Relationship between quiet standing position and perceptibility of standing position in the anteroposterior direction

We investigated the relationship between an individual's center of pressure in the anteroposterior direction in quiet standing (QS) and perceptibility of different standing positions. The position of the center of pressure in the anteroposterior direction (CoPy position) while standing was represented as the percentage distance (%FL) from the hindmost point of the heel in relation to foot length. CoPy position in QS was located from 31 to 58%FL. Perceptibility of standing position was evaluated by the difference between the reference position and the subject's attempt to reproduce that position. Subjects were tested for their ability to reproduce reference positions selected randomly from a total of 13 positions at 5%FL increments from 20 to 80%FL. Using an approximation formula curve, we identified the relationship between reference position and reproduction absolute error. The standing position range with reproduction error exceeding 90% of the difference between the maximum and minimum errors was defined as the low perceptibility range of standing position. The approximation curve had one peak near QS. CoPy positions in QS were located in the low perceptibility range, except for five subjects with a more posterior location. The correlation coefficient between CoPy positions in QS (x) and reference position (y) showing maximum error was 0.70 and the regression line was y=0.464x+28.2; the intersection point with y=x was 53%FL. Reproduction absolute errors in reference positions at 20-30%FL and 70-80%FL were significantly smaller than those at 40-60%FL (p<0.05). We concluded the following. (1) Standing positions showing the lowest perceptibility are located close to the QS position; however, in subjects whose QS position is located more posteriorly, the standing position showing maximum error is more anterior. (2) Perceptibility of extreme forward- and backward-leaning positions is very high and independent of individual QS position.     

Transcapillary fluid transfer and plasma volume changes in response to quiet standing and LBNP

Quiet standing is one of the conditions of daily life. Still, it may lead to acute circulatory failure even in normal man, a phenomenon ascribed mainly to the early large pooling of blood and secondary decrease in central blood volume. Reduction of plasma volume (PV) by filtration in dependent regions apparently contributes, but there is no indication that this process is of major importance during short periods of standing still in normal life. Hence, studies have indicated that the plasma fluid loss occurs at relatively slow rate due to the presence of protective mechanisms that prevent rapid fluid loss.     

Design and simulation of a pneumatic, stored-energy, hybrid orthosis for gait restoration

Loss of mobility due to lower limb paralysis is a common result of thoracic level spinal cord injury. Functional electrical stimulation (FES) can restore primitive gait in the vicinity of a wheelchair by using electrical stimulation to generate muscle contractions. A new concept for FES-assisted gait is presented that combines electrical stimulation with an orthosis that contains a fluid power system to store and transfer energy during the gait cycle. The energy storage orthosis (ESO) can be driven through a complete gait cycle using only stimulation of the quadriceps muscles. The conceptual design of the ESO was completed and implemented in a dynamic simulation model and in a benchtop prototype for engineering measurements. No studies were conducted with human subjects. The results demonstrate the potential of the ESO concept for a feasible gait-assist system and the validity of the simulation model as a means for designing the system.     

Analysis of two components of the human center of mass trajectory in quiet standing

The assumption that two subsystems control the balance during quiet standing in humans is considered. Their function is to control the slow movement of the reference point and rapid stabilization of the center of mass (COM) relative to this point. A method allowing the COM trajectory to be divided into the corresponding two components, which was developed earlier, has been used to analyze and compare the time patterns of these processes. The results of this analysis have shown that the movement of the reference point is dominant in terms of the oscillation amplitude. Therefore, the oscillations of the COM trajectory reflect the slow movement of the reference point and are practically unrelated to the stabilization of the COM relative to this point. The possibility of applying the decomposition of the COM trajectory into components to fundamental and clinical research is discussed.     

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.     

Reweighting of sensory inputs to control quiet standing in children from 7 to 11 and in adults

How sensory organization for postural control matures in children is not clear at this time. The present study examined, in children aged 7 to 11 and in adults, the postural control modifications in quiet standing when somatosensory inputs from the ankle were disturbed. Since the reweighting of sensory inputs is not mature before 10, we hypothesized that postural stability was more affected in children than in adults when somatosensory inputs were altered and that this postural instability decreased as age increased during childhood. 37 children aged 7 to 11 years and 9 adults participated in the experiments. The postural task was a semi-tandem position with the right foot in front of the left one. Postural performance was measured by means of a force platform. Two experimental conditions were presented to the participants to maintain quiet standing: With or without altered somatosensory inputs (i.e., with or without ankles vibration). Results showed that postural stability--and thus how the reweighting process of the visual/somatosensory inputs matured--increased non-monotonically between 7 years of age and adult age: There was a linear improvement of postural stability from 7 to 10, followed by a more steady behaviour between 10 and 11 and then postural stability increased to reach the adults' level of performance.     

Effects of lower-leg rhythmic cuff inflation on cardiovascular autonomic responses during quiet standing in healthy subjects

To determine the effects of muscle pump function on cardiac autonomic activity in response to quiet standing, we simulated the muscle pump effect by rhythmic lower-leg cuff inflation (RCI) with four cuff pressures of 0 (sham), 40, 80, and 120 mmHg at 5 cycles/min. The R-R interval (RRI) and beat-to-beat blood pressure (BP) were acquired in healthy subjects (6 males and 5 females, aged 21-24 yr). From the continuous BP measurement, stroke volume (SV) was calculated by a pulse-contour method. Using spectral and cross-spectral analysis, RRI and systolic BP variability as well as the gain of spontaneous cardiac baroreflex sensitivity (sBRS) were estimated for the low- and high-frequency (HF) bands. Compared with the sham condition, RCI with cuff pressures of 80 and 120 mmHg led to increases in the mean RRI (P < 0.01) and HF power of RRI fluctuation (P < 0.05 for 80 mmHg and P < 0.01 for 120 mmHg) during quiet standing. Reduction in SV during standing was suppressed, and the sBRS of the HF band for standing were increased by RCI for either cuff pressure (P < 0.05 for 80 mmHg and P < 0.01 for 120 mmHg). However, at 40 mmHg RCI, these remained unchanged. These results suggest that, during standing, RCI of the lower leg increases cardiac vagal outflow when the cuff pressure is raised enough to oppose the hydrostatic-induced venous pressure in the calf.     

The effect of training on endurance and the cardiovascular responses of individuals with paraplegia during dynamic exercise induced by functional electrical stimulation

Endurance for dynamic exercise, cardiac output, blood pressure, heart rate, ventilation, and oxygen consumption was measured in eight individuals with paraplegia at the end of 4-min bouts of exercise on a friction braked cycle ergometer. Movement of the subjects' legs was induced by electrically stimulating the quadriceps, gluteus maximus and hamstring muscles with a computer-controlled biphasic square--wave current at a frequency of 30 Hz. The friction braked cycle ergometer was pedalled at work rates which varied between 0 and 40 W. Measurements were repeated after 3 and 6 months to assess the affect of training. After 3 months of training it was found that endurance increased from 8 min at a work rate of 0 W to 30 min at a work rate of 40 W. Compared to the cardiovascular responses in non-paralyzed subjects, computerized cycle ergometry was found to be associated with higher relative stresses for a given level of absolute work. Mean blood pressure, for example, increased by over 30% during maximal work in individuals with paralysis compared to the typical response obtained for able-bodied subjects. Analysis of the data showed that instead of the 20-30% metabolic efficiency commonly reported for cycle ergometry, the calculated metabolic efficiency during computer-controlled cycle ergometry was only 3.6%.     

Electrical stimulation in multiple sclerosis. Comparison of transcutaneous electrical stimulation and epidural spinal cord stimulation

Forty-nine multiple sclerosis patients with bladder symptoms and/or walking disability were subjected to a therapeutic trial with electrical spinal cord stimulation and transcutaneous electrical stimulation, a second aim being to compare these two treatments. A clear subjective improvement in bladder symptoms was achieved in the majority of the cases, and this was substantiated by objective parameters. In a proportion of cases a more moderate improvement seems to have been achieved in a variety of symptoms. Transcutaneous electrical stimulation seems to be a useful selection procedure for later electrical spinal cord stimulation.     

A general-purpose microprocessor system for medical instrumentation and electrical stimulation

The article describes the design of a user-defined multipurpose system based on the Zilog Z-80, 8-bit microprocessor. The basic concept comprises a mainframe with a keyboard/display interface for communication between user and system. Different types of instrumentation equipment can be obtained using the same mainframe; only the contents of the program memory have to be changed. Up to seven programmable input/output boards can be installed. Some special-purpose boards are constructed to improve the versatility of the system. The major advantage of the presented system is that it can be applied at any time in the laboratory in an experiment or in the hospital for diagnostic or therapeutic purposes, without the engagement of existing computer memory.