The effect of short-term changes in body mass distribution on feed-forward postural control

It was recently shown that short-term changes in the whole body mass and associated changes in the vertical position of the center of mass (COM) modify anticipatory postural adjustments (APAs) [Li X, Aruin AS. The effect of short-term changes in the body mass on anticipatory postural adjustments. Exp Brain Res 2007;181:333–46]. In this study, we investigated whether changes in the body mass distribution and related changes in the anterior–posterior COM position affect APA generation. Fourteen subjects were instructed to catch a 2.2 kg load with their arms extended while standing with no additional weight or while carrying a 9.08 kg weight. Adding weight to a backpack, front pack or belly pocket was associated with an increase of the whole body mass, but it also involved changes in the anterior–posterior (A/P) and vertical positions of the COM. Electromyographic activity of leg and trunk muscles, body kinematics, and ground reaction forces were recorded and quantified within the typical time intervals of APAs. APAs were modified in conditions with changed body mass distribution: increased magnitude of anticipatory EMG activity in leg and trunk muscles, as well as co-activation of leg muscles and decreased anticipatory displacement of the COM in the vertical direction, were seen in conditions with increased body mass. Changes in the COM position induced in both A/P and vertical directions were associated with increased anticipatory EMG activity. In addition, they were linked to a co-activation of muscles at the ankle joints and significant changes in the center of pressure (COP) position. Modifications of the COM position induced in the A/P direction were related to increased anticipatory EMG activity in the leg and trunk muscles. At the same time, no significant differences in anticipatory EMG activity or displacement of COP were observed when changes of COM position were induced in the vertical direction. The study outcome suggests that the CNS uses different strategies while generating APAs in conditions with changes in the COM position induced in the anterior–posterior and vertical directions.     

Sway-dependent modulation of the triceps surae H-reflex during standing.

Previous research has shown that changes in spinal excitability occur during the postural sway of quiet standing. In the present study, it was of interest to examine the independent effects of sway position and sway direction on the efficacy of the triceps surae Ia pathway, as reflected by the Hoffman (H)-reflex amplitude, during standing. Eighteen participants, tested under two different experimental protocols, stood quietly on a force platform. Percutaneous electrical stimulation was applied to the posterior tibial nerve when the position and direction of anteroposterior (A-P) center of pressure (COP) signal satisfied the criteria for the various experimental conditions. It was found that, regardless of sway position, a larger amplitude of the triceps surae H-reflex (difference of 9-14%; P = 0.005) occurred when subjects were swaying in the forward compared with the backward direction. The effects of sway position, independent of the sway direction, on spinal excitability exhibited a trend (P = 0.075), with an 8.9 +/- 3.7% increase in the H-reflex amplitude occurring when subjects were in a more forward position. The observed changes to the efficacy of the Ia pathway cannot be attributed to changes in stimulus intensity, as indicated by a constant M-wave amplitude, or to the small changes in the level of background electromyographic activity. One explanation for the changes in reflex excitability with respect to the postural sway of standing is that the neural modulation may be related to the small lengthening and shortening contractions occurring in the muscles of the triceps surae.     

Lateral dynamic balance reactions to circular translation of the visual field

Lateral sway of subjects in spontaneous dynamic balance conditions on a seesaw platform was measured during a visual stimulation monocularly produced by a rotating glass covered with a prism membrane. Prism rotation induced the perception of a circular translation of the whole visual field and an ocular pursuit movement. Therefore, the retinal slip that occurs in normal pursuit was cancelled. Strong stereo-typed postural reactions were observed in a direction that depended upon both the vertical visual field deviation and the eye stimulated: upper position of the right visual field induced a leftward sway resulting from an extension of the right hemibody; symmetrical reactions occurred for the left stimulation. The results suggest that the postural reactions recorded depend on the isolated oculomotor activity and, in addition, on retinal afferences corresponding to the temporal crescent of the stimulated side, which orientates the postural reaction on the homolateral lower limb muscles.     

Dominant side in single-leg stance stability during floor oscillations at various frequencies

Background

We investigated lateral dominance in the postural stability of single-leg stance with anteroposterior floor oscillations at various frequencies.

Methods

Thirty adults maintained a single-leg stance on a force platform for 20 seconds per trial. Trials were performed with no oscillation (static condition) and with anteroposterior floor oscillations (2.5-cm amplitude) at six frequencies: 0.25, 0.5, 0.75, 1.0, 1.25 and 1.5 Hz (dynamic condition). A set of three trials was performed on each leg in each oscillation frequency in random order. The mean speed of the center of pressure in the anteroposterior direction (CoP_ap) was calculated as an index of postural stability, and frequency analysis of CoP_ap sway was performed. Footedness for carrying out mobilizing activities was assessed with a questionnaire.

Results

CoP_ap speed exponentially increased as oscillation frequency increased in both legs. The frequency analysis of CoP_ap showed a peak <0.3 Hz at no oscillation. The frequency components at 0.25-Hz oscillation included common components with no oscillation and those at 1.5-Hz oscillation showed the maximum amplitude among all conditions. Postural stability showed no significant difference between left- and right-leg stance at no oscillation and oscillations ≤1.25 Hz, but at 1.5-Hz oscillation was significantly higher in the right-leg stance than in the left-leg stance. For the lateral dominance of postural stability at individual levels, the lateral difference in postural stability at no oscillation was positively correlated with that at 0.25-Hz oscillation (r = 0.51) and negatively correlated with that at 1.5-Hz oscillation (r = -0.53). For 70% of subjects, the dominant side of postural stability was different at no oscillation and 1.5-Hz oscillation. In the subjects with left- or right-side dominance at no oscillation, 94% or 38% changed their dominant side at 1.5-Hz oscillation, with a significant difference between these percentages. In the 1.5-Hz oscillation, 73% of subjects had concordance between the dominant side of postural stability and that of mobilizing footedness.

Conclusion

In static conditions, there was no lateral dominance of stability during single-leg stance. At 1.5-Hz oscillation, the highest frequency, right-side dominance of postural stability was recognized. Functional role in supporting leg may be divided between left and right legs according to the change of balance condition from static to dynamic.     

Assessment of influence of breath holding and hyperventilation on human postural stability with spectral analysis of stabilographic signal

The influence of breath holding and voluntary hyperventilation on the traditional stabilometric parameters and the frequency characteristics of stabilographic signal was studied. We measured the stabilometric parameters on a force platform (“Ritm”, Russia) in the 107 healthy volunteers during quiet breath, voluntary hyperventilation (20 seconds) and maximal inspiratory breath holding (20 seconds). Respiratory frequency, respiratory amplitude and ventilation were estimated with the strain gauge. We found that antero-posterior and medio-lateral sway amplitude and velocity as well as sway surface during breath holding and during quiet breathing were the same, so breath holding didn’t influence the postural stability. However, the spectral parameters in the antero-posterior direction shifted to the high frequency range due to an alteration of the respiratory muscles’ contractions during breath holding versus quiet breath. Voluntary hyperventilation caused a significant increase of all stabilographic indices that implied an impairment of the postural stability. We also found that the spectral indices shifted toward the high-frequency range, and this shift was much greater compared to that during breath holding. Besides, amplitudes of the spectral peaks also increased. Perhaps, such change of the spectral indices was due to distortion of the proprioceptive information because of increased excitability of the nerve fibers during hyperventilation. Maximal inspiratory breath holding caused an activation of the postural control mechanisms. It was manifested as an elevation of the sway oscillations’ frequency with no postural stability changes. Hyperventilation led to the greatest strain of the postural control and to a decrease of the postural stability, which was manifested as an increase of center of pressure oscillations’ amplitude and frequency.     

Early postural adjustments in preparation to whole-body voluntary sway

We studied postural adjustments associated with a quick voluntary postural sway under two conditions, self-paced and simple reaction-time. Standing subjects were required to produce quick discrete shifts of the center of pressure (COP) forward. About 400-500 ms prior to the instructed COP shift, there were deviations of the COP in the opposite direction (backwards) accompanied by changes in the activation levels of several postural muscles. Under the reaction-time conditions, the timing of those early postural adjustments did not change (repeated measures MANOVA: p > 0.05) while its magnitude increased significantly (confirmed by repeated measures MANOVA: p < 0.05). These observations are opposite to those reported for anticipatory postural adjustments under simple reaction time conditions (a significant change in the timing without major changes in the magnitude). We conclude that there are two types of feed-forward postural adjustments. Early postural adjustments prepare the body for the planned action and/or expected perturbation. Some of these preparatory actions may be mechanically necessary. Later, anticipatory postural adjustments generate net forces and moments of force acting against those associated with the expected perturbation. Both types of adjustments fit well the referent configuration hypothesis, which offers a unified view on movement-posture control.     

Human postural responses to different frequency vibrations of lower leg muscles

We analyzed human postural responses to muscle vibration applied at four different frequencies to lower leg muscles, the lateral gastrocnemius (GA) or tibialis anterior (TA) muscles. The muscle vibrations induced changes in postural orientation characterized by the center of pressure (CoP) on the force platform surface on which the subjects were standing. Unilateral vibratory stimulation of TA induced body leaning forward and in the direction of the stimulated leg. Unilateral vibration of GA muscles induced body tilting backwards and in the opposite direction of the stimulated leg. The time course of postural responses was similar and started within 1 s after the onset of vibration by a gradual body tilt. When a new slope of the body position was reached, oscillations of body alignment occurred. When the vibrations were discontinued, this was followed by rapid recovery of the initial body position. The relationship between the magnitude of the postural response and frequency of vibration differed between TA and GA. While the magnitude of postural responses to TA vibration increased approximately linearly in the 60-100 Hz range of vibration frequency, the magnitude of response to GA vibration increased linearly only at lower frequencies of 40-60 Hz. The direction of body tilt induced by muscle vibration did not depend on the vibration frequency.     

How experienced alpine-skiers cope with restrictions of ankle degrees-of-freedom when wearing ski-boots in postural exercises

The present study investigates the mechanisms underlying changes in postural strategy that occur to compensate for mechanical ankle joint restrictions induced by wearing ski-boots during postural exercises. Fourteen experienced skiers were asked to stand as still as possible in a stable (STA) posture and in 2 postures with instability in the medio/lateral and antero/posterior (ML and AP postures) direction. Postural tasks were performed with eyes open or closed and while wearing or not wearing ski-boots. The electromyographic (EMG) activity of representative lower limb muscles and positions of centre-of-foot pressure (COP) were recorded and analyzed. Our results illustrated enhanced postural performances with ski-boots in the STA posture, whereas postural performances remained unchanged when wearing ski-boots in the ML and AP postures. Analysis of COP sways in the frequency domain did not illustrate any modification in the contribution of different neuronal loops when the study subjects wore ski-boots. EMG showed that the mechanical effects of wearing ski-boots were compensated by changes in postural strategy through the reorganization of muscle coordination, made possible by inherent redundancies in the human body. The preservation of postural performances, despite restrictions of ankle degrees-of-freedom induced by ski-boots, emphasizes the subjects’ capacity to exploit the additional support provided by ski-boots by adequately adjusting muscle coordination to control posture in different balance conditions.     

The effects of early stages of aging on postural sway: A multiple domain balance assessment using a force platform

Technical advancements in instrumentation and analytical methods have improved the ability of assessing balance control. This study investigated the effects of early stages of aging on postural sway using traditional and contemporary postural indices from different domains. Eleven healthy young adults and fourteen healthy non-faller older adults performed two postural tasks: (a) functional limits of stability and (b) unperturbed bipedal stance for 120 s. Postural indices from spatial, temporal, frequency, and structural domains were extracted from the body’s center of pressure (COP) signals and its Rambling and Trembling components. Results revealed a preservation of functional limits of upright stability in older adults accompanied by larger, faster, and shakier body sway in both anterior-posterior and medio-lateral directions; increased medio-lateral sway frequency; increased irregularity of body sway pattern in time in both directions; and increased area, variability, velocity, and jerkiness of both rambling and trembling components of the COP displacement in the anterior-posterior direction (p < 0.02). Such changes might be interpreted as compensatory adjustments to the age-related decline of sensory, neural, and motor functions. In conclusion, balance assessment using postural indices from different domains extracted from the COP displacement was able to capture subtle effects of the natural process of aging on the mechanisms of postural control. Our findings suggest the use of such indices as potential markers for postural instability and fall risk in older adults.     

Muscle synergies during shifts of the center of pressure by standing persons: identification of muscle modes

When a standing person performs a movement such that the center of gravity shifts, the activity of postural muscles adjusts to keep the balance. We assume that such adjustments are controlled using a small set of central variables, while each variable induces changes in the activity of a subgroup of postural muscles. The purpose of this study has been to identify such muscle groups (muscle modes or M-modes) and compare them across tasks and subjects. Four tasks required the subjects to release a load from extended arms leading to a center of pressure (COP) shift prior to the load release. The fifth task required an explicit COP shift by voluntary sway. Electromyographic activity of 11 postural muscles on one side of the body was integrated over a 100-ms interval corresponding to the early stage of the COP shift, and this integrated EMG activity was subjected to a principal component (PC) analysis across multiple repetitions of each task. Three PCs were identified and associated with a push-back M-mode, a push-forward M-mode, and a mixed M-mode. Cluster analysis of the PC vectors across tasks and across subjects confirmed the existence of distinctive push-forward and push-back muscle groups. PC vectors were also compared across tasks and across subjects using cosines as a measure of colinearity between pairs of vectors. In general, M-modes were similar across both tasks and subjects. We conclude that shifts of the COP, whether implicit or explicit, are controlled using a small set of central variables associated with changes in the activity of robust subsets of postural muscles. These results can be used for future analysis of muscle synergies associated with postural tasks.     

Chaos in Balance: Non-Linear Measures of Postural Control Predict Individual Variations in Visual Illusions of Motion

Visually-induced illusions of self-motion (vection) can be compelling for some people, but they are subject to large individual variations in strength. Do these variations depend, at least in part, on the extent to which people rely on vision to maintain their postural stability? We investigated by comparing physical posture measures to subjective vection ratings. Using a Bertec balance plate in a brightly-lit room, we measured 13 participants'' excursions of the centre of foot pressure (CoP) over a 60-second period with eyes open and with eyes closed during quiet stance. Subsequently, we collected vection strength ratings for large optic flow displays while seated, using both verbal ratings and online throttle measures. We also collected measures of postural sway (changes in anterior-posterior CoP) in response to the same visual motion stimuli while standing on the plate. The magnitude of standing sway in response to expanding optic flow (in comparison to blank fixation periods) was predictive of both verbal and throttle measures for seated vection. In addition, the ratio between eyes-open and eyes-closed CoP excursions during quiet stance (using the area of postural sway) significantly predicted seated vection for both measures. Interestingly, these relationships were weaker for contracting optic flow displays, though these produced both stronger vection and more sway. Next we used a non-linear analysis (recurrence quantification analysis, RQA) of the fluctuations in anterior-posterior position during quiet stance (both with eyes closed and eyes open); this was a much stronger predictor of seated vection for both expanding and contracting stimuli. Given the complex multisensory integration involved in postural control, our study adds to the growing evidence that non-linear measures drawn from complexity theory may provide a more informative measure of postural sway than the conventional linear measures.     

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.     

Relationship of multiscale entropy to task difficulty and sway velocity in healthy young adults

Abstract

Purpose/background: Multiscale entropy (MSE) is a nonlinear measure of postural control that quantifies how complex the postural sway is by assigning a complexity index to the center of pressure (COP) oscillations. While complexity has been shown to be task dependent, the relationship between sway complexity and level of task challenge is currently unclear. This study tested whether MSE can detect short-term changes in postural control in response to increased standing balance task difficulty in healthy young adults and compared this response to that of a traditional measure of postural steadiness, root mean square of velocity (VRMS).

Methods: COP data from 20?s of quiet stance were analyzed when 30 healthy young adults stood on the following surfaces: on floor and foam with eyes open and closed and on the compliant side of a Both Sides Up (BOSU) ball with eyes open. Complexity index (CompI) was derived from MSE curves.

Results: Repeated measures analysis of variance across standing conditions showed a statistically significant effect of condition (p?<?0.001) in both the anterior–posterior and medio-lateral directions for both CompI and VRMS. In the medio-lateral direction there was a gradual increase in CompI and VRMS with increased standing challenge. In the anterior–posterior direction, VRMS showed a gradual increase whereas CompI showed significant differences between the BOSU and all other conditions. CompI was moderately and significantly correlated with VRMS.

Conclusions: Both nonlinear and traditional measures of postural control were sensitive to the task and increased with increasing difficulty of standing balance tasks in healthy young adults.     

Human postural response to lower leg muscle vibration of different duration

Body lean response to bilateral vibrations of soleus muscles were investigated in order to understand the influence of proprioceptive input from lower leg in human stance control. Proprioceptive stimulation was applied to 17 healthy subjects by two vibrators placed on the soleus muscles. Frequency and amplitude of vibration were 60 Hz and 1 mm, respectively. Vibration was applied after a 30 s of baseline. The vibration duration of 10, 20, 30 s respectively was used with following 30 s rest. Subjects stood on the force platform with eyes closed. Postural responses were characterized by center of pressure (CoP) displacements in the anterior-posterior (AP) direction. The CoP-AP shifts as well as their amplitudes and velocities were analyzed before, during and after vibration. Vibration of soleus muscles gradually increased backward body tilts. There was a clear dependence of the magnitude of final CoP shift on the duration of vibration. The amplitude and velocity of body sway increased during vibration and amplitude was significantly modulated by duration of vibration as well. Comparison of amplitude and velocity of body sway before and after vibration showed significant post-effects. Presented findings showed that somatosensory stimulation has a long-term, direction-specific influence on the control of postural orientation during stance. Further, the proprioceptive input altered by soleus muscles vibration showed significant changes in postural equilibrium during period of vibration with interesting post-effects also.     

Shannon and Renyi entropies to classify effects of Mild Traumatic Brain Injury on postural sway

Background

Mild Traumatic Brain Injury (mTBI) has been identified as a major public and military health concern both in the United States and worldwide. Characterizing the effects of mTBI on postural sway could be an important tool for assessing recovery from the injury.

Methodology/Principal Findings

We assess postural sway by motion of the center of pressure (COP). Methods for data reduction include calculation of area of COP and fractal analysis of COP motion time courses. We found that fractal scaling appears applicable to sway power above about 0.5 Hz, thus fractal characterization is only quantifying the secondary effects (a small fraction of total power) in the sway time series, and is not effective in quantifying long-term effects of mTBI on postural sway. We also found that the area of COP sensitively depends on the length of data series over which the COP is obtained. These weaknesses motivated us to use instead Shannon and Renyi entropies to assess postural instability following mTBI. These entropy measures have a number of appealing properties, including capacity for determination of the optimal length of the time series for analysis and a new interpretation of the area of COP.

Conclusions

Entropy analysis can readily detect postural instability in athletes at least 10 days post-concussion so that it appears promising as a sensitive measure of effects of mTBI on postural sway.

Availability

The programs for analyses may be obtained from the authors.     

Is the attenuation effect on the ankle muscles activity from the EMG biofeedback generalized to – or compensated by – other lower limb muscles during standing?

Biofeedback based on electromyograms (EMGs) has been recently proposed to reduce exaggerated postural activity. Whether the effect of EMG biofeedback on the targeted muscles generalizes to – or is compensated by – other muscles is still an open question we address here. Fourteen young individuals were tested in three 60 s standing trials, without and with EMG-audio feedback: (i) collectively from soleus and medial gastrocnemius and (ii) from medial gastrocnemii. The Root Mean Square (RMS) of bipolar EMGs sampled from postural muscles bilaterally was computed to assess the degree of activity and postural sway was assessed from the center of pressure (CoP). In relation to standing at naturally, EMG-audio feedback from soleus and medial gastrocnemii decreased plantar flexors’ activity (∼10 %) but at the cost of increased amplitude of tibialis anterior (∼5%) and vasti muscles (∼20 %) accompanied by a posterior shift of the mean CoP position. However, EMG-audio feedback from medial gastrocnemii reduced only plantar flexors’ activity (∼5%) when compared to standing at naturally. Current results suggest the EMG biofeedback has the potential to reduce calf muscles’ activity without loading other postural muscles especially when using medial gastrocnemii as feedback source, with implications on postural training aimed at assisting individuals in activating more efficiently postural muscles during standing.     

Synergistic co-activation in multi-directional postural control in humans

To examine the muscle synergies of multi-directional postural control, we calculated the target-directed variance fraction (η) and net action direction of each muscle using the electromyogram-weighted averaging (EWA) method. Subjects stood barefoot on a force platform and maintained their posture by producing a center of pressure (COP) in twelve target directions. Surface electromyograms were recorded from 6 right-sided muscles: tibialis anterior (TA), soleus (SOL), lateral gastrocnemius (LG), medial gastrocnemius (MG), fibularis longus (FL), and gluteus medius (GM). η was calculated from COP with duration of 20-s, during which the COP was relatively constant. The EWA method was applied to the EMG and the two COP components to estimate the net action direction of each muscle. The results showed that η values in all directions did not cross the 0.8 threshold. This suggests that human postural control is achieved by synergistic co-activation. The EWA revealed that the net action directions of TA, SOL, LG, MG, and GM were 277.6°, 71.1°, 87.7°, 94.0°, and 2.2°, respectively. This suggests that postural maintenance by muscle synergy can be attributed to the relevant muscles having various action directions. These results demonstrate that muscle synergies can be investigated using COP fluctuations.     

Modeling human postural sway using an intermittent control and hemodynamic perturbations

Ground reaction force during human quiet stance is modulated synchronously with the cardiac cycle through hemodynamics [1]. This almost periodic hemodynamic force induces a small disturbance torque to the ankle joint, which is considered as a source of endogenous perturbation that induces postural sway. Here we consider postural sway dynamics of an inverted pendulum model with an intermittent control strategy, in comparison with the traditional continuous-time feedback controller. We examine whether each control model can exhibit human-like postural sway, characterized by its power law behavior at the low frequency band 0.1–0.7 Hz, when it is weakly perturbed by periodic and/or random forcing mimicking the hemodynamic perturbation. We show that the continuous control model with typical feedback gain parameters hardly exhibits the human-like sway pattern, in contrast with the intermittent control model. Further analyses suggest that deterministic, including chaotic, slow oscillations that characterize the intermittent control strategy, together with the small hemodynamic perturbation, could be a possible mechanism for generating the postural sway.     

Electromyographic and kinematic studies of tail movements during falling in cats

When falling from an inverted position, EMG activities of tail muscles (the m. extensor caudae lateralis, m. abductor caudae externus, m. flexor caudae longus) and tail movements were recorded in 7 long-tailed adult cats. After being released from an elevated position, cat rotates the tail in a reverse direction to rotation of other parts of the cat's body then lands on four legs. Rotation of the tail was started by EMG activities of the tail muscles on one side. Both synchronized and alternating groups of discharge occur between its left and right side, while extensor and flexor movements and displacements of its tail appear in the air. After transection of ventral roots from the coccygeal spinal segments innervating tail muscles, cats often fail to land on four legs. These facts suggest that that tail movements control body balance in the air when falling from an inverted position.