Visual and somatosensory contributions to infant sitting postural control

Abstract

There are a limited number of studies that have investigated sitting posture during infancy and the contribution of the sensory systems. The goal of this study was to examine the effects of altered visual and somatosensory signals on infant sitting postural control. Thirteen infants (mean age?±?SD, 259.69?±?16.88?days) participated in the study. Initially, a single physical therapist performed the Peabody Developmental Motor Scale to determine typical motor development. Then the child was placed onto a force platform under four randomized conditions: (a) Control (C) – sat independently on the force plate, (b) Somatosensory (SS) – Sat independently on a foam pad (low density), (c) Visual (VS) – sat independently on the force plate while the lights were turned off creating dim lighting, and (d) Combination of b and c (NVSS). Center of pressure (COP) data from both the anterior-posterior (AP) and the medial-lateral (ML) directions were acquired through the Vicon software at 240?Hz. The lights off conditions, both VS and NVSS, lead to increased Root Mean Square (RMS) and Range values in the AP direction, as well as increased Lyapunov Exponent (LyE) values in the ML direction. Altered visual information lead to greater disturbances of sitting postural control in typically developing infants than altered somatosensory information. The lights off conditions (VS and NVSS), unveiled different control mechanisms for AP and ML direction during sitting. Thus, the present findings confirm the dominance of vision during the early acquisition of a new postural accomplishment.     

Effect of Japanese sitting style (seiza) on the center of foot pressure after standing

Seiza is one of the most commonly used sitting postures in various enrichment lessons of Japanese origin. It is reported that Seiza with large knee flexion produces harmful effects on the cartilage of knee joints and hemodynamics of the lower legs. This study aimed at examining the influence of Seiza on tissue oxygenation kinetics of the lower limbs, plantar somatic and cutaneous sensation, and the center of foot pressure (COP) sway using 10 young adults. COP sway was measured for 1 min just after sitting on a chair for 10 min (pre-test), after 30-min Seiza (post-test 1), and 5 min after Seiza (post-test 2). To evaluate the COP sway, we used 4 body sway factors; unit time sway factor (F1), front-back sway factor (F2), left-right sway factor (F3) and high frequency band power spectrum factor (F4). Physiological parameters (i.e., tissue oxygenation kinetics in the lower legs and sensation on the sole) were measured during 30-min Seiza (continuously on tissue oxygenation, and at 1 min intervals on sensation), and for 1 min just before each COP test (pre-test, post-test 1 and 2).Oxygenated hemoglobin/myoglobin (Hb/Mb) concentration decreased markedly and deoxygenated Hb/Mb concentration increased markedly, resulting in reaching a plateau state at around 7 min. Tissue Hb/Mb index changed little during Seiza. Proprioceptive perception thresholds increased rapidly about 17 min after Starting Seiza. Means of 3 COP sway factors of F1, F2 and F4 were significantly higher in post-test 1 than in pre-test and post-test 2. In conclusion, a marked decrease in tissue oxygen concentration of the lower legs within 4-5 min, and an increase of proprioceptive perception thresholds in the sole at about 17 min are induced by Seiza. Although wiggle and quick body sway in the antero-posterior axis increases markedly in an upright posture just after maintaining Seiza for 30 min, sway recovers after sitting on a chair for 5 min.     

Effect of haptic supplementation on postural control of younger and older adults in an unstable sitting task

Standing postural control is known to be altered during aging, but age-related changes in sitting postural control have scarcely been explored. The present experiment studied the roles of visual and haptic information in a sitting task in both young and older adults. Fifteen young and fifteen older adults participated in this study. Six experimental conditions were performed with eyes open and eyes closed: quiet sitting, rocker-board sitting, and 4 conditions of haptic supplementation, provided by a hand-held pen, during rocker-board sitting. Classical variables were extracted from the center of pressure (COP) and pen trajectories, and the stabilogram diffusion analysis was performed on the COP data. Three-way ANOVAs (Group × Vision × Condition) were carried out.Postural instability was strongly attenuated by haptic supplementation in both age groups. Furthermore, instability due to visual deprivation was compensated by haptic supplementation. Long- and short-term diffusion coefficients were smaller in conditions of haptic supplementation. The present study confirmed the effect of haptic supplementation on both open-loop and closed-loop mechanisms of postural control and extended it to unstable sitting in young and older adults despite the complex biomechanical systems involved in sitting postural tasks.     

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

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

Infant sitting postural control appears robust across changes in surface context

Aim of the study: Independent sitting requires the control of the involved body segments over the base of support using information obtained from the three sensory systems (visual, vestibular, and somatosensory). The contribution of somatosensory information in infant sitting has not been explored. To address this gap, we altered the context of the sitting support surface and examined the infants’ immediate postural responses.

Materials and methods: Ten 7-month-old typically developing infants sat on compliant and firm surfaces in one session. Spatial, frequency, and temporal measures of postural control were obtained using center of pressure data.

Results Our results suggest that infants’ postural sway is not immediately affected by the different types of foam surface while sitting.

Conclusions: It seems that mature sitter infants are able to adapt to different environmental constraints by disregarding the distorted somatosensory information from the support surface and relying more on their remaining senses (visual and vestibular) to control their sitting posture.     

The variability and complexity of sitting postural control are associated with discomfort

The present investigation examined the variability of sitting postural movement in relation to the development of perceived discomfort by means of linear and nonlinear analysis. Nine male subjects participated in this study. Discomfort ratings, kinetic and kinematics data were recorded during prolonged sitting. Body part discomfort index, displacement of the center of pressure (COP) in anterior–posterior and medial–lateral directions as well as lumbar curvature were calculated. Mean, standard deviation and sample entropy values were extracted from COP and lumbar curvature signals. Standard deviation and sample entropy were used to assess the degree of variability and complexity of sitting. A correlation analysis was performed to determine the correlation of each parameter with discomfort. There were no correlations between discomfort and any of the mean values. On the contrary, the standard deviations of the COP displacement in both directions and lumbar curvature were positively correlated to discomfort, whereas sample entropies were negatively correlated. The present study suggests that the increase in degree of variability and the decrease in complexity of sitting postural control are interrelated with the increase in perceived discomfort. Finally, the present study underlined the importance of quantifying motor variability for understanding the biomechanics of seated posture.     

Blood pressure and blood flow variation during postural change from sitting to standing: model development and validation.

Short-term cardiovascular responses to postural change from sitting to standing involve complex interactions between the autonomic nervous system, which regulates blood pressure, and cerebral autoregulation, which maintains cerebral perfusion. We present a mathematical model that can predict dynamic changes in beat-to-beat arterial blood pressure and middle cerebral artery blood flow velocity during postural change from sitting to standing. Our cardiovascular model utilizes 11 compartments to describe blood pressure, blood flow, compliance, and resistance in the heart and systemic circulation. To include dynamics due to the pulsatile nature of blood pressure and blood flow, resistances in the large systemic arteries are modeled using nonlinear functions of pressure. A physiologically based submodel is used to describe effects of gravity on venous blood pooling during postural change. Two types of control mechanisms are included: 1) autonomic regulation mediated by sympathetic and parasympathetic responses, which affect heart rate, cardiac contractility, resistance, and compliance, and 2) autoregulation mediated by responses to local changes in myogenic tone, metabolic demand, and CO(2) concentration, which affect cerebrovascular resistance. Finally, we formulate an inverse least-squares problem to estimate parameters and demonstrate that our mathematical model is in agreement with physiological data from a young subject during postural change from sitting to standing.     

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

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

Effect of tongue position on postural stability during quiet standing in healthy young males

Abstract

Background and aims: Role of the neck and jaw sensory motor system in control of body balance has been established. Tongue is an integral part of jaw sensory motor system and helps in execution of purposeful and precise motor tasks like eating, drinking and speaking. The purpose of this study was to evaluate the possible effects of tongue position on the postural control system.

Materials and method: We compared the mean center of gravity (COG) velocity during quiet standing on an unstable surface with eyes closed during two test conditions: (i) with habitual jaw resting position and (ii) with instructed tongue positioned against the upper incisors. One hundred and sixteen normal healthy male subjects (average age 31.56?±?8.51 years and height 170.86?±?7.26?cm) participated in the study. Their COG velocity (deg/s) was measured using the NeuroCom® Balance Master version 8.5.0 (Clackamas, OR, USA).

Results and conclusions: The results show that COG velocity decreased significantly while tongue was positioned against upper incisors in comparison to the habitual jaw resting position. Our findings suggest that the tongue positioning can modulate postural control mechanisms. Tongue positioning against the upper incisors can enhance the postural stability during upright standing on an unstable surface and in the absence of vision in healthy young adults. Our findings can be of value for evaluation and rehabilitation protocols for postural control dysfunction.     

Study of age-related changes in postural control during quiet standing through Linear Discriminant Analysis

Background  

The human body adopts a number of strategies to maintain an upright position. The analysis of the human balance allows for the understanding and identification of such strategies. The displacement of the centre of pressure (COP) is a measure that has been successfully employed in studies regarding the postural control. Most of these investigations are related to the analysis of individuals suffering from neuromuscular disorders. Recent studies have shown that the elderly population is growing very fast in many countries all over the world, and therefore, researches that try to understand changes in this group are required. In this context, this study proposes the analysis of the postural control, measured by the displacement of the COP, in groups of young and elderly adults.     

Associations between trunk postural control in walking and unstable sitting at various levels of task demand

Trunk postural control (TPC) has been investigated in several populations and tasks. Previous work observed targeted training of TPC via isolated trunk control tasks may improve performance in other activities (e.g., walking). However, the nature of this relationship remains unknown. We therefore investigated the relationship between TPC, at both the global (i.e., response to finite perturbations) and local (i.e., resistance to continuous perturbations) levels, during walking and unstable sitting, both at varying levels of task demand. Thirteen individuals (11 Male, 2 Female) with no recent history (past 12 months) of illness, injury, or musculoskeletal disorders walked on a dual-belt treadmill at four speeds (−20%, −10%, +10%, and + 20% of self-selected walking speed) and completed an unstable sitting task at four levels of chair instability (100, 75, 60, and 45% of an individual’s “neutral” stability as defined by the gravitational gradient). Three-dimensional trunk and pelvic kinematics were collected. Tri-planar Lyapunov exponents and sample entropy characterized local TPC. Global TPC was characterized by ranges of motion and, for seated trials, metrics derived from center-of-pressure time series (i.e., path length, 95% confidence ellipse area, mean velocity, and RMS position). No strong or significant correlations (−0.057 < ρ < 0.206) were observed between local TPC during walking and unstable sitting tasks. However, global TPC declined in both walking and unstable sitting as task demand increased, with a moderate inter-task relationship (0.336 < ρ < 0.544). While the mechanisms regulating local TPC are inherently different, global TPC may be similarly regulated across both tasks, supporting future translation of improvements in TPC between tasks.     

Effect of limited knee-flexion range on peak hip moments of force while transferring from sitting to standing

The hypothesis that limiting the knee-flexion range increases the peak hip-extension moment while transferring from sitting to standing was tested by filming (100 fps) ten normal human volunteers. With the knees flexed 105 degrees from full extension (0 degrees) the mean (+/- 1 S.D.) peak hip-extension moment was 142 (+/- 37) Nm. With the knees flexed only 75 degrees subjects threw their arms and trunks forward to a greater extent, with a peak moment of 253 (+/- 65) Nm (p less than 0.0001). If the peak moments rise to a similar degree in patients with arthritis and limited knee-flexion range, they may accelerate hip joint damage or the loosening of hip endoprostheses.     

Determination of esophageal probe insertion length based on standing and sitting height

The present study derives simple formulas for the prediction of optimal insertion length of an esophageal temperature-sensitive probe from the measurements of either standing or sitting height. The formulas assume that the optimal site for an esophageal temperature probe is in the region of the esophagus bounded by the left ventricle and aorta, corresponding to the level of the eighth and ninth thoracic vertebrae (T8 and T9, respectively). An esophageal probe was constructed of polyethylene tubing containing 1-cm segments of alternating radiopaque and nonradiopaque tubing in the distal 20 cm of the probe. The probe was inserted through a nostril into the esophagus of 20 subjects (12 males and 8 females) of various heights (range 163-194.6 cm) and weights (range 52.2-100.8 kg), and lateral chest radiograms were obtained for determination of the insertion length of the probe (L) required to situate the probe in the retrocardiac esophagus. Analysis of the radiograms demonstrated that, at the level of the intervertebral disc between T8 and T9, the probe was below the tracheal bifurcation and close to the left ventricle. The distance from the nasal flare to this level showed a good correlation with the subject's stretched stature (r2 = 0.71) and sitting height (r2 = 0.86). The following equations were derived to predict the placement of the esophageal probe at the T8/T9 level based on standing height: L (CM) = 0.228 x (standing height) - 0.194, and sitting height: L (cm) = 0.479 x (sitting height) - 4.44.     

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.     

Effect of exercise-induced fatigue on postural control of the knee

Muscle fatigue is associated with reduced power output and work capacity of the skeletal muscle. Fatigue-induced impairments in muscle function are believed to be a potential cause of increased injury rates during the latter stages of athletic competition and often occur during unexpected perturbations. However the effect of fatigue on functionally relevant, full body destabilizing perturbations has not been investigated. This study examines the effect of muscle fatigue on the activation of the quadriceps and hamstrings to fast, full body perturbations evoked by a moveable platform. Surface electromyographic (EMG) signals were recorded from the knee extensor (vastus medialis, rectus femoris, and vastus lateralis) and flexor muscles (biceps femoris and semitendinosus) of the right leg in nine healthy men during full body perturbations performed at baseline and immediately following high intensity exercise performed on a bicycle ergometer. In each condition, participants stood on a moveable platform during which 16 randomized postural perturbations (eight repetitions of two perturbation types: 8 cm forward slides, 8 cm backward slides) with varying inter-perturbation time intervals were performed over a period of 2-3 min. Maximal voluntary knee extension force was measured before and after the high intensity exercise protocol to confirm the presence of fatigue. Immediately after exercise, the maximal force decreased by 63% and 66% for knee extensors and flexors, respectively (P<0.0001). During the post-exercise postural perturbations, the EMG average rectified value (ARV) was significantly lower than the baseline condition for both the knee extensors (average across all muscles; baseline: 19.7±25.4μV, post exercise: 16.2±19.4 μV) and flexors (baseline: 24.3±20.9 μV, post exercise: 13.8±11.0 μV) (both P<0.05). Moreover the EMG onset was significantly delayed for both the knee extensors (baseline: 132.7±32.9 ms, post exercise: 170.8±22.9 ms) and flexors (baseline: 139.1±38.8 ms, post exercise: 179.3±50.9 ms) (both P<0.05). A significant correlation (R(2)=0.53; P<0.05) was identified between the percent reduction of knee extension MVC and the percent change in onset time of the knee extensors post exercise. This study shows that muscle fatigue induces a reduction and delay in the activation of both the quadriceps and hamstring muscles in response to rapid destabilizing perturbations potentially reducing the stability around the knee.     

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.     

Effect of hip and ankle muscle fatigue on unipedal postural control

Fatigue and deficits in postural control may predispose musculoskeletal injury. The purpose of this study was to examine the effects of fatigue at the hip and ankle during frontal plane movements on postural control during single-leg stance. Thirteen healthy volunteers completed two testing sessions 1 week apart consisting of isokinetic fatigue of the frontal plane movers of either the ankle or hip with measures of static unipedal postural control taken before and after fatigue. Postural control was assessed during three 30-s trials of unilateral stance with eyes open before and after the fatigue protocol at each testing session. Mean center of pressure (COP) excursion velocity in the sagittal and frontal planes was compared between pre- and post-fatigue across the two joints. Fatigue of the hip musculature led to postural control impairments in the frontal and sagittal planes, while fatigue of the ankle musculature did not significantly impair postural control in either plane. Our results suggest that there is a greater effect of localized fatigue of the frontal plane movers of the hip compared to the ankle on maintenance of a postural control in single-leg stance.     

Effect of a dual task on postural control in dyslexic children

Several studies have examined postural control in dyslexic children; however, their results were inconclusive. This study investigated the effect of a dual task on postural stability in dyslexic children. Eighteen dyslexic children (mean age 10.3±1.2 years) were compared with eighteen non-dyslexic children of similar age. Postural stability was recorded with a platform (TechnoConcept®) while the child, in separate sessions, made reflex horizontal and vertical saccades of 10° of amplitude, and read a text silently. We measured the surface and the mean speed of the center of pressure (CoP). Reading performance was assessed by counting the number of words read during postural measures. Both groups of children were more stable while performing saccades than while reading a text. Furthermore, dyslexic children were significantly more unstable than non-dyslexic children, especially during the reading task. Finally, the number of words read by dyslexic children was significantly lower than that of non-dyslexic children and, in contrast to the non-dyslexic children. In line with the U-shaped non-linear interaction model, we suggest that the attention consumed by the reading task could be responsible for the loss of postural control in both groups of children. The postural instability observed in dyslexic children supports the hypothesis that such children have a lack of integration of multiple sensorimotor inputs.     

Characteristics of postural sway in older adults standing on a soft surface

Postural responses to challenging situations were studied in older adults as they stood on a foam surface. The experiment was designed to assess the relative contributions made by visual and somatosensory information to the correction of postural sway. Twenty-four subjects, aged 56-83, stood for 20 s on a 1) firm or 2) foam surface with 1) the eyes open or 2) the eyes closed. Centre-of-pressure trajectories under the subjects' feet were measured by using a force platform. A repeated-measure two-way MANCOVA (two surfaces vs. two vision conditions) showed a significant main effect for the surface, but not for the vision. No covariate effect for age was found. Anterior-posterior sway increased in the subjects who were merely standing on the foam surface independent of the vision condition. Medial-lateral sway dramatically increased if the subjects stood on the foam surface with their eyes closed, but not if they stood with their eyes open. These results indicate that older adults rely more on visual information to correct mediolateral postural sway. It appears that the deterioration in visual acuity that occurs with aging may increase the risk of sideway falls, particularly in challenging situations, e.g., when standing on irregular or soft surfaces.