvers with similar cardiac distension, suppression of AVP release is dependent on the increase in PP and, furthermore, probably unaffected by static aortic baroreceptor stimulation.     

Features of learning voluntary control of posture after pyramidal and nigrostriatal lesions

The study was aimed at investigation of a deficit of learning the center-of-pressure voluntary control in patients with lesions of corticospinal and nigrostriatal systems. Thirty three patients with Parkinson's disease and 20 patients with hemiparesis after cerebrovascular accidents in the MCA participated in the investigation. The subjects stood on a force platform and in the form of a computer game were trained to match the projection of the center of pressure (a cursor) with a target on the screen under the visual feedback control. Two different postural tasks were presented. In the first task the direction of the center-of-pressure shift was not known before, so the subject learned the general strategy of the center-pressure control. In the other task a precise postural coordination should be formed. The voluntary control of the center-of-pressure position was found to be impaired in both groups of patients. In the task of moving the center of pressure in various directions (general strategy), no differences in the initial deficit of the task performance were found between the groups, but the learning was more efficient in the group of hemiparetic patients. However, in the task with precise postural coordination, despite the greater initial deficit in the parkinsonian patients, the learning in this group of patients was substantially more efficient than in hemiparetic patients. The results suggest both common and different features of the involvement of the corticospinal and nigrostriatal systems in learning voluntary control of posture.     

Postural stability during gait for adults with hereditary spastic paraparesis

Individuals with hereditary spastic paraparesis (HSP) are often impaired in their ability to control posture as a result of the neurological and musculoskeletal implications of their condition. This research aimed to assess postural stability during gait in a group of adults with HSP. Ten individuals with HSP and 10 healthy controls underwent computerized gait analysis while walking barefoot along a 10-m track. Two biomechanics methods were used to assess stability: the center of pressure and center of mass separation (COP-COM) method, and the extrapolated center of mass (XCOM) method. Spatiotemporal and kinematic variables were also investigated. The XCOM method identified deficits in mediolateral stability for the HSP group at both heel strike and mid-stance. The group with HSP also had slower walking velocity, lower cadence, more time spent in double stance, larger step widths, and greater lateral trunk flexion than the control group. These results suggest that individuals with HSP adjust characteristics of their gait to minimize the instability arising from their impairments but have residual deficits in mediolateral stability. This may result in an increased risk of falls, particularly in the sideways direction.     

Deep brain stimulation amplitude alters posture shift velocity in Parkinson’s disease

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is now widely used to alleviate symptoms of Parkinson’s disease (PD). The specific aim of this study was to identify posture control measures that may be used to improve selection of DBS parameters in the clinic and this was carried out by changing the DBS stimulation amplitude. A dynamic posture shift paradigm was used to assess posture control in 4 PD STN-DBS subjects. Each subject was tested at 4 stimulation amplitude settings. Movements of the center of pressure and the position of the pelvis were monitored and several quantitative indices were calculated. The presence of any statistically significant changes in several normalized indices due to reduced/no stimulation was tested using the one-sample t test. The peak velocity and the average movement velocity during the initial and mid phases of movement towards the target posture were substantially reduced. These results may be explained in terms of increased akinesia and bradykinesia due to altered stimulation conditions. Thus, the dynamic posture shift paradigm may be an effective tool to quantitatively characterize the effects of DBS on posture control and should be further investigated as a tool for selection of DBS parameters in the clinic.     

Temporal pattern of the control actions accomplishing stabilization of the vertical posture of man

The problem of determination of the temporal patterns of control actions, which accomplish the process of the vertical posture stabilization, was considered. On the basis of stabilogram analysis, it was concluded that the temporal pattern of the trajectory components of pressure center (PC) motion consists of interval sequences. Motion velocity is practically constant within each interval. Transition to the following interval is accompanied by a spasmodic change not only in the velocity magnitude but also in its sign. It was shown that velocity constancy at the linear interval is the result of linear time change in control actions. A conclusion was drawn about the presence of two separate mechanisms realizing the process of stabilization of the vertical posture. They form independent control actions oriented in the frontal and sagittal planes.     

Balance control during an arm raising movement in bipedal stance: which biomechanical factor is controlled?

In order to obtain new insight into the control of balance during arm raising movements in bipedal stance, we performed a biomechanical analysis of kinematics and dynamical aspects of arm raising movements by combining experimental work, large-scale models of the body, and techniques simulating human behavior. A comparison between experimental and simulated joint kinematics showed that the minimum torque change model yielded realistic trajectories. We then performed an analysis based on computer simulations. Since keeping the center of pressure (CoP) and the projection of the center of mass (CoM) inside the support area is essential for equilibrium, we modeled an arm raising movement where displacement of one or the other variable is limited. For this optimization model, the effects of adding equilibrium constraints on movement trajectories were investigated. The results show that: (a) the choice of the regulated variable influences the strategy adopted by the system and (b) the system was not able to regulate the CoM for very fast movements without compromising its balance. Consequently, we suggest that the system is able to maintain balance while raising the arm by only controlling the CoP. This may be done mainly by using hip mechanisms and controlling net ankle torque.     

健康青年静态立位平衡功能的研究

目的:完善健康青年静态立位平衡参数常模和探讨人处于不利站立条件下姿势控制变化规律。方法:从某军校本科学员中随机抽取108名,对8种不同站立条件下的立位平衡功能进行测试,同时比较不同站立姿势下重心晃动的变化。结果:与睁眼站立相比,闭眼站立和闭眼站立于脚垫上,人体重心会不自主地向脚掌移动,同时重心晃动的轨迹长度和面积明显增加,而单位面积轨迹长度明显降低。另外,人体前后方向晃动的程度较大,而左右晃动的程度稍小。结论:健康人姿势控制由视觉、前庭和下肢本体感觉等共同维持的,任何系统受到限制,都会影响平衡功能。当人处于不利站立条件时,人的身体会本能地向前倾斜来维持平衡,同时本研究为涉及人体立位平衡方面的研究提供了新的研究方法和思路。     

Maintenance of Human Vertical Posture upon Asymmetric Leg Loading and Fixation of the Knee Joint of One Leg

Maintenance of a vertical posture was studied in standing subjects with a fixed knee joint of one leg and a different weight distribution between the legs. Knee fixation on one leg did not affect the speed of movements of the common center of pressure (CP) at any weight distribution between the legs, and the stability of vertical posture was therefore unchanged. However, the relative contributions of the legs to the posture control changed when knee movements of one leg were restricted. The speed of CP movements of the free leg was independent of the weight loading on the leg. The speed of CP movements of the leg with the knee fixed depended on the weight distribution and was higher when the leg was loaded. Thus, the leg with the fixed knee joint made a greater contribution to maintaining vertical posture when the leg was loaded. Yet its contribution was comparable with that of the unloaded free contralateral leg even in this case, as was evident from lack of differences in CP movements between the two legs. It was assumed that the leg with the free knee joint played a major role in maintaining equilibrium of vertical posture, while the leg with the fixed knee joint mostly acted to more finely adjust the body position.     

Posture strategies generated by constrained optimization

For people with motion disorders, posture can impact fatigue, discomfort or deformities in the long term. Orthopedic treatments such as orthoses or orthopedic surgeries which change geometric properties can improve posture in these individuals. In this study, a model has been created to study posture strategies in such situations. A 3D mechanical model consisting of eight rigid segments and 30 muscle groups is used in which varying moment arms along the ranges of motion and biarticular muscles are considered. The method is based on static optimization, both to solve the load sharing in the muscle system and to choose posture strategy. The optimization computes the specific posture with minimal required effort (level of muscle activations), while fulfilling constraints containing subject specific ranges of motion, muscle strength/weakness and external support if present. Anthropometry and strength were scaled to each individual, based on reported pediatric anthropometry and strength values, combined with each individual's physical assessment. A control group of 10 able-bodied subjects as well as three subjects with motion disorders were studied, and simulated posture was compared with experimental data. The simulation showed reasonable to good agreement and ability to predict the effect of motion disorders and of external support. An example of application in parameter studies was also presented wherein ankle orthosis angles were varied. The model allows the user to study muscle activity at the muscle group level, position of center of mass and moments at joints in various situations.     

Influence of a movable support under one leg on human vertical posture during standing with asymmetrical load on legs

Changes in the vertical posture maintenance were studied when the legs were placed on supports of different degrees of mobility and part of the body weight was voluntarily transferred to one leg. The aim of these experiments was to explore how the mobility of support under the feet affects the balance and how this effect depends on the load distribution between the legs during standing. When both legs were on rigid immovable supports, the vertical posture was maintained by control of the center of pressure (CP) on both legs. When the subject transferred the weight to one foot, the posture was maintained mainly due to the control of CP of the loaded leg. When the legs were on supports of different degrees of mobility, the balance was maintained by the leg on the immovable support. This result was observed both when the subject stood with symmetrical load on the legs and when the load was transferred to one leg. Even when the leg was unloaded but placed on the immovable support, its CP moved more compared to the CP of the loaded leg on a movable support. The results obtained show that the support mobility is a factor that determines the mechanisms of posture maintenance, and this factor is more significant than load distribution between the legs. Thus, the upright posture is maintained with the physical properties of support under the feet taken into account.     

Human upright posture control in a virtual visual environment

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

Effect of locomotor training and functional electrical stimulation on postural function in children with severe cerebral palsy

Cerebral palsy (CP) considerably impairs the ability to maintain upright stance. The effects of locomotor training and functional electrical stimulation (FES) on postural control were determined in 27 children aged 6–12 years with severe CP. The severity level of the clinical manifestations of CP was classified as 3 according to the Gross Motor Function Classification System (GMFCS). All patients participated in 15 30-min mechanical therapy sessions using robot-assisted passive stepping. In 12 out of 27 children, the locomotion therapy was accompanied by FES. Stabilometry and plantography tests were performed in 23 healthy age-matched children. Postural control in children with CP differed from the stabilograms of healthy children in a forward shift of the center of pressure (COP) projection; higher values of the COP trajectory area and length, the mean amplitude of the COP oscillations, and the absence of COP response to the eyes closed condition. After treatment, the posturographic characteristics tended to normalize in relation to the values obtained in neurologically intact children. The improvement was observed in 43% of children without FES and in 75% of children in the group with FES. Analysis of plantograms revealed normalization of footprints in children who received FES. Thus, it was demonstrated that FES combined with locomotor training resulted in the improvement in vertical posture control in children with severe CP.     

Specific and Nonspecific Visual Influences on the Stability of the Vertical Posture in Humans

We studied physiological mechanisms of vision-related stabilization of the vertical posture in humans using a stabilographic technique; spontaneous deviations of the projection of the center of gravity during quiet stance and magnitudes of the postural response to vibratory stimulation of proprioceptors of the lower leg muscles under varied conditions of visual control were measured. The stability of quiet stance, as estimated according to the root mean square value of the sagittal component of the stabilogram, was the best with eyes open. Vibration-induced postural responses were the smallest also under these conditions. Spontaneous postural sway and the amplitude of response to vibratory stimulation increased when only a central sector of visual field (20 ang. deg) was preserved and, especially, under conditions of closed eyes and horizontal inversion of visual perception using prismatic spectacles. Parallel changes in the quantitative stabilographic indices and amplitude of vibration-induced postural responses show that the intensity of the latter is probably determined by the background stiffness of the musculoskeletal system. We tried to estimate separately the contributions of the stiffness factor, on the one hand, and specific visual influences, on the other hand, by testing the parameters of quiet stance and postural responses under conditions of standing while lightly touching a support with the index finger. We found that the influence of the conditions of visual control on the stability of quiet stance while touching the support was eliminated. At the same time, the magnitude of postural responses to vibratory stimulation decreased but, nonetheless, changed with visual conditions in the same manner as when standing without additional support. We conclude that vision performs a dual function in the control of the vertical posture; it forms the basis for the spatial reference system and serves the source of information on the movements of one's body.     

Participation of the neostriatum transmission system in automation of motor skills in dogs

The study shows that, in spite of high criteria of performing inctrumental reflex, the ability to repeat the reflex performance, the increase in tonic component of the response, a dostinct diagonal pattern of posture readjustment, and the local (not diffuse) projection of the mass centre position upon tensoplatforms of anterior paws were only observed after a prolonged training that led to automation of the skill. The instrumental response automation effect could be obtained at once following a bilateral microinjection of carbacholine into the neostriatum. The same albeit a weaker effect could be obtained with bilateral microinjections of D2 Dopamine receptor blocking agent Raclopride into the neostriatum. Bilateral injections of Pyrenzepine yield an opposite result: an increase in the physical component of the response < a disorder in the diagonal pattern of posture readjustment, and a diffuse nature of projection of the mass centre position of anterior paws on tensoplatforms. Indirect efferent output of the neostriatum seems to play an important role in motor instrumental reflex as well as in the process of automation of the motor skill.     

Comparative analysis of the dynamics of human postural control during fixation and pursuit of a visual target

The properties of the system maintaining the upright posture were compared in different states of the oculomotor system: during target fixation and horizontal fast and slow pursuit (0.1 and 0.01 Hz), recording the trajectories of the center of pressure in the frontal and the sagittal planes. Methods of nonlinear analysis were applied to assess the similarity in pairwise comparisons. The overall similarity of the frontal plane dynamics proved to be higher than that of the sagittal plane dynamics. However, differences were revealed in fast pursuit versus slow pursuit or fixation in the frontal but not in the sagittal plane. Such differences may reflect the different inertia of the oculomotor and the balance control systems. In general, the results are consistent with the current notions on the two orthogonal subsystems of postural control.     

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

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

Effect of an additional manual motor task on the maintenance of equilibrium in the frontal and sagittal planes in standing subjects

The postural oscillations of a standing subject during an additional manual motor task consisting in holding a movable ball in the center of a flat box were studied. The movements of the center of pressure (CP) in the frontal and sagittal planes were studied when subjects were standing on a stable rigid support and on a movable unstable support. The effect of the additional motor task on the movement of the CP depended on the stability of the support. When the additional task was performed, the sagittal movements of the CP increased in the case a movable support and did not increase when the support was stable. The additional task decreased the frontal movements of CP in the case of a stable support, and it did not change the frontal movements of CP when the support was unstable. Thus, the performance of an additional motor task led to a reduction of the efficiency of the postural control system in maintaining equilibrium on an unstable support. This decrease may be due to a greater cortical influence on the posture control system in subjects standing on a movable support in comparison with this influence in the case of a stable support.