Effect of sensory-motor latencies and active muscular stiffness on stability for an ankle-hip model of balance on a balance board

To achieve human upright posture (UP) and avoid falls, the central nervous system processes visual, vestibular, and proprioceptive information to activate the appropriate muscles to accelerate or decelerate the body’s center of mass. In this process, sensory-motor (SM) latencies and muscular deficits, even in healthy older adults, may cause falls. This condition is worse for people with chronic neuromuscular deficits (stroke survivors, patients with multiple sclerosis or Parkinson’s disease). One therapeutic approach is to recover or improve quiet UP by utilizing a balance board (BB) (a rotating surface with a tunable stiffness and time delay), where a patient attempts to maintain UP while task difficulty is manipulated. While BBs are commonly used, it is unclear how UP is maintained or how changes in system parameters such as SM latencies and BB time delay affect UP stability. To understand these questions, it is important that mathematical models be developed with enough degrees-of-freedom to capture the many responses evoked during the maintenance of UP on a BB. This paper presents an ankle-hip model of balance on a BB, which is used to study the combined effect of SM latencies and active muscular stiffness of the ankle and hip joints, and the BB stiffness and time delay on UP stability. The analysis predicts that people with proprioceptive, visual, vestibular loss, or increased SM latencies may show either leaning postures or larger body-sway. The results show that the BB time delay and the visual and vestibular feedback have the largest impact on UP stability.     

Dynamic stability of a human standing on a balance board

The neuromuscular system used to stabilize upright posture in humans is a nonlinear dynamical system with time delays. The analysis of this system is important for improving balance and for early diagnosis of neuromuscular disease. In this work, we study the dynamic coupling between the neuromuscular system and a balance board—an unstable platform often used to improve balance in young athletes, and older or neurologically impaired patients. Using a simple inverted pendulum model of human posture on a balance board, we describe a surprisingly broad range of divergent and oscillatory CoP/CoM responses associated with instabilities of the upright equilibrium. The analysis predicts that a variety of sudden changes in the stability of upright postural equilibrium occurs with slow continuous deterioration in balance board stiffness, neuromuscular gain, and time delay associated with the changes in proprioceptive/vestibular/visual-neuromuscular feedback. The analysis also provides deeper insight into changes in the control of posture that enable stable upright posture on otherwise unstable platforms.     

Evaluation of the roles of passive and active control of balance using a balance control model

At present there is a lack of consensus regarding the relative roles of passive and active control of quiet upright stance. In the current work, this issue was investigated using two simulation models based on contemporary theories. Specifically, the two models, both of which assumed active control torques to be generated from an optimal neural controller, differed with respect to whether or not passive control torques (stiffness and damping) were included. Model parameters were specified using experimental center-of-pressure (COP) time series obtained during upright stance, and comparisons then made between simulated and actual COP-based measures. Including both active and passive joint torques in the control model did not appear to lead to any improvement in the ability to simulate COP compared with only including active joint torque. Further, simulated passive control torques were typically less than 10% of the active control torques, though some exceptions were found. These results, along with existing empirical evidence, suggest that active control torque is dominant in maintaining balance during upright stance.     

The effect of a haptic biofeedback system on postural control in patients with stroke: An experimental pilot study

Background: Impaired balance in patients with hemiparesis caused by stroke is frequently related to deficits in the central integration of afferent inputs, and traditional rehabilitation reinforces excessive visual reliance by focusing on visual compensation.

Objective: The present study investigated whether a balance task involving a haptic biofeedback (BF) system, which provided supplementary vibrotactile sensory cues associated with center-of-foot-pressure displacement, improved postural control in patients with stroke.

Methods: Seventeen stroke patients were assigned to two groups: the Vibrotactile BF and Control groups. During the balance task (i.e., standing on a foam mat), participants in the Vibrotactile BF group tried to stabilize their postural sway while wearing the BF system around the pelvic girdle. In the Control group, participants performed an identical postural task without the BF system.

Results: Pre- and post-test measurements of postural control using a force plate revealed that the stability of bipedal posture in the Vibrotactile BF group was markedly improved compared with that in the Control group.

Conclusions: A balance task involving a vibrotactile BF system improved postural stability in patients with stroke immediately. This confirms the potential of a haptic-based BF system for balance training, both in routine clinical practice and in everyday life.     

Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy

Objective:To evaluate the effects of a core stability exercise program on balance, coordination, and severity of ataxia in children with cerebellar ataxic cerebral palsy (CP).Methods:Forty children with cerebellar ataxic CP (mean age: 6.75±1.35 years) were randomly assigned to a control group and an intervention group for 2 months of follow-up. The control group received a standard physical therapy program three times weekly (1 h per session), while the intervention group received a core stability program for 30 min, in addition to the selected physical therapy program. Both groups were evaluated pre-treatment and post-treatment using the Scale for the Assessment and Rating of Ataxia, the Balance Error Scoring Systems scale, Bruininks-Oseretsky tests of motor proficiency, and HUMAC balance system scores.Results:We found statistically significant reductions in the severity of ataxia, as well as improved balance and coordination in both groups, with stronger effects observed in the intervention group (P<0.05).Conclusion:The core stability program can improve balance and coordination in children with cerebellar ataxic CP when incorporated with a standard physical therapy program.     

Responsiveness to rehabilitation of balance and gait impairment in elderly with peripheral neuropathy

Elderly people with peripheral neuropathy of the lower limbs (PNLL) demonstrate a typical balance and gait impairment because of sensory ataxia. There is evidence that rehabilitation produces important gains on balance and gait. However, responsiveness to rehabilitation of balance and gait measures is unknown in PNLL. Aim of the current work is to evaluate the responsiveness to rehabilitation of balance, gait and sensory ataxia measures in elderly with PNLL.Twenty-five elderly with PNLL attending physiotherapy and occupational therapy during inpatient rehabilitation were recruited. Balance and gait measures (including static posturography, TUG test and the 10 m walking test) were administered on admission and discharge. An accelerometer secured to the trunk was used for TUG recording and static balance assessment. Static balance was tested with open and closed eyes, so as to assess sensory ataxia.Following rehabilitation, patients improved gait [admission vs discharge, mean(SD): 0.86(0.33) vs 0.98(0.32) m/s], TUG [18.7(7.8) vs 15.1(5.2) s] and turning [46.2(15.3) vs 53.3(15.3) °/s]. However, none of 12 static balance parameters derived from trunk acceleration significantly changed. Principal component analysis showed that before training, eyes closed and eyes open balance correlated with orthogonal components (one and two vs. three and four). After training, eyes open and eyes closed balance were more similar to each other being both correlated with component one.Responsiveness to rehabilitation is larger for gait than static balance measured by trunk acceleration. However, exercise can also have a beneficial effect on sensory ataxia by making eyes closed balance more similar to eyes open balance.     

Reduction of neuromuscular redundancy for postural force generation using an intrinsic stability criterion

Postural control requires the coordination of multiple muscles to achieve both endpoint force production and postural stability. Multiple muscle activation patterns can produce the required force for standing, but the mechanical stability associated with any given pattern may vary, and has implications for the degree of delayed neural feedback necessary for postural stability. We hypothesized that muscular redundancy is reduced when muscle activation patterns are chosen with respect to intrinsic musculoskeletal stability as well as endpoint force production. We used a three-dimensional musculoskeletal model of the cat hindlimb with 31 muscles to determine the possible contributions of intrinsic muscle properties to limb stability during isometric force generation. Using dynamic stability analysis we demonstrate that within the large set of activation patterns that satisfy the force requirement for posture, only a reduced subset produce a mechanically stable limb configuration. Greater stability in the frontal-plane suggests that neural control mechanisms are more highly active for sagittal-plane and for ankle joint control. Even when the limb was unstable, the time-constants of instability were sufficiently great to allow long-latency neural feedback mechanisms to intervene, which may be preferential for movements requiring maneuverability versus stability. Local joint stiffness of muscles was determined by the stabilizing or destabilizing effects of moment-arm versus joint angle relationships. By preferentially activating muscles with high local stiffness, muscle activation patterns with feedforward stabilizing properties could be selected. Such a strategy may increase intrinsic postural stability without co-contraction, and may be useful criteria in the force-sharing problem.     

Decreased lower limb muscle recruitment contributes to the inability of older adults to recover with a single step following a forward loss of balance

In response to a balance disturbance, older individuals often require multiple steps to prevent a fall. Reliance on multiple steps to recover balance is predictive of a future fall, so studies should determine the mechanisms underlying differences between older adults who can and cannot recover balance with a single step. This study compared neural activation parameters of the major leg muscles during balance recovery from a sudden forward loss of balance in older individuals capable of recovering with a single step and those who required multiple steps to regain balance. Eighty-one healthy, community dwelling adults aged 70 ± 3 participated. Loss of balance was induced by releasing participants from a static forward lean. Participants performed four trials at three initial lean magnitudes and were subsequently classified as single or multiple steppers. Although step length was shorter in multiple compared to single steppers (F = 9.64; p = 0.02), no significant differences were found between groups in EMG onset time in the step limb muscles (F = 0.033–0.769; p = 0.478–0.967). However, peak EMG normalised to values obtained during maximal voluntary contraction was significantly higher in single steppers in 6 of the 7 stepping limb muscles (F = 1.054–4.167; p = 0.045–0.024). These data suggest that compared to multiple steppers, single steppers recruit a larger proportion of the available motor unit pool during balance recovery. Thus, modulation of EMG amplitude plays a larger role in balance recovery than EMG timing in this context.     

Effects of two passive back-support exoskeletons on postural balance during quiet stance and functional limits of stability

While occupational back-support exoskeletons (BSEs) are considered as potential workplace interventions, BSE use may compromise postural control. Thus, we investigated the effects of passive BSEs on postural balance during quiet upright stance and functional limits of stability. Twenty healthy adults completed trials of quiet upright stance with differing levels of difficulty (bipedal and unipedal stance; each with eyes open and closed), and executed maximal voluntary leans. Trials were done while wearing two different BSEs (SuitX™, Laevo™) and in a control (no-BSE) condition. BSE use significantly increased center-of-pressure (COP) median frequency and mean velocity during bipedal stance. In unipedal stance, using the Laevo™ was associated with a significant improvement in postural balance, especially among males, as indicated by smaller COP displacement and sway area, and a longer time to contact the stability boundary. BSE use may affect postural balance, through translation of the human + BSE center-of-mass, restricted motion, and added supportive torques. Furthermore, larger effects of BSEs on postural balance were evident among males. Future work should further investigate the gender-specificity of BSE effects on postural balance and consider the effects of BSEs on dynamic stability.     

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.     

Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy

Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support. Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesized that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects. Seventeen UPVD patients and 17 healthy subjects performed six tasks on a force plate: forwards and backwards leaning, to determine limits of stability, and upright standing with and without Achilles tendon vibration, each with eyes open and closed (with blackout glasses). The COP displacement of the patients was significantly greater in the vibration tasks than the controls and came closer to the posterior base of support boundary than the controls in all tasks. Achilles tendon vibration led to a distinctly more backward sway in both subject groups. Five of the patients could not complete the eyes closed with vibration task. Due to the greater reduction in stance stability when the proprioceptive, compared with the visual, sensory system was disturbed, we suggest that proprioception may be more important for maintaining upright stance than vision. UPVD patients, in particular, showed more difficulty in controlling postural stability in the posterior direction with visual and proprioceptive sensory disturbance.     

感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响

目的:探讨感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响。方法:选取2016年1月到2017年12月期间成都市妇女儿童中心医院康复科收治的痉挛型脑瘫患儿80例为研究对象,根据随机数字表法将80例患儿分为对照组(40例)和观察组(40例)。对照组患儿采用常规康复训练进行治疗,观察组患儿采用感觉统合训练结合常规康复训练进行治疗。比较两组脑瘫患儿的平衡控制功能、步态、粗大运动功能测试量表-88(GMFM-88)D区和E区的评分。结果:治疗3个月后两组患儿的Rivermead活动指数、Berg平衡量表得分均明显升高,且观察组患儿的Rivermead活动指数、Berg平衡量表得分高于对照组(P0.05)。治疗3个月后两组患儿的步行足长、步速明显增加,步宽明显减小(P0.05),且观察组患儿步行足长、步速大于对照组,步宽小于对照组(P0.05)。治疗3个月后两组患儿的GMFM-88 D区、GMFM-88 E区得分均分别明显升高(P0.05),且观察组患儿的GMFM-88 D区、GMFM-88 E区得分均分别高于对照组(P0.05)。结论:感觉统合训练结合常规康复训练可有效改善痉挛型脑瘫患儿的平衡控制功能、步态以及粗大运动功能。     

Magnitude of forward trunk flexion influences upper limb muscular efforts and dynamic postural stability requirements during sitting pivot transfers in individuals with spinal cord injury

The purpose of this study was to investigate the effects of imposing different degrees of forward trunk flexion during sitting pivot transfers on electromyographic activity at the leading and trailing upper limb muscles and on dynamic stability requirements. Thirty-two individuals with a spinal cord injury performed three types of sitting pivot transfers: natural technique, exaggerated forward trunk flexion and upright trunk position. Ground reaction forces, trunk kinematics, and bilateral electromyographic activity of eight upper limb muscles were recorded. Electromyographic data were analyzed using the area under the curve of the muscular utilization ratio. Dynamic stability requirements of sitting pivot transfers were assess using a dynamic equilibrium model. Compared to the natural strategy, significantly greater muscle activities were found for the forward trunk flexion condition at the anterior deltoid and both heads of the pectorialis major, whereas the upright trunk strategy yielded greater muscle activity at the latissimus dorsii and the triceps. The forward flexed condition was found to be more dynamically stable, with a lower stabilizing force, increased area of base of support and greater distance traveled. Thus, transferring with a more forward trunk inclination, even though it increases work of few muscles, may be a beneficial trade-off because increased dynamic stability of this technique and versatility in terms of potential distance of the transfer.     

核心力量训练对篮球专业大学生平衡控制能力及血液某些生化指标的影响*

目的:观察12周的核心力量训练对篮球专业大学生受试者平衡控制能力及血液某些生化指标的影响。方法:对14名受试者进行每周3次,每次90 min,为期12周的核心力量训练,所有受试者在训练前1周及训练第12周后进行睁眼和闭眼状态下的左右腿单脚站立重心移动面积和重心移动速度等平衡能力指标及BU、CK、WBC、HB、T、C和T/C等常规生化指标测试。结果:①12周的核心力量训练后睁眼和闭眼状态下的左右脚重心移动面积和移动速度都较训练前非常显著性降低(P＜0.01);②睁眼及闭眼状态下的左右脚重心移动面积和移动速度在训练前及训练后均存在明显的差异性和不平衡性(P＜0.01)。③核心力量训练后睁眼及闭眼状态下的双侧重心移动面积差异都较训练前有所减小,其中睁眼状态下的双侧重心移动面积差异较训练前明显减小(P＜0.01);而睁眼及闭眼状态下的双侧重心移动速度差异都较训练前有所变大,且睁眼状态下的双侧重心移动速度差异较训练前明显增大(P＜0.01)。④核心力量训练后BU和CK较训练前明显降低(P＜0.05),WBC、HB、T和C较训练前大幅升高(P＞ 0.05),T/C较训练前则轻微地降低(P＞0.05)。结论:12周的核心力量训练有助于篮球专业大学生下肢平衡控制能力的提高,机体对训练负荷适应能力的增强,使身体机能保持在较好的水平。     

Applying heat and mass balance theory to determine the flow rate for the measurement of benthic material flux in a flow-through system

Movement of water overlying the sediments has not been taken into consideration in most of the experiments conducted to estimate the dissolved material flux from the sediment. Even in recent experiments that incorporated the stirring motion, interpretation of the data is difficult, because the mixing rate used may be different from actual mixing rate in the field. We propose a method to estimate the in situ mixing rate that should be used to set the flow rate in a flow-through core incubation system. The flow rate is calculated from the vertical mixing rate of the water that is deduced from the heat diffusivity. Release rates of NO₃+NO₂–N obtained from our flow-through incubation system were higher by 1–3 orders of magnitude than those from the conventional diffusion calculation method that estimates the flux from the gradient of nutrient concentration across the sediment-water interface. Increase in NO₃+NO₂–N flux is considered to be due to intensification of the nitrification process as a result of an increase in dissolved oxygen (DO) supply with the motion of water. DO supply is also considered to be an important factor controlling macrofaunal abundance and consequently their excretory contributions to the fluxes of dissolved organic nitrogen as well as NH₄–N. From this point of view, we strongly recommend the application of heat and mass balance theory to estimate nitrogen flux using a flow-through experimental system.     

Study of a combined sulfur autotrophic with proton-exchange membrane electrodialytic denitrification technology: sulfate control and pH balance

A novel combined system established for nitrate removal from aqueous solution consisted of two parts: sulfur autotrophic denitrification and bio-electrochemical denitrification based on proton-exchange membrane electrodialysis (PEMED). The system was operated at various hydraulic retention times (HRT) and current intensities. Its optimum operation condition was also determined. The combined process had pH adjustment thus generating less nitrite than PEMED process. The denitrification rate of sulfur autotrophic part was dependent on HRT, while shorter HRT could reduce the sulfate generated by the sulfur autotrophic process. The denitrification rate of PEMED process depended on the applied current. For 32 ± 1 mg-N/L nitrate in influent, the optimum operation parameters of combined process were: HRT 2 h; applied current 350 mA. The combined reactor could achieve 95.8% nitrate removal without nitrite accumulation, the pH of effluent kept neutral and the sulfate of effluent was 202.1 mg/L, lower than the drinking water standard in China.     

Ecological studies to assess the efficacy of biological control on populations of alligator weed and lippia

Abstract  The risk of non-target effects from biological control agents can be reduced if we can better identify effective agents prior to release. Introducing only those agents with high potential for effective control will reduce the number of agents released and reduce the probability of both direct and indirect non-target impacts. Identifying effective agents requires understanding the roles that resources, disturbances and herbivory play in regulating plant populations under natural field conditions. Here we propose a series of experiments that will contrast the mechanisms of population regulation of two invasive wetland plants, alligator weed ( Alternanthera philoxeroides ) and lippia ( Phyla canescens ), with native congener species, Alternanthera denticulata and Phyla nodiflora . We hypothesise that the native plants will have greater growth rates when nutrients are low and herbivores are present, whereas the introduced plants will exhibit greater growth rates when nutrients are high and herbivores are absent.     

长江中游地区生态系统服务平衡与城镇化的空间关系

生态系统服务与城镇化的相互作用关系研究是目前国际人地系统研究的热点和前沿领域。以长江中游地区325个县为研究单元,通过生态系统服务供需平衡评估矩阵法与城镇化相关指标分别测算了1995年、2005年、2015年生态系统服务平衡状况和城镇化水平,同时运用双变量空间自相关模型、空间计量模型探索了生态系统服务平衡与城镇化的空间关系。研究结果表明：（1）研究期间长江中游地区生态系统服务平衡状况不断恶化,而城镇化水平则持续上升;（2）生态系统服务平衡与城镇化之间存在显著负相关关系,不同区域的空间聚类模式表现出异质性;（3）添加控制变量的空间计量模型被证明能更好解释生态系统服务平衡与城镇化的空间关系,结果显示城镇化对态系统服务平衡的影响具有负外部效应,这种负外部效应在城镇化发展到一定阶段时逐渐减弱。建议,在城镇化进程中应统筹管理生态空间,尝试跨区域合作,实现生态与经济资源的共享与互补。     

An in vitro model to assess mechanisms and efficacy of a cellular conduit for treatment of avascular meniscal injuries

Tears in the avascular portion of the knee meniscus are commonplace and are frequently incapable of healing spontaneously. Delivery of synovial cells from the meniscal periphery to avascular injuries can result in an effective healing response but is difficult to accomplish surgically. This report describes the development of a novel in vitro model comprised of three-dimensionally cultured cells in agarose used to assess the proof of concept that a cellular conduit device could be used to facilitate the delivery of synovial fibroblasts from a cell source to a remote acellular recipient site. The results indicate that synovial fibroblasts are capable of migrating through a cellular conduit more optimally than a created trephined channel over a clinically relevant distance in response to a chemotactic gradient. This model proved to be a reliable way to assess fibroblast-like synoviocyte migration in a clinically relevant fashion for application to avascular meniscal tear healing methodologies, and provided mechanistic information regarding the successful in vivo testing of this specific biomedical device.     

An automated method to morph finite element whole-body human models with a wide range of stature and body shape for both men and women

Field data analyses have shown that small female, obese, and/or older occupants are at increased risks of death and serious injury in motor-vehicle crashes compared with mid-size young men. The current adult finite element (FE) human models represent occupants in the same three body sizes (large male, mid-size male, and small female) as those for the contemporary adult crash dummies. Further, the time needed to develop an FE human model using the traditional method is measured in months or even years. In the current study, an improved regional mesh morphing method based on landmark-based radial basis function (RBF) interpolation was developed to rapidly morph a mid-size male FE human model into different geometry targets. A total of 100 human models with a wide range of human attributes were generated. A pendulum chest impact condition was applied to each model as an initial assessment of the resulting variability in response. The morphed models demonstrated mesh quality similar to the baseline model. The peak impact forces and chest deflections in the chest pendulum impacts varied substantially with different models, supportive of consideration of population variation in evaluating the occupant injury risks. The method developed in this study will enable future safety design optimizations targeting at various vulnerable populations that cannot be considered with the current models.