A model-based approach to stabilizing crutch supported paraplegic standing by artificial hip joint stiffness.

PubMed

van der Spek, Jaap H; Veltink, Peter H; Hermens, Hermie J; Koopman, Bart F J M; Boom, Herman B K

2003-12-01

The prerequisites for stable crutch supported standing were analyzed in this paper. For this purpose, a biomechanical model of crutch supported paraplegic stance was developed assuming the patient was standing with extended knees. When using crutches during stance, the crutches will put a position constraint on the shoulder, thus reducing the number of degrees of freedom. Additional hip-joint stiffness was applied to stabilize the hip joint and, therefore, to stabilize stance. The required hip-joint stiffness for changing crutch placement and hip-joint offset angle was studied under static and dynamic conditions. Modeling results indicate that, by using additional hip-joint stiffness, stable crutch supported paraplegic standing can be achieved, both under static as well as dynamic situations. The static equilibrium postures and the stability under perturbations were calculated to be dependent on crutch placement and stiffness applied. However, postures in which the hip joint was in extension (C postures) appeared to the most stable postures. Applying at least 60 N x m/rad hip-joint stiffness gave stable equilibrium postures in all cases. Choosing appropriate hip-joint offset angles, the static equilibrium postures changed to more erect postures, without causing instability or excessive arm forces to occur.

Postflight Quiet Stance Stability of Astronauts Following Recovery From a Simulated Fall

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Kofman, I. S.; Fisher, E. A.; Cerisano, J. M.; Lawrence, E. L.; Peters, B. T.; Harm, D. L.; Kulecz, W.; Mulavara, A. P.; Fiedler, M. J.;

Assessment of postural instability in patients with Parkinson's disease.

PubMed

Błaszczyk, J W; Orawiec, R; Duda-Kłodowska, D; Opala, G

2007-10-01

Postural instability is one of the most disabling features of idiopathic Parkinson's disease (PD). In this study, we focused on postural instability as the main factor predisposing parkinsonians to falls. For this purpose, changes in sway characteristics during quiet stance due to visual feedback exclusion were studied. We searched for postural sway measures that could be potential discriminators for an increased fall risk. A group of 110 subjects: 55 parkinsonians (Hoehn and Yahr: 1-3), and 55 age-matched healthy volunteers participated in the experiment. Their spontaneous sway characteristics while standing quiet with eyes open and eyes closed were analyzed. We found that an increased mediolateral sway and sway area while standing with eyes closed are characteristic of parkinsonian postural instability and may serve to quantify well a tendency to fall. These sway indices significantly correlated with disease severity rated both by the Hoehn and Yahr scale as well as by the Motor Section of the UPDRS. A forward shift of a mean COP position in parkinsonians which reflects their flexed posture was also significantly greater to compare with the elderly subjects and exhibited a high sensitivity to visual conditions. Both groups of postural sway abnormalities identified here may be used as accessible and reliable measures which allow for quantitative assessment of postural instability in Parkinson's disease.

Static and dynamic posture control in postlingual cochlear implanted patients: effects of dual-tasking, visual and auditory inputs suppression

PubMed Central

Bernard-Demanze, Laurence; Léonard, Jacques; Dumitrescu, Michel; Meller, Renaud; Magnan, Jacques; Lacour, Michel

2014-01-01

Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body's position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. This study was aimed at evaluating the effects of postlingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static (stable platform) and dynamic (platform in translation) conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the CI activated (ON) or not (OFF). Results showed that the postural performance of the CI patients strongly differed from the controls, mainly in the EC condition. The CI patients showed significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk: they behaved dynamically without vision like an inverted pendulum while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well as dual-tasking did not really improve the dynamic postural performance of the CI patients. We conclude that CI patients become strongly visual dependent mainly in challenging postural conditions, a result they have to be awarded of particularly when getting older. PMID:24474907

Static and dynamic posture control in postlingual cochlear implanted patients: effects of dual-tasking, visual and auditory inputs suppression.

PubMed

Bernard-Demanze, Laurence; Léonard, Jacques; Dumitrescu, Michel; Meller, Renaud; Magnan, Jacques; Lacour, Michel

2013-01-01

Posture control is based on central integration of multisensory inputs, and on internal representation of body orientation in space. This multisensory feedback regulates posture control and continuously updates the internal model of body's position which in turn forwards motor commands adapted to the environmental context and constraints. The peripheral localization of the vestibular system, close to the cochlea, makes vestibular damage possible following cochlear implant (CI) surgery. Impaired vestibular function in CI patients, if any, may have a strong impact on posture stability. The simple postural task of quiet standing is generally paired with cognitive activity in most day life conditions, leading therefore to competition for attentional resources in dual-tasking, and increased risk of fall particularly in patients with impaired vestibular function. This study was aimed at evaluating the effects of postlingual cochlear implantation on posture control in adult deaf patients. Possible impairment of vestibular function was assessed by comparing the postural performance of patients to that of age-matched healthy subjects during a simple postural task performed in static (stable platform) and dynamic (platform in translation) conditions, and during dual-tasking with a visual or auditory memory task. Postural tests were done in eyes open (EO) and eyes closed (EC) conditions, with the CI activated (ON) or not (OFF). Results showed that the postural performance of the CI patients strongly differed from the controls, mainly in the EC condition. The CI patients showed significantly reduced limits of stability and increased postural instability in static conditions. In dynamic conditions, they spent considerably more energy to maintain equilibrium, and their head was stabilized neither in space nor on trunk: they behaved dynamically without vision like an inverted pendulum while the controls showed a whole body rigidification strategy. Hearing (prosthesis on) as well as dual-tasking did not really improve the dynamic postural performance of the CI patients. We conclude that CI patients become strongly visual dependent mainly in challenging postural conditions, a result they have to be awarded of particularly when getting older.

Mechanical effort predicts the selection of ankle over hip strategies in nonstepping postural responses

PubMed Central

Jonkers, Ilse; De Schutter, Joris; De Groote, Friedl

2016-01-01

Experimental studies have shown that a continuum of ankle and hip strategies is used to restore posture following an external perturbation. Postural responses can be modeled by feedback control with feedback gains that optimize a specific objective. On the one hand, feedback gains that minimize effort have been used to predict muscle activity during perturbed standing. On the other hand, hip and ankle strategies have been predicted by minimizing postural instability and deviation from upright posture. It remains unclear, however, whether and how effort minimization influences the selection of a specific postural response. We hypothesize that the relative importance of minimizing mechanical work vs. postural instability influences the strategy used to restore upright posture. This hypothesis was investigated based on experiments and predictive simulations of the postural response following a backward support surface translation. Peak hip flexion angle was significantly correlated with three experimentally determined measures of effort, i.e., mechanical work, mean muscle activity and metabolic energy. Furthermore, a continuum of ankle and hip strategies was predicted in simulation when changing the relative importance of minimizing mechanical work and postural instability, with increased weighting of mechanical work resulting in an ankle strategy. In conclusion, the combination of experimental measurements and predictive simulations of the postural response to a backward support surface translation showed that the trade-off between effort and postural instability minimization can explain the selection of a specific postural response in the continuum of potential ankle and hip strategies. PMID:27489362

Effect of aging on dynamic postural stability and variability during a multi-directional lean and reach object transportation task.

PubMed

Huntley, Andrew H; Zettel, John L; Vallis, Lori Ann

2016-01-01

A "reach and transport object" task that represents common activities of daily living may provide improved insight into dynamic postural stability and movement variability deficits in older adults compared to previous lean to reach and functional reach tests. Healthy young and older, community dwelling adults performed three same elevation object transport tasks and two multiple elevation object transport tasks under two self-selected speeds, self-paced and fast-paced. Dynamic postural stability and movement variability was quantified by whole-body center of mass motion. Older adults demonstrated significant decrements in frontal plane stability during the multiple elevation tasks while exhibiting the same movement variability as their younger counterparts, regardless of task speed. Interestingly, older adults did not exhibit a tradeoff in maneuverability in favour of maintaining stability throughout the tasks, as has previously been reported. In conclusion, the multi-planar, ecologically relevant tasks employed in the current study were specific enough to elucidate decrements in dynamic stability, and thus may be useful for assessing fall risk in older adults with suspected postural instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The arm posture in children with unilateral Cerebral Palsy is mainly related to antero-posterior gait instability.

PubMed

Meyns, Pieter; Duysens, Jacques; Desloovere, Kaat

2016-09-01

In this observational case-control study we aimed to determine whether altered arm postures in children with unilateral CP (uniCP) are related to gait instability in a specific direction. Antero-posterior and medio-lateral Foot Placement Estimator instability measures and arm posture measures (vertical and antero-posterior hand position, sagittal and frontal upper arm elevation angle) were determined in eleven uniCP (7 years-10 months) and twenty-four typically developing children (9 years-6 months) at two walking speeds. Spearman-rank correlation analyses were made to examine the relationship between antero-posterior and medio-lateral arm posture and gait instability. Arm posture in both planes was related to antero-posterior instability (e.g. sagittal and frontal upper arm elevation angle correlated moderately with antero-posterior instability; R=0.41, p<0.001, R=-0.47, p<0.001). In uniCP, increased antero-posterior instability was associated with a higher (R=-0.62, p=0.002) and more frontal position of the hemiplegic hand (R=-0.58, p=0.005), while the non-hemiplegic upper arm was rotated more backward (R=0.63, p=0.002) and both upper arms rotated more sideways (hemiplegic: R=-0.58, p=0.004; non-hemiplegic: R=-0.55, p=0.008). The altered non-hemiplegic (sagittal and frontal) arm posture in uniCP may be a compensation to reduce antero-posterior gait instability. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigating the anticipatory postural adjustment phase of gait initiation in different directions in chronic ankle instability patients.

PubMed

Ebrahimabadi, Zahra; Naimi, Sedigheh Sadat; Rahimi, Abbas; Sadeghi, Heydar; Hosseini, Seyed Majid; Baghban, Alireza Akbarzadeh; Arslan, Syed Asadullah

2018-01-01

The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions. A total of 20 chronic ankle instability participants and 20 healthy individuals initiated gait on a force plate in forward, 30° lateral, and 30° medial directions. According to the results of the present study, the peak lateral center of pressure shift decreased in forward direction compared to that in other directions in both groups. Also, it was found that the peak lateral center of pressure shift and the vertical center of mass velocity decreased significantly in chronic ankle instability patients, as compared with those of the healthy individuals. According to the results of the present study, it seems that chronic ankle instability patients modulate the anticipatory postural adjustment phase of gait initiation, compared with healthy control group, in order to maintain postural stability. These changes were observed in different directions, too. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cinerama sickness and postural instability.

PubMed

Bos, Jelte E; Ledegang, Wietse D; Lubeck, Astrid J A; Stins, John F

2013-01-01

Motion sickness symptoms and increased postural instability induced by motion pictures have been reported in a laboratory, but not in a real cinema. We, therefore, carried out an observational study recording sickness severity and postural instability in 19 subjects before, immediately and 45 min after watching a 1 h 3D aviation documentary in a cinema. Sickness was significantly larger right after the movie than before, and in a lesser extent still so after 45 min. The average standard deviation of the lateral centre of pressure excursions was significantly larger only right afterwards. When low-pass filtered at 0.1 Hz, lateral and for-aft excursions were both significantly larger right after the movie, while for-aft excursions then remained larger even after 45 min. Speculating on previous findings, we predict more sickness and postural instability in 3D than in 2D movies, also suggesting a possible, but yet unknown risk for work-related activities and vehicle operation. Watching motion pictures may be sickening and posturally destabilising, but effects in a cinema are unknown. We, therefore, carried out an observational study showing that sickness then is mainly an issue during the exposure while postural instability is an issue afterwards.

Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability.

PubMed

Wikstrom, Erik A; Song, Kyeongtak; Lea, Ashley; Brown, Nastassia

2017-07-01

  One of the major concerns after an acute lateral ankle sprain is the potential for development of chronic ankle instability (CAI). The existing research has determined that clinician-delivered plantar massage improves postural control in those with CAI. However, the effectiveness of self-administered treatments and the underlying cause of any improvements remain unclear.   To determine (1) the effectiveness of a self-administered plantar-massage treatment in those with CAI and (2) whether the postural-control improvements were due to the stimulation of the plantar cutaneous receptors.   Crossover study.   University setting.   A total of 20 physically active individuals (6 men and 14 women) with self-reported CAI.   All participants completed 3 test sessions involving 3 treatments: a clinician-delivered manual plantar massage, a patient-delivered self-massage with a ball, and a clinician-delivered sensory brush massage.   Postural control was assessed using single-legged balance with eyes open and the Star Excursion Balance Test.   Static postural control improved (P ≤ .014) after each of the interventions. However, no changes in dynamic postural control after any of the interventions were observed (P > .05). No differences were observed between a clinician-delivered manual plantar massage and either a patient-delivered self-massage with a ball or a clinician-delivered sensory brush massage in any postural-control outcome.   In those with CAI, single 5-minute sessions of traditional plantar massage, self-administered massage, and sensory brush massage each resulted in comparable static postural-control improvements. The results also provide empirical evidence suggesting that the mechanism for the postural-control improvements is the stimulation of the plantar cutaneous receptors.

Postural Instability Induced by Visual Motion Stimuli in Patients With Vestibular Migraine

PubMed Central

Lim, Yong-Hyun; Kim, Ji-Soo; Lee, Ho-Won; Kim, Sung-Hee

2018-01-01

Patients with vestibular migraine are susceptible to motion sickness. This study aimed to determine whether the severity of posture instability is related to the susceptibility to motion sickness. We used a visual motion paradigm with two conditions of the stimulated retinal field and the head posture to quantify postural stability while maintaining a static stance in 18 patients with vestibular migraine and in 13 age-matched healthy subjects. Three parameters of postural stability showed differences between VM patients and controls: RMS velocity (0.34 ± 0.02 cm/s vs. 0.28 ± 0.02 cm/s), RMS acceleration (8.94 ± 0.74 cm/s2 vs. 6.69 ± 0.87 cm/s2), and sway area (1.77 ± 0.22 cm2 vs. 1.04 ± 0.25 cm2). Patients with vestibular migraine showed marked postural instability of the head and neck when visual stimuli were presented in the retinal periphery. The pseudo-Coriolis effect induced by head roll tilt was not responsible for the main differences in postural instability between patients and controls. Patients with vestibular migraine showed a higher visual dependency and low stability of the postural control system when maintaining quiet standing, which may be related to susceptibility to motion sickness. PMID:29930534

Postural Instability Induced by Visual Motion Stimuli in Patients With Vestibular Migraine.

PubMed

Lim, Yong-Hyun; Kim, Ji-Soo; Lee, Ho-Won; Kim, Sung-Hee

2018-01-01

Patients with vestibular migraine are susceptible to motion sickness. This study aimed to determine whether the severity of posture instability is related to the susceptibility to motion sickness. We used a visual motion paradigm with two conditions of the stimulated retinal field and the head posture to quantify postural stability while maintaining a static stance in 18 patients with vestibular migraine and in 13 age-matched healthy subjects. Three parameters of postural stability showed differences between VM patients and controls: RMS velocity (0.34 ± 0.02 cm/s vs. 0.28 ± 0.02 cm/s), RMS acceleration (8.94 ± 0.74 cm/s 2 vs. 6.69 ± 0.87 cm/s 2 ), and sway area (1.77 ± 0.22 cm 2 vs. 1.04 ± 0.25 cm 2 ). Patients with vestibular migraine showed marked postural instability of the head and neck when visual stimuli were presented in the retinal periphery. The pseudo-Coriolis effect induced by head roll tilt was not responsible for the main differences in postural instability between patients and controls. Patients with vestibular migraine showed a higher visual dependency and low stability of the postural control system when maintaining quiet standing, which may be related to susceptibility to motion sickness.

Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective?

PubMed

McKeon, Patrick O; Hertel, Jay

2008-01-01

To answer the following clinical questions: (1) Can prophylactic balance and coordination training reduce the risk of sustaining a lateral ankle sprain? (2) Can balance and coordination training improve treatment outcomes associated with acute ankle sprains? (3) Can balance and coordination training improve treatment outcomes in patients with chronic ankle instability? PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Only studies assessing the influence of balance training on the primary outcomes of risk of ankle sprain or instrumented postural control measures derived from testing on a stable force plate using the modified Romberg test were included. Studies had to provide results for calculation of relative risk reduction and numbers needed to treat for the injury prevention outcomes or effect sizes for the postural control measures. We calculated the relative risk reduction and numbers needed to treat to assess the effect of balance training on the risk of incurring an ankle sprain. Effect sizes were estimated with the Cohen d for comparisons of postural control performance between trained and untrained groups. Prophylactic balance training substantially reduced the risk of sustaining ankle sprains, with a greater effect seen in those with a history of a previous sprain. Completing at least 6 weeks of balance training after an acute ankle sprain substantially reduced the risk of recurrent ankle sprains; however, consistent improvements in instrumented measures of postural control were not associated with training. Evidence is lacking to assess the reduction in the risk of recurrent sprains and inconclusive to demonstrate improved instrumented postural control measures in those with chronic ankle instability who complete balance training. Balance training can be used prophylactically or after an acute ankle sprain in an effort to reduce future ankle sprains, but current evidence is insufficient to assess this effect in patients with chronic ankle instability.

Cybersickness without the wobble: Experimental results speak against postural instability theory.

PubMed

Dennison, Mark Stephen; D'Zmura, Michael

2017-01-01

It has been suggested that postural instability is necessary for cybersickness to occur. Seated and standing subjects used a head-mounted display to view a virtual tunnel that rotated about their line of sight. We found that the offset direction of perceived vertical settings matched the direction of the tunnel's rotation, so replicating earlier findings. Increasing rotation speed caused cybersickness to increase, but had no significant impact on perceived vertical settings. Postural sway during rotation was similar to postural sway during rest. While a minority of subjects exhibited postural sway in response to the onset of tunnel rotation, the majority did not. Furthermore, cybersickness increased with rotation speed similarly for the seated and standing conditions. Finally, subjects with greater levels of cybersickness exhibited less variation in postural sway. These results lead us to conclude that the link between postural instability and cybersickness is a weak one in the present experiment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Postural Stability in Older Adults With Alzheimer Disease.

PubMed

Mesbah, Normala; Perry, Meredith; Hill, Keith D; Kaur, Mandeep; Hale, Leigh

2017-03-01

The prevalence of adults with Alzheimer disease (AD) aged >65 years is increasing and estimated to quadruple by 2051. The aim of this study was to investigate postural stability in people with mild to moderate AD and factors contributing to postural instability compared with healthy peers (controls). A computerized systematic search of databases and a hand search of reference lists for articles published from 1984 onward (English-language articles only) were conducted on June 2, 2015, using the main key words "postural stability" and "Alzheimer's disease." Sixty-seven studies were assessed for eligibility (a confirmed diagnosis of AD, comparison of measured postural stability between participants with AD and controls, measured factors potentially contributing to postural instability). Data were extracted, and Downs and Black criteria were applied to evaluate study quality. Eighteen articles were analyzed using qualitative synthesis and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Strength of evidence was guided by the Grading of Recommendations Assessment, Development and Evaluation. Strong evidence was found that: (1) older adults with mild to moderate AD have reduced static and functional postural stability compared with healthy peers (controls) and (2) attentional demand during dual-task activity and loss of visual input were key factors contributing to postural instability. Deta-analysis was not possible due to heterogeneity of the data. Postural stability is impaired in older adults with mild to moderate AD. Decreasing visual input and concentrating on multiple tasks decrease postural stability. To reduce falls risk, more research discerning appropriate strategies for the early identification of impairment of postural stability is needed. Standardization of population description and consensus on outcome measures and the variables used to measure postural -instability and its contributing factors are necessary to ensure meaningful synthesis of data. © 2017 American Physical Therapy Association

Systematic Review of Postural Control and Lateral Ankle Instability, Part II: Is Balance Training Clinically Effective

PubMed Central

McKeon, Patrick O; Hertel, Jay

2008-01-01

Objective: To answer the following clinical questions: (1) Can prophylactic balance and coordination training reduce the risk of sustaining a lateral ankle sprain? (2) Can balance and coordination training improve treatment outcomes associated with acute ankle sprains? (3) Can balance and coordination training improve treatment outcomes in patients with chronic ankle instability? Data Sources: PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Study Selection: Only studies assessing the influence of balance training on the primary outcomes of risk of ankle sprain or instrumented postural control measures derived from testing on a stable force plate using the modified Romberg test were included. Studies had to provide results for calculation of relative risk reduction and numbers needed to treat for the injury prevention outcomes or effect sizes for the postural control measures. Data Extraction: We calculated the relative risk reduction and numbers needed to treat to assess the effect of balance training on the risk of incurring an ankle sprain. Effect sizes were estimated with the Cohen d for comparisons of postural control performance between trained and untrained groups. Data Synthesis: Prophylactic balance training substantially reduced the risk of sustaining ankle sprains, with a greater effect seen in those with a history of a previous sprain. Completing at least 6 weeks of balance training after an acute ankle sprain substantially reduced the risk of recurrent ankle sprains; however, consistent improvements in instrumented measures of postural control were not associated with training. Evidence is lacking to assess the reduction in the risk of recurrent sprains and inconclusive to demonstrate improved instrumented postural control measures in those with chronic ankle instability who complete balance training. Conclusions: Balance training can be used prophylactically or after an acute ankle sprain in an effort to reduce future ankle sprains, but current evidence is insufficient to assess this effect in patients with chronic ankle instability. PMID:18523567

The effect of visual-vestibulosomatosensory conflict induced by virtual reality on postural stability in humans.

PubMed

Nishiike, Suetaka; Okazaki, Suzuyo; Watanabe, Hiroshi; Akizuki, Hironori; Imai, Takao; Uno, Atsuhiko; Kitahara, Tadashi; Horii, Arata; Takeda, Noriaki; Inohara, Hidenori

2013-01-01

In this study, we examined the effects of sensory inputs of visual-vestibulosomatosensory conflict induced by virtual reality (VR) on subjective dizziness, posture stability and visual dependency on postural control in humans. Eleven healthy young volunteers were immersed in two different VR conditions. In the control condition, subjects walked voluntarily with the background images of interactive computer graphics proportionally synchronized to their walking pace. In the visual-vestibulosomatosensory conflict condition, subjects kept still, but the background images that subjects experienced in the control condition were presented. The scores of both Graybiel's and Hamilton's criteria, postural instability and Romberg ratio were measured before and after the two conditions. After immersion in the conflict condition, both subjective dizziness and objective postural instability were significantly increased, and Romberg ratio, an index of the visual dependency on postural control, was slightly decreased. These findings suggest that sensory inputs of visual-vestibulosomatosensory conflict induced by VR induced motion sickness, resulting in subjective dizziness and postural instability. They also suggest that adaptation to the conflict condition decreases the contribution of visual inputs to postural control with re-weighing of vestibulosomatosensory inputs. VR may be used as a rehabilitation tool for dizzy patients by its ability to induce sensory re-weighing of postural control.

Difference in postural control between patients with functional and mechanical ankle instability.

PubMed

Chen, Henry; Li, Hong-Yun; Zhang, Jian; Hua, Ying-Hui; Chen, Shi-Yi

2014-10-01

Lateral ankle sprain is one of the most common injuries. Since the structural and pathological differences in mechanical ankle instability (MAI) and functional ankle instability (FAI) may not be the same, it may be better to treat these as separate groups. The purpose of this study was to compare the difference in postural sway between MAI and FAI in patients with chronic ankle instability (CAI). Twenty-six patients with CAI and 14 healthy control participants were included in the study. The CAI patients were subdivided into MAI (15 patients) and FAI (11 patients) groups. Patients who were diagnosed with lateral ankle ligaments rupture by magnetic resonance imaging and ultrasonography were assigned to the MAI group. All participants performed single-limb postural sway tests 3 times on each leg with eyes closed and open. The average distances from the mean center of pressure position in the mediolateral and anteroposterior directions were recorded and compared among the 3 groups. The unstable ankles in the MAI group showed significantly greater postural sway in the anterior, posterior, and medial directions compared with those in the control group with eyes closed. With eyes open, significantly greater postural sway was found in the anterior direction. In the FAI group, no difference was found in postural sway compared with those in the control group. The MAI group showed significantly greater postural sway in the anterior direction compared with the FAI group with eyes closed and open. No significant difference in postural sway was found between the unstable and stable ankles in the MAI or FAI groups, with or without vision. Patients with MAI have deficits in postural control, especially in anterior-posterior directions. However, no difference was found in postural sway in patients with FAI compared with healthy people. As MAI patients suffer from deficits in postural control, balance training should be applied in those patients. In addition, special training should also include the contralateral side after a unilateral ankle ligament injured. © The Author(s) 2014.

Postural control assessment in students with normal hearing and sensorineural hearing loss.

PubMed

Melo, Renato de Souza; Lemos, Andrea; Macky, Carla Fabiana da Silva Toscano; Raposo, Maria Cristina Falcão; Ferraz, Karla Mônica

2015-01-01

Children with sensorineural hearing loss can present with instabilities in postural control, possibly as a consequence of hypoactivity of their vestibular system due to internal ear injury. To assess postural control stability in students with normal hearing (i.e., listeners) and with sensorineural hearing loss, and to compare data between groups, considering gender and age. This cross-sectional study evaluated the postural control of 96 students, 48 listeners and 48 with sensorineural hearing loss, aged between 7 and 18 years, of both genders, through the Balance Error Scoring Systems scale. This tool assesses postural control in two sensory conditions: stable surface and unstable surface. For statistical data analysis between groups, the Wilcoxon test for paired samples was used. Students with hearing loss showed more instability in postural control than those with normal hearing, with significant differences between groups (stable surface, unstable surface) (p<0.001). Students with sensorineural hearing loss showed greater instability in the postural control compared to normal hearing students of the same gender and age. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Effects of joint mobilization on chronic ankle instability: a randomized controlled trial.

PubMed

Cruz-Díaz, David; Lomas Vega, Rafael; Osuna-Pérez, Maria Catalina; Hita-Contreras, Fidel; Martínez-Amat, Antonio

2015-01-01

To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported instability of patients with chronic ankle instability (CAI). A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p < 0.001). The effect sizes of group-by-time interaction, measured with eta-squared, oscillated between 0.954 for DFROM and 0.288 for SEBT posteromedial distance. In within-group analysis, the manipulation group showed an improvement at 6 months follow-up in CAIT [mean = 5.23, CI 95% (4.63-5.84)], DFROM [mean = 6.77, CI 95% (6.45-7.08)], anterior SEBT [mean = 7.35, CI 95% (6.59-8.12)], posteromedial SEBT [mean = 3.32, CI 95% (0.95-5.69)], and posterolateral SEBT [mean = 2.55, CI 95% (2.20-2.89)]. Joint mobilization techniques applied to subjects suffering from CAI were able to improve ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability. Implications for Rehabilitation Functional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities. The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history. ROM restriction, subjective feeling of instability and dynamic postural control are benefiting from the joint mobilization application.

The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction.

PubMed

Li, Hong-Yun; Zheng, Jie-Jiao; Zhang, Jian; Cai, Ye-Hua; Hua, Ying-Hui; Chen, Shi-Yi

2016-04-01

Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability. A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients. At 6 months after the operation, with the patients' eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation. Postural control was improved by reconstructing the lateral ligaments. IV.

Disruption of postural readaptation by inertial stimuli following space flight

NASA Technical Reports Server (NTRS)

Black, F. O.; Paloski, W. H.; Reschke, M. F.; Igarashi, M.; Guedry, F.; Anderson, D. J.

1999-01-01

Postural instability (relative to pre-flight) has been observed in all shuttle astronauts studied upon return from orbital missions. Postural stability was more closely examined in four shuttle astronaut subjects before and after an 8 day orbital mission. Results of the pre- and post-flight postural stability studies were compared with a larger (n = 34) study of astronauts returning from shuttle missions of similar duration. Results from both studies indicated that inadequate vestibular feedback was the most significant sensory deficit contributing to the postural instability observed post flight. For two of the four IML-1 astronauts, post-flight postural instability and rate of recovery toward their earth-normal performance matched the performance of the larger sample. However, post-flight postural control in one returning astronaut was substantially below mean performance. This individual, who was within normal limits with respect to postural control before the mission, indicated that recovery to pre-flight postural stability was also interrupted by a post-flight pitch plane rotation test. A similar, though less extreme departure from the mean recovery trajectory was present in another astronaut following the same post-flight rotation test. The pitch plane rotation stimuli included otolith stimuli in the form of both transient tangential and constant centripetal linear acceleration components. We inferred from these findings that adaptation on orbit and re-adaptation on earth involved a change in sensorimotor integration of vestibular signals most likely from the otolith organs.

Postural stability of biped robots and the foot-rotation indicator (FRI) point

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goswami, A.

1999-06-01

The focus of this paper is the problem of foot rotation in biped robots during the single-support phase. Foot rotation is an indication of postural instability, which should be carefully treated in a dynamically stable walk and avoided altogether in a statically stable walk. The author introduces the foot-rotation indicator (FRI) point, which is a point on the foot/ground-contact surface where the net ground-reaction force would have to act to keep the foot stationary. To ensure no foot rotation, the FRI point must remain within the convex hull of the foot-support area. In contrast with the ground projection of themore » center of mass (GCoM), which is a static criterion, the FRI point incorporates robot dynamics. As opposed to the center of pressure (CoP) -- better known as the zero-moment point (ZMP) in the robotics literature -- which may not leave the support area, the FRI point may leave the area. In fact, the position of the FRI point outside the footprint indicates the direction of the impending rotation and the magnitude of rotational moment acting on the foot. Owing to these important properties, the FRI point helps not only to monitor the state of postural stability of a biped robot during the entire gait cycle, but indicates the severity of instability of the gait as well. In response to a recent need, the paper also resolves the misconceptions surrounding the CoP/ZMP equivalence.« less

The Effect of Joint Mobilization on Dynamic Postural Control in Patients With Chronic Ankle Instability: A Critically Appraised Topic.

PubMed

Kosik, Kyle B; Gribble, Phillip A

2018-01-01

Clinical Scenario: Dorsiflexion range of motion is an important factor in the performance of the Star Excursion Balance Test (SEBT). While patients with chronic ankle instability (CAI) commonly experience decreased reach distances on the SEBT, ankle joint mobilization has been suggested to be an effective therapeutic intervention for targeting dorsiflexion range of motion. What is the evidence to support ankle joint mobilization for improving performance on the SEBT in patients with CAI? Summary of Key Findings: The literature was searched for articles examining the effects of ankle joint mobilization on scores of the SEBT. A total of 3 peer-reviewed articles were retrieved, 2 prospective individual cohort studies and 1 randomized controlled trial. Only 2 articles demonstrated favorable results following 6 sessions of ankle joint mobilization. Clinical Bottom Line: Despite the mixed results, the majority of the available evidence suggests that ankle joint mobilization improves dynamic postural control. Strength of Recommendation: In accordance with the Centre of Evidence Based Medicine, the inconsistent results and the limited high-quality studies indicate that there is level C evidence to support the use of ankle joint mobilization to improve performance on the SEBT in patients with CAI.

Longer reaction time of the fibularis longus muscle and reduced postural control in basketball players with functional ankle instability: A pilot study.

PubMed

Méndez-Rebolledo, Guillermo; Guzmán-Muñoz, Eduardo; Gatica-Rojas, Valeska; Zbinden-Foncea, Hermann

2015-08-01

Motor control evaluation in subjects with functional ankle instability is questionable when both ankles of the same subject are compared (affected vs non-affected). To compare the postural control and reaction time of ankle muscles among: basketball players with FAI (instability group), basketball players without FAI (non-instability group) and healthy non-basketball-playing participants (control group). Case-control study. Laboratory. Instability (n = 10), non-instability (n = 10), and control groups (n = 11). Centre of pressure variables (area, velocity and sway) were measured with a force platform. Reaction time of ankle muscles was measured via electromyography. A one-way ANOVA demonstrated that there were significant differences between the instability and non-instability groups in the fibularis longus (p < 0.001), fibularis brevis (p = 0.031) and tibialis anterior (p = 0.049) muscles. Repeated-measures ANOVA and post hoc analysis determined significant differences for the area between the instability and non-instability groups (p = 0.001). Basketball players with FAI have reduced postural control and longer reaction time of the fibularis and tibialis anterior muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?

PubMed

Horak, Fay B

2006-09-01

Postural control is no longer considered simply a summation of static reflexes but, rather, a complex skill based on the interaction of dynamic sensorimotor processes. The two main functional goals of postural behaviour are postural orientation and postural equilibrium. Postural orientation involves the active alignment of the trunk and head with respect to gravity, support surfaces, the visual surround and internal references. Sensory information from somatosensory, vestibular and visual systems is integrated, and the relative weights placed on each of these inputs are dependent on the goals of the movement task and the environmental context. Postural equilibrium involves the coordination of movement strategies to stabilise the centre of body mass during both self-initiated and externally triggered disturbances of stability. The specific response strategy selected depends not only on the characteristics of the external postural displacement but also on the individual's expectations, goals and prior experience. Anticipatory postural adjustments, prior to voluntary limb movement, serve to maintain postural stability by compensating for destabilising forces associated with moving a limb. The amount of cognitive processing required for postural control depends both on the complexity of the postural task and on the capability of the subject's postural control system. The control of posture involves many different underlying physiological systems that can be affected by pathology or sub-clinical constraints. Damage to any of the underlying systems will result in different, context-specific instabilities. The effective rehabilitation of balance to improve mobility and to prevent falls requires a better understanding of the multiple mechanisms underlying postural control.

A new approach of the Star Excursion Balance Test to assess dynamic postural control in people complaining from chronic ankle instability.

PubMed

Pionnier, Raphaël; Découfour, Nicolas; Barbier, Franck; Popineau, Christophe; Simoneau-Buessinger, Emilie

2016-03-01

The purpose of this study was to quantitatively and qualitatively assess dynamic balance with accuracy in individuals with chronic ankle instability (CAI). To this aim, a motion capture system was used while participants performed the Star Excursion Balance Test (SEBT). Reached distances for the 8 points of the star were automatically computed, thereby excluding any dependence to the experimenter. In addition, new relevant variables were also computed, such as absolute time needed to reach each distance, lower limb ranges of motion during unipodal stance, as well as absolute error of pointing. Velocity of the center of pressure and range of variation of ground reaction forces have also been assessed during the unipodal phase of the SEBT thanks to force plates. CAI group exhibited smaller reached distances and greater absolute error of pointing than the control group (p<0.05). Moreover, the ranges of motion of lower limbs joints, the velocity of the center of pressure and the range of variation of the ground reaction forces were all significantly smaller in the CAI group (p<0.05). These reduced quantitative and qualitative performances highlighted a lower dynamic postural control. The limited body movements and accelerations during the unipodal stance in the CAI group could highlight a protective strategy. The present findings could help clinicians to better understand the motor strategies used by CAI patients during dynamic balance and may guide the rehabilitation process. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of foot orthoses on patients with chronic ankle instability.

PubMed

Richie, Douglas H

2007-01-01

Chronic instability of the ankle can be the result of mechanical and functional deficits. An acute ankle sprain can cause mechanical and functional instability, which may or may not respond to standard rehabilitation programs. Chronic instability results when there is persistent joint laxity of the ankle or when one or more components of neuromuscular control of the ankle are compromised. A loss of balance or postural control seems to be the most consistent finding among athletes with chronic instability of the ankle. Recent research in patients with acute and chronic ankle instability has revealed positive effects of foot orthoses on postural control. This article reviews the current research relevant to the use of foot orthoses in patients with chronic ankle instability and clarifies the suggested benefits and the shortcomings of these investigations.

Postural stability changes in the elderly with cataract simulation and refractive blur.

PubMed

Anand, Vijay; Buckley, John G; Scally, Andy; Elliott, David B

2003-11-01

To determine the influence of cataractous and refractive blur on postural stability and limb-load asymmetry (LLA) and to establish how postural stability changes with the spatial frequency and contrast of the visual stimulus. Thirteen elderly subjects (mean age, 70.76 +/- 4.14 [SD] years) with no history of falls and normal vision were recruited. Postural stability was determined as the root mean square [RMS] of the center of pressure (COP) signal in the anterior-posterior (A-P) and medial-lateral directions and LLA was determined as the ratio of the average body weight placed on the more-loaded limb to the less-loaded limb, recorded during a 30-second period. Data were collected under normal standing conditions and with somatosensory system input disrupted. Measurements were repeated with four visual targets with high (8 cyc/deg) or low (2 cyc/deg) spatial frequency and high (Weber contrast, approximately 95%) or low (Weber contrast, approximately 25%) contrast. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with cataract simulation. The data were analyzed in a population-averaged linear model. The cataract simulation caused significant increases in postural instability equivalent to that caused by 8-D blur conditions, and its effect was greater when the input from the somatosensory system was disrupted. High spatial frequency targets increased postural instability. Refractive blur, cataract simulation, or eye closure had no effect on LLA. Findings indicate that cataractous and refractive blur increase postural instability, and show why the elderly, many of whom have poor vision along with musculoskeletal and central nervous system degeneration, are at greater risk of falling. Findings also highlight that changes in contrast sensitivity rather than resolution changes are responsible for increasing postural instability. Providing low spatial frequency information in certain environments may be useful in maintaining postural stability. Correcting visual impairment caused by uncorrected refractive error and cataracts could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.

Is PIGD a legitimate motor subtype in Parkinson disease?

PubMed

Kotagal, Vikas

2016-06-01

Parkinson disease is a chronic progressive syndrome with a broad array of clinical features. Different investigators have suggested the heterogeneous motor manifestations of early Parkinson disease can be conceptualized through a taxonomy of clinical subtypes including tremor-predominant and postural instability and gait difficulty-predominant subtypes. Although it is theoretically valuable to distinguish subtypes of Parkinson disease, the reality is that few patients fit these discrete categories well and many transition from exhibiting elements of one subtype to elements of another. In the time since the initial description of the postural instability and gait difficulty-predominant subtype, Parkinson disease clinical research has blossomed in many ways - including an increased emphasis on the role of medical comorbidities and extranigral pathologies in Parkinson disease as markers of prognostic significance. By conceptualizing the pathogenesis of an expansive disease process in the limited terms of categorical motor subtypes, we run the risk of overlooking or misclassifying clinically significant pathogenic risk factors that lead to the development of motor milestones such as falls and related axial motor disability. Given its critical influence on quality of life and overall prognosis, we are in need of a model of postural instability and gait difficulty-predominant features in Parkinson disease that emphasizes the overlooked pathological influence of aging and medical comorbidities on the development of axial motor burden and postural instability and gait difficulty-predominant features. This Point of View proposes thinking of postural instability and gait difficulties in Parkinson disease not as a discrete subtype, but rather as multidimensional continuum influenced by several overlapping age-related pathologies.

An active balance board system with real-time control of stiffness and time-delay to assess mechanisms of postural stability.

PubMed

Cruise, Denise R; Chagdes, James R; Liddy, Joshua J; Rietdyk, Shirley; Haddad, Jeffrey M; Zelaznik, Howard N; Raman, Arvind

2017-07-26

Increased time-delay in the neuromuscular system caused by neurological disorders, concussions, or advancing age is an important factor contributing to balance loss (Chagdes et al., 2013, 2016a,b). We present the design and fabrication of an active balance board system that allows for a systematic study of stiffness and time-delay induced instabilities in standing posture. Although current commercial balance boards allow for variable stiffness, they do not allow for manipulation of time-delay. Having two controllable parameters can more accurately determine the cause of balance deficiencies, and allows us to induce instabilities even in healthy populations. An inverted pendulum model of human posture on such an active balance board predicts that reduced board rotational stiffness destabilizes upright posture through board tipping, and limit cycle oscillations about the upright position emerge as feedback time-delay is increased. We validate these two mechanisms of instability on the designed balance board, showing that rotational stiffness and board time-delay induced the predicted postural instabilities in healthy, young adults. Although current commercial balance boards utilize control of rotational stiffness, real-time control of both stiffness and time-delay on an active balance board is a novel and innovative manipulation to reveal balance deficiencies and potentially improve individualized balance training by targeting multiple dimensions contributing to standing balance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predicting Dynamic Postural Instability Using Center of Mass Time-to-Contact Information

PubMed Central

Hasson, Christopher J.; Van Emmerik, Richard E.A.; Caldwell, Graham E.

2008-01-01

Our purpose was to determine whether spatiotemporal measures of center of mass motion relative to the base of support boundary could predict stepping strategies after upper-body postural perturbations in humans. We expected that inclusion of center of mass acceleration in such time-to-contact (TtC) calculations would give better predictions and more advanced warning of perturbation severity. TtC measures were compared with traditional postural variables, which don’t consider support boundaries, and with an inverted pendulum model of dynamic stability developed by Hof et al. (2005). A pendulum was used to deliver sequentially increasing perturbations to 10 young adults, who were strapped to a wooden backboard that constrained motion to sagittal plane rotation about the ankle joint. Subjects were instructed to resist the perturbations, stepping only if necessary to prevent a fall. Peak center of mass and center of pressure velocity and acceleration demonstrated linear increases with postural challenge. In contrast, boundary relevant minimum TtC values decreased nonlinearly with postural challenge, enabling prediction of stepping responses using quadratic equations. When TtC calculations incorporated center of mass acceleration, the quadratic fits were better and gave more accurate predictions of the TtC values that would trigger stepping responses. In addition, TtC minima occurred earlier with acceleration inclusion, giving more advanced warning of perturbation severity. Our results were in agreement with TtC predictions based on Hof’s model, and suggest that TtC may function as a control parameter, influencing the postural control system’s decision to transition from a stationary base of support to a stepping strategy. PMID:18556003

Efficacy and Safety of Pedunculopontine Nuclei (PPN) Deep Brain Stimulation in the Treatment of Gait Disorders: A Meta-Analysis of Clinical Studies.

PubMed

Golestanirad, Laleh; Elahi, Behzad; Graham, Simon J; Das, Sunit; Wald, Lawrence L

2016-01-01

Pedunculopontine nucleus (PPN) has complex reciprocal connections with basal ganglia, especially with internal globus pallidus and substantia nigra, and it has been postulated that PPN stimulation may improve gait instability and freezing of gait. In this meta-analysis, we will assess the evidence for PPN deep brain stimulation in treatment of gait and motor abnormalities especially focusing on Parkinson disease patients. PubMed and Scopus electronic databases were searched for related studies published before February 2014. Medline (1966-2014), Embase (1974-2010), CINAHL, Web of Science, Scopus bibliographic, and Google Scholar databases (1960-2014) were also searched for studies investigating effect of PPN deep brain stimulation in treatment of postural and postural instability and total of ten studies met the inclusion criteria for this analysis. Our findings showed a significant improvement in postural instability (p<0.001) and motor symptoms of Parkinson disease on and off medications (p<0.05), but failed to show improvement in freezing of gait. Despite significant improvement in postural instability observed in included studies, evidence from current literature is not sufficient to generalize these findings to the majority of patients.

Postural control deficits in people with fibromyalgia: a pilot study

PubMed Central

2011-01-01

Introduction Postural instability and falls are increasingly recognized problems in patients with fibromyalgia (FM). The purpose of this study was to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability. We further sought to determine whether postural instability is associated with strength, proprioception and lower-extremity myofascial trigger points (MTPs); FM symptoms and physical function; dyscognition; balance confidence; and medication use. Last, we evaluated self-reported of falls over the past six months. Methods In this cross-sectional study, we compared middle-aged FM patients and age-matched HCs who underwent computerized dynamic posturography testing and completed the Fibromyalgia Impact Questionnaire-Revised (FIQR) and balance and fall questionnaires. All subjects underwent a neurological and musculoskeletal examination. Descriptive statistics were used to characterize the sample and explore the relationships between variables. The relationships between subjective, clinical and objective variables were evaluated by correlation and regression analyses. Results Twenty-five FM patients and twenty-seven HCs (combined mean age ± standard deviation (SD): 48.6 ± 9.7 years) completed testing. FM patients scored statistically lower on composite sensory organization tests (primary outcome; P < 0.010), as well as with regard to vestibular, visual and somatosensory ratio scores on dynamic posturography. Balance confidence was significantly different between groups, with FM patients reporting less confidence than HCs (mean ± SD: 81.24 ± 19.52 vs. 98.52 ± 2.45; P < 0.001). Interestingly, 76% to 84% of FM patients had gastrocnemius and/or anterior tibialis MTPs. Postural stability was best predicted by dyscognition, FIQR score and body mass index. Regarding falls, 3 (11%) of 27 HCs had fallen only once during the past 6 months, whereas 18 (72%) of 25 FM patients had fallen at least once. Fifteen FM patients (60%) reported falling at least three times in the past six months. Conclusions In this study, we report that middle-aged FM patients have consistent objective sensory deficits on dynamic posturography, despite having a normal clinical neurological examination. Further study is needed to determine prospective fall rates and the significance of lower-extremity MTPs. The development of interventions to improve balance and reduce falls in FM patients may need to combine balance training with exercise and cognitive training. PMID:21810264

Trial-to-trial adaptation in control of arm reaching and standing posture

PubMed Central

Pienciak-Siewert, Alison; Horan, Dylan P.

2016-01-01

Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability. PMID:27683888

Trial-to-trial adaptation in control of arm reaching and standing posture.

PubMed

Pienciak-Siewert, Alison; Horan, Dylan P; Ahmed, Alaa A

2016-12-01

Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability. Copyright © 2016 the American Physiological Society.

Association of postural instability with asymptomatic cerebrovascular damage and cognitive decline: the Japan Shimanami health promoting program study.

PubMed

Tabara, Yasuharu; Okada, Yoko; Ohara, Maya; Uetani, Eri; Kido, Tomoko; Ochi, Namiko; Nagai, Tokihisa; Igase, Michiya; Miki, Tetsuro; Matsuda, Fumihiko; Kohara, Katsuhiko

2015-01-01

Asymptomatic cerebral small-vessel disease (cSVD) in elderly individuals are potent risk factors for stroke. In addition to common clinical risk factors, postural instability has been postulated to be associated with cSVD in older frail patients. Here, we conducted a cross-sectional study to understand the possible link between postural instability and asymptomatic cSVD further, namely periventricular hyperintensity, lacunar infarction, and microbleeds, as well as cognitive function, in a middle-aged to elderly general population (n=1387). Postural instability was assessed based on one-leg standing time (OLST) and posturography findings. cSVD was evaluated by brain MRI. Mild cognitive impairment was assessed using a computer-based questionnaire, and carotid intima-media thickness as an index of atherosclerosis was measured via ultrasonography. Frequency of short OLST, in particular <20 s, increased linearly with severity of cSVD (lacunar infarction lesion: none, 9.7%; 1, 16.0%; >2, 34.5%; microbleeds lesion: none, 10.1%; 1, 15.3%; >2, 30.0%; periventricular hyperintensity grade: 0, 5.7%; 1, 11.5%; >2, 23.7%). The association of short OLST with lacunar infarction and microbleeds but not periventricular hyperintensity remained significant even after adjustment for possible covariates (lacunar infarction, P=0.009; microbleeds, P=0.003; periventricular hyperintensity, P=0.601). In contrast, no significant association was found between posturographic parameters and cSVD, whereas these parameters were linearly associated with OLST. Short OLST was also significantly associated with reduced cognitive function independent of covariates, including cSVD (P=0.002). Postural instability was found to be associated with early pathological changes in the brain and functional decline, even in apparently healthy subjects. © 2014 American Heart Association, Inc.

The effectiveness of foot orthotics in improving postural control in individuals with chronic ankle instability: a critically appraised topic.

PubMed

Gabriner, Michael L; Braun, Brittany A; Houston, Megan N; Hoch, Matthew C

2015-02-01

Chronic ankle instability (CAI) is a condition commonly experienced by physically active individuals. It has been suggested that foot orthotics may increase a CAI patient's postural control. For patients with CAI, is there evidence to suggest that an orthotic intervention will help improve postural control? The literature was searched for studies of level 2 evidence or higher that investigated the effects of foot orthotics on postural control in patients with CAI. The search of the literature produced 5 possible studies for inclusion; 2 studies met the inclusion criteria and were included. One randomized controlled trial and 1 outcomes study were included. Foot orthotics appear to be effective at improving postural control in patients with CAI. There is moderate evidence to support the use of foot orthotics in the treatment of CAI to help improve postural control. There is grade B evidence that foot orthotics help improve postural control in people with CAI. The Centre of Evidence Based Medicine recommends a grade of B for level 2 evidence with consistent findings.

Anticipatory postural adjustments and focal performance during bilateral forward-reach task under different stance conditions.

PubMed

Yiou, Eric; Mezaour, Malha; Le Bozec, Serge

2009-04-01

This study investigated how young healthy subjects control their equilibrium in situations of instability specifically elicited by a reduced capacity of force production in the postural muscle system. Ten subjects displaced a bar forward with both hands at maximal velocity toward a target while standing on the dominant leg (UNID), on the nondominant leg (UNIND), or on both legs. In each stance condition, anticipatory postural adjustments (APAs) were elicited. Along the anteroposterior axis, APAs were two-times longer in UNID and UNIND than in bipedal stance, while the anticipatory inertia forces remained equivalent. The focal performance was maintained without any additive postural perturbation. A small effect of leg dominance could be detected on APAs along the mediolateral axis (i.e., anticipatory inertia forces were higher in UNIND than in UNID). These results stress the adaptability of the central nervous system to the instability specifically elicited by reduced postural muscle system efficiency.

Gait, posture and cognition in Parkinson's disease

PubMed Central

Barbosa, Alessandra Ferreira; Chen, Janini; Freitag, Fernanda; Valente, Debora; Souza, Carolina de Oliveira; Voos, Mariana Callil; Chien, Hsin Fen

2016-01-01

Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD. PMID:29213470

Hip strength and star excursion balance test deficits of patients with chronic ankle instability.

PubMed

McCann, Ryan S; Crossett, Ian D; Terada, Masafumi; Kosik, Kyle B; Bolding, Brenn A; Gribble, Phillip A

2017-11-01

To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength. Single-blinded, cross-sectional, case-control study. Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at P<0.05. The CAI group had lower SEBT-ANT scores compared to LAS copers (P=0.03) and controls (P=0.03). The CAI group had lower ABD compared to LAS copers (P=0.03) and controls (P=0.02). The CAI group had lower ER compared to LAS copers (P=0.01) and controls (P=0.01). ER (R 2 =0.25, P=0.01) and ABD (R 2 =0.25, P=0.01) explained 25% of the CAI group's SEBT-PM and SEBT-PL variances, respectively. The CAI group had deficient dynamic postural control and isometric hip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The influence of ankle dorsiflexion and self-reported patient outcomes on dynamic postural control in participants with chronic ankle instability.

PubMed

Terada, Masafumi; Harkey, Matthew S; Wells, Ashley M; Pietrosimone, Brian G; Gribble, Phillip A

2014-01-01

We investigated the influence of ankle dorsiflexion range of motion (DF-ROM) and self-reported patient outcomes on dynamic postural control assessed with the Star Excursion Balance Test (SEBT) in individuals with chronic ankle instability (CAI). Twenty-nine participants with self-reported CAI volunteered. The primary outcome measurements were categorized into clinician-and patient-generated. Clinician-generated outcome measurements included anterior (SEBT-A), posteriormedial (SEBT-PM) and posteriorlateral (SEBT-PL) reach distances (cm) normalized by leg length (cm) of the SEBT, maximum weight-bearing dorsiflexion (WB-DF) (cm), and open-chain DF-ROM (°). Self-reported patient-generated outcome measures included the foot and ankle ability measure and the level of perceived pain, stiffness, stability, and function of their involved ankle on a 10-cm visual analog scale (VAS). Pearson product moment correlations were used to examine the relationship of the SEBT performances with DF-ROM and self-reported patient outcome measures. A multiple linear regression was performed to determine the influence of patient- and clinician-generated measures on the SEBT. SEBT-A performance was significantly and fairly correlated with WB-DF (r=0.410, p=0.014), perceived ankle stiffness (r=0.477, p=0.014), and open-chain DF-ROM (r=0.404, p=0.015). The strongest predictor of the variance in SEBT-A was the combination of the variance in WB-DF and VAS-stiffness (R2=0.348, p=0.004). There were no significant correlations with the SEBT-PM and SEBT-PL. WB-DF and VAS-stiffness may represent targets for intervention that need to be addressed to produce the best outcome in participants with CAI when altered dynamic postural control is detected on the SEBT-A. Copyright © 2014 Elsevier B.V. All rights reserved.

Anticipatory and Compensatory Postural Adjustments in Response to External Lateral Shoulder Perturbations in Subjects with Parkinson's Disease.

PubMed

de Azevedo, Alexandre Kretzer E Castro; Claudino, Renato; Conceição, Josilene Souza; Swarowsky, Alessandra; Santos, Márcio José Dos

2016-01-01

The purpose of this study was to investigate the anticipatory (APA) and compensatory (CPA) postural adjustments in individuals with Parkinson's disease (PD) during lateral instability of posture. Twenty-six subjects (13 individuals with PD and 13 healthy matched controls) were exposed to predictable lateral postural perturbations. The electromyographic (EMG) activity of the lateral muscles and the displacement of the center of pressure (COP) were recorded during four time intervals that are typical for postural adjustments, i.e., immediately before (APA1, APA2) and after (CPA1 and CPA2) the postural disturbances. The magnitude of the activity of the lateral muscles in the group with PD was lower only during the CPA time intervals and not during the anticipatory adjustments (APAs). Despite this finding, subjects with PD exhibit smaller COP excursions before and after the disturbance, probably due to lack of flexibility and proprioceptive impairments. The results of this study suggest that postural instability in subjects with PD can be partially explained by decreased postural sway, before and after perturbations, and reduced muscular activity after body disturbances. Our findings can motivate new studies to investigate therapeutic interventions that optimize the use of postural adjustment strategies in subjects with PD.

Postural and Cortical Responses Following Visual Occlusion in Adults with and without ASD

ERIC Educational Resources Information Center

Goh, Kwang Leng; Morris, Susan; Parsons, Richard; Ring, Alexander; Tan, Tele

2018-01-01

Autism is associated with differences in sensory processing and motor coordination. Evidence from electroencephalography suggests individual perturbation evoked response (PER) components represent specific aspects of postural disturbance processing; P1 reflects the detection and N1 reflects the evaluation of postural instability. Despite the…

Postural stability in the elderly during sensory perturbations and dual tasking: the influence of refractive blur.

PubMed

Anand, Vijay; Buckley, John G; Scally, Andy; Elliott, David B

2003-07-01

To determine the influence of refractive blur on postural stability during somatosensory and vestibular system perturbation and dual tasking. Fifteen healthy, elderly subjects (mean age, 71 +/- 5 years), who had no history of falls and had normal vision, were recruited. Postural stability during standing was assessed using a force platform, and was determined as the root mean square (RMS) of the center of pressure (COP) signal in the anterior-posterior (A-P) and medial-lateral directions collected over a 30-second period. Data were collected under normal standing conditions and with somatosensory and vestibular system perturbations. Measurements were repeated with an additional physical and/or cognitive task. Postural stability was measured under conditions of binocular refractive blur of 0, 1, 2, 4, and 8 D and with eyes closed. The data were analyzed with a population-averaged linear model. The greatest increases in postural instability were due to disruptions of the somatosensory and vestibular systems. Increasing refractive blur caused increasing postural instability, and its effect was greater when the input from the other sensory systems was disrupted. Performing an additional cognitive and physical task increased A-P RMS COP further. All these detrimental effects on postural stability were cumulative. The findings highlight the multifactorial nature of postural stability and indicate why the elderly, many of whom have poor vision and musculoskeletal and central nervous system degeneration, are at greater risk of falling. The findings also highlight that standing instability in both normal and perturbed conditions was significantly increased with refractive blur. Correcting visual impairment caused by uncorrected refractive error could be a useful intervention strategy to help prevent falls and fall-related injuries in the elderly.

Assessing Sensorimotor Function Following ISS with Computerized Dynamic Posturography.

PubMed

Wood, Scott J; Paloski, William H; Clark, Jonathan B

2015-12-01

Postflight postural ataxia reflects both the control strategies adopted for movement in microgravity and the direct effects of deconditioning. Computerized dynamic posturography (CDP) has been used during the first decade of the International Space Station (ISS) expeditions to quantify the initial postflight decrements and recovery of postural stability. The CDP data were obtained on 37 crewmembers as part of their pre- and postflight medical examinations. Sensory organization tests evaluated the ability to make effective use of (or suppress inappropriate) visual, vestibular, and somatosensory information for balance control. This report focuses on eyes closed conditions with either a fixed or sway-referenced base of support, with the head erect or during pitch-head tilts (± 20° at 0.33 Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Motor-control tests were also used to evaluate a crewmember's ability to automatically recover from unexpected support-surface perturbations. The standard Romberg condition was the least sensitive. Dynamic head tilts led to increased incidence of falls and revealed significantly longer recovery than head-erect conditions. Improvements in postflight postural performance during the later expeditions may be attributable to higher preflight baselines and/or advanced exercise capabilities aboard the ISS. The diagnostic assessment of postural instability is more pronounced during unstable-support conditions requiring active head movements. In addition to supporting return-to-duty decisions by flight surgeons, the CDP provides a standardized sensorimotor measure that can be used to evaluate the effectiveness of countermeasures designed to either minimize deconditioning on orbit or promote reconditioning upon return to Earth.

Three-dimensional evaluation of postural stability in Parkinson's disease with mobile technology.

PubMed

Ozinga, Sarah J; Koop, Mandy Miller; Linder, Susan M; Machado, Andre G; Dey, Tanujit; Alberts, Jay L

2017-01-01

Postural instability is a hallmark of Parkinson's disease. Objective metrics to characterize postural stability are necessary for the development of treatment algorithms to aid in the clinical setting. The aim of this project was to validate a mobile device platform and resultant three-dimensional balance metric that characterizes postural stability. A mobile Application was developed, in which biomechanical data from inertial sensors within a mobile device were processed to characterize movement of center of mass in the medial-lateral, anterior-posterior and trunk rotation directions. Twenty-seven individuals with Parkinson's disease and 27 age-matched controls completed various balance tasks. A postural stability metric quantifying the amplitude (peak-to-peak) of sway acceleration in each movement direction was compared between groups. The peak-to-peak value in each direction for each individual with Parkinson's disease across all trials was expressed as a normalized value of the control data to identify individuals with severe postural instability, termed Cleveland Clinic-Postural Stability Index. In all conditions, the balance metric for peak-to-peak was significantly greater in Parkinson's disease compared to controls (p < 0.01 for all tests). The balance metric, in conjunction with mobile device sensors, provides a rapid and systematic metric for quantifying postural stability in Parkinson's disease.

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review.

PubMed

Mustapa, Amirah; Justine, Maria; Mohd Mustafah, Nadia; Jamil, Nursuriati; Manaf, Haidzir

2016-01-01

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were "postural control," "balance," "gait performance," "diabetes mellitus," and "diabetic peripheral neuropathy." Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults.

Modulation of Excitability in the Temporoparietal Junction Relieves Virtual Reality Sickness.

PubMed

Takeuchi, Naoyuki; Mori, Takayuki; Suzukamo, Yoshimi; Izumi, Shin-Ichi

2018-06-01

Virtual reality (VR) immersion often provokes subjective discomfort and postural instability, so called VR sickness. The neural mechanism of VR sickness is speculated to be related to visual-vestibular information mismatch and/or postural instability. However, the approaches proposed to relieve VR sickness through modulation of brain activity are poorly understood. Using transcranial direct current stimulation (tDCS), we aimed to investigate whether VR sickness could be relieved by the modulation of cortical excitability in the temporoparietal junction (TPJ), which is known to be involved in processing of both vestibular and visual information. Twenty healthy subjects received tDCS over right TPJ before VR immersion. The order of the three types of tDCS (anodal, cathodal, and sham) was counterbalanced across subjects. We evaluated the subjective symptoms, heart rate, and center of pressure at baseline, after tDCS, and after VR immersion. VR immersion using head-mounted displays provoked subjective discomfort and postural instability. However, anodal tDCS over right TPJ ameliorated subjective disorientation symptoms and postural instability induced by VR immersion compared with sham condition. The amelioration of VR sickness by anodal tDCS over the right TPJ might result from relief of the sensory conflict and/or facilitation of vestibular function. Our result not only has potential clinical implications for the neuromodulation approach of VR sickness but also implies a causal role of the TPJ in VR sickness.

Postural control system influences intrinsic alerting state.

PubMed

Barra, Julien; Auclair, Laurent; Charvillat, Agnès; Vidal, Manuel; Pérennou, Dominic

2015-03-01

Numerous studies using dual-task paradigms (postural and cognitive) have shown that postural control requires cognitive resources. However, the influence of postural control on attention components has never been directly addressed. Using the attention network test (ANT), which assesses specifically each of the 3 components of attention-alertness, orientation, and executive control-within a single paradigm, we investigated the effect of postural balance demand on these 3 components. Forty-two participants completed the ANT in 3 postural conditions: (a) supine, a very stable position; (b) sitting on a chair, an intermediate position; and (c) standing with feet lined up heel to toe, a very instable position known as the Romberg position. Our results revealed that the difficulty of postural control does modulate alerting in such a way that it improves with the level of instability of the position. Regarding the orienting and executive control components of attention, performance was not different when participants were standing upright or seated, whereas in the supine position, performance dropped. The strong and specific interaction between postural control and the alerting system suggests that these mechanisms may share parts of the underlying neural circuits. We discuss the possible implication of the locus coeruleus, known to be involved in both postural balance and alerting. Also, our findings concerning orienting and executive control systems suggest that supine posture could have a specific effect on cognitive activities. These effects are discussed in terms of particularities resulting from the supine position. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Clinical application of the Panjabi neutral zone hypothesis: the Stabilimax NZ posterior lumbar dynamic stabilization system.

PubMed

Yue, James J; Timm, Jens P; Panjabi, Manohar M; Jaramillo-de la Torre, Jorge

2007-01-15

The neutral zone (NZ) is a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. The NZ appears to be a clinically important measure of spinal stability function. Its size may increase with injury to the spinal column, which in turn may result in spinal instability or low-back pain. Dynamic stabilization systems are designed to support and stabilize the spine while maintaining range of motion (ROM). The Stabilimax NZ device has been designed to reduce the NZ after spinal injury to treat pain while preserving ROM.

The Effect of Sensory Noise Created by Compliant and Sway-Referenced Support Surfaces on Postural Stability

NASA Technical Reports Server (NTRS)

Forth, Katharine E.; Taylor, Laura C.; Paloski, William H.

2006-01-01

The purpose of the present experiment was to compare in normal human subjects the differential effects on postural stability of introducing somatosensory noise via compliant and/or sway-referenced support surfaces during quiet standing. The use of foam surfaces (two thicknesses: thin (0.95cm) and thick (7.62cm)) and sway-referenced support allowed comparison between two different types of destabilizing factors that increased ankle/foot somatosensory noise. Under some conditions neck extensions were used to increase sensory noise by deviating the vestibular system from its optimal orientation for balance control. The impact of these conditions on postural control was assessed through objective measures of instability. Thick foam and sway-referenced support conditions generated comparable instability in subjects, as measured by equilibrium score and minimum time-to-contact. However, simultaneous application of the conditions resulted in greater instability, suggesting a higher level of generated sensory noise and thus, different receptor types affected during each manipulation. Indeed, sway-referenced support generated greater anterior-posterior center-of-mass (COM) sway, while thick foam generated greater medio-lateral COM sway and velocity. Neck extension had minimal effect on postural stability until combined with simultaneous thick foam and sway-referenced support. Thin foam never generated enough sensory noise to affect postural stability even with noise added by sway-reference support or neck extension. These results provide an interesting window into the central integration of redundant sensory information and indicate the postural impact of sensory inputs is not solely based on their existence, but also their level of noise.

Hemodynamic Response of the Supplementary Motor Area during Locomotor Tasks with Upright versus Horizontal Postures in Humans

PubMed Central

Obayashi, Shigeru; Nakajima, Katsumi; Hara, Yukihiro

2016-01-01

To understand cortical mechanisms related to truncal posture control during human locomotion, we investigated hemodynamic responses in the supplementary motor area (SMA) with quadrupedal and bipedal gaits using functional near-infrared spectroscopy in 10 healthy adults. The subjects performed three locomotor tasks where the degree of postural instability varied biomechanically, namely, hand-knee quadrupedal crawling (HKQuad task), upright quadrupedalism using bilateral Lofstrand crutches (UpQuad task), and typical upright bipedalism (UpBi task), on a treadmill. We measured the concentration of oxygenated hemoglobin (oxy-Hb) during the tasks. The oxy-Hb significantly decreased in the SMA during the HKQuad task, whereas it increased during the UpQuad task. No significant responses were observed during the UpBi task. Based on the degree of oxy-Hb responses, we ranked these locomotor tasks as UpQuad > UpBi > HKQuad. The order of the different tasks did not correspond with postural instability of the tasks. However, qualitative inspection of oxy-Hb time courses showed that oxy-Hb waveform patterns differed between upright posture tasks (peak-plateau-trough pattern for the UpQuad and UpBi tasks) and horizontal posture task (downhill pattern for the HKQuad task). Thus, the SMA may contribute to the control of truncal posture accompanying locomotor movements in humans. PMID:27413555

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review

PubMed Central

Mustapa, Amirah; Mohd Mustafah, Nadia; Jamil, Nursuriati

2016-01-01

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were “postural control,” “balance,” “gait performance,” “diabetes mellitus,” and “diabetic peripheral neuropathy.” Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults. PMID:27525281

Primary postural instability: a cause of recurrent sudden falls in the elderly.

PubMed

Djaldetti, R; Lorberboym, M; Melamed, E

2006-12-01

Elderly patients with recurrent falls are frequently diagnosed with an extrapyramidal syndrome. This study aims to characterise a distinct group of patients with recurrent falls and postural instability as a hallmark of the clinical examination. The study took place in the Movement Disorders Unit, Rabin Medical Center, Petah Tiqva, Israel among 26 patients with recurrent falls who had no clinical evidence of a neurodegenerative disease. Medical records, neurological examination and brain imaging studies were assessed. Falls in these patients were sudden, unprovoked, with no vertigo or loss of consciousness. All had postural instability with minimal or no abnormality on the neurological examination. Brain imaging showed diffuse ischaemic changes in 65%. [(123)I]-FPCIT SPECT with the dopamine transporter ligand, performed in five patients, was normal in all. Recurrent falls might be caused by a neurological syndrome that primarily affects balance control. The importance of identifying this disorder is its distinction from other parkinsonian syndromes causing falls.

Effect of visual distortion on postural balance in a full immersion stereoscopic environment

NASA Astrophysics Data System (ADS)

Faubert, Jocelyn; Allard, Remy

2004-05-01

This study attempted to determine the influence of non-linear visual movements on our capacity to maintain postural control. An 8x8x8 foot CAVE immersive virtual environment was used. Body sway recordings were obtained for both head and lower back (lumbar 2-3) positions. The subjects were presented with visual stimuli for periods of 62.5 seconds. Subjects were asked to stand still on one foot while viewing stimuli consisting of multiplied sine waves generating movement undulation of a textured surface (waves moving in checkerboard pattern). Three wave amplitudes were tested: 4 feet, 2 feet, and 1 foot. Two viewing conditions were also used; observers looking at 36 inches in front of their feet; observers looking at a distance near the horizon. The results were compiled using an instability index and the data showed a profound and consistent effect of visual disturbances on postural balance in particular for the x (side-to-side) movement. We have demonstrated that non-linear visual distortions similar to those generated by progressive ophthalmic lenses of the kind used for presbyopia corrections, can generate significant postural instability. This instability is particularly evident for the side-to-side body movement and is most evident for the near viewing condition.

Evalution of the effectiveness of multimodal approach to the management of cervical vertigo.

PubMed

Jaroshevskyi, Olexandr A; Payenok, Oleksandr S; Logvinenko, Anna V

2017-01-01

Vertigo is one of the most common complaints among patients consulting neurologists and general practitioners - family medicine. A special form of dizziness is cervical vertigo. However, the presence of chronic vertigo and imbalance in this group of patients makes it possible to include the treatment of vestibular rehabilitation in the program. Evalution of the effectiveness of multimodal approach to the management of cervical vertigo. 109 patients aged from 18 to 45 with vertigo together with myofascial pain syndrome of neck and shoulder area were examined. The survey included a sample of Dix-Hallpike, neurological and otoneurological examinations, Doppler ultrasound of the main arteries of the head and neck, brain MRI, functional spondylography of the cervical spine. For quantitive evaluation of the impact of vertigo on daily life the questionnaire DHI (Dizziness Handicap Inventory) was used. Testing was performed in two stages - before treatment and in 2 weeks' time. Patients were randomly divided into 3 groups which differ in their therapeutic tactics. In all three groups the normalization of the biomechanical pattern and elimination of musculo-tonic disorders accompanied by a decrease of a pain syndrome and a decrease in the severity or complete regression of dizziness and postural instability. At the same time, in groups 2 and 3, in which in addition to manual therapy, patients received acupuncture, there was a distinct positive dynamics of a pain syndrome according to VAS, Neck Disability Index and the Dizziness Handicap Inventory. A marked regression of vertigo and postural instability can be observed in patients in which the treatment along with manual therapy and acupuncture, a complex of vestibular rehabilitation was used. The multimodal approach using manual therapy in combination with acupuncture and vestibular rehabilitation showed the maximum therapeutic effect on elimination of musculo-tonic disorders, reduction of a pain syndrome with a complete regression of vertigo and postural instability.

Unipedal postural stability in nonathletes with core instability after intensive abdominal drawing-in maneuver.

PubMed

Lee, Nam G; You, Joshua Sung H; Kim, Tae H; Choi, Bong S

2015-02-01

The exact neuromechanical nature and relative contribution of the abdominal drawing-in maneuver (ADIM) to postural instability warrants further investigation in uninjured and injured populations. To determine the effects of the ADIM on static core and unipedal postural stability in nonathletes with core instability. Controlled laboratory study. University research laboratory. A total of 19 nonathletes (4 women: age = 22.3 ± 1.3 years, height = 164.0 ± 1.7 cm, mass = 56.0 ± 4.6 kg; 15 men: age = 24.6 ± 2.8 years, height = 172.6 ± 4.7 cm, mass = 66.8 ± 7.6 kg) with core instability. Participants received ADIM training with visual feedback 20 minutes each day for 7 days each week over a 2-week period. Core instability was determined using a prone formal test and measured by a pressure biofeedback unit. Unipedal postural stability was determined by measuring the center-of-pressure sway and associated changes in the abdominal muscle-thickness ratios. Electromyographic activity was measured concurrently in the external oblique, erector spinae, gluteus medius, vastus medialis oblique, tibialis anterior, and medial gastrocnemius muscles. All participants initially were unable to complete the formal test. However, after the 2-week ADIM training period, all participants were able to reduce the pressure biofeedback unit by a range of 4 to 10 mm Hg from an initial 70 mm Hg and maintain it at 60 to 66 mm Hg with minimal activation of the external oblique (t(18) = 3.691, P = .002) and erector spinae (t(18) = 2.823, P = .01) muscles. Monitoring of the pressure biofeedback unit and other muscle activations confirmed that the correct muscle contraction defining the ADIM was accomplished. This core stabilization was well maintained in the unipedal-stance position, as evidenced by a decrease in the center-of-pressure sway measures (t(18) range, 3.953-5.775, P < .001), an increased muscle-thickness ratio for the transverse abdominis (t(18) = -2.327, P = .03), and a reduction in external oblique muscle activity (t(18) = 3.172, P = .005). We provide the first evidence to highlight the positive effects of ADIM training on core and postural stability in nonathletes with core instability.

Intensive Abdominal Drawing-In Maneuver After Unipedal Postural Stability in Nonathletes With Core Instability

PubMed Central

Lee, Nam G.; You, Joshua (Sung) H.; Kim, Tae H.; Choi, Bong S.

2015-01-01

Context: The exact neuromechanical nature and relative contribution of the abdominal drawing-in maneuver (ADIM) to postural instability warrants further investigation in uninjured and injured populations. Objective: To determine the effects of the ADIM on static core and unipedal postural stability in nonathletes with core instability. Design: Controlled laboratory study. Setting: University research laboratory. Patients or Other Participants: A total of 19 nonathletes (4 women: age = 22.3 ± 1.3 years, height = 164.0 ± 1.7 cm, mass = 56.0 ± 4.6 kg; 15 men: age = 24.6 ± 2.8 years, height = 172.6 ± 4.7 cm, mass = 66.8 ± 7.6 kg) with core instability. Intervention(s): Participants received ADIM training with visual feedback 20 minutes each day for 7 days each week over a 2-week period. Main Outcome Measures(s): Core instability was determined using a prone formal test and measured by a pressure biofeedback unit. Unipedal postural stability was determined by measuring the center-of-pressure sway and associated changes in the abdominal muscle-thickness ratios. Electromyographic activity was measured concurrently in the external oblique, erector spinae, gluteus medius, vastus medialis oblique, tibialis anterior, and medial gastrocnemius muscles. Results: All participants initially were unable to complete the formal test. However, after the 2-week ADIM training period, all participants were able to reduce the pressure biofeedback unit by a range of 4 to 10 mm Hg from an initial 70 mm Hg and maintain it at 60 to 66 mm Hg with minimal activation of the external oblique (t18 = 3.691, P = .002) and erector spinae (t18 = 2.823, P = .01) muscles. Monitoring of the pressure biofeedback unit and other muscle activations confirmed that the correct muscle contraction defining the ADIM was accomplished. This core stabilization was well maintained in the unipedal-stance position, as evidenced by a decrease in the center-of-pressure sway measures (t18 range, 3.953–5.775, P < .001), an increased muscle-thickness ratio for the transverse abdominis (t18 = −2.327, P = .03), and a reduction in external oblique muscle activity (t18 = 3.172, P = .005). Conclusions: We provide the first evidence to highlight the positive effects of ADIM training on core and postural stability in nonathletes with core instability. PMID:25531145

An optimal state estimation model of sensory integration in human postural balance

NASA Astrophysics Data System (ADS)

Kuo, Arthur D.

2005-09-01

We propose a model for human postural balance, combining state feedback control with optimal state estimation. State estimation uses an internal model of body and sensor dynamics to process sensor information and determine body orientation. Three sensory modalities are modeled: joint proprioception, vestibular organs in the inner ear, and vision. These are mated with a two degree-of-freedom model of body dynamics in the sagittal plane. Linear quadratic optimal control is used to design state feedback and estimation gains. Nine free parameters define the control objective and the signal-to-noise ratios of the sensors. The model predicts statistical properties of human sway in terms of covariance of ankle and hip motion. These predictions are compared with normal human responses to alterations in sensory conditions. With a single parameter set, the model successfully reproduces the general nature of postural motion as a function of sensory environment. Parameter variations reveal that the model is highly robust under normal sensory conditions, but not when two or more sensors are inaccurate. This behavior is similar to that of normal human subjects. We propose that age-related sensory changes may be modeled with decreased signal-to-noise ratios, and compare the model's behavior with degraded sensors against experimental measurements from older adults. We also examine removal of the model's vestibular sense, which leads to instability similar to that observed in bilateral vestibular loss subjects. The model may be useful for predicting which sensors are most critical for balance, and how much they can deteriorate before posture becomes unstable.

The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus.

PubMed

Abram, Katrin; Bohne, Silvia; Bublak, Peter; Karvouniari, Panagiota; Klingner, Carsten M; Witte, Otto W; Guntinas-Lichius, Orlando; Axer, Hubertus

2016-01-01

Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.

Trunk Accelerometry Reveals Postural Instability in Untreated Parkinson's Disease

PubMed Central

Mancini, Martina; Horak, Fay B.; Zampieri, Cris; Carlson-Kuhta, Patricia; Nutt, John G.; Chiari, Lorenzo

2017-01-01

While several studies have shown that subjects with advanced Parkinson's disease (PD) exhibit abnormalities in sway parameters during quiet standing, abnormalities of postural sway associated with untreated PD have not been reported. Although not clinically apparent, we hypothesized that spontaneous sway in quiet stance is abnormal in people with untreated PD. We examined 13 subjects, recently diagnosed with PD, who were not yet taking any anti-parkinsonian medications and 12 healthy, age-matched control subjects. Postural sway was measured with a linear accelerometer on the posterior trunk (L5 level) and compared with traditional forceplate measures of sway. Subjects stood for two minutes under two conditions: eyes open (EO) and eyes closed (EC). One of the most discriminative measures of postural changes in subjects with untreated PD was the increased ‘JERK’ of lower trunk in the EO condition, measured with the accelerometer. Root mean square and the frequency dispersion of postural sway in the EO condition also discriminated sway in untreated PD subjects compared to controls subjects. We conclude that accelerometer-based sway metrics could be used as objective measures of postural instability in untreated PD. Accelerometer-based analysis of spontaneous sway may provide a powerful tool for early clinical trials and for monitoring the effects of treatment of balance disorders in subjects with PD. PMID:21641263

The influence of aging and attentional demands on recovery from postural instability.

PubMed

Stelmach, G E; Zelaznik, H N; Lowe, D

1990-06-01

It is well known that the risk of a debilitating injury from a fall is much higher for elderly than for young individuals. In addition, it is well documented that healthy elderly subjects exhibit increased postural sway during normal stance tasks. In the present experiment, we explored the notion that control of minor postural instability in elderly subjects is attention demanding. Postural sway of eight elderly (mean age = 70.0 years) and eight young (mean age = 20.0 years) subjects was measured under two different secondary demands during stable and mildly unstable upright stance. There were two types of work loads. Either a cognitive (math task) or motor (hand-squeeze) task was performed during the second segment of a 50-second standing trial. The effect of these work loads on mean velocity, range, and variability of range of center of foot pressure was measured during the destabilizing activity of arm swinging and subsequent recovery period. Following seven seconds of 1 Hz arm-swinging activity, elderly subjects showed a marked increase in recovery time to normal stance when concurrently performing an arithmetic task. This result suggests that recovery from a posturally destabilizing activity, involving proprioceptive and vestibular information, places increased attentional demands on the postural support system of the elderly.

Influence of visual control, conduction, and central integration on static and dynamic balance in healthy older adults.

PubMed

Perrin, P P; Jeandel, C; Perrin, C A; Béné, M C

1997-01-01

Aging is associated with decreased balance abilities, resulting in an increased risk of fall. In order to appreciate the visual, somatosensory, and central signals involved in balance control, sophisticated methods of posturography assessment have been developed, using static and dynamic tests, eventually associated with electromyographic measurements. We applied such methods to a population of healthy older adults in order to appreciate the respective importance of each of these sensorial inputs in aging individuals. Posture control parameters were recorded on a force-measuring platform in 41 healthy young (age 28.5 +/- 5.9 years) and 50 older (age 69.8 +/- 5.9 years) adults, using a static test and two dynamic tests performed by all individuals first with eyes open, then with eyes closed. The distance covered by the center of foot pressure, sway area, and anteroposterior oscillations were significantly higher, with eyes open or closed, in older people than in young subjects. Significant differences were noted in dynamic tests with longer latency responses in the group of old people. Dynamic recordings in a sinusoidal test had a more regular pattern when performed eyes open in both groups and evidenced significantly greater instability in old people. These data suggest that vision remains important in maintaining postural control while conduction and central integration become less efficient with age.

Comparison of Postural Recovery Following Short and Long Duration Spaceflights

NASA Technical Reports Server (NTRS)

Wood, S. J.; Fiedler, J.; Taylor, L. C.; Kozlovskaya, I.; Black, F. O.; Paloski, W. H.

2010-01-01

INTRODUCTION: Post-flight postural ataxia reflects adaptive changes to vestibulo-spinal reflexes and control strategies adopted for movement in weightlessness. Quantitative measures obtained during computerized dynamic posturography (CDP) from US and Russian programs provide insight into the effect of spaceflight duration in terms of both the initial decrements and recovery of postural stability. METHODS: CDP was obtained on 117 crewmembers following Shuttle flights lasting 4-17 days, and on 64 crewmembers following long-duration missions lasting 48-380 days. Although the number and timing of sessions varied, the goal was to characterize postural recovery pooling similar measures from different research and flight medicine programs. This report focuses on eyes closed, head erect conditions with either a fixed or sway-referenced base of support. A smaller subset of subjects repeated the sway-referenced condition while making pitch head movements (+/- 20deg at 0.33Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Fall probability was modeled using Bayesian statistical methods to estimate parameters of a logit function. RESULTS: The standard Romberg condition was the least sensitive. Longer duration flights led to larger decrements in stability with sway-reference support during the first 1-2 days, although the timecourse of recovery was similar across flight duration with head erect. Head movements led to increased incidence of falls during the first week, with a significantly longer recovery following long duration flights. CONCLUSIONS: The diagnostic assessment of postural instability, and differences in the timecourse of postural recovery between short and long flight durations, are more pronounced during unstable support conditions requiring active head movements.

Lower Extremity Biomechanics in Athletes With Ankle Instability After a 6-Week Integrated Training Program

PubMed Central

Huang, Pi-Yin; Chen, Wen-Ling; Lin, Cheng-Feng; Lee, Heng-Ju

2014-01-01

Context: Plyometric exercise has been recommended to prevent lower limb injury, but its feasibility in and effects on those with functional ankle instability (FAI) are unclear. Objective: To investigate the effect of integrated plyometric and balance training in participants with FAI during a single-legged drop landing and single-legged standing position. Design: Randomized controlled clinical trial. Setting: University motion-analysis laboratory. Patients or Other Participants: Thirty athletes with FAI were divided into 3 groups: plyometric group (8 men, 2 women, age = 23.20 ± 2.82 years; 10 unstable ankles), plyometric-balance (integrated)–training group (8 men, 2 women, age = 23.80 ± 4.13 years; 10 unstable ankles), and control group (7 men, 3 women, age = 23.50 ± 3.00 years; 10 unstable ankles). Intervention(s): A 6-week plyometric-training program versus a 6-week integrated-training program. Main Outcome Measure(s): Postural sway during single-legged standing with eyes open and closed was measured before and after training. Kinematic data were recorded during medial and lateral single-legged drop landings after a 5-second single-legged stance. Results: Reduced postural sway in the medial-lateral direction and reduced sway area occurred in the plyometric- and integrated-training groups. Generally, the plyometric training and integrated training increased the maximum angles at the hip and knee in the sagittal plane, reduced the maximum angles at the hip and ankle in the frontal and transverse planes in the lateral drop landing, and reduced the time to stabilization for knee flexion in the medial drop landing. Conclusions: After 6 weeks of plyometric training or integrated training, individuals with FAI used a softer landing strategy during drop landings and decreased their postural sway during the single-legged stance. Plyometric training improved static and dynamic postural control and should be incorporated into rehabilitation programs for those with FAI. PMID:24568224

Assessment of Relationships Between Joint Motion Quality and Postural Control in Patients With Chronic Ankle Joint Instability.

PubMed

Bączkowicz, Dawid; Falkowski, Krzysztof; Majorczyk, Edyta

2017-08-01

Study Design Controlled laboratory study, cross-sectional. Background Lateral ankle sprains are among the most common injuries encountered during athletic participation. Following the initial injury, there is an alarmingly high risk of reinjury and development of chronic ankle instability (CAI), which is dependent on a combination of factors, including sensorimotor deficits and changes in the biomechanical environment of the ankle joint. Objective To evaluate CAI-related disturbances in arthrokinematic motion quality and postural control and the relationships between them. Methods Sixty-three male subjects (31 with CAI and 32 healthy controls) were enrolled in the study. For arthrokinematic motion quality analysis, the vibroarthrographic signals were collected during ankle flexion/extension motion using an acceleration sensor and described by variability (variance of mean squares [VMS]), amplitude (mean of 4 maximal and 4 minimal values [R4]), and frequency (vibroarthrographic signal bands of 50 to 250 Hz [P1] and 250 to 450 Hz [P2]) parameters. Using the Biodex Balance System, single-leg dynamic balance was measured by overall, anteroposterior, and mediolateral stability indices. Results Values of vibroarthrographic parameters (VMS, R4, P1 and P2) were significantly higher in the CAI group than those in the control group (P<.01). Similar results were obtained for all postural control parameters (overall, anteroposterior, and mediolateral stability indices; P<.05). Moreover, correlations between the overall stability index and VMS, and P1 and P2, as well as between the anteroposterior stability index and P1 and P2, were observed in the CAI patient group, but not in controls. Conclusion In patients with CAI, deficits in both quality of ankle arthrokinematic motion and postural control were present. Therefore, physical therapy interventions focused on improving ankle neuromuscular control and arthrokinematic function are necessary in CAI patient care. J Orthop Sports Phys Ther 2017;47(8):570-577. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6836.

Intermittent Feedback-Control Strategy for Stabilizing Inverted Pendulum on Manually Controlled Cart as Analogy to Human Stick Balancing

PubMed Central

Yoshikawa, Naoya; Suzuki, Yasuyuki; Kiyono, Ken; Nomura, Taishin

2016-01-01

The stabilization of an inverted pendulum on a manually controlled cart (cart-inverted-pendulum; CIP) in an upright position, which is analogous to balancing a stick on a fingertip, is considered in order to investigate how the human central nervous system (CNS) stabilizes unstable dynamics due to mechanical instability and time delays in neural feedback control. We explore the possibility that a type of intermittent time-delayed feedback control, which has been proposed for human postural control during quiet standing, is also a promising strategy for the CIP task and stick balancing on a fingertip. Such a strategy hypothesizes that the CNS exploits transient contracting dynamics along a stable manifold of a saddle-type unstable upright equilibrium of the inverted pendulum in the absence of control by inactivating neural feedback control intermittently for compensating delay-induced instability. To this end, the motions of a CIP stabilized by human subjects were experimentally acquired, and computational models of the system were employed to characterize the experimental behaviors. We first confirmed fat-tailed non-Gaussian temporal fluctuation in the acceleration distribution of the pendulum, as well as the power-law distributions of corrective cart movements for skilled subjects, which was previously reported for stick balancing. We then showed that the experimental behaviors could be better described by the models with an intermittent delayed feedback controller than by those with the conventional continuous delayed feedback controller, suggesting that the human CNS stabilizes the upright posture of the pendulum by utilizing the intermittent delayed feedback-control strategy. PMID:27148031

Intermittent Feedback-Control Strategy for Stabilizing Inverted Pendulum on Manually Controlled Cart as Analogy to Human Stick Balancing.

PubMed

Yoshikawa, Naoya; Suzuki, Yasuyuki; Kiyono, Ken; Nomura, Taishin

2016-01-01

The stabilization of an inverted pendulum on a manually controlled cart (cart-inverted-pendulum; CIP) in an upright position, which is analogous to balancing a stick on a fingertip, is considered in order to investigate how the human central nervous system (CNS) stabilizes unstable dynamics due to mechanical instability and time delays in neural feedback control. We explore the possibility that a type of intermittent time-delayed feedback control, which has been proposed for human postural control during quiet standing, is also a promising strategy for the CIP task and stick balancing on a fingertip. Such a strategy hypothesizes that the CNS exploits transient contracting dynamics along a stable manifold of a saddle-type unstable upright equilibrium of the inverted pendulum in the absence of control by inactivating neural feedback control intermittently for compensating delay-induced instability. To this end, the motions of a CIP stabilized by human subjects were experimentally acquired, and computational models of the system were employed to characterize the experimental behaviors. We first confirmed fat-tailed non-Gaussian temporal fluctuation in the acceleration distribution of the pendulum, as well as the power-law distributions of corrective cart movements for skilled subjects, which was previously reported for stick balancing. We then showed that the experimental behaviors could be better described by the models with an intermittent delayed feedback controller than by those with the conventional continuous delayed feedback controller, suggesting that the human CNS stabilizes the upright posture of the pendulum by utilizing the intermittent delayed feedback-control strategy.

Childhood Exposure to Manganese and Postural Instability in Children living near a Ferromanganese Refinery in Southeastern Ohio

PubMed Central

Rugless, Fedoria; Bhattacharya, Amit; Succop, Paul; Dietrich, Kim N.; Cox, Cyndy; Alden, Jody; Kuhnell, Pierce; Barnas, Mary; Wright, Robert; Parsons, Patrick J.; Praamsma, Meredith L.; Palmer, Christopher D.; Beidler, Caroline; Wittberg, Richard; Haynes, Erin N.

2014-01-01

Airborne manganese (Mn) exposure can result in neurotoxicity and postural instability in occupationally exposed workers, yet few studies have explored the association ambient exposure to Mn in children and postural stability. The goal of this study was to determine the association between Mn and lead (Pb) exposure, as measured by blood Pb, blood and hair Mn and time weighted distance (TWD) from a ferromanganese refinery, and postural stability in children. A subset of children ages 7–9 years enrolled in the Marietta Community Actively Researching Exposure Study (CARES) were invited to participate. Postural balance was conducted on 55 children residing in Marietta, Ohio and the surrounding area. Samples of blood were collected and analyzed for Mn and Pb, and samples of hair were analyzed for Mn. Neuromotor performance was assessed using postural balance testing with a computer force platform system. Pearson correlations were calculated to identify key covariates. Associations between postural balance testing conditions and Mn and Pb exposure were estimated with linear regression analyses adjusting for gender, age, parent IQ, parent age. Mean blood Mn was 10 μg/L (SEM=0.36), mean blood Pb was 0.85 μg/dL (SEM=0.05), and mean hair Mn was 0.76 μg/g (SEM=0.16). Mean residential distance from the refinery was 11.5 km (SEM=0.46). All three measures of Mn exposure were significantly associated with poor postural balance. In addition, low-level blood Pb was also negatively associated with balance outcomes. We conclude that Mn exposure and low-level blood Pb are significantly associated with poor postural balance. PMID:24370548

Postural Stability in Cigarette Smokers and During Abstinence from Alcohol

PubMed Central

Schmidt, Thomas Paul; Pennington, David Louis; Durazzo, Timothy Craig; Meyerhoff, Dieter Johannes

2014-01-01

Background Static postural instability is common in alcohol dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. Methods A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and non-smoking ALC (nsALC) and to 74 smoking (sCON) and non-smoking light/non-drinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (approximately 1 week, 5 weeks, 34 weeks of abstinence from alcohol); a subset of nsCON was re-tested at 40 weeks. We tested if cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across time points within ALC. Results Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all three time points and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks was non-significant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Conclusions Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. PMID:24721012

Postural stability in cigarette smokers and during abstinence from alcohol.

PubMed

Schmidt, Thomas P; Pennington, David L; Durazzo, Timothy C; Meyerhoff, Dieter J

2014-06-01

Static postural instability is common in alcohol-dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and nonsmoking ALC (nsALC) and to 71 smoking (sCON) and nonsmoking light/nondrinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (TPs; approximately 1, 5, 34 weeks of abstinence from alcohol); a subset of nsCON was retested at 40 weeks. We tested whether cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across TPs within ALC. Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all 3 TPs and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks were nonsignificant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. Copyright © 2014 by the Research Society on Alcoholism.

Shannon and Renyi Entropies to Classify Effects of Mild Traumatic Brain Injury on Postural Sway

PubMed Central

Gao, Jianbo; Hu, Jing; Buckley, Thomas; White, Keith; Hass, Chris

2011-01-01

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. PMID:21931720

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

PubMed

Gao, Jianbo; Hu, Jing; Buckley, Thomas; White, Keith; Hass, Chris

2011-01-01

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. 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. 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. The programs for analyses may be obtained from the authors.

The addition of body armor diminishes dynamic postural stability in military soldiers.

PubMed

Sell, Timothy C; Pederson, Jonathan J; Abt, John P; Nagai, Takashi; Deluzio, Jennifer; Wirt, Michael D; McCord, Larry J; Lephart, Scott M

2013-01-01

Poor postural stability has been identified as a risk factor for lower extremity musculoskeletal injury. The additional weight of body armor carried by Soldiers alters static postural stability and may predispose Soldiers to lower extremity musculoskeletal injuries. However, static postural stability tasks poorly replicate the dynamic military environment, which places considerable stress on the postural control system during tactical training and combat. Therefore, the purpose of this study was to examine the effects of body armor on dynamic postural stability during single-leg jump landings. Thirty-six 101st Airborne Division (Air Assault) Soldiers performed single-leg jump landings in the anterior direction with and without wearing body armor. The dynamic postural stability index and the individual stability indices (medial-lateral stability index, anterior-posterior stability index, and vertical stability index) were calculated for each condition. Paired sample t-tests were performed to determine differences between conditions. Significant differences existed for the medial-lateral stability index, anterior-posterior stability index, vertical stability index, and dynamic postural stability index (p < 0.05). The addition of body armor resulted in diminished dynamic postural stability, which may result in increased lower extremity injuries. Training programs should address the altered dynamic postural stability while wearing body armor in attempts to promote adaptations that will result in safer performance during dynamic tasks.

Postural steadiness and ankle force variability in peripheral neuropathy

PubMed Central

Paxton, Roger J.; Feldman-Kothe, Caitlin; Trabert, Megan K.; Hitchcock, Leah N.; Reiser, Raoul F.; Tracy, Brian L.

2015-01-01

Introduction The purpose was to determine the effect of peripheral neuropathy (PN) on motor output variability for ankle muscles of older adults, and the relation between ankle motor variability and postural stability in PN patients. Methods Older adults with (O-PN) and without PN (O), and young adults (Y) underwent assessment of standing postural stability and ankle muscle force steadiness. Results O-PN displayed impaired ankle muscle force control and postural stability compared with O and Y groups. For O-PN, the amplitude of plantarflexor force fluctuations was moderately correlated with postural stability under no-vision conditions (r = 0.54, P = 0.01). Discussion The correlation of variations in ankle force with postural stability in PN suggests a contribution of ankle muscle dyscontrol to the postural instability that impacts physical function for older adults with PN. PMID:26284897

Modulation of the Fibularis Longus Hoffmann Reflex and Postural Instability Associated With Chronic Ankle Instability

PubMed Central

Kim, Kyung-Min; Hart, Joseph M.; Saliba, Susan A.; Hertel, Jay

2016-01-01

Context: Individuals with chronic ankle instability (CAI) present with decreased modulation of the Hoffmann reflex (H-reflex) from a simple to a more challenging task. The neural alteration is associated with impaired postural control, but the relationship has not been investigated in individuals with CAI. Objective: To determine differences in H-reflex modulation and postural control between individuals with or without CAI and to identify if they are correlated in individuals with CAI. Design: Descriptive laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 15 volunteers with CAI (9 males, 6 females; age = 22.6 ± 5.8 years, height = 174.7 ± 8.1 cm, mass = 74.9 ± 12.8 kg) and 15 healthy sex-matched volunteers serving as controls (9 males, 6 females; age = 23.8 ± 5.8 years, height = 171.9 ± 9.9 cm, mass = 68.9 ± 15.5 kg) participated. Intervention(s): Maximum H-reflex (Hmax) and motor wave (Mmax) from the soleus and fibularis longus were recorded while participants lay prone and then stood in unipedal stance. We assessed postural tasks of unipedal stance with participants' eyes closed for 10 seconds using a forceplate. Main Outcome Measure(s): We normalized Hmax to Mmax to obtain Hmax : Mmax ratios for the 2 positions. For each muscle, H-reflex modulation was quantified using the percentage change scores in Hmax : Mmax ratios calculated from prone position to unipedal stance. Center-of-pressure data were used to compute 4 time-to-boundary variables. Separate independent-samples t tests were performed to determine group differences. Pearson product moment correlation coefficients were calculated between the modulation and balance measures in the CAI group. Results: The CAI group presented less H-reflex modulation in the soleus (t26 = −3.77, P = .001) and fibularis longus (t25 = −2.59, P = .02). The mean of the time-to-boundary minima in the anteroposterior direction was lower in the CAI group (t28 = −2.06, P = .048). We observed a correlation (r = 0.578, P = .049) between the fibular longus modulation and mean of time-to-boundary minima in the anteroposterior direction. Conclusions: The strong relationship indicated that, as H-reflex amplitude in unipedal stance was less down modulated, unipedal postural control was more impaired. Given the deficits in H-reflex modulation and postural control in the CAI group, the relationship may provide insights into the neurophysiologic mechanism of postural instability. PMID:27583692

Dynamic stability requirements during gait and standing exergames on the wii fit® system in the elderly

PubMed Central

2012-01-01

Background In rehabilitation, training intensity is usually adapted to optimize the trained system to attain better performance (overload principle). However, in balance rehabilitation, the level of intensity required during training exercises to optimize improvement in balance has rarely been studied, probably due to the difficulty in quantifying the stability level during these exercises. The goal of the present study was to test whether the stabilizing/destabilizing forces model could be used to analyze how stability is challenged during several exergames, that are more and more used in balance rehabilitation, and a dynamic functional task, such as gait. Methods Seven healthy older adults were evaluated with three-dimensional motion analysis during gait at natural and fast speed, and during three balance exergames (50/50 Challenge, Ski Slalom and Soccer). Mean and extreme values for stabilizing force, destabilizing force and the ratio of the two forces (stability index) were computed from kinematic and kinetic data to determine the mean and least level of dynamic, postural and overall balance stability, respectively. Results Mean postural stability was lower (lower mean destabilizing force) during the 50/50 Challenge game than during all the other tasks, but peak postural instability moments were less challenging during this game than during any of the other tasks, as shown by the minimum destabilizing force values. Dynamic stability was progressively more challenged (higher mean and maximum stabilizing force) from the 50/50 Challenge to the Soccer and Slalom games, to the natural gait speed task and to the fast gait speed task, increasing the overall stability difficulty (mean and minimum stability index) in the same manner. Conclusions The stabilizing/destabilizing forces model can be used to rate the level of balance requirements during different tasks such as gait or exergames. The results of our study showed that postural stability did not differ much between the evaluated tasks (except for the 50/50 Challenge), compared to dynamic stability, which was significantly less challenged during the games than during the functional tasks. Games with greater centre of mass displacements and changes in the base of support are likely to stimulate balance control enough to see improvements in balance during dynamic functional tasks, and could be tested in pathological populations with the approach used here. PMID:22607025

Effects of reduced plantar cutaneous sensation on static postural control in individuals with and without chronic ankle instability.

PubMed

Song, Kyeongtak; Kang, Tae Kyu; Wikstrom, Erik A; Jun, Hyung-Pil; Lee, Sae Yong

2017-10-01

The purpose of this study was to determine how reduced plantar cutaneous sensation influences static postural control in individuals with and without CAI. A case-control study design. Twenty-six individuals with self-reported CAI and 26 matched healthy controls participated in this study. The plantar aspect of the participants' foot was then submersed in ice water (0°C) for 10min to reduce plantar sensation. Before and after the cooling procedure, plantar cutaneous sensation thresholds and single leg balance with eyes open and closed were assessed. Significantly, higher scores were observed in both groups after ice water submersion (p<0.001) indicating a significant reduction in the plantar cutaneous sensitivity after the cooling procedure. In single limb balance with eyes open, there were significant intervention main effects for the TTB ML mean (p<0.001), TTB AP mean (p=0.035) and TTB ML SD (p=0.021); indicating postural control improvement in both groups post-cooling. In single limb balance with eyes closed, Group×Intervention interactions were observed for the TTB AP mean (p=0.003) and TTB AP SD (p=0.017); indicating postural control deficits in CAI group post-cooling, but no changes in the control group. The main finding of this study was that reduced plantar cutaneous sensation induced by an ice submersion procedure caused eyes closed postural control impairments in those with CAI but not healthy controls. The present investigation demonstrated that the ability to dynamically reweight among sensory inputs to maintain postural stability appears to be diminished in CAI patients compared to healthy controls. Copyright © 2016. Published by Elsevier Ltd.

Postural orientation and equilibrium processes associated with increased postural sway in autism spectrum disorder (ASD).

PubMed

Wang, Zheng; Hallac, Rami R; Conroy, Kaitlin C; White, Stormi P; Kane, Alex A; Collinsworth, Amy L; Sweeney, John A; Mosconi, Matthew W

2016-01-01

Increased postural sway has been repeatedly documented in children with autism spectrum disorder (ASD). Characterizing the control processes underlying this deficit, including postural orientation and equilibrium, may provide key insights into neurophysiological mechanisms associated with ASD. Postural orientation refers to children's ability to actively align their trunk and head with respect to their base of support, while postural equilibrium is an active process whereby children coordinate ankle dorsi-/plantar-flexion and hip abduction/adduction movements to stabilize their upper body. Dynamic engagement of each of these control processes is important for maintaining postural stability, though neither postural orientation nor equilibrium has been studied in ASD. Twenty-two children with ASD and 21 age and performance IQ-matched typically developing (TD) controls completed three standing tests. During static stance, participants were instructed to stand as still as possible. During dynamic stances, participants swayed at a comfortable speed and magnitude in either anterior-posterior (AP) or mediolateral (ML) directions. The center of pressure (COP) standard deviation and trajectory length were examined to determine if children with ASD showed increased postural sway. Postural orientation was assessed using a novel virtual time-to-contact (VTC) approach that characterized spatiotemporal dimensions of children's postural sway (i.e., body alignment) relative to their postural limitation boundary, defined as the maximum extent to which each child could sway in each direction. Postural equilibrium was quantified by evaluating the amount of shared or mutual information of COP time series measured along the AP and ML directions. Consistent with prior studies, children with ASD showed increased postural sway during both static and dynamic stances relative to TD children. In regard to postural orientation processes, children with ASD demonstrated reduced spatial perception of their postural limitation boundary towards target directions and reduced time to correct this error during dynamic postural sways but not during static stance. Regarding postural equilibrium, they showed a compromised ability to decouple ankle dorsi-/plantar-flexion and hip abduction/adduction processes during dynamic stances. These results suggest that deficits in both postural orientation and equilibrium processes contribute to reduced postural stability in ASD. Specifically, increased postural sway in ASD appears to reflect patients' impaired perception of their body movement relative to their own postural limitation boundary as well as a reduced ability to decouple distinct ankle and hip movements to align their body during standing. Our findings that deficits in postural orientation and equilibrium are more pronounced during dynamic compared to static stances suggests that the increased demands of everyday activities in which children must dynamically shift their COP involve more severe postural control deficits in ASD relative to static stance conditions that often are studied. Systematic assessment of dynamic postural control processes in ASD may provide important insights into new treatment targets and neurodevelopmental mechanisms.

Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study.

PubMed

Sinaki, Mehrsheed; Lynn, Susan G

2002-04-01

To assess the effect of a proprioceptive dynamic posture training program on balance in osteoporotic women with kyphotic posture. Subjects were randomly assigned to either a proprioceptive dynamic posture training program or exercise only group. Anthropometric measurements, muscle strength, level of physical activity, computerized dynamic posturography, and spine radiography were performed at baseline and 1 mo. At the 1-mo follow-up, three groups were formed on the basis of the baseline computerized dynamic posturography results. In general, groups 1 and 2 had no significant change at 1 mo, whereas group 3 improved balance significantly at 1 mo. The subjects who had abnormal balance and used the proprioceptive dynamic posture training program had the most significant improvement in balance. Improved balance could reduce the risk of falls.

Effect of fibular repositioning taping in adult basketball players with chronic ankle instability: a randomized, placebo-controlled, crossover trial.

PubMed

Alves, Yanina; Ribeiro, Fernando; Silva, Anabela G

2017-07-05

Chronic ankle instability presents a high incidence and prevalence in basketbal players. It's important to develop strategies to reduce the functional and mechanical limitations resulting from this condition. To compare the effect of Mulligan ́s fibular repositioning taping with a placebo taping immediatly after application and after a running test (Yo-Yo IRT). 16 adult basketball players (10 male, 6 female) with chronic ankle instability and mean age 21.50 ± 2.76 years old. Assessment of static postural control (15 seconds of unipedal stance test with eyes closed in a force platform), functional performance (figure 8 hop test and lateral hop test) and neuromuscular control (peroneus longus latency time in sudden inversion) in two conditions: Mulligan and Placebo. No significant effect was found for the intervantion factor in both hop tests (p>0.170), but there was a significant effect for the time factor (p<0.03). For the peroneus longus latency time, there was a significant interaction between factors (p=0.028) and also for time (p=0.042). No significant effect was found for any of the static postural control variables (area, speed and total displacement) (p≥0.10). There was no differences between Mulligan's fibular repositioning taping and Placebo taping in postural control and functional performance in basketball players with chronic ankle instability. However, Mulligan's taping appears to reduce peroneus longus latency time after a running when compared with a placebo taping.

Foam pad of appropriate thickness can improve diagnostic value of foam posturography in detecting postural instability.

PubMed

Liu, Bo; Leng, Yangming; Zhou, Renhong; Liu, Jingjing; Liu, Dongdong; Liu, Jia; Zhang, Su-Lin; Kong, Wei-Jia

2018-04-01

The present study investigated the effect of foam thickness on postural stability in patients with unilateral vestibular hypofunction (UVH) during foam posturography. Static and foam posturography were performed in 33 patients (UVH group) and 30 healthy subjects (control group) with eyes open (EO) and closed (EC) on firm surface and on 1-5 foam pad(s). Sway velocity (SV) of center of pressure, standing time before falling (STBF) and falls reaction were recorded and analyzed. (1) SVs had an increasing tendency in both groups as the foam pads were added under EO and EC conditions. (2) STBFs, only in UVH group with EC, decreased with foam thickness increasing. (3) Significant differences in SV were found between the control and UVH group with EO (except for standing on firm surface, on 1 and 2 foam pad(s)) and with EC (all surface conditions). (4) Receiver operating characteristic curve analysis showed that the SV could better reflect the difference in postural stability between the two groups while standing on the 4 foam pads with EC. Our study showed that diagnostic value of foam posturography in detecting postural instability might be enhanced by using foam pad of right thickness.

The effects of narrow and elevated path walking on aperture crossing.

PubMed

Hackney, Amy L; Cinelli, Michael E; Denomme, Luke T; Frank, James S

2015-06-01

The study investigated the impact that action capabilities have on identifying possibilities for action, particularly how postural threat influences the passability of apertures. To do this, the ability to maintain balance was challenged by manipulating the level of postural threat while walking. First, participants walked along a 7m path and passed through two vertical obstacles spaced 1.1-1.5×the shoulder width apart during normal walking. Next, postural threat was manipulated by having participants complete the task either walking on a narrow, ground level path or on an elevated/narrow path. Despite a decrease in walking speed as well as an increase in trunk sway in both the narrow and elevated/narrow walking conditions, the passability of apertures was only affected when the consequence of instability was greatest. In the elevated/narrow walking condition, individuals maintained a larger critical point (rotated their shoulders for larger aperture widths) compared to normal walking. However, this effect was not observed for the narrow path walking suggesting that the level of postural threat was not enough to impose similar changes to the critical point. Therefore, it appears that manipulating action capabilities by increasing postural threat does indeed influence aperture crossing behavior, however the consequence associated with instability must be high before both gait characteristics and the critical point are affected. Copyright © 2015 Elsevier B.V. All rights reserved.

Postural muscle atrophy prevention and recovery and bone remodelling through high frequency proprioception for astronauts

NASA Astrophysics Data System (ADS)

Riva, Dario; Rossitto, Franco; Battocchio, Luciano

2009-09-01

The difficulty in applying active exercises during space flights increases the importance of passive countermeasures, but coupling load and instability remains indispensable for generating high frequency (HF) proprioceptive flows and preventing muscle atrophy and osteoporosis. The present study, in microgravity conditions during a parabolic flight, verified whether an electronic system, composed of a rocking board, a postural reader and a bungee-cord loading apparatus creates HF postural instability comparable to that reachable on the Earth. Tracking the subject, in single stance, to real-time visual signals is necessary to obtain HF instability situations. The bungee-cord loading apparatus allowed the subject to manage the 81.5% body weight load (100% could easily be exceeded). A preliminary training programme schedule on the Earth and in space is suggested. Comparison with a pathological muscle atrophy is presented. The possibility of generating HF proprioceptive flows could complement current countermeasures for the prevention and recovery of muscle atrophy and osteoporosis in terrestrial and space environments. These exercises combine massive activation of spindles and joint receptors, applying simultaneously HF variations of pressure to different areas of the sole of the foot. This class of exercises could improve the effectiveness of current countermeasures, reducing working time and fatigue.

Static Postural Stability in Chronic Ankle Instability, An Ankle Sprain and Healthy Ankles.

PubMed

Kwon, Yong Ung

2018-05-18

To identify the single leg balance (SLB) test that discriminates among healthy, coper, and chronic ankle instability (CAI) groups and to determine effects of ankle muscles on the balance error scoring system (BESS) among the three populations. 60 subjects (20 per group) performed the SLB test with eyes open (EO) and eyes closed (EC). Normalized mean amplitude (NMA) of the tibia anterior (TA), fibularis longus (FL), and medial gastrocnemius (MG) muscles and BESS were measured while performing the SLB test. The coper group had a lower error score than the CAI group in the EC. NMA was greater in the CAI group compared to in the healthy and coper groups regardless of muscle type. NMA of the TA was less than the PL and MG regardless of the group in the EO. The CAI group demonstrated greater NMAs of the PL and MG than the healthy and coper groups in the EC. The CAI group demonstrated greater NMA of the PL and MG by compensating their ankle muscles in the EO and EC. BESS suggests that the coper group may have coping mechanisms to stabilize static postural control compared to the CAI group. The EC may be better to detect static postural instability in the CAI or coper group. © Georg Thieme Verlag KG Stuttgart · New York.

The clinical utility of posturography.

PubMed

Visser, Jasper E; Carpenter, Mark G; van der Kooij, Herman; Bloem, Bastiaan R

2008-11-01

Postural instability and falls are common and devastating features of ageing and many neurological, visual, vestibular or orthopedic disorders. Current management of these problems is hampered by the subjective and variable nature of the available clinical balance measures. In this narrative review, we discuss the clinical utility of posturography as a more objective and quantitative measure of balance and postural instability, focusing on several areas where clinicians presently experience the greatest difficulties in managing their patients: (a) to make an appropriate differential diagnosis in patients presenting with falls or balance impairment; (b) to reliably identify those subjects who are at risk of falling; (c) to objectively and quantitatively document the outcome of therapeutic interventions; and (d) to gain a better pathophysiological understanding of postural instability and falls, as a basis for the development of improved treatment strategies to prevent falling. In each of these fields, posturography offers several theoretical advantages and, when applied correctly, provides a useful tool to gain a better understanding of pathophysiological mechanisms in patients with balance disorders, at the group level. However, based on the available evidence, none of the existing techniques is currently able to significantly influence the clinical decision making in individual patients. We critically review the shortcomings of posturography as it is presently used, and conclude with several recommendations for future research.

Postural dynamism during computer mouse and keyboard use: A pilot study.

PubMed

Van Niekerk, S M; Fourie, S M; Louw, Q A

2015-09-01

Prolonged sedentary computer use is a risk factor for musculoskeletal pain. The aim of this study was to explore postural dynamism during two common computer tasks, namely mouse use and keyboard typing. Postural dynamism was described as the total number of postural changes that occurred during the data capture period. Twelve participants were recruited to perform a mouse and a typing task. The data of only eight participants could be analysed. A 3D motion analysis system measured the number of cervical and thoracic postural changes as well as, the range in which the postural changes occurred. The study findings illustrate that there is less postural dynamism of the cervical and thoracic spinal regions during computer mouse use, when compared to keyboard typing. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The validity and reliability of a dynamic neuromuscular stabilization-heel sliding test for core stability.

PubMed

Cha, Young Joo; Lee, Jae Jin; Kim, Do Hyun; You, Joshua Sung H

2017-10-23

Core stabilization plays an important role in the regulation of postural stability. To overcome shortcomings associated with pain and severe core instability during conventional core stabilization tests, we recently developed the dynamic neuromuscular stabilization-based heel sliding (DNS-HS) test. The purpose of this study was to establish the criterion validity and test-retest reliability of the novel DNS-HS test. Twenty young adults with core instability completed both the bilateral straight leg lowering test (BSLLT) and DNS-HS test for the criterion validity study and repeated the DNS-HS test for the test-retest reliability study. Criterion validity was determined by comparing hip joint angle data that were obtained from BSLLT and DNS-HS measures. The test-retest reliability was determined by comparing hip joint angle data. Criterion validity was (ICC2,3) = 0.700 (p< 0.05), suggesting a good relationship between the two core stability measures. Test-retest reliability was (ICC3,3) = 0.953 (p< 0.05), indicating excellent consistency between the repeated DNS-HS measurements. Criterion validity data demonstrated a good relationship between the gold standard BSLLT and DNS-HS core stability measures. Test-retest reliability data suggests that DNS-HS core stability was a reliable test for core stability. Clinically, the DNS-HS test is useful to objectively quantify core instability and allow early detection and evaluation.

Postural control and head stability during natural gaze behaviour in 6- to 12-year-old children.

PubMed

Schärli, A M; van de Langenberg, R; Murer, K; Müller, R M

2013-06-01

We investigated how the influence of natural exploratory gaze behaviour on postural control develops from childhood into adulthood. In a cross-sectional design, we compared four age groups: 6-, 9-, 12-year-olds and young adults. Two experimental trials were performed: quiet stance with a fixed gaze (fixed) and quiet stance with natural exploratory gaze behaviour (exploratory). The latter was elicited by having participants watch an animated short film on a large screen in front of them. 3D head rotations in space and centre of pressure (COP) excursions on the ground plane were measured. Across conditions, both head rotation and COP displacement decreased with increasing age. Head movement was greater in the exploratory condition in all age groups. In all children-but not in adults-COP displacement was markedly greater in the exploratory condition. Bivariate correlations across groups showed highly significant positive correlations between COP displacement in ML direction and head rotation in yaw, roll, and pitch in both conditions. The regularity of COP displacements did not show a clear developmental trend, which indicates that COP dynamics were qualitatively similar across age groups. Together, the results suggest that the contribution of head movement to eye-head saccades decreases with age and that head instability-in part resulting from such gaze-related head movements-is an important limiting factor in children's postural control. The lack of head stabilisation might particularly affect children in everyday activities in which both postural control and visual exploration are required.

Gabapentin can improve postural stability and quality of life in primary orthostatic tremor.

PubMed

Rodrigues, Julian P; Edwards, Dylan J; Walters, Susan E; Byrnes, Michelle L; Thickbroom, Gary; Stell, Rick; Mastaglia, Frank L

2005-07-01

Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. Copyright 2005 Movement Disorder Society.

The Role of Neuromuscular Changes in Aging and Knee Osteoarthritis on Dynamic Postural Control

PubMed Central

Takacs, Judit; Carpenter, Mark G.; Garland, S. Jayne; Hunt, Michael A.

2013-01-01

Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA. PMID:23696951

Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults.

PubMed

Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Goldberg, Allon; Adamo, Diane E

2016-01-01

Postural control requires the integration of sensorimotor information to maintain balance and to properly position and orient the body in response to external stimuli. Age-related declines in peripheral and central sensory and motor function contribute to postural instability and falls. This study investigated the contribution of head position, standing surface, and vision on postural sway in 26 community-dwelling older adults. Participants were asked to maintain a stable posture under conditions that varied standing surface, head position, and the availability of visual information. Significant main and interaction effects were found for all three factors. Findings from this study suggest that postural sway responses require the integration of available sources of sensory information. These results have important implications for fall risks in older adults and suggest that when standing with the head extended and eyes closed, older adults may place themselves at risk for postural disequilibrium and loss of balance. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Orthostatic stress is necessary to maintain the dynamic range of cardiovascular control in space

NASA Technical Reports Server (NTRS)

Baisch, J. F.; Wolfram, G.; Beck, L.; Drummer, C.; Stormer, I.; Buckey, J.; Blomqvist, G.

2000-01-01

In the upright position, gravity fills the low-pressure systems of human circulation with blood and interstitial fluid in the sections below the diaphragm. Without gravity one pressure component in the vessels disappears and the relationship between hydrostatic pressure and oncotic pressure, which regulates fluid passage across the capillary endothelium in the terminal vascular bed, shifts constantly. The visible consequences of this are a puffy face and "bird" legs. The plasma volume shrinks in space and the range of cardiovascular control is reduced. When they stand up for the first time after landing, 30-50% of astronauts suffer from orthostatic intolerance. It remains unclear whether microgravity impairs cardiovascular reflexes, or whether it is the altered volume status that causes the cardiovascular instability following space flight. Lower body negative pressure was used in several space missions to stimulate the cardiovascular reflexes before, during and after a space flight. The results show that cardiovascular reflexes are maintained in microgravity. However, the astronauts' volume status changed in space, towards a volume-retracted state, as measurements of fluid-regulating hormones have shown. It can be hypothesized that the control of circulation and body fluid homeostasis in humans is adapted to their upright posture in the Earth's gravitational field. Autonomic control regulates fluid distribution to maintain the blood pressure in that posture, which most of us have to cope with for two-thirds of the day. A determined amount of interstitial volume is necessary to maintain the dynamic range of cardiovascular control in the upright posture; otherwise orthostatic intolerance may occur more often.

Changes in postural control in patients with Parkinson's disease: a posturographic study.

PubMed

Doná, F; Aquino, C C; Gazzola, J M; Borges, V; Silva, S M C A; Ganança, F F; Caovilla, H H; Ferraz, H B

2016-09-01

Postural instability is one of the most disabling features in Parkinson's disease (PD), and often leads to falls that reduce mobility and functional capacity. The objectives of this study were to analyse the limit of stability (LOS) and influence of the manipulation of visual, somatosensorial and visual-vestibular information on postural control in patients with PD and healthy subjects. Cross-sectional. Movement Disorders Unit, university setting. Eighty-two subjects aged between 37 and 83 years: 41 with Parkinson's disease in the 'on' state and 41 healthy subjects with no neurological disorders. Both groups were matched in terms of sex and age. Unified Parkinson's Disease Rating Scale (UPDRS)-motor score, modified Hoehn and Yahr staging, Dynamic Gait Index (DGI) and posturography with integrated virtual reality. The parameters analysed by posturography were LOS area, area of body centre of pressure excursion and balance functional reserve in the standing position in 10 conditions (open and closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction). The mean UPDRS motor score and DGI score were 27 [standard deviation (SD) 14] and 21 (SD 3), respectively. Thirteen participants scored between 0 and 19 points, indicating major risk of falls. Posturographic assessment showed that patients with PD had significantly lower LOS area and balance functional reserve values, and greater body sway area in all posturographic conditions compared with healthy subjects. Patients with PD have reduced LOS area and greater postural sway compared with healthy subjects. The deterioration in postural control was significantly associated with major risk of falls. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The visual control of stability in children and adults: postural readjustments in a ground optical flow.

PubMed

Baumberger, Bernard; Isableu, Brice; Flückiger, Michelangelo

2004-11-01

The aim of this research was to analyse the development of postural reactions to approaching (AOF) and receding (ROF) ground rectilinear optical flows. Optical flows were shaped by a pattern of circular spots of light projected on the ground surface by a texture flow generator. The geometrical structure of the projected scenes corresponded to the spatial organisation of visual flows encountered in open outdoor settings. Postural readjustments of 56 children, ranging from 7 to 11 years old, and 12 adults were recorded by the changes of the centre of foot pressure (CoP) on a force platform during 44-s exposures to the moving texture. Before and after the optical flows exposure, a 24-s motionless texture served as a reference condition. Effect of ground rectilinear optical flows on postural control development was assessed by analysing sway latencies (SL), stability performances and postural orientation. The main results that emerge from this experiment show that postural responses are directionally specific to optical flow pattern and that they vary as a function of the motion onset and offset. Results showed that greater developmental changes in postural control occurred in an AOF (both at the onset and offset of the optical flow) than in an ROF. Onset of an approaching flow induced postural instability, canonical shifts in postural orientation and long latencies in children which were stronger than in the receding flow. This pattern of responses evolved with age towards an improvement in stability performances and shorter SL. The backward decreasing shift of the CoP in children evolved in adults towards forward postural tilt, i.show $132#e. in the opposite direction of the texture's motion. Offset of an AOF motion induced very short SL in children (which became longer in adult subjects), strong postural instability, but weaker shift of orientation compared to the receding one. Postural stability improved and orientation shift evolved to forward inclinations with age. SL remained almost constant across age at both onset and offset of the receding flow. Critical developmental periods seem to occur by the age of 8 and 10 years, as suggested by the transient 'neglect' of the children to optical flows. Linear vection was felt by 90% of the 7 year olds and decreased with age to reach 55% in adult subjects. The mature sensorimotor coordination subserving the postural organisation shown in adult subjects is an example aiming at reducing the postural effects induced by optical flows. The data are discussed in relation to the perceptual importance of mobile visual references on a ground support.

Laterality of repetitive finger movement performance and clinical features of Parkinson's disease.

PubMed

Stegemöller, Elizabeth; Zaman, Andrew; MacKinnon, Colum D; Tillman, Mark D; Hass, Chris J; Okun, Michael S

2016-10-01

Impairments in acoustically cued repetitive finger movement often emerge at rates near to and above 2Hz in persons with Parkinson's Disease (PD) in which some patients move faster (hastening) and others move slower (bradykinetic). The clinical features impacting this differential performance of repetitive finger movement remain unknown. The purpose of this study was to compare repetitive finger movement performance between the more and less affected side, and the difference in clinical ratings among performance groups. Forty-one participants diagnosed with idiopathic PD completed an acoustically cued repetitive finger movement task while "on" medication. Eighteen participants moved faster, 10 moved slower, and 13 were able to maintain the appropriate rate at rates above 2Hz. Clinical measures of laterality, disease severity, and the UPDRS were obtained. There were no significant differences between the more and less affected sides regardless of performance group. Comparison of disease severity, tremor, and rigidity among performance groups revealed no significant differences. Comparison of posture and postural instability scores revealed that the participants that demonstrated hastening had worse posture and postural instability scores. Consideration of movement rate during the clinical evaluation of repetitive finger movement may provide additional insight into varying disease features in persons with PD. Copyright © 2016 Elsevier B.V. All rights reserved.

Vestibular plasticity following orbital spaceflight: recovery from postflight postural instability

NASA Technical Reports Server (NTRS)

Black, F. O.; Paloski, W. H.; Doxey-Gasway, D. D.; Reschke, M. F.

1995-01-01

Results of previous studies suggested that the vestibular mediated postural instability observed in astronauts upon return to earth from orbital spaceflight may be exacerbated by an increased weighting of visual inputs for spatial orientation and control of movement. This study was performed to better understand the roles of visual and somatosensory contributions to recovery of normal sensori-motor postural control in returning astronauts. Preflight and postflight, 23 astronaut volunteers were presented randomly with three trials of six sensory organization test (SOT) conditions in the EquiTest system test battery. Sagittal plane center-of-gravity (COG) excursions computed from ground reaction forces were significantly higher on landing day than preflight for those test conditions presenting sway-referenced visual and/or somatosensory orientation cues. The ratio of summed peak-to-peak COG sway amplitudes on the two sway-referenced vision tests (SOTs 3 + 6) compared to the two eyes closed tests (SOTs 2 + 5) was increased on landing day, indicating an increased reliance on visual orientation cues for postural control. The ratio of peak-to-peak COG excursions on sway-referenced surfaces (SOTs 4, 5 & 6) to an earth fixed support surfaces (SOTs 1, 2 & 3) increased even more after landing suggesting primary reliance on somatosensory orientation cues for recovery of postflight postural stability. Readaptation to sway-referenced support surfaces took longer than readaptation to sway-referenced vision. The increased reliance on visual and somatosensory inputs disappeared in all astronauts 4-8 days following return to earth.

Losing touch: age-related changes in plantar skin sensitivity, lower limb cutaneous reflex strength, and postural stability in older adults

PubMed Central

Peters, Ryan M.; McKeown, Monica D.; Carpenter, Mark G.

2016-01-01

Age-related changes in the density, morphology, and physiology of plantar cutaneous receptors negatively impact the quality and quantity of balance-relevant information arising from the foot soles. Plantar perceptual sensitivity declines with age and may predict postural instability; however, alteration in lower limb cutaneous reflex strength may also explain greater instability in older adults and has yet to be investigated. We replicated the age-related decline in sensitivity by assessing monofilament and vibrotactile (30 and 250 Hz) detection thresholds near the first metatarsal head bilaterally in healthy young and older adults. We additionally applied continuous 30- and 250-Hz vibration to drive mechanically evoked reflex responses in the tibialis anterior muscle, measured via surface electromyography. To investigate potential relationships between plantar sensitivity, cutaneous reflex strength, and postural stability, we performed posturography in subjects during quiet standing without vision. Anteroposterior and mediolateral postural stability decreased with age, and increases in postural sway amplitude and frequency were significantly correlated with increases in plantar detection thresholds. With 30-Hz vibration, cutaneous reflexes were observed in 95% of young adults but in only 53% of older adults, and reflex gain, coherence, and cumulant density at 30 Hz were lower in older adults. Reflexes were not observed with 250-Hz vibration, suggesting this high-frequency cutaneous input is filtered out by motoneurons innervating tibialis anterior. Our findings have important implications for assessing the risk of balance impairment in older adults. PMID:27489366

Prediction of Post-stroke Falls by Quantitative Assessment of Balance.

PubMed

Lee, Hyun Haeng; Jung, Se Hee

2017-06-01

To evaluate characteristics of the postural instability in patients with stroke and to present a prediction model of post-stroke falls. Patients with a first-ever stroke who had been evaluated by the Balance Master (BM) at post-stroke 3 months (±1 month) between August 2011 and December 2015 were enrolled. Parameters for the postural instability, such as the weight bearing asymmetry (WBA) and postural sway velocity (PSV), were obtained. The fall events in daily lives were assessed via structured telephone interview with a fall related questionnaire. A total of 71 patients (45 men; 45 with ischemic stroke) were enrolled in this study. All subjects underwent BM evaluation at 3.03±0.40 months after stroke. The mean WBA was 17.18%±13.10% and mean PSV (measured as °/s) were noted as 0.66±0.37 (eyes-open on firm surface), 0.89±0.75 (eyes-closed on firm surface), 1.45±1.09 (eyes-open on soft surface), and 3.10±1.76 (eyes-closed on soft surface). A prediction model of post-stroke falls was drawn by multiple logistic regression analysis as follows: Risk of post-stroke falls = -2.848 + 1.878 x (PSV ECSS ) + 0.154 x (age=1 if age≥65; age=0 if age<65). The weight bearing asymmetry and postural sway were significantly increased in patients with stroke. Older age and impaired postural control increased the risk of post-stroke falls.

Footwear for the neuropathic patient: offloading and stability.

PubMed

van Deursen, Robert

2008-01-01

Diabetic neuropathy is related to plantar ulceration through a variety of factors of which increased plantar pressures and loss of protective sensation are the most important. Loss of sensation in the lower limbs is also related to postural instability and an increased risk of falling. Ankle and foot proprioception play an important role in postural control and this sensory function is also affected by neuropathy. It is conceivable that footwear, orthotics, casts and braces used for treatment or prevention of plantar ulceration through offloading of the injured or at-risk foot area can exacerbate the postural instability and risk of falling. This has, however, received very limited attention in the literature. There are studies that have demonstrated that footwear adjustments can influence balance and stability in healthy, elderly subjects. The adjustments made to footwear for the diabetic foot are generally more dramatic and, therefore, are expected to have a greater influence on postural stability. Furthermore, casts and braces tend to deviate even more from normal footwear. This may seriously interfere with normal gait and posture and, therefore, stability. So far the evidence suggests that patients wearing such devices demonstrate markedly reduced activity levels. This reduced activity could add to the effect of offloading. This could also be interpreted to indicate problems with stability. This presentation will review the different types of offloading interventions frequently used for ulcer treatment and prevention and will consider the mechanical effect of these interventions on stability.

Measures of static postural control moderate the association of strength and power with functional dynamic balance.

PubMed

Forte, Roberta; Boreham, Colin A G; De Vito, Giuseppe; Ditroilo, Massimiliano; Pesce, Caterina

2014-12-01

Age-related reductions in strength and power are considered to negatively impact balance control, but the existence of a direct association is still an issue of debate. This is possibly due to the fact that balance assessment is complex, reflects different underlying physiologic mechanisms and involves quantitative measurements of postural sway or timing of performance during balance tasks. The present study evaluated the moderator effect of static postural control on the association of power and strength with dynamic balance tasks. Fifty-seven healthy 65-75 year old individuals performed tests of dynamic functional balance (walking speed under different conditions) and of strength, power and static postural control. Dynamic balance performance (walking speed) was associated with lower limb strength and power, as well as postural control under conditions requiring postural adjustments (narrow surface walking r(2) = 0.31, p < 0.001). An interaction effect between strength and static postural control was found with narrow surface walking and talking while walking (change of β 0.980, p < 0.001 in strength for 1 SD improvements in static postural control for narrow walking, and [Formula: see text] -0.730, p < 0.01 in talking while walking). These results indicate that good static postural control facilitates the utilisation of lower limb strength to better perform complex, dynamic functional balance tasks. Practical implications for assessment and training are discussed.

Dose postural control improve following application of transcutaneous electrical nerve stimulation in diabetic peripheral neuropathic patients? A randomized placebo control trial.

PubMed

Saadat, Z; Rojhani-Shirazi, Z; Abbasi, L

2017-12-01

peripheral neuropathy is the most common problem of diabetes. Neuropathy leads to lower extremity somatosensory deficits and postural instability in these patients. However, there are not sufficient evidences for improving postural control in these patients. To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with diabetic neuropathy. Twenty eighth patients with diabetic neuropathy (40-55 Y/O) participated in this RCT study. Fourteen patients in case group received TENS and sham TENS was used for control group. Force plate platform was used to extract sway velocity and COP displacement parameters for postural control evaluation. The mean sway velocity and center of pressure displacement along the mediolateral and anteroposterior axes were not significantly different between two groups after TENS application (p>0.05). Application of 5min high frequency TENS on the knee joint could not improve postural control in patients with diabetic neuropathy. Copyright © 2017. Published by Elsevier Ltd.

Impact of soft and hard insole density on postural stability in older adults.

PubMed

Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Palacios Peña, Domingo

2012-01-01

A significant predictor of falls in the elderly population is attributed to postural instability. Thus, it is important to identify and implement practical clinical interventions to enhance postural stability in older adults. Shoe insoles have been identified as a mechanism to enhance postural control, and our study aimed to evaluate the impact of 2 shoe insoles on static standing balance in healthy, older adults compared with standing posture while barefoot. We hypothesized that both hard and soft shoe insoles would decrease postural sway compared with the barefoot condition. Indeed, excursion distances and sway areas were reduced, and sway velocity was decreased when wearing insoles. The hard insole was also effective when visual feedback was removed, suggesting that the more rigid an insole, the greater potential reduction in fall risk. Thus, shoe insoles may be a cost-effective, clinical intervention that is easy to implement to reduce the risk of falling in the elderly population. Copyright © 2012 Mosby, Inc. All rights reserved.

Pilot Study: Measuring the Effects of Center of Gravity Shift on Postural Stability

NASA Technical Reports Server (NTRS)

Times-Marshall, Chelsea; Reschke, Millard

2009-01-01

It has been shown that astronauts returning from space often experience postural instability due to the stimulus rearrangement of the visual, vestibular, and proprioceptive systems. However, postural control may also be influenced by the head-ward shift in their center of gravity (CG) that occurs as a result of the expansion of their spinal column by as much as two inches during long duration space flight, as well as the CG shift that occurs from the Life Support Pack on the extra-vehicular activity (EVA) suit. This study investigated the effect on postural stability after (1) an immediate shift in the CG towards the head, (2) a 30 minute adaptation to the shifted CG, and (3) immediate shift of the CG back to normal, accomplished by donning and removing a modified backpack. We hypothesized that at each immediate shift in CG, postural performance will be compromised.

Motor intensive anti-gravity training improves performance in dynamic balance related tasks in persons with Parkinson's disease.

PubMed

Malling, Anne Sofie B; Jensen, Bente R

2016-01-01

Recent studies indicate that the effect of training on motor performance in persons with Parkinson's disease (PDP) is dependent on motor intensity. However, training of high motor intensity can be hard to apply in PDP due to e.g. bradykinesia, rigidity, tremor and postural instability. Therefore, the aim was to study the effect of motor intensive training performed in a safe anti-gravity environment using lower-body positive pressure (LBPP) technology on performance during dynamic balance related tasks. Thirteen male PDP went through an 8-week control period followed by 8 weeks of motor intensive antigravity training. Seventeen healthy males constituted a control group (CON). Performance during a five repetition sit-to-stand test (STS; sagittal plane) and a dynamic postural balance test (DPB; transversal plane) was evaluated. Effect measures were completion time, functional rates of force development, directional changes and force variance. STS completion time improved by 24% to the level of CON which was explained by shorter sitting-time and standing-time and larger numeric rate of force change during lowering to the chair, indicating faster vertical directional change and improved relaxation. DPB completion time tended to improve and was accompanied by improvements of functional medial and lateral rates of force development and higher vertical force variance during DPB. Our results suggest that the performance improvements may relate to improved inter-limb coordination. It is concluded that 8 weeks of motor intensive training in a safe LBPP environment improved performance during dynamic balance related tasks in PDP. Copyright © 2015 Elsevier B.V. All rights reserved.

M.I.T./Canadian vestibular experiments on the Spacelab-1 mission. V - Postural responses following exposure to weightlessness

NASA Technical Reports Server (NTRS)

Kenyon, R. V.; Young, L. R.

1986-01-01

The four science crewmembers of Spacelab-1 were tested for postural control before and after a 10 day mission in weightlessness. Previous reports have shown changes in astronaut postural behavior following a return to earth's 1-g field. This study was designed to identify changes in EMG latency and amplitudes that might explain the instabilities observed post-flight. Erect posture was tested having the subject stand on a pneumatically driven posture platform which pitched rapidly and unexpectedly about the ankles causing dorsi- and plantarflexion. Electromyographic (EMG) activity from the tibialis anterior and the gastrocnemius-soleus muscles was measured during eyes open and eyes closed trials. The early (pre 500 ms) EMG response characteristics (latency, amplitude) in response to a disturbance in the posture of the subject were apparently unchanged by the 10 days of weightlessness. However, the late (post 500 ms) response showed higher amplitudes than was found pre-flight. General postural control was quantitatively measured pre- and post-flight by a 'sharpened Romberg Rails test'. This test showed decrements in standing stability with eyes closed for several days post-flight.

Shoulder Impingement Treatment

MedlinePlus

... imbalance in the rotator cuff or scapular muscles, postural abnormalities, shoulder joint instability, or improper training or ... and corrected. Phase Goals Methods Comments I Pain control Limit overhead activity or anything that causes pain. ...

The Dynamics of Flow and Three-dimensional Motion Around a Morphologically Complex Aquatic Plant

NASA Astrophysics Data System (ADS)

Boothroyd, R.; Hardy, R. J.; Warburton, J.; Marjoribanks, T.

2016-12-01

Aquatic vegetation has a significant impact on the hydraulic functioning of river systems. The morphology of an individual plant can influence the mean and turbulent properties of the flow, and the plant posture reconfigures to minimise drag. We report findings from a flume and numerical experiment investigating the dynamics of motion and three-dimensional flow around an isolated Hebe odora plant over a range of flow conditions. In the flume experiment, a high definition video camera recorded plant motion dynamics and three-dimensional velocity profiles were measured using an acoustic Doppler velocimeter. By producing a binary image of the plant in each frame, the plant dynamics can be quantified. Zones of greatest plant motion are on the upper and leeward sides of the plant. With increasing flow the plant is compressed and deflected downwards by up to 18% of the unstressed height. Plant tip motions are tracked and shown to lengthen with increasing flow, transitioning from horizontally dominated to vertically dominated motion. The plant acts as a porous blockage to flow, producing spatially heterogeneous downstream velocity fields with the measured wake length decreasing by 20% with increasing flow. These measurements are then used as boundary conditions and to validate a computational fluid dynamics (CFD) model. By explicitly accounting for the time-averaged plant posture, good agreement is found between flume measurements and model predictions. The flow structures demonstrate characteristics of a junction vortex system, with plant shear layer turbulence dominated by Kelvin-Helmholtz and Görtler-type vortices generated through shear instability. With increasing flow, drag coefficients decrease by up to 8%, from 1.45 to 1.34. This is equivalent to a change in the Manning's n term from 0.086 to 0.078.

The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability.

PubMed

Powden, Cameron J; Hogan, Kathleen K; Wikstrom, Erik A; Hoch, Matthew C

2017-05-01

Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI). Examine the immediate effects of talocrural joint traction in those with CAI. Blinded, crossover. Laboratory. Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering "yes" to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool. Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected. The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P < .05. No significant treatment effects were identified for any variables. A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.

Age-Related Changes in Dynamic Postural Control and Attentional Demands are Minimally Affected by Local Muscle Fatigue

PubMed Central

Remaud, Anthony; Thuong-Cong, Cécile; Bilodeau, Martin

2016-01-01

Normal aging results in alterations in the visual, vestibular and somtaosensory systems, which in turn modify the control of balance. Muscle fatigue may exacerbate these age-related changes in sensory and motor functions, and also increase the attentional demands associated with dynamic postural control. The purpose of this study was to investigate the effect of aging on dynamic postural control and posture-related attentional demands before and after a plantar flexor fatigue protocol. Participants (young adults: n = 15; healthy seniors: n = 13) performed a dynamic postural task along the antero-posterior (AP) and the medio-lateral (ML) axes, with and without the addition of a simple reaction time (RT) task. The dynamic postural task consisted in following a moving circle on a computer screen with the representation of the center of pressure (COP). This protocol was repeated before and after a fatigue task where ankle plantar flexor muscles were targeted. The mean COP-target distance and the mean COP velocity were calculated for each trial. Cross-correlation analyses between the COP and target displacements were also performed. RTs were recorded during dual-task trials. Results showed that while young adults adopted an anticipatory control mode to move their COP as close as possible to the target center, seniors adopted a reactive control mode, lagging behind the target center. This resulted in longer COP-target distance and higher COP velocity in the latter group. Concurrently, RT increased more in seniors when switching from static stance to dynamic postural conditions, suggesting potential alterations in the central nervous system (CNS) functions. Finally, plantar flexor muscle fatigue and dual-tasking had only minor effects on dynamic postural control of both young adults and seniors. Future studies should investigate why the fatigue-induced changes in quiet standing postural control do not seem to transfer to dynamic balance tasks. PMID:26834626

Functional contributors to poor movement and balance control in patients with low back pain: A descriptive analysis.

PubMed

Ayhan, Cigdem; Bilgin, Sevil; Aksoy, Songul; Yakut, Yavuz

2016-08-10

Automatic and voluntary body position control is essential for postural stability; however, little is known about individual factors that impair the sensorimotor system associated with low back pain (LBP). To evaluate automatic and voluntary motor control impairments causing postural instability in patients with LBP. Motor control impairments associated with poor movement and balance control were analyzed prospectively in 32 patients with LBP. Numeric Rating Scale (NRS) for pain assessment, Oswestry Disability Index (ODI) for disability measurement, and computerized dynamic posturography (CDP) for analysis of postural responses were used to measure outcomes of all patients. Computerized dynamic posturography tests including Sensory organization test (SOT), limits of stability test (movement velocity, directional control, endpoint, and maximum excursion), rhythmic weight shift (rhythmic movement speed and directional control), and adaptation test (toes-up and toes-down tests) were performed and the results compared with NeuroCom normative data. The mean age of the patients was 40.50 ± 12.28 years. Lower equilibrium scores were observed in SOT (p < 0.05). There was a significant increase in reaction time and decrease in movement velocity, directional control, and endpoint excursion (p < 0.05). Speed of rhythmic movement along the anteroposterior direction decreased, while speed increased along the lateral direction (p < 0.05). Poor directional control was recorded in the anteroposterior direction (p < 0.05). Toes-down test showed an increased COG sway in patients compared with that in the controls (p < 0.05). LBP causes poor voluntary control of body positioning, a reduction in movement control, delays in movement initiation, and a difficulty to adapt to sudden surface changes.

The integration of multiple proprioceptive information: effect of ankle tendon vibration on postural responses to platform tilt.

PubMed

Hatzitaki, Vassilia; Pavlou, Marousa; Bronstein, Adolfo M

2004-02-01

Previous studies have looked at co-processing of multiple proprioceptive inputs but few have investigated the effect of separate dynamic and tonic predominantly proprioceptive disruptions applied concurrently at the same segment. The purpose of the present study was to investigate how simultaneous ankle tendon vibration, a tonic stimulus, with a dynamic toes-up (TU) or toes-down (TD) platform perturbation (1) affects postural stability and (2) influences the adaptation process. Sixteen normal subjects (ten male, six female, mean age 26 +/- 4.8 years) stood blindfolded on a moving platform with vibrators attached bilaterally over the Achilles tendons. Participants were tested in quiet stance (QS), and with five successive TU and TD tilts. All tests were conducted both with (QS+V, TU+V, TD+V) and without vibration. Centre of pressure (CoP) displacements and pitch angular trunk velocity were recorded. Results for QS+V showed a significant 1.02-cm backward CoP displacement (P<0.01) and a significant increase in trunk velocity (peak-to-peak amplitude, P<0.05; SD of trunk velocity, P<0.05). TU+V resulted in a non-significant increase of maximum backwards CoP displacement when compared to TU alone. In addition, no notable effect of vibration on other measures of CoP (pre-tilt position, SD and area of sway) and trunk velocity (peak-to-peak, SD and area of sway) indicates that TU+V does not introduce significantly greater instability compared to tilt alone. In the TD condition, vibration was found to be a stabilising influence, causing a significant shift of the mean pre-tilt position 0.85 cm backwards (P<0.01) and a substantial decrease in the area of forward CoP displacement (P<0.01). However, maximum forwards CoP displacement and trunk velocity measures were not significantly altered during TD+V. Furthermore, in neither TU nor TD was the time-course or pattern of adaptation disrupted by the additional application of vibration. In conclusion, although vibration significantly affects postural measures when applied in isolation, this finding does not hold when it is applied in combination with a more dynamic stimulus. Instead it seems that once postural stability has been disrupted the central nervous system can rapidly assess information from a weaker tonic input and utilise or suppress it appropriately, depending on its effect towards overall postural control. It can be concluded that postural responses to the concurrent application of different predominantly proprioceptive stimuli are dependent upon the type of stimulus and the ability of the central nervous system to rapidly assess and re-weigh available sensory inputs.

Reinforcement learning for stabilizing an inverted pendulum naturally leads to intermittent feedback control as in human quiet standing.

PubMed

Michimoto, Kenjiro; Suzuki, Yasuyuki; Kiyono, Ken; Kobayashi, Yasushi; Morasso, Pietro; Nomura, Taishin

2016-08-01

Intermittent feedback control for stabilizing human upright stance is a promising strategy, alternative to the standard time-continuous stiffness control. Here we show that such an intermittent controller can be established naturally through reinforcement learning. To this end, we used a single inverted pendulum model of the upright posture and a very simple reward function that gives a certain amount of punishments when the inverted pendulum falls or changes its position in the state space. We found that the acquired feedback controller exhibits hallmarks of the intermittent feedback control strategy, namely the action of the feedback controller is switched-off intermittently when the state of the pendulum is located near the stable manifold of the unstable saddle-type upright equilibrium of the inverted pendulum with no active control: this action provides an opportunity to exploit transiently converging dynamics toward the unstable upright position with no help of the active feedback control. We then speculate about a possible physiological mechanism of such reinforcement learning, and suggest that it may be related to the neural activity in the pedunculopontine tegmental nucleus (PPN) of the brainstem. This hypothesis is supported by recent evidence indicating that PPN might play critical roles for generation and regulation of postural tonus, reward prediction, as well as postural instability in patients with Parkinson's disease.

Mechanisms of postural control in alcoholic men and women: biomechanical analysis of musculoskeletal coordination during quiet standing.

PubMed

Sullivan, Edith V; Rose, Jessica; Pfefferbaum, Adolf

2010-03-01

Excessive sway during quiet standing is a common sequela of chronic alcoholism even with prolonged sobriety. Whether alcoholic men and women who have remained abstinent from alcohol for weeks to months differ from each other in the degree of residual postural instability and biomechanical control mechanisms has not been directly tested. We used a force platform to characterize center-of-pressure biomechanical features of postural sway, with and without stabilizing conditions from touch, vision, and stance, in 34 alcoholic men, 15 alcoholic women, 22 control men, and 29 control women. Groups were matched in age (49.4 years), general intelligence, socioeconomic status, and handedness. Each alcoholic group was sober for an average of 75 days. Analysis of postural sway when using all 3 stabilizing conditions versus none revealed diagnosis and sex differences in ability to balance. Alcoholics had significantly longer sway paths, especially in the anterior-posterior direction, than controls when maintaining erect posture without balance aids. With stabilizing conditions the sway paths of all groups shortened significantly, especially those of alcoholic men, who demonstrated a 3.1-fold improvement in sway path difference between the easiest and most challenging conditions; the remaining 3 groups, each showed a approximately 2.4-fold improvement. Application of a mechanical model to partition sway paths into open-loop and closed-loop postural control systems revealed that the sway paths of the alcoholic men but not alcoholic women were characterized by greater short-term (open-loop) diffusion coefficients without aids, often associated with muscle stiffening response. With stabilizing factors, all 4 groups showed similar long-term (closed loop) postural control. Correlations between cognitive abilities and closed-loop sway indices were more robust in alcoholic men than alcoholic women. Reduction in sway and closed-loop activity during quiet standing with stabilizing factors shows some differential expression in men and women with histories of alcohol dependence. Nonetheless, enduring deficits in postural instability of both alcoholic men and alcoholic women suggest persisting liability for falling.

Relationship between antigravity control and postural control in young children.

PubMed

Sellers, J S

1988-04-01

The purposes of this study were 1) to determine the relationship between antigravity control (supine flexion and prone extension) and postural control (static and dynamic balance), 2) to determine the quality of antigravity and postural control, and 3) to determine whether sex and ethnic group differences correlate with differences in antigravity control and postural control in young children. I tested 107 black, Hispanic, and Caucasian children in a Head Start program, with a mean age of 61 months. The study results showed significant relationships between antigravity control and postural control. Subjects' supine flexion performance was significantly related to the quantity and quality of their static and dynamic balance performance, whereas prone extension performance was related only to the quality of dynamic balance performance. Quality scale measurements (r = .90) indicated that the children in this study had not yet developed full antigravity or postural control. The study results revealed differences between sexes in the quality of static balance and prone extension performance and ethnic differences in static balance, dynamic balance, and prone extension performance.

Should Ballet Dancers Vary Postures and Underfoot Surfaces When Practicing Postural Balance?

PubMed

Steinberg, Nili; Waddington, Gordon; Adams, Roger; Karin, Janet; Tirosh, Oren

2018-01-01

Postural balance (PB) is an important component skill for professional dancers. However, the effects of different types of postures and different underfoot surfaces on PB have not adequately been addressed. The main aim of this study was to investigate the effect of different conditions of footwear, surfaces, and standing positions on static and dynamic PB ability of young ballet dancers. A total of 36 male and female young professional ballet dancers (aged 14-19 years) completed static and dynamic balance testing, measured by head and lumbar accelerometers, while standing on one leg in the turnout position, under six different conditions: (1) "relaxed" posture; (2) "ballet" posture; (3) barefoot; (4) ballet shoes with textured insoles; (5) barefoot on a textured mat; and (6) barefoot on a spiky mat. A condition effect was found for static and dynamic PB. Static PB was reduced when dancers stood in the ballet posture compared with standing in the relaxed posture and when standing on a textured mat and on a spiky mat (p < .05), and static PB in the relaxed posture was significantly better than PB in all the other five conditions tested. Dynamic PB was significantly better while standing in ballet shoes with textured insoles and when standing on a spiky mat compared with all other conditions (p < .05). The practical implications derived from this study are that both male and female dancers should try to be relaxed in their postural muscles when practicing a ballet aligned position, including dance practice on different types of floors and on different types of textured/spiky materials may result in skill transfer to practice on normal floor surfaces, and both static and dynamic PB exercises should be assessed and generalized into practical dance routines.

Susceptibility to Fear of Heights in Bilateral Vestibulopathy and Other Disorders of Vertigo and Balance

PubMed Central

Brandt, Thomas; Grill, Eva; Strupp, Michael; Huppert, Doreen

2018-01-01

Aims: To determine the susceptibility to visual height intolerance (vHI) in patients with acquired bilateral vestibulopathy (BVP). The question was whether postural instability in BVP, which is partially compensated for by visual substitution of the impaired vestibular control of balance, leads to an increased susceptibility. This is of particular importance since fear of heights is dependent on body posture, and visual control of balance at heights can no longer substitute vestibular input. For comparison susceptibility to vHI was determined in patients with other vestibular or functional disorders. Methods: A total of 150 patients aged 18 or above who had been referred to the German Center for Vertigo and Balance Disorders and diagnosed to have BVP were surveyed with a standardized questionnaire by specifically trained neurological professionals. Further, 481 patients with other vestibular or functional disorders were included. Results: Susceptibility to vHI was reported by 29% (32 % in females, 25% in males) of the patients with BVP. Patients with vHI were slightly younger (67 vs. 71 years). Seventy percent of those with vHI reported avoidance of climbing, hiking, stairs, darkness, cycling or swimming (84% of those without vHI). Mean age for onset of vHI was 40 years. Susceptibility to vHI was higher in patients with other vertigo disorders than in those with BVP: 64% in those with phobic postural vertigo, 61% in vestibular migraine, 56% in vestibular paroxysmia, 54% in benign paroxysmal positional vertigo, 49% in unilateral vestibulopathy and 48% in Menière's disease. Conclusions: The susceptibility to vHI in BVP was not higher than that of the general population (28%).This allows two explanations that need not be alternatives but contribute to each other: (1) Patients with a bilateral peripheral vestibular deficit largely avoid exposure to heights because of their postural instability. (2) The irrational anxiety to fall from heights triggers increased susceptibility to vHI, not the objective postural instability. However, patients with BVP do not exhibit increased comorbid anxiety disorders. This view is supported by the significantly increased susceptibility to vHI in other vestibular syndromes, which are characterized by an increased comorbidity of anxiety disorders.

Genetics Home Reference: multiple system atrophy

MedlinePlus

... inability to hold the body upright and balanced (postural instability). The other type of multiple system atrophy , ... cells in parts of the nervous system that control movement, balance and coordination, and autonomic functioning. The ...

Sit still and pay attention: Using the Wii Balance-Board to detect lapses in concentration in children during psychophysical testing.

PubMed

Jones, Pete R

2018-05-16

During psychophysical testing, a loss of concentration can cause observers to answer incorrectly, even when the stimulus is clearly perceptible. Such lapses limit the accuracy and speed of many psychophysical measurements. This study evaluates an automated technique for detecting lapses based on body movement (postural instability). Thirty-five children (8-11 years of age) and 34 adults performed a typical psychophysical task (orientation discrimination) while seated on a Wii Fit Balance Board: a gaming device that measures center of pressure (CoP). Incorrect responses on suprathreshold catch trials provided the "reference standard" measure of when lapses in concentration occurred. Children exhibited significantly greater variability in CoP on lapse trials, indicating that postural instability provides a feasible, real-time index of concentration. Limitations and potential applications of this method are discussed.

Assessing Forelimb Function after Unilateral Cervical SCI using Novel Tasks: Limb Step-alternation, Postural Instability and Pasta Handling

PubMed Central

Schallert, Timothy; Schmidt, Christine E.

2013-01-01

Cervical spinal cord injury (cSCI) can cause devastating neurological deficits, including impairment or loss of upper limb and hand function. A majority of the spinal cord injuries in humans occur at the cervical levels. Therefore, developing cervical injury models and developing relevant and sensitive behavioral tests is of great importance. Here we describe the use of a newly developed forelimb step-alternation test after cervical spinal cord injury in rats. In addition, we describe two behavioral tests that have not been used after spinal cord injury: a postural instability test (PIT), and a pasta-handling test. All three behavioral tests are highly sensitive to injury and are easy to use. Therefore, we feel that these behavioral tests can be instrumental in investigating therapeutic strategies after cSCI. PMID:24084700

Assessing forelimb function after unilateral cervical SCI using novel tasks: limb step-alternation, postural instability and pasta handling.

PubMed

Khaing, Zin Z; Geissler, Sydney A; Schallert, Timothy; Schmidt, Christine E

2013-09-16

Cervical spinal cord injury (cSCI) can cause devastating neurological deficits, including impairment or loss of upper limb and hand function. A majority of the spinal cord injuries in humans occur at the cervical levels. Therefore, developing cervical injury models and developing relevant and sensitive behavioral tests is of great importance. Here we describe the use of a newly developed forelimb step-alternation test after cervical spinal cord injury in rats. In addition, we describe two behavioral tests that have not been used after spinal cord injury: a postural instability test (PIT), and a pasta-handling test. All three behavioral tests are highly sensitive to injury and are easy to use. Therefore, we feel that these behavioral tests can be instrumental in investigating therapeutic strategies after cSCI.

Parkinsonism in fragile X-associated tremor/ataxia syndrome (FXTAS): revisited.

PubMed

Niu, Yu-Qiong; Yang, Jin-Chen; Hall, Deborah A; Leehey, Maureen A; Tassone, Flora; Olichney, John M; Hagerman, Randi J; Zhang, Lin

2014-04-01

Parkinsonian features have been used as a minor diagnostic criterion for fragile X-associated tremor/ataxia syndrome (FXTAS). However, prior studies have examined parkinsonism (defined as having bradykinesia with at least rest tremor or postural instability) mostly in premutation carriers without a diagnosis of FXTAS. The current study was intended to elaborate this important aspect of the FXTAS spectrum, and to quantify the relationships between parkinsonism, FXTAS clinical staging and genetic/molecular measures. Thirty eight (38) FXTAS patients and 10 age-matched normal controls underwent a detailed neurological examination that included all but one item (i.e. rigidity) of the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). The FXTAS patient group displayed substantially higher prevalence of parkinsonian features including body bradykinesia (57%) and rest tremor (26%), compared to the control group. Furthermore, parkinsonism was identified in 29% of FXTAS patients. Across all patients, body bradykinesia scores significantly correlated with FXTAS clinical stage, FMR1 mRNA level, and ataxic gait of cerebellar origin, while postural instability was associated with intention tremor. Parkinsonian features in FXTAS appear to be characterized as bradykinesia concurrent with cerebellar gait ataxia, postural instability accompanied by intention tremor, and frequent rest tremor, representing distinctive patterns that highlight the need for further clinical studies including genetic testing for the FMR1 premutation. The association between FMR1 mRNA level and bradykinesia implicates pathophysiological mechanisms which may link FMR1 mRNA toxicity, dopamine deficiency and parkinsonism in FXTAS. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modeling complex flow structures and drag around a submerged plant of varied posture

NASA Astrophysics Data System (ADS)

Boothroyd, Richard J.; Hardy, Richard J.; Warburton, Jeff; Marjoribanks, Timothy I.

2017-04-01

Although vegetation is present in many rivers, the bulk of past work concerned with modeling the influence of vegetation on flow has considered vegetation to be morphologically simple and has generally neglected the complexity of natural plants. Here we report on a combined flume and numerical model experiment which incorporates time-averaged plant posture, collected through terrestrial laser scanning, into a computational fluid dynamics model to predict flow around a submerged riparian plant. For three depth-limited flow conditions (Reynolds number = 65,000-110,000), plant dynamics were recorded through high-definition video imagery, and the numerical model was validated against flow velocities collected with an acoustic Doppler velocimeter. The plant morphology shows an 18% reduction in plant height and a 14% increase in plant length, compressing and reducing the volumetric canopy morphology as the Reynolds number increases. Plant shear layer turbulence is dominated by Kelvin-Helmholtz type vortices generated through shear instability, the frequency of which is estimated to be between 0.20 and 0.30 Hz, increasing with Reynolds number. These results demonstrate the significant effect that the complex morphology of natural plants has on in-stream drag, and allow a physically determined, species-dependent drag coefficient to be calculated. Given the importance of vegetation in river corridor management, the approach developed here demonstrates the necessity to account for plant motion when calculating vegetative resistance.

Walking on ballast impacts balance.

PubMed

Wade, Chip; Garner, John C; Redfern, Mark S; Andres, Robert O

2014-01-01

Railroad workers often perform daily work activities on irregular surfaces, specifically on ballast rock. Previous research and injury epidemiology have suggested a relationship between working on irregular surfaces and postural instability. The purpose of this study was to examine the impact of walking on ballast for an extended duration on standing balance. A total of 16 healthy adult males walked on a 7.62 m × 4.57 m (25 ft × 15 ft) walking surface of no ballast (NB) or covered with ballast (B) of an average rock size of about 1 inch for 4 h. Balance was evaluated using dynamic posturography with the NeuroCom(®) Equitest System(™) prior to experiencing the NB or B surface and again every 30 min during the 4 h of ballast exposure. Dependent variables were the sway velocity and root-mean-square (RMS) sway components in the medial-lateral and anterior-posterior directions. Repeated measures ANOVA revealed statistically significant differences in RMS and sway velocity between ballast surface conditions and across exposure times. Overall, the ballast surface condition induced greater sway in all of the dynamic posturography conditions. Walking on irregular surfaces for extended durations has a deleterious effect on balance compared to walking on a surface without ballast. These findings of changes in balance during ballast exposure suggest that working on an irregular surface may impact postural control.

Predicting balance improvements following STARS treatments in chronic ankle instability participants.

PubMed

Wikstrom, Erik A; McKeon, Patrick O

2017-04-01

Sensory Targeted Ankle Rehabilitation Strategies that stimulate sensory receptors improve postural control in chronic ankle instability participants. However, not all participants have equal responses. Therefore, identifying predictors of treatment success is needed to improve clinician efficiency when treating chronic ankle instability. Therefore, the purpose was to identify predictors of successfully improving postural control in chronic ankle instability participants. Secondary data analysis. Fifty-nine participants with self-reported chronic ankle instability participated. The condition was defined as a history of at least two episodes of "giving way" within the past 6 months; and limitations in self-reported function as measured by the Foot and Ankle Ability Measure. Participants were randomized into three treatment groups (plantar massage, ankle joint mobilization, calf stretching) that received 6, 5-min treatment sessions over a 2-week period. The main outcome measure was treatment success, defined as a participant exceeding the minimal detectable change score for a clinician-oriented single limb balance test. Participants with ≥3 balance test errors had a 73% probability of treatment success following ankle joint mobilizations. Participants with a self-reported function between limb difference <16.07% and who made >2.5 errors had a 99% probability of treatment success following plantar massage. Those who sustained ≥11 ankle sprains had a 94% treatment success probability following calf stretching. Self-reported functional deficits, worse single limb balance, and number of previous ankle sprains are important characteristics when determining if chronic ankle instability participants will have an increased probability of treatment success. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

PubMed Central

2011-01-01

Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: [1] Cumberland Ankle Instability Tool (CAIT) scores, [2] Star Excursion Balance Test (SEBT) reach distances, [3] ankle joint plantar flexion during drop landing and drop vertical jumping, and [4] ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors. PMID:21658224

Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report.

PubMed

O'Driscoll, Jeremiah; Kerin, Fearghal; Delahunt, Eamonn

2011-06-09

Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

Stance Postural Strategies in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy

PubMed Central

Missori, Paolo; Trompetto, Carlo; Fattapposta, Francesco

2016-01-01

Introduction Polyneuropathy leads to postural instability and an increased risk of falling. We investigated how impaired motor impairment and proprioceptive input due to neuropathy influences postural strategies. Methods Platformless bisegmental posturography data were recorded in healthy subjects and patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Each subject stood on the floor, wore a head and a hip electromagnetic tracker. Sway amplitude and velocity were recorded and the mean direction difference (MDD) in the velocity vector between trackers was calculated as a flexibility index. Results Head and hip postural sway increased more in patients with CIDP than in healthy controls. MDD values reflecting hip strategies also increased more in patients than in controls. In the eyes closed condition MDD values in healthy subjects decreased but in patients remained unchanged. Discussion Sensori-motor impairment changes the balance between postural strategies that patients adopt to maintain upright quiet stance. Motor impairment leads to hip postural strategy overweight (eyes open), and prevents strategy re-balancing when the sensory context predominantly relies on proprioceptive input (eyes closed). PMID:26977594

Dynamic postural stability for double-leg drop landing.

PubMed

Niu, Wenxin; Zhang, Ming; Fan, Yubo; Zhao, Qinping

2013-01-01

Dynamic postural stability has been widely studied for single-leg landing, but seldom considered for double-leg landing. This study aimed to evaluate the dynamic postural stability and the influence mechanism of muscle activities during double-leg drop landing. Eight recreationally active males and eight recreationally active females participated in this study and dropped individually from three heights (0.32 m, 0.52 m, and 0.72 m). Ground reaction force was recorded to calculate the time to stabilisation. Electromyographic activities were recorded for selected lower-extremity muscles. A multivariate analysis of variance was carried out and no significant influence was found in time to stabilisation between genders or limb laterals (P > 0.05). With increasing drop height, time to stabilisation decreased significantly in two horizontal directions and the lower-extremity muscle activities were enhanced. Vertical time to stabilisation was not significantly influenced by drop height. Dynamic postural stability improved by neuromuscular change more than that required due to the increase of drop height. Double-leg landing on level ground is a stable movement, and the body would often be injured before dynamic postural stability is impaired. It is understandable to protect tissues from mechanical injuries by the sacrifice of certain dynamic postural stability in the design of protective devices or athlete training.

Management of postural sensory conflict and dynamic balance control in late-stage Parkinson's disease.

PubMed

Colnat-Coulbois, S; Gauchard, G C; Maillard, L; Barroche, G; Vespignani, H; Auque, J; Perrin, P P

2011-10-13

Parkinson's disease (PD) is known to affect postural control, especially in situations needing a change in balance strategy or when a concurrent task is simultaneously performed. However, few studies assessing postural control in patients with PD included homogeneous population in late stage of the disease. Thus, this study aimed to analyse postural control and strategies in a homogeneous population of patients with idiopathic advanced (late-stage) PD, and to determine the contribution of peripheral inputs in simple and more complex postural tasks, such as sensory conflicting and dynamic tasks. Twenty-four subjects with advanced PD (duration: median (M)=11.0 years, interquartile range (IQR)=4.3 years; Unified Parkinson's Disease Rating Scale (UPDRS): M "on-dopa"=13.5, IQR=7.8; UPDRS: M "off-dopa"=48.5, IQR=16.8; Hoehn and Yahr stage IV in all patients) and 48 age-matched healthy controls underwent static (SPT) and dynamic posturographic (DPT) tests and a sensory organization test (SOT). In SPT, patients with PD showed reduced postural control precision with increased oscillations in both anterior-posterior and medial-lateral planes. In SOT, patients with PD displayed reduced postural performances especially in situations in which visual and vestibular cues became predominant to organize balance control, as was the ability to manage balance in situations for which visual or proprioceptive inputs are disrupted. In DPT, postural restabilization strategies were often inefficient to maintain equilibrium resulting in falls. Postural strategies were often precarious, postural regulation involving more hip joint than ankle joint in patients with advanced PD than in controls. Difficulties in managing complex postural situations, such as sensory conflicting and dynamic situations might reflect an inadequate sensory organization suggesting impairment in central information processing. Copyright © 2011. Published by Elsevier Ltd.

The effects of muscle hypotonia and weakness on balance: a study on Prader-Willi and Ehlers-Danlos syndrome patients.

PubMed

Galli, Manuela; Cimolin, Veronica; Vismara, Luca; Grugni, Graziano; Camerota, Filippo; Celletti, Claudia; Albertini, Giorgio; Rigoldi, Chiara; Capodaglio, Paolo

2011-01-01

Prader-Willi syndrome (PWS) and Ehlers-Danlos syndrome (EDS) are two different genetical disorders both characterized, among other features, by muscular hypotonia. Postural control seems to be impaired in both conditions. The aim of the present study was to quantitatively compare postural control in adult PWS and EDS using stabilometric platform to unveil possible common determinants of impaired balance. We enrolled 11 PWS and 21 EDS adult patients and 20 age-matched controls. They were instructed to maintain an upright standing position for 30s with open eyes (OEs) focusing on a 6 cm black circle positioned at a distance of 1.5m. Both PWS and EDS patients were characterized by higher RANGEML, RANGEAP and trajectory length of CoP values as compared to CG. No statistically differences were found between PWS and EDS in terms of any of these parameters. The results demonstrated that both PWS and EDS are characterized by a severe postural instability. Muscle hypotonia and weakness may account for reduced balance capacity. Quantitative characterization of instability is important to identify, develop and enhance rehabilitation interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults.

PubMed

Granacher, Urs; Lacroix, Andre; Muehlbauer, Thomas; Roettger, Katrin; Gollhofer, Albert

2013-01-01

Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 ± 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 ± 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Program compliance was excellent with participants of the INT group completing 92% of the training sessions. Significant group × test interactions were found for the maximal isometric strength of the trunk flexors (34%, p < 0.001), extensors (21%, p < 0.001), lateral flexors (right: 48%, p < 0.001; left: 53%, p < 0.001) and left rotators (42%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11%, p < 0.001) and coronal plane (11%, p = 0.06) directions, for stride velocity (9%, p < 0.05), the coefficient of variation in stride velocity (31%, p < 0.05), the Functional Reach test (20%, p < 0.05) and the Timed Up and Go test (4%, p < 0.05) in favor of the INT group. CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training. Copyright © 2012 S. Karger AG, Basel.

Impaired limb reaction to displacement of center of gravity in rats with unilateral striatal ischemic injury.

PubMed

Nobile, Cameron W; Palmateer, Julie M; Kane, Jackie; Hurn, Patricia D; Schallert, Timothy; Adkins, DeAnna L

2014-10-01

Clinical stroke often results in impaired balance and increased vulnerability to severe injuries due to falling. To evaluate potential preclinical treatments that might target these deficits, it will be important to include tests capable of assessing these impairments chronically in animal models. Previously, we developed a postural instability test (PIT) that revealed chronic, unilateral impairments in postural stability in rat models of hemi-Parkinson's disease (PD) and of unilateral cervical spinal cord injury. Here, we investigated whether this test was also capable of revealing long-term stroke-induced impairments in postural support in rats. Additionally, we examined the ability of more common tests of sensorimotor function to detect chronic impairments. We found that the PIT detected chronic deficits in postural stability/balance enduring for up to 6 weeks post-stroke, outlasting impairments detected in other tests of forelimb sensorimotor function, including asymmetries in upright postural support (cylinder test) and vibrissae-evoked forelimb placing.

Improvement of anticipatory postural adjustments for balance control: effect of a single training session.

PubMed

Kanekar, Neeta; Aruin, Alexander S

2015-04-01

Humans use anticipatory and compensatory postural strategies to maintain and restore balance when perturbed. Inefficient generation and utilization of anticipatory postural adjustments (APAs) is one of the reasons for postural instability. The aim of the study was to investigate the role of training in improvement of APAs and its effect on subsequent control of posture. Thirteen healthy young adults were exposed to predictable external perturbations before and after a single training session consisting of catches of a medicine ball thrown at the shoulder level. 3-D body kinematics, EMG activity of thirteen trunk and lower limb muscles, and ground reaction forces were recorded before and immediately after a single training session. Muscle onsets, EMG integrals, center of pressure (COP), and center of mass (COM) displacements were analyzed during the anticipatory and compensatory phases of postural control. The effect of a single training session was seen as significantly early muscle onsets and larger anticipatory COP displacements. As a result, significantly smaller peak COM displacements were observed after the perturbation indicating greater postural stability. The outcome of this study provides a background for examining the role of training in improvement of APAs and its effect on postural stability in individuals in need. Copyright © 2014 Elsevier Ltd. All rights reserved.

Age-related effects on postural control under multi-task conditions.

PubMed

Granacher, Urs; Bridenbaugh, Stephanie A; Muehlbauer, Thomas; Wehrle, Anja; Kressig, Reto W

2011-01-01

Changes in postural sway and gait patterns due to simultaneously performed cognitive (CI) and/or motor interference (MI) tasks have previously been reported and are associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of a CI and/or MI task on static and dynamic postural control in young and elderly subjects, and to find out whether there is an association between measures of static and dynamic postural control while concurrently performing the CI and/or MI task. A total of 36 healthy young (n = 18; age: 22.3 ± 3.0 years; BMI: 21.0 ± 1.6 kg/m(2)) and elderly adults (n = 18; age: 73.5 ± 5.5 years; BMI: 24.2 ± 2.9 kg/m(2)) participated in this study. Static postural control was measured during bipedal stance, and dynamic postural control was obtained while walking on an instrumented walkway. Irrespective of the task condition, i.e. single-task or multiple tasks, elderly participants showed larger center-of-pressure displacements and greater stride-to-stride variability than younger participants. Associations between measures of static and dynamic postural control were found only under the single-task condition in the elderly. Age-related deficits in the postural control system seem to be primarily responsible for the observed results. The weak correlations detected between static and dynamic measures could indicate that fall-risk assessment should incorporate dynamic measures under multi-task conditions, and that skills like erect standing and walking are independent of each other and may have to be trained complementarily. Copyright © 2010 S. Karger AG, Basel.

Fear of falling and postural reactivity in patients with glaucoma.

PubMed

Daga, Fábio B; Diniz-Filho, Alberto; Boer, Erwin R; Gracitelli, Carolina P B; Abe, Ricardo Y; Medeiros, Felipe A

2017-01-01

To investigate the relationship between postural metrics obtained by dynamic visual stimulation in a virtual reality environment and the presence of fear of falling in glaucoma patients. This cross-sectional study included 35 glaucoma patients and 26 controls that underwent evaluation of postural balance by a force platform during presentation of static and dynamic visual stimuli with head-mounted goggles (Oculus Rift). In dynamic condition, a peripheral translational stimulus was used to induce vection and assess postural reactivity. Standard deviations of torque moments (SDTM) were calculated as indicative of postural stability. Fear of falling was assessed by a standardized questionnaire. The relationship between a summary score of fear of falling and postural metrics was investigated using linear regression models, adjusting for potentially confounding factors. Subjects with glaucoma reported greater fear of falling compared to controls (-0.21 vs. 0.27; P = 0.039). In glaucoma patients, postural metrics during dynamic visual stimulus were more associated with fear of falling (R2 = 18.8%; P = 0.001) than static (R2 = 3.0%; P = 0.005) and dark field (R2 = 5.7%; P = 0.007) conditions. In the univariable model, fear of falling was not significantly associated with binocular standard perimetry mean sensitivity (P = 0.855). In the multivariable model, each 1 Nm larger SDTM in anteroposterior direction during dynamic stimulus was associated with a worsening of 0.42 units in the fear of falling questionnaire score (P = 0.001). In glaucoma patients, postural reactivity to a dynamic visual stimulus using a virtual reality environment was more strongly associated with fear of falling than visual field testing and traditional balance assessment.

Fear of falling and postural reactivity in patients with glaucoma

PubMed Central

Daga, Fábio B.; Diniz-Filho, Alberto; Boer, Erwin R.; Gracitelli, Carolina P. B.; Abe, Ricardo Y.; Medeiros, Felipe A.

2017-01-01

Purpose To investigate the relationship between postural metrics obtained by dynamic visual stimulation in a virtual reality environment and the presence of fear of falling in glaucoma patients. Methods This cross-sectional study included 35 glaucoma patients and 26 controls that underwent evaluation of postural balance by a force platform during presentation of static and dynamic visual stimuli with head-mounted goggles (Oculus Rift). In dynamic condition, a peripheral translational stimulus was used to induce vection and assess postural reactivity. Standard deviations of torque moments (SDTM) were calculated as indicative of postural stability. Fear of falling was assessed by a standardized questionnaire. The relationship between a summary score of fear of falling and postural metrics was investigated using linear regression models, adjusting for potentially confounding factors. Results Subjects with glaucoma reported greater fear of falling compared to controls (-0.21 vs. 0.27; P = 0.039). In glaucoma patients, postural metrics during dynamic visual stimulus were more associated with fear of falling (R2 = 18.8%; P = 0.001) than static (R2 = 3.0%; P = 0.005) and dark field (R2 = 5.7%; P = 0.007) conditions. In the univariable model, fear of falling was not significantly associated with binocular standard perimetry mean sensitivity (P = 0.855). In the multivariable model, each 1 Nm larger SDTM in anteroposterior direction during dynamic stimulus was associated with a worsening of 0.42 units in the fear of falling questionnaire score (P = 0.001). Conclusion In glaucoma patients, postural reactivity to a dynamic visual stimulus using a virtual reality environment was more strongly associated with fear of falling than visual field testing and traditional balance assessment. PMID:29211742

Kinematic predictors of star excursion balance test performance in individuals with chronic ankle instability.

PubMed

Hoch, Matthew C; Gaven, Stacey L; Weinhandl, Joshua T

2016-06-01

The Star Excursion Balance Test has identified dynamic postural control deficits in individuals with chronic ankle instability. While kinematic predictors of Star Excursion Balance Test performance have been evaluated in healthy individuals, this has not been thoroughly examined in individuals with chronic ankle instability. Fifteen individuals with chronic ankle instability completed the anterior reach direction of the Star Excursion Balance Test and weight-bearing dorsiflexion assessments. Maximum reach distances on the Star Excursion Balance Test were measured in cm and normalized to leg length. Three-dimensional trunk, hip, knee, and ankle motion of the stance limb were recorded during each anterior reach trial using a motion capture system. Sagittal, frontal, and transverse plane displacement observed from trial initiation to the point of maximum reach was calculated for each joint or segment and averaged for analysis. Pearson product-moment correlations were performed to examine the relationships between kinematic variables, maximal reach, and weight-bearing dorsiflexion. A backward multiple linear regression model was developed with maximal reach as the criterion variable and kinematic variables as predictors. Frontal plane displacement of the trunk, hip, and ankle and sagittal plane knee displacement were entered into the analysis. The final model (p=0.004) included all three frontal plane variables and explained 81% of the variance in maximal reach. Maximal reach distance and several kinematic variables were significantly related to weight-bearing dorsiflexion. Individuals with chronic ankle instability who demonstrated greater lateral trunk displacement toward the stance limb, hip adduction, and ankle eversion achieved greater maximal reach. Copyright © 2016. Published by Elsevier Ltd.

Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations.

PubMed

Bloem, Bastiaan R; Marinus, Johan; Almeida, Quincy; Dibble, Lee; Nieuwboer, Alice; Post, Bart; Ruzicka, Evzen; Goetz, Christopher; Stebbins, Glenn; Martinez-Martin, Pablo; Schrag, Anette

2016-09-01

Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Hemispheric specificity for proprioception: Postural control of standing following right or left hemisphere damage during ankle tendon vibration.

PubMed

Duclos, Noémie C; Maynard, Luc; Abbas, Djawad; Mesure, Serge

2015-11-02

Right brain damage (RBD) following stroke often causes significant postural instability. In standing (without vision), patients with RBD are more unstable than those with left brain damage (LBD). We hypothesised that this postural instability would relate to the cortical integration of proprioceptive afferents. The aim of this study was to use tendon vibration to investigate whether these changes were specific to the paretic or non-paretic limbs. 14 LBD, 12 RBD patients and 20 healthy subjects were included. Displacement of the Centre of Pressure (CoP) was recorded during quiet standing, then during 3 vibration conditions (80 Hz - 20s): paretic limb, non-paretic limb (left and right limbs for control subjects) and bilateral. Vibration was applied separately to the peroneal and Achilles tendons. Mean antero-posterior position of the CoP, variability and velocity were calculated before (4s), during and after (24s) vibration. For all parameters, the strongest perturbation was during Achilles vibrations. The Achilles non-paretic condition induced a larger backward displacement than the Achilles paretic condition. This condition caused specific behaviour on the velocity: the LBD group was perturbed at the onset of the vibrations, but gradually recovered their stability; the RBD group was significantly perturbed thereafter. After bilateral Achilles vibration, RBD patients required the most time to restore initial posture. The reduction in use of information from the paretic limb may be a central strategy to deal with risk-of-fall situations such as during Achilles vibration. The postural behaviour is profoundly altered by lesions of the right hemisphere when proprioception is perturbed. Copyright © 2015 Elsevier B.V. All rights reserved.

Height effects in real and virtual environments.

PubMed

Simeonov, Peter I; Hsiao, Hongwei; Dotson, Brian W; Ammons, Douglas E

2005-01-01

The study compared human perceptions of height, danger, and anxiety, as well as skin conductance and heart rate responses and postural instability effects, in real and virtual height environments. The 24 participants (12 men, 12 women), whose average age was 23.6 years, performed "lean-over-the-railing" and standing tasks on real and comparable virtual balconies, using a surround-screen virtual reality (SSVR) system. The results indicate that the virtual display of elevation provided realistic perceptual experience and induced some physiological responses and postural instability effects comparable to those found in a real environment. It appears that a simulation of elevated work environment in a SSVR system, although with reduced visual fidelity, is a valid tool for safety research. Potential applications of this study include the design of virtual environments that will help in safe evaluation of human performance at elevation, identification of risk factors leading to fall incidents, and assessment of new fall prevention strategies.

Destabilization of Human Balance Control by Static and Dynamic Head Tilts

NASA Technical Reports Server (NTRS)

Paloski, William H.; Wood, Scott J.; Feiveson, Alan H.; Black, F. Owen; Hwang, Emma Y.; Reschke, Millard F.

2004-01-01

To better understand the effects of varying head movement frequencies on human balance control, 12 healthy adult humans were studied during static and dynamic (0.14,0.33,0.6 Hz) head tilts of +/-30deg in the pitch and roll planes. Postural sway was measured during upright stance with eyes closed and altered somatosensory inputs provided by a computerized dynamic posturography (CDP) system. Subjects were able to maintain upright stance with static head tilts, although postural sway was increased during neck extension. Postural stability was decreased during dynamic head tilts, and the degree of destabilization varied directly with increasing frequency of head tilt. In the absence of vision and accurate foot support surface inputs, postural stability may be compromised during dynamic head tilts due to a decreased ability of the vestibular system to discern the orientation of gravity.

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers

PubMed Central

Sirois-Leclerc, Geneviève; Remaud, Anthony

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources. PMID:28323843

Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers.

PubMed

Sirois-Leclerc, Geneviève; Remaud, Anthony; Bilodeau, Martin

2017-01-01

Postural control is not a fully automatic process, but requires a certain level of attention, particularly as the difficulty of the postural task increases. This study aimed at testing whether experienced contemporary dancers, because of their specialized training involving the control of posture/balance, would present with a dual-task performance suggesting lesser attentional demands associated with dynamic postural control compared with non-dancers. Twenty dancers and 16 non-dancers performed a dynamic postural tracking task in both antero-posterior and side-to-side directions, while standing on a force platform. The postural task was performed, in turn, 1) as a stand-alone task, and concurrently with both 2) a simple reaction time task and 3) a choice reaction time task. Postural control performance was estimated through variables calculated from centre of pressure movements. Although no overall group difference was found in reaction time values, we found a better ability to control the side to side movements of the centre of pressure during the tracking task in dancers compared with non-dancers, which was dependent on the secondary task. This suggests that such increased ability is influenced by available attentional resources.

Changes in Postural Control After a Ball-Kicking Balance Exercise in Individuals With Chronic Ankle Instability

PubMed Central

Conceição, Josilene Souza; Schaefer de Araújo, Felipe Gustavo; Santos, Gilmar Moraes; Keighley, John

2016-01-01

Context:  Rehabilitation programs for patients with chronic ankle instability (CAI) generally involve balance-perturbation training (BPT). Anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are the primary strategies used to maintain equilibrium during body perturbations. Little is known, however, about how APAs and CPAs are modified to promote better postural control for individuals with CAI after BPT. Objective:  To investigate the effect of BPT that involves kicking a ball on postural-control strategies in individuals with CAI. Design:  Randomized controlled clinical trial. Setting:  Laboratory. Patients or Other Participants:  We randomly assigned 44 volunteers with CAI to either a training group (TG; 11 women, 11 men; age = 24 ± 4 years, height = 173.0 ± 9.8 cm, mass = 72.64 ± 11.98 kg) or control group (CG; 11 women, 11 men; age = 22 ± 3 years, height = 171.0 ± 9.7 cm, mass = 70.00 ± 11.03 kg). Intervention(s):  The TG performed a single 30-minute training session that involved kicking a ball while standing on 1 foot. The CG received no intervention. Main Outcome Measure(s):  The primary outcome was the sum of the integrated electromyographic activity (∑∫EMG) of the lower extremity muscles in the supporting limb that were calculated during typical intervals for APAs and CPAs. A secondary outcome was center-of-pressure displacement during similar intervals. Results:  In the TG after training, the ∑∫EMG decreased in both dorsal and ventral muscles during compensatory adjustment (ie, the time interval that followed lower limb movement). During this interval, muscle activity (∑∫EMG) was less in the TG than in the CG. Consequently, center-of-pressure displacement increased during the task after training. Conclusions:  A single session of ball-kicking BPT promoted changes in postural-control strategies in individuals with CAI. These results should stimulate new and more comprehensive studies to investigate the effect of this and other BPT techniques on postural control in patients with CAI. PMID:27295488

Stereotypy and Motor Control: Differences in the Postural Stability Dynamics of Persons with Stereotyped and Dyskinetic Movement Disorders.

ERIC Educational Resources Information Center

Bodfish, James W.; Parker, Dawn E.; Lewis, Mark H.; Sprague, Robert L.; Newell, Karl M.

2001-01-01

This study examined whether dynamic measures of postural stability differentiated stereotyped movement disorder from dyskinetic movement disorder in a severely mentally retarded population. Participants (N=20) with either stereotypy or dyskinesia movement disorders and a control group were given a goal-oriented postural stability task. Both groups…

The effect of paraquat inhalation on parkinsonism, organ morphology and anatomy of mice and its recovery with the application of etliringea hemisphaerica (blume, r.m. smith) crude extract

NASA Astrophysics Data System (ADS)

Muslim, Choirul; Nurul Kamila, Santi

2018-03-01

This research is aimed to understand the effect of paraquat herbicide inhalation on Parkinsonism, morphology and anatomy change in mice, and its recovery with Etliringea hemisphaerica crude extract application. Sixty mice were placed into three following groups: group R0 were mice receiving standard food ransom, R1 were a group of mice receiving the regular food ransom plus inhalation of 1% paraquat, and R2 were a group of R1 plus obtaining 0,39mg/bw extract E. hemisphaerica (Bl.) R.M. Smith). After 2 X 7 days of sub-sequential application of both paraquat and “helani tulip” extract, we observed the effects. The examination included bradikinesia attitude, postural instability and rigidity, morphology and anatomy of brain, liver, blood, lung, and kidney. The data were tabulated and analyzed qualitative and semi quantitative description on the behavioural disorder, the alteration of morphology and anatomy, and their remedy based on Sander 2004, Junqueira and Carneiro, 2007. The results showed that the application of paraquat caused strong bradikinesia, postural instability and rigidity. The treatment of the extract was only resulting in the bradikinesia removal but was minor improving the consequence of postural instability and rigidity. Paraquat was not affecting the morphology of neural brain but was altering the morphology and anatomy of lung, liver, blood, and the kidney. In general, the negative impact of the paraquat was weakly eliminated by the treatment of “helani tulip” extract.

Postural Ataxia in Cerebellar Downbeat Nystagmus: Its Relation to Visual, Proprioceptive and Vestibular Signals and Cerebellar Atrophy.

PubMed

Helmchen, Christoph; Kirchhoff, Jan-Birger; Göttlich, Martin; Sprenger, Andreas

2017-01-01

The cerebellum integrates proprioceptive, vestibular and visual signals for postural control. Cerebellar patients with downbeat nystagmus (DBN) complain of unsteadiness of stance and gait as well as blurred vision and oscillopsia. The aim of this study was to elucidate the differential role of visual input, gaze eccentricity, vestibular and proprioceptive input on the postural stability in a large cohort of cerebellar patients with DBN, in comparison to healthy age-matched control subjects. Oculomotor (nystagmus, smooth pursuit eye movements) and postural (postural sway speed) parameters were recorded and related to each other and volumetric changes of the cerebellum (voxel-based morphometry, SPM). Twenty-seven patients showed larger postural instability in all experimental conditions. Postural sway increased with nystagmus in the eyes closed condition but not with the eyes open. Romberg's ratio remained stable and was not different from healthy controls. Postural sway did not change with gaze position or graviceptive input. It increased with attenuated proprioceptive input and on tandem stance in both groups but Romberg's ratio also did not differ. Cerebellar atrophy (vermal lobule VI, VIII) correlated with the severity of impaired smooth pursuit eye movements of DBN patients. Postural ataxia of cerebellar patients with DBN cannot be explained by impaired visual feedback. Despite oscillopsia visual feedback control on cerebellar postural control seems to be preserved as postural sway was strongest on visual deprivation. The increase in postural ataxia is neither related to modulations of single components characterizing nystagmus nor to deprivation of single sensory (visual, proprioceptive) inputs usually stabilizing stance. Re-weighting of multisensory signals and/or inappropriate cerebellar motor commands might account for this postural ataxia.

Postural Ataxia in Cerebellar Downbeat Nystagmus: Its Relation to Visual, Proprioceptive and Vestibular Signals and Cerebellar Atrophy

PubMed Central

Helmchen, Christoph; Kirchhoff, Jan-Birger; Göttlich, Martin; Sprenger, Andreas

2017-01-01

Background The cerebellum integrates proprioceptive, vestibular and visual signals for postural control. Cerebellar patients with downbeat nystagmus (DBN) complain of unsteadiness of stance and gait as well as blurred vision and oscillopsia. Objectives The aim of this study was to elucidate the differential role of visual input, gaze eccentricity, vestibular and proprioceptive input on the postural stability in a large cohort of cerebellar patients with DBN, in comparison to healthy age-matched control subjects. Methods Oculomotor (nystagmus, smooth pursuit eye movements) and postural (postural sway speed) parameters were recorded and related to each other and volumetric changes of the cerebellum (voxel-based morphometry, SPM). Results Twenty-seven patients showed larger postural instability in all experimental conditions. Postural sway increased with nystagmus in the eyes closed condition but not with the eyes open. Romberg’s ratio remained stable and was not different from healthy controls. Postural sway did not change with gaze position or graviceptive input. It increased with attenuated proprioceptive input and on tandem stance in both groups but Romberg’s ratio also did not differ. Cerebellar atrophy (vermal lobule VI, VIII) correlated with the severity of impaired smooth pursuit eye movements of DBN patients. Conclusions Postural ataxia of cerebellar patients with DBN cannot be explained by impaired visual feedback. Despite oscillopsia visual feedback control on cerebellar postural control seems to be preserved as postural sway was strongest on visual deprivation. The increase in postural ataxia is neither related to modulations of single components characterizing nystagmus nor to deprivation of single sensory (visual, proprioceptive) inputs usually stabilizing stance. Re-weighting of multisensory signals and/or inappropriate cerebellar motor commands might account for this postural ataxia. PMID:28056109

Transfer of Dynamic Learning Across Postures

PubMed Central

Wolpert, Daniel M.

2009-01-01

When learning a difficult motor task, we often decompose the task so that the control of individual body segments is practiced in isolation. But on re-composition, the combined movements can result in novel and possibly complex internal forces between the body segments that were not experienced (or did not need to be compensated for) during isolated practice. Here we investigate whether dynamics learned in isolation by one part of the body can be used by other parts of the body to immediately predict and compensate for novel forces between body segments. Subjects reached to targets while holding the handle of a robotic, force-generating manipulandum. One group of subjects was initially exposed to the novel robot dynamics while seated and was then tested in a standing position. A second group was tested in the reverse order: standing then sitting. Both groups adapted their arm dynamics to the novel environment, and this movement learning transferred between seated and standing postures and vice versa. Both groups also generated anticipatory postural adjustments when standing and exposed to the force field for several trials. In the group that had learned the dynamics while seated, the appropriate postural adjustments were observed on the very first reach on standing. These results suggest that the CNS can immediately anticipate the effect of learned movement dynamics on a novel whole-body posture. The results support the existence of separate mappings for posture and movement, which encode similar dynamics but can be adapted independently. PMID:19710374

Review of first trial responses in balance control: influence of vestibular loss and Parkinson's disease.

PubMed

Allum, J H J; Tang, K-S; Carpenter, M G; Oude Nijhuis, L B; Bloem, B R

2011-04-01

The reaction to an unexpected balance disturbance is unpracticed, often startling and frequently associated with falls. This everyday situation can be reproduced in an experimental setting by exposing standing humans to sudden, unexpected and controlled movements of a support surface. In this review, we focus on the responses to the very first balance perturbation, the so-called first trial reactions (FTRs). Detailed analysis of FTRs may have important implications, both for clinical practice (providing new insights into the pathophysiological mechanisms underlying accidental falls in real life) and for understanding human physiology (what triggers and mediates these FTRs, and what is the relation to startle responses?). Several aspects of the FTRs have become clear. FTRs are characterized by an exaggerated postural reaction, with large EMG responses and co-contracting muscles in multiple body segments. This balance reaction is associated with marked postural instability (greater body sway to the perturbation). When the same perturbation is repeated, the size of the postural response habituates and the instability disappears. Other issues about FTRs remain largely unresolved, and these are addressed here. First, the functional role of FTRs is discussed. It appears that FTRs produce primarily increased trunk flexion during the multi-segmental response to postural perturbations, thus producing instability. Second, we consider which sensory signals trigger and modulate FTRs, placing specific emphasis on the role of vestibular signals. Surprisingly, vestibular signals appear to have no triggering role, but vestibular loss leads to excessive upper body FTRs due to loss of the normal modulatory influence. Third, we address the question whether startle-like responses are contributing to FTRs triggered by proprioceptive signals. We explain why this issue is still unresolved, mainly because of methodological difficulties involved in separating FTRs from 'pure' startle responses. Fourth, we review new work about the influence of perturbation direction on FTRs. Recent work from our group shows that the largest FTRs are obtained for toe-up support surface rotations which perturb the COM in the posterior direction. This direction corresponds to the directional preponderance for falls seen both in the balance laboratory and in daily life. Finally, we briefly touch upon clinical diagnostic issues, addressing whether FTRs (as opposed to habituated responses) could provide a more ecologically valid perspective of postural instability in patients compared to healthy subjects. We conclude that FTRs are an important source of information about human balance performance, both in health and disease. Future studies should no longer discard FTRs, but routinely include these in their analyses. Particular emphasis should be placed on the link between FTRs and everyday balance performance (including falls), and on the possible role played by startle reactions in triggering or modulating FTRs. Copyright © 2011 Elsevier B.V. All rights reserved.

Quantitative posturography in altered sensory conditions: a way to assess balance instability in patients with chronic whiplash injury.

PubMed

Madeleine, Pascal; Prietzel, Hanne; Svarrer, Heine; Arendt-Nielsen, Lars

2004-03-01

To quantify neck mobility and posture with and without various postural perturbations. A multivariable 2-group study with repeated measures and treatments. A human performance laboratory. Eleven patients with chronic whiplash injury (mean age, 33.3+/-6.7 y; weight, 73.4+/-11.4 kg; height, 173.3+/-7.2 cm) with a sex- and age-matched control group (mean age, 33.1+/-6.8 y; weight, 68+/-12.5 kg; height, 171.5+/-6.3 cm). Neck mobility and the effects of postural perturbations affecting the visual, vestibular, cutaneous, proprioceptive, and nociceptive systems were measured. Active range of motion, neck position sense, and postural activity. We found significantly reduced neck mobility and increased postural activity in the patient group compared with the control group. In patients, there was significantly greater postural activity with eyes closed, eyes open and speaking, and eyes closed with Achilles' tendons vibrations compared with eyes open with no vibrations. In the controls, there was no significant effect of experimental muscle pain on postural activity. Patients with chronic whiplash injury had a protective response to neck movement and different tuning, sequencing, and execution of the postural synergies probably because of excessive reliance on visual input despite a possible deficit and altered vestibular and/or proprioceptive activity. In healthy volunteers, the pain induced by a single bolus injection of hypertonic saline was probably too limited in intensity and spreading to decrease postural stability.

Increased dynamic regulation of postural tone through Alexander Technique training

PubMed Central

Cacciatore, TW; Gurfinkel, VS; Horak, FB; Cordo, PJ; Ames, KE

2010-01-01

Gurfinkel and colleagues (2006) recently found that healthy adults dynamically modulate postural muscle tone in the body axis during anti-gravity postural maintenance and that this modulation is inversely correlated with axial stiffness. Our objective in the present study was to investigate whether dynamic modulation of axial postural tone can change through training. We examined whether teachers of the Alexander Technique (AT), who undergo “long-term” (3-year) training, have greater modulation of axial postural tone than matched control subjects. In addition, we performed a longitudinal study on the effect of “short-term” (10-week) AT training on the axial postural tone of individuals with low back pain (LBP), since short term AT training has previously been shown to reduce LBP. Axial postural tone was quantified by measuring the resistance of the neck, trunk and hips to small (±10°), slow (1°/s) torsional rotation during stance. Modulation of tone was determined by the torsional resistance to rotation (peak-to-peak, phase-advance, and variability of torque) and axial muscle activity (EMG). Peak-to-peak torque was lower (~50%), while phase-advance and cycle-to-cycle variability were enhanced for AT teachers compared to matched control subjects at all levels of the axis. In addition, LBP subjects decreased trunk and hip stiffness following short-term AT training compared to a control intervention. While changes in static levels of postural tone may have contributed to the reduced stiffness observed with the AT, our results suggest that dynamic modulation of postural tone can be enhanced through long-term training in the AT, which may constitute an important direction for therapeutic intervention. PMID:21185100

Increased dynamic regulation of postural tone through Alexander Technique training.

PubMed

Cacciatore, T W; Gurfinkel, V S; Horak, F B; Cordo, P J; Ames, K E

2011-02-01

Gurfinkel and colleagues (2006) recently found that healthy adults dynamically modulate postural muscle tone in the body axis during anti-gravity postural maintenance and that this modulation is inversely correlated with axial stiffness. Our objective in the present study was to investigate whether dynamic modulation of axial postural tone can change through training. We examined whether teachers of the Alexander Technique (AT), who undergo "long-term" (3-year) training, have greater modulation of axial postural tone than matched control subjects. In addition, we performed a longitudinal study on the effect of "short-term" (10-week) AT training on the axial postural tone of individuals with low back pain (LBP), since short term AT training has previously been shown to reduce LBP. Axial postural tone was quantified by measuring the resistance of the neck, trunk and hips to small (±10°), slow (1°/s) torsional rotation during stance. Modulation of tone was determined by the torsional resistance to rotation (peak-to-peak, phase-advance, and variability of torque) and axial muscle activity (EMG). Peak-to-peak torque was lower (∼50%), while phase-advance and cycle-to-cycle variability were enhanced for AT teachers compared to matched control subjects at all levels of the axis. In addition, LBP subjects decreased trunk and hip stiffness following short-term AT training compared to a control intervention. While changes in static levels of postural tone may have contributed to the reduced stiffness observed with the AT, our results suggest that dynamic modulation of postural tone can be enhanced through long-term training in the AT, which may constitute an important direction for therapeutic intervention. Copyright © 2010 Elsevier B.V. All rights reserved.

Evaluation of the temporal structure of postural sway fluctuations based on a comprehensive set of analysis tools

NASA Astrophysics Data System (ADS)

Kirchner, M.; Schubert, P.; Schmidtbleicher, D.; Haas, C. T.

2012-10-01

The analysis of postural control has a long history. Traditionally, the amount of body sway is solely used as an index of postural stability. Although this leads to some extent to an effective evaluation of balance performance, the control mechanisms involved have not yet been fully understood. The concept of nonlinear dynamics suggests that variability in the motor output is not randomness but structure, providing the stimulus to reveal the functionality of postural sway. The present work evaluates sway dynamics by means of COP excursions in a quiet standing task versus a dual-task condition in three different test times (30, 60, 300 s). Besides the application of traditional methods-which estimate the overall size of sway-the temporal pattern of body sway was quantified via wavelet transform, multiscale entropy and fractal analysis. We found higher sensitivity of the structural parameters to modulations of postural control strategies and partly an improved evaluation of sway dynamics in longer recordings. It could be shown that postural control modifications take place on different timescales corresponding to the interplay of the sensory systems. A continued application of nonlinear analysis can help to better understand postural control mechanisms.

Postural Stabilization Strategies to Motor Contagion Induced by Action Observation Are Impaired in Parkinson’s Disease

PubMed Central

Pelosin, Elisa; Bisio, Ambra; Pozzo, Thierry; Lagravinese, Giovanna; Crisafulli, Oscar; Marchese, Roberta; Abbruzzese, Giovanni; Avanzino, Laura

2018-01-01

Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects’ body sway. Parkinson’s disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation. In this study, an action observation paradigm for assessing postural reaction to motor contagion in PD subjects and healthy older adults was used. Postural stability changes were measured during the observation of a static stimulus (control condition) and during a point-light display of a gymnast balancing on a rope (biological stimulus). Our results showed that, during the observation of the biological stimulus, sway area and antero-posterior and medio-lateral displacements of center of pressure significantly increased only in PD participants, whereas correct stabilization reactions were present in elderly subjects. These results demonstrate that PD leads to a decreased capacity to control automatic imitative tendencies induced by motor contagion. This behavior could be the consequence either of an inability to inhibit automatic imitative tendencies or of the cognitive load requested by the task. Whatever the case, the issue about the ability to inhibit automatic imitative tendencies could be crucial for PD patients since it might increase falls risk and injuries. PMID:29545771

Effect of static foot posture on the dynamic stiffness of foot joints during walking.

PubMed

Sanchis-Sales, E; Sancho-Bru, J L; Roda-Sales, A; Pascual-Huerta, J

2018-05-01

The static foot posture has been related to the development of lower limb injuries. This study aimed to investigate the dynamic stiffness of foot joints during gait in the sagittal plane to understand the role of the static foot posture in the development of injuries. Seventy healthy adult male subjects with different static postures, assessed by the Foot Posture Index (FPI) (30 normal, 20 highly pronated and 20 highly supinated), were recruited. Kinematic and kinetic data were recorded using an optical motion capture system and a pressure platform, and dynamic stiffness at the different stages of the stance was calculated from the slopes of the linear regression on the flexion moment-angle curves. The effect of foot type on dynamic stiffness and on ranges of motion and moments was analysed using ANOVAs and post-hoc tests, and linear correlation between dynamic stiffness and FPI was also tested. Highly pronated feet showed a significantly smaller range of motion at the ankle and metatarsophalangeal joints and also a larger range of moments at the metatarsophalangeal joint than highly supinated feet. Dynamic stiffness during propulsion was significantly greater at all foot joints for highly pronated feet, with positive significant correlations with the squared FPI. Highly supinated feet showed greater dynamic stiffness than normal feet, although to a lesser extent. Highly pronated feet during normal gait experienced the greatest decrease in the dorsiflexor moments during propulsion, normal feet being the most balanced regarding work generated and absorbed. Extreme static foot postures show greater dynamic stiffness during propulsion and greater absorbed work, which increases the risk of developing injuries. The data presented may be used when designing orthotics or prostheses, and also when planning surgery that modifies joint stiffness. Copyright © 2018 Elsevier B.V. All rights reserved.

Investigating the Feasibility and Utility of Bedside Balance Technology Acutely After Pediatric Concussion: A Pilot Study.

PubMed

Rhine, Tara D; Byczkowski, Terri L; Clark, Ross A; Babcock, Lynn

2016-05-01

To examine postural instability in children acutely after concussion, using the Wii Balance Board (WBB). We hypothesized that children with traumatic brain injury would have significantly worse balance relative to children without brain injury. Prospective case-control pilot study. Emergency department of a tertiary urban pediatric hospital. Cases were a convenience sample 11-16 years old who presented within 6 hours of sustaining concussion. Two controls, matched on gender, height, and age, were enrolled for each case that completed study procedures. Controls were children who presented for a minor complaint that was unlikely to affect balance. Not applicable. The participant's postural sway expressed as the displacement in centimeters of the center of pressure during a timed balance task. Balance testing was performed using 4 stances (single or double limb, eyes open or closed). Three of the 17 (17.6%) cases were too dizzy to complete testing. One stance, double limbs eyes open, was significantly higher in cases versus controls (85.6 vs 64.3 cm, P = 0.04). A simple test on the WBB consisting of a 2-legged standing balance task with eyes open discriminated children with concussion from non-head-injured controls. The low cost and feasibility of this device make it a potentially viable tool for assessing postural stability in children with concussion for both longitudinal research studies and clinical care. These pilot data suggest that the WBB is an inexpensive tool that can be used on the sideline or in the outpatient setting to objectively identify and quantify postural instability.

Comparison of four specific dynamic office chairs with a conventional office chair: impact upon muscle activation, physical activity and posture.

PubMed

Ellegast, Rolf P; Kraft, Kathrin; Groenesteijn, Liesbeth; Krause, Frank; Berger, Helmut; Vink, Peter

2012-03-01

Prolonged and static sitting postures provoke physical inactivity at VDU workplaces and are therefore discussed as risk factors for the musculoskeletal system. Manufacturers have designed specific dynamic office chairs featuring structural elements which promote dynamic sitting and therefore physical activity. The aim of the present study was to evaluate the effects of four specific dynamic chairs on erector spinae and trapezius EMG, postures/joint angles and physical activity intensity (PAI) compared to those of a conventional standard office chair. All chairs were fitted with sensors for measurement of the chair parameters (backrest inclination, forward and sideward seat pan inclination), and tested in the laboratory by 10 subjects performing 7 standardized office tasks and by another 12 subjects in the field during their normal office work. Muscle activation revealed no significant differences between the specific dynamic chairs and the reference chair. Analysis of postures/joint angles and PAI revealed only a few differences between the chairs, whereas the tasks performed strongly affected the measured muscle activation, postures and kinematics. The characteristic dynamic elements of each specific chair yielded significant differences in the measured chair parameters, but these characteristics did not appear to affect the sitting dynamics of the subjects performing their office tasks. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Assessment of postural asymmetry in mild to moderate Parkinson's disease.

PubMed

Geurts, A C H; Boonstra, T A; Voermans, N C; Diender, M G; Weerdesteyn, V; Bloem, B R

2011-01-01

Asymmetry of symptoms of Parkinson's disease is clinically most evident for appendicular impairments. For axial impairments such as freezing of gait, asymmetry is less obvious. To date, asymmetries in balance control in PD patients have seldom been studied. Therefore, in this study we investigated whether postural control can be asymmetrically affected in mild to moderate PD patients. Seventeen PD patients were instructed to stand as still and symmetrically as possible on a dual force-plate during two trials. Dynamic postural asymmetry was assessed by comparing the centre-of-pressure velocities between both legs. Results showed that four patients (24%) had dynamic postural asymmetry, even after correcting for weight-bearing asymmetry. Hence, this study suggests that postural control can be asymmetrical in early PD. However, future studies should investigate the prevalence of dynamic postural asymmetry, in a larger group of PD patients. It should also be further investigated whether this approach can be used as a tool to support the initial diagnosis or monitor disease progression, or as an outcome measure for interventions aimed at improving balance in PD. Copyright © 2010 Elsevier B.V. All rights reserved.

Neuromechanical tuning of nonlinear postural control dynamics

NASA Astrophysics Data System (ADS)

Ting, Lena H.; van Antwerp, Keith W.; Scrivens, Jevin E.; McKay, J. Lucas; Welch, Torrence D. J.; Bingham, Jeffrey T.; DeWeerth, Stephen P.

2009-06-01

Postural control may be an ideal physiological motor task for elucidating general questions about the organization, diversity, flexibility, and variability of biological motor behaviors using nonlinear dynamical analysis techniques. Rather than presenting "problems" to the nervous system, the redundancy of biological systems and variability in their behaviors may actually be exploited to allow for the flexible achievement of multiple and concurrent task-level goals associated with movement. Such variability may reflect the constant "tuning" of neuromechanical elements and their interactions for movement control. The problem faced by researchers is that there is no one-to-one mapping between the task goal and the coordination of the underlying elements. We review recent and ongoing research in postural control with the goal of identifying common mechanisms underlying variability in postural control, coordination of multiple postural strategies, and transitions between them. We present a delayed-feedback model used to characterize the variability observed in muscle coordination patterns during postural responses to perturbation. We emphasize the significance of delays in physiological postural systems, requiring the modulation and coordination of both the instantaneous, "passive" response to perturbations as well as the delayed, "active" responses to perturbations. The challenge for future research lies in understanding the mechanisms and principles underlying neuromechanical tuning of and transitions between the diversity of postural behaviors. Here we describe some of our recent and ongoing studies aimed at understanding variability in postural control using physical robotic systems, human experiments, dimensional analysis, and computational models that could be enhanced from a nonlinear dynamics approach.

The effect of cinnarizine and cocculus indicus on simulator sickness.

PubMed

Lucertini, Marco; Mirante, Nadia; Casagrande, Maria; Trivelloni, Pierandrea; Lugli, Vittoria

2007-05-16

Pensacola Simulator Sickness Questionnaire (SSQ) is a valuable method to analyse symptoms evoked by exposure to a flight simulator environment that can also be adopted to evaluate the effectiveness of preventive tools, aiming at reducing simulator sickness (SS). In this study we analysed SSQ data in subjects undergoing a standard ground based spatial disorientation training inside a flight simulator, in order to evaluate the SS prevention obtained with two different pharmacological tools. Twelve males volunteers participated to an experimental design based on a double-blind, balanced administration of either 30 mg cinnarizine (CIN), or Cocculus Indicus 6CH (COC), or placebo (PLC) before one trial of about one hour spent inside a spatial disorientation trainer. All subjects underwent the three different conditions (CIN, COC, PLC) during 3 non-consecutive days separated by at least 2 weeks. During each experimental day, all subjects filled in SSQ. In addition, both postural instability (with the use of a static stabilometric platform), and sleepiness symptoms were evaluated. All the tests were performed before and after the simulated flight, at different times, in one-and-half-hour intervals. Results indicated a strong increase of sickness after flight simulation that linearly decreased, showing pre-simulator scores after 1.30 hours. In contrast to both PLC and COC, CIN showed significant side effects immediately following flight simulation, with no benefit at the simultaneous SSQ scores. Globally, no highly significant differences between COC and PLC were observed, although a minor degree of postural instability could be detected after COC administration. As far as the present exposure to a simulator environment is concerned, none of the pharmacological tools administered in this study resulted effective in reducing SS symptoms as detected by the SSQ. Moreover, CIN significantly increased sleepiness and postural instability in most subjects.

Asymmetrical Pedaling Patterns in Parkinson's Disease Patients

PubMed Central

Penko, Amanda L.; Hirsch, Joshua R.; Voelcker-Rehage, Claudia; Martin, Philip E.; Blackburn, Gordon; Alberts, Jay L.

2015-01-01

Background Approximately 1.5 million Americans are affected by Parkinson's disease [1] which includes the symptoms of postural instability and gait dysfunction. Currently, clinical evaluations of postural instability and gait dysfunction consist of a subjective rater assessment of gait patterns using items from the Unified Parkinson's Disease Rating Scale, and assessments can be insensitive to the effectiveness of medical interventions. Current research suggests the importance of cycling for Parkinson's disease patients, and while Parkinson's gait has been evaluated in previous studies, little is known about lower extremity control during cycling. The purpose of this study is to examine the lower extremity coordination patterns of Parkinson's patients during cycling. Methods Twenty five participants, ages 44-72, with a clinical diagnosis of idiopathic Parkinson's disease participated in an exercise test on a cycle ergometer that was equipped with pedal force measurements. Crank torque, crank angle and power produced by right and left leg were measured throughout the test to calculate Symmetry Index at three stages of exercise (20 Watt, 60 Watt, maximum performance). Findings Decreases in Symmetry Index were observed for average power output in Parkinson's patients as workload increased. Maximum power Symmetry Index showed a significant difference in symmetry between performance at both the 20 Watt and 60 Watt stage and the maximal resistance stage. Minimum power Symmetry Index did not show significant differences across the stages of the test. While lower extremity asymmetries were present in Parkinson's patients during pedaling, these asymmetries did not correlate to postural instability and gait dysfunction Unified Parkinson's Disease Rating Scale scores. Interpretation This pedaling analysis allows for a more sensitive measure of lower extremity function than the Unified Parkinson's Disease Rating Scale and may help to provide unique insight into current and future lower extremity function. PMID:25467810

Effects of focal ankle joint cooling on unipedal static balance in individuals with and without chronic ankle instability.

PubMed

Kim, Kyung-Min; Hart, Joseph M; Saliba, Susan A; Hertel, Jay

2015-01-01

Application of cryotherapy over an injured joint has been shown to improve muscle function, yet it is unknown how ankle cryotherapy affects postural control. Our purpose was to determine the effects of a 20-min focal ankle joint cooling on unipedal static stance in individuals with and without chronic ankle instability (CAI). Fifteen young subjects with CAI (9 males, 6 females) and 15 healthy gender-matched controls participated. All subjects underwent two intervention sessions on different days in which they had a 1.5L plastic bag filled with either crushed ice (active treatment) or candy corn (sham) applied to the ankle. Unipedal stance with eyes closed for 10s were assessed with a forceplate before and after each intervention. Center of pressure (COP) data were used to compute 10 specific dependent measures including velocity, area, standard deviation (SD), and percent range of COP excursions, and mean and SD of time-to-boundary (TTB) minima in the anterior-posterior (AP) and mediolateral directions. For each measure a three-way (Group-Intervention-Time) repeated ANOVAs found no significant interactions and main effects involving intervention (all Ps > 0.05). There were group main effects found for mean velocity (F(1,28) = 6.46, P = .017), area (F(1,28) = 12.83, P = .001), and mean of TTB minima in the AP direction (F(1,28) = 5.19, P = .031) indicating that the CAI group demonstrated greater postural instability compared to the healthy group. Postural control of unipedal stance was not significantly altered following focal ankle joint cooling in groups both with and without CAI. Ankle joint cryotherapy was neither beneficial nor harmful to single leg balance. Copyright © 2014 Elsevier B.V. All rights reserved.

INFLUENCE OF INJURY ON DYNAMIC POSTURAL CONTROL IN RUNNERS.

PubMed

Meardon, Stacey; Klusendorf, Anna; Kernozek, Thomas

2016-06-01

Injury has been linked with altered postural control in active populations. The association between running injury and dynamic postural control has not been examined. The purpose of this study was to examine dynamic postural control in injured and uninjured runners using the Star Excursion Balance Test (SEBT), Time to Stabilization (TTS) of ground reaction forces following a single-leg landing, and postural stability indices reflecting the fluctuations in GRFs during single-leg landing and stabilization tasks (forward and lateral hop). It was hypothesized that dynamic postural control differences would exist between runners with a history of injury that interrupted training for ≥7 days (INJ) when compared to runners without injury (CON). Case-control study. Twenty-two INJ (14 F, 8 M; 23.7 ± 2.1 y; 22.3 ± 2.8 kg/m2; 29.5 ± 16.3 mi/wk) currently running > 50% pre-injury mileage without pain were compared with twenty-two matched CON (14F, 8M; 22.7 ± 1.2 y; 22.7 ± 2.7 kg/m2; 31.2 ± 19.6 mi/wk). INJ group was stratified by site of injury into two groups (Hip/Thigh/Knee and Lower Leg/Ankle/Foot) for secondary analysis. Leg length-normalized anterior, posterolateral, and posteromedial reach distances on the SEBT, medial/lateral and anterior/posterior ground reaction force TTS, directional postural stability indices, and a composite dynamic postural stability index (DPSI), were assessed using mixed model ANOVA (α=0.05) and effect sizes (d). No group X direction interaction or group differences were observed for the SEBT (p=0.51, 0.71) or TTS (p=0.83, 0.72) measures. A group X direction interaction was found for postural stability indices during the forward landing task (p<0.01). Both Hip/Thigh/Knee and Lower leg/Ankle/Foot INJ groups demonstrated a greater vertical postural stability index (VPSI) (p=0.01 for both, d=0.80, 0.95) and DPSI (p=0.01, 0.02, d=0.75, 0.93) when compared to CON suggesting impaired balance control. A group X direction interaction was also found for postural stability indices during the lateral landing task (p=0.03). Only the Hip/Thigh/Knee INJ runners displayed a greater VPSI (p=0.01, d=0.91) and DPSI (p=0.017, d=0.89) when compared to CON. When compared to CON, INJ runners demonstrated impaired dynamic control of vertical forces when performing the single leg landing and stabilization tasks. Clinicians should consider addressing dynamic control of vertical loads through functional tasks during the rehabilitation of running injury. Level 3.

Neural Control of Posture in Individuals with Persisting Postconcussion Symptoms.

PubMed

Helmich, Ingo; Berger, Alisa; Lausberg, Hedda

2016-12-01

Postural instability has been shown to characterize individuals who suffered from long-term symptoms after mild traumatic brain injury. However, recordings of neural processes during postural control are difficult to realize with standard neuroimaging techniques. Thus, we used functional nearinfrared spectroscopy to investigate brain oxygenation of individuals with persistent postconcussion symptoms (pPCS) during postural control in altered environments. We compared brain oxygenation and postural sway during balance control in three groups: individuals suffering from pPCS, individuals with a history of mild traumatic brain injury but without pPCS, and healthy controls. Individuals were investigated during postural control tasks with six different conditions: i) eyes opened, ii) eyes closed, and iii) blurred visual input, each while standing a) on a stable and b) an unstable surface. In all groups, during the eyes closed/unstable surface condition as compared with the other conditions, the postural sway increased as well as the brain oxygenation in frontal brain cortices. In the most difficult balance condition, as compared with the other two groups, subjects with pPCS applied more force over time to keep balance as measured by the force plate system with a significantly greater activation in frontopolar/orbitofrontal areas of the right hemisphere. As subjects with pPCS applied more force over time to control balance, we propose that with regard to cognitive processes, the increase of cerebral activation in these individuals indicates an increase of attention-demanding processes during postural control in altered environments.

Frequency of postural changes during sitting whilst using a desktop computer--exploring an analytical methodology.

PubMed

Niekerk, Sjan-Mari van; Louw, Quinette Abigail; Grimmer-Sommers, Karen

2014-01-01

Dynamic movement whilst sitting is advocated as a way to reduce musculoskeletal symptoms from seated activities. Conventionally, in ergonomics research, only a 'snapshot' of static sitting posture is captured, which does not provide information on the number or type of movements over a period of time. A novel approach to analyse the number of postural changes whist sitting was employed in order to describe the sitting behaviour of adolescents whilst undertaking computing activities. A repeated-measures observational study was conducted. A total of 12 high school students were randomly selected from a conveniently selected school. Fifteen minutes of 3D posture measurements were recorded to determine the number of postural changes whilst using computers. Data of 11 students were able to be analysed. Large intra-subject variation of the median and IQR was observed, indicating frequent postural changes whilst sitting. Better understanding of usual dynamic postural movements whilst sitting will provide new insights into causes of musculoskeletal symptoms experienced by computer users.

Otolith and Vertical Canal Contributions to Dynamic Postural Control

NASA Technical Reports Server (NTRS)

Black, F. Owen

1999-01-01

The objective of this project is to determine: 1) how do normal subjects adjust postural movements in response to changing or altered otolith input, for example, due to aging? and 2) how do patients adapt postural control after altered unilateral or bilateral vestibular sensory inputs such as ablative inner ear surgery or ototoxicity, respectively? The following hypotheses are under investigation: 1) selective alteration of otolith input or abnormalities of otolith receptor function will result in distinctive spatial, frequency, and temporal patterns of head movements and body postural sway dynamics. 2) subjects with reduced, altered, or absent vertical semicircular canal receptor sensitivity but normal otolith receptor function or vice versa, should show predictable alterations of body and head movement strategies essential for the control of postural sway and movement. The effect of altered postural movement control upon compensation and/or adaptation will be determined. These experiments provide data for the development of computational models of postural control in normals, vestibular deficient subjects and normal humans exposed to unusual force environments, including orbital space flight.

Relationship between Muscle Function, Muscle Typology and Postural Performance According to Different Postural Conditions in Young and Older Adults

PubMed Central

Paillard, Thierry

2017-01-01

Although motor output of the postural function clearly influences postural performance in young and older subjects, no relationship has been formally established between them. However, the relationship between lower-extremity muscle strength/power and postural performance is often pointed out, especially in older subjects. In fact, the influence of motor output may vary according to the postural condition considered (e.g., static, dynamic, challenging, disturbing). In static postural condition, there may be a relationship between lower-extremity muscle strength and postural performance when the value of muscle strength is below a certain threshold in older subjects. Above this threshold of muscle strength, this relationship may disappear. In dynamic postural condition, lower-extremity muscle power could facilitate compensatory postural actions, limiting induced body imbalance likely to generate falls in older subjects. In young subjects, there could be a relationship between very early rapid torque of the leg extensor muscles and postural performance. In the case of postural reaction to (external) perturbations, a high percentage of type II muscle fibers could be associated with the ability to react quickly to postural perturbations in young subjects, while it may enable a reduction in the risk of falls in older subjects. In practice, in older subjects, muscle strength and/or power training contributes to reducing the risk of falls, as well as slowing down the involution of muscle typology regarding type II muscle fibers. PMID:28861000

Relationship between Muscle Function, Muscle Typology and Postural Performance According to Different Postural Conditions in Young and Older Adults.

PubMed

Paillard, Thierry

2017-01-01

Although motor output of the postural function clearly influences postural performance in young and older subjects, no relationship has been formally established between them. However, the relationship between lower-extremity muscle strength/power and postural performance is often pointed out, especially in older subjects. In fact, the influence of motor output may vary according to the postural condition considered (e.g., static, dynamic, challenging, disturbing). In static postural condition, there may be a relationship between lower-extremity muscle strength and postural performance when the value of muscle strength is below a certain threshold in older subjects. Above this threshold of muscle strength, this relationship may disappear. In dynamic postural condition, lower-extremity muscle power could facilitate compensatory postural actions, limiting induced body imbalance likely to generate falls in older subjects. In young subjects, there could be a relationship between very early rapid torque of the leg extensor muscles and postural performance. In the case of postural reaction to (external) perturbations, a high percentage of type II muscle fibers could be associated with the ability to react quickly to postural perturbations in young subjects, while it may enable a reduction in the risk of falls in older subjects. In practice, in older subjects, muscle strength and/or power training contributes to reducing the risk of falls, as well as slowing down the involution of muscle typology regarding type II muscle fibers.

The contribution of proprioceptive information to postural control in elderly and patients with Parkinson's disease with a history of falls.

PubMed

Bekkers, Esther M J; Dockx, Kim; Heremans, Elke; Vercruysse, Sarah; Verschueren, Sabine M P; Mirelman, Anat; Nieuwboer, Alice

2014-01-01

Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinson's disease (PD) is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS) were derived from the differences between maximal center of pressure (CoP) displacement in anterior-posterior (AP) and medio-lateral (ML) direction during a maximal leaning task. Task conditions comprised standing with eyes open (EO) and eyes closed (EC): (1) on a stable surface; (2) an unstable surface; and (3) with Achilles tendon vibration. CoP displacements were calculated as a percentage of their respective LoS. Perceived LoS did not differ between groups. PD patients showed greater ML CoP displacement than elderly fallers (EF) across all conditions (p = 0.043) and tended to have higher postural sway in relation to the LoS (p = 0.050). Both groups performed worse on an unstable surface and during tendon vibration compared to standing on a stable surface with EO and even more so with EC. Both PD and EF had more AP sway in all conditions with EC compared to EO (p < 0.001) and showed increased CoP displacements when relying on proprioception only compared to standing with normal sensory input. This implies a similar role of the proprioceptive system in postural control in fallers with and without PD. PD fallers showed higher ML sway after sensory manipulations, as a result of which these values approached their perceived LoS more closely than in EF. We conclude that despite a similar fall history, PD patients showed more ML instability than EF, irrespective of sensory manipulation, but had a similar reliance on ankle proprioception. Hence, we recommend that rehabilitation and fall prevention for PD should focus on motor rather than on sensory aspects.

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

PubMed Central

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness.

PubMed

Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E; Eckhardt-Henn, Annegret; Dieterich, Marianne

2015-01-01

Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V ), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

Comparison of the postural and physiological effects of two dynamic workstations to conventional sitting and standing workstations.

PubMed

Botter, Juliane; Ellegast, Rolf P; Burford, Eva-Maria; Weber, Britta; Könemann, Reinier; Commissaris, Dianne A C M

2016-03-01

Increasing evidence is being found for the association of health risk factors with work-related physical inactivity. An increasing number of people are being exposed to this form of inactivity, and as a result, various interventions aimed at increasing physical activity during working hours are being developed. This study aims to investigate the differences in postural, muscular and physical activities resulting from two dynamic workstations, namely an elliptical trainer and a treadmill workstation, compared with a conventional sitting and standing workstation. Twelve participants completed five standardised office tasks in a laboratory setting at all workstations. No significant effect was found regarding changes in posture and the muscular activity was only significantly higher for the trapezius muscle (50th percentile: 8.1 %MVC) at the dynamic workstations. For the dynamic workstations, physical activity ranged from 4.0 to 14.9 × 10(-2) g, heart rate from 14.3 to 27.5 %HRR and energy expenditure from 1.8 to 3.1 METs. Practitioner Summary: Work-related physical inactivity is associated with health risk factors. In this study, physiological and postural effects of dynamic workstations were assessed in comparison to conventional workstations. No significant effects were found regarding changes in posture and muscular activity. Physical activity, heart rate and energy expenditure increased for the dynamic workstations.

Static and dynamic single leg postural control performance during dual-task paradigms.

PubMed

Talarico, Maria K; Lynall, Robert C; Mauntel, Timothy C; Weinhold, Paul S; Padua, Darin A; Mihalik, Jason P

2017-06-01

Combining dynamic postural control assessments and cognitive tasks may give clinicians a more accurate indication of postural control under sport-like conditions compared to single-task assessments. We examined postural control, cognitive and squatting performance of healthy individuals during static and dynamic postural control assessments in single- and dual-task paradigms. Thirty participants (female = 22, male = 8; age = 20.8 ± 1.6 years, height = 157.9 ± 13.0 cm, mass = 67.8 ± 20.6 kg) completed single-leg stance and single-leg squat assessments on a force plate individually (single-task) and concurrently (dual-task) with two cognitive assessments, a modified Stroop test and the Brooks Spatial Memory Test. Outcomes included centre of pressure speed, 95% confidence ellipse, squat depth and speed and cognitive test measures (percentage of correct answers and reaction time). Postural control performance varied between postural control assessments and testing paradigms. Participants did not squat as deep and squatted slower (P < 0.001) during dual-task paradigms (≤12.69 ± 3.4 cm squat depth, ≤16.20 ± 4.6 cm · s -1 squat speed) compared to single-task paradigms (14.57 ± 3.6 cm squat depth, 19.65 ± 5.5 cm · s -1 squat speed). The percentage of correct answers did not change across testing conditions, but Stroop reaction time (725.81 ± 59.2 ms; F 2,58  = 7.725, P = 0.001) was slowest during single-leg squats compared to baseline (691.64 ± 80.1 ms; P = 0.038) and single-task paradigms (681.33 ± 51.5 ms; P < 0.001). Dynamic dual-task assessments may be more challenging to the postural control system and may better represent postural control performance during dynamic activities.

Masticatory efficiency contributing to the improved dynamic postural balance: A cross-sectional study.

PubMed

Hwang, Hae-Yun; Choi, Jun-Seon; Kim, Hee-Eun

2018-05-28

To evaluate whether masticatory efficiency is associated with dynamic postural balance. Masticatory dysfunction can cause deterioration of general health due to nutritional imbalances, thereby negatively affecting postural balance. However, few studies have investigated the association between masticatory efficiency and postural balance. The masticatory efficiency of 74 participants was evaluated by calculating mixing ability index (MAI) using a wax cube. The timed up and go test (TUGT) was used to measure dynamic balance. Participants with an MAI above or below the median value of 1.05 were defined as having high or low masticatory efficiency, respectively. An independent samples t-test was used to identify significant differences in TUGT, according to masticatory efficiency. Analysis of covariance was performed to adjust for confounding factors. Logistic regression analysis was used to assess the correlation between masticatory efficiency and postural balance. The high masticatory efficiency group could complete the TUGT exercise approximately 1.67 seconds faster while maintaining the postural balance, compared to the low masticatory efficiency group (P = .005). Furthermore, the postural imbalance odds of the group with high mastication efficiency decreased by 0.14-fold, relative to the group with low mastication efficiency (95% confidence interval: 0.04-0.46). With some reservations about statistical power, the association found between masticatory efficiency and postural balance justifies further investigations to confirm the strength of the associations, and possibly to identify causal relationships between mastication and posture in old age. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Identifying postural control and thresholds of instability utilizing a motion-based ATV simulator.

DOT National Transportation Integrated Search

2017-01-01

Our ATV simulator is currently the only one in existence that allows studies of human subjects engaged in active riding, a process that is necessary for ATV operators to perform in order to maintain vehicle control, in a virtual reality environ...

Understanding balance differences in individuals with multiple sclerosis with mild disability: An investigation of differences in sensory feedback on postural and dynamic balance control

NASA Astrophysics Data System (ADS)

Denomme, Luke T.

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS) and causes a broad range of neurological symptoms. One of the most common symptoms experienced by individuals with MS is poor balance control during standing and walking. The main mechanism underlying impaired balance control in MS appears to result from slowed somatosensory conduction and impaired central integration. The current thesis assessed postural and dynamic control of balance of 'individuals with MS with mild disability' (IwMS). IwMS were compared to 'healthy age-matched individuals' (HAMI) and community-dwelling 'older adults' (OA). The purpose of this thesis was to quantify differences in postural and dynamic control of balance in IwMS to the two populations who display balance control differences across the lifespan and represent two extreme ends of the balance control continuum due to natural aging. IwMS (n = 12, x¯age: 44 +/- 9.4 years), HAMI (n = 12, x¯age: 45 +/- 9.9 years) and community-dwelling OA (n = 12, x¯ age: 68.1 +/- 4.5 years) postural and dynamic balance control were evaluated during a Romberg task as well as a dynamic steering task. The Romberg task required participants to stand with their feet together and hands by their sides for 45 seconds with either their eyes open or closed. The dynamic steering task required participants to walk and change direction along the M-L plane towards a visual goal. Results from these two tasks reveal that IwMS display differences in postural control when compared to HAMI when vision was removed as well as differences in dynamic stability margin during steering situations. During the postural control task IwMS displayed faster A-P and M-L COP velocities when vision was removed and their COP position was closer to their self-selected maximum stability limits compared to HAMI. Assessment of dynamic stability during the steering task revealed that IwMS displayed reduced walking speed and cadence during the straight walking portion of the task in addition to a smaller DSM range (i.e., COM remained close to lateral BOS) during the entire steering task. These results suggest that IwMS adopt postural and dynamic control strategies (i.e., increased COP velocity, smaller self-selected maximal sway comfort zones and reduced walking speed) in order to maintain stability and complete the tasks. Results further revealed that IwMS display similar levels of postural and dynamic stability to OA despite differences in the type of sensory impairment possessed by each group. The findings also provide insights into the comparison of IwMS to two populations who represent the two extreme ends of the balance control continuum: HAMI and OA. Our data indicates that the level of postural and dynamic balance control in IwMS appears to express similar characteristics and may be located closer to the OA population on this continuum. Future research should evaluate the level of somatosensory impairment (i.e., monofilament testing and tuning fork tendon tap testing) between IwMS and OA in order to better differentiate levels of postural and dynamic balance control between groups and to gain a better understanding of where each group may be specifically located on the age-related balance control continuum.

A mobile system for assessment of physiological response to posture transitions.

PubMed

Jovanov, Emil; Milosevic, Mladen; Milenković, Aleksandar

2013-01-01

Posture changes initiate a dynamic physiological response that can be used as an indicator of the overall health status. We introduce an inconspicuous mobile wellness monitoring system (imWell) that continuously assesses the dynamic physiological response to posture transitions during activities of daily living. imWell utilizes a Zephyr BioHarness 3 physiological monitor that continually reports heart activity and physical activity via Bluetooth to a personal device (e.g. smartphone). The personal device processes the reported activity data in real-time to recognize posture transitions from the accelerometer data and to characterize dynamic heart response to posture changes. It annotates, logs, and uploads the heart activity data to our mHealth server. In this paper we present algorithms for detection of posture transitions and heart activity characterization during a sit-to-stand transition. The proposed system was tested on seven healthy subjects performing a predefined protocol. The total average and standard deviation for sit-to-stand transition time is 2.7 ± 0.69 s, resulting in the change of heart rate of 27.36 ± 9.30 bpm (from 63.3 ± 9.02 bpm to 90.66 ± 10.09 bpm).

Effects of 30-, 60-, and 90-Day Bed Rest on Postural Control in Men and Women

NASA Technical Reports Server (NTRS)

Esteves, Julie; Taylor, Laura C.; Vanya, Robert D.; Dean, S. Lance; Wood, Scott J.

2011-01-01

INTRODUCTION Head-down-tilt bed rest (HDT) has been used as a safe gr ound-based analog to mimic and develop countermeasures for the physiological effects of spaceflight, including decrements in postural stability. The purpose of this investigation was to characterize the effects of 30-, 60-, and 90-day bed rest on postural control in men and women. METHODS Twenty-nine subjects (18M,11F) underwent 13 days of ambula tory acclimatization and were placed in 6? HDT for 30 (n=12), 60 (n=8), or 90 (n=9) days, followed by 14 days of ambulatory recovery. Computerized dynamic posturography (CDP) was used to assess changes in sensory and motor components of postural control, and recovery after HDT. Sensory Organization Tests (SOTs) objectively evaluate one?s ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Stability during the SOTs was assessed using peak-to-peak sway and convergence toward stability limits to derive an equilibrium score. Motor Control Tests (MCTs) evaluate one?s ability to recover from unexpected support surface perturbations, with performance determined by center-of-pressure path length. Whole-body kinematic data were collected to determine body-sway strategy used to maintain stability during each condition. Baselines were determined pre-HDT. Recovery was tracked post-HDT on days 0, 1, 2, and 4. RESULTS Immediately after HDT, subjects showed decreased performance on most SOTs, primarily on sway-referenced support conditions, typically returning to baseline levels within 4 days. MCT performance was not significantly affected. There were no significant gender or duration differences in performance. Kinematic data revealed a tendency to use ankle strategy to maintain an upright stance during most SOT conditions. Interestingly, six subjects (2M,4F) experienced orthostatic intolerance and were unable to complete day 0 testing. CONCLUSION HDT mimics some un loading mechanisms of spaceflight and elicits orthostatic issues present post-spaceflight (contributing to instability); however, it does not sufficiently address the vestibular dysfunction which occurs post-spaceflight.

The Measurement, Nomological Net, and Theory of Perceived Self-Esteem Instability: Applying the Conservation of Resources Theory to Understand the Construct.

PubMed

Howard, Matt C

2018-01-01

The current article performs the first focused investigation into the construct of perceived self-esteem instability (P-SEI). Four studies investigate the construct's measurement, nomological net, and theoretical dynamics. Study 1 confirms the factor structure of a P-SEI Measure, supporting that P-SEI can be adequately measured. Study 2 identifies an initial nomological net surrounding P-SEI, showing that the construct is strongly related to stable aspects of the self (i.e., neuroticism and core self-evaluations). In Studies 3 and 4, the Conservation of Resources Theory is applied to develop and test five hypotheses. These studies show that P-SEI is predicted by self-esteem level and stressors, and the relationship of certain stressors is moderated by self-esteem contingencies. P-SEI also predicts stress, depression, anxiety, and certain defensive postures. From these studies and the integration of Conservation of Resources Theory, we suggest that P-SEI emerges through an interaction between environmental influences and personal resources, and we provide a theoretical model to better understand the construct of P-SEI. We suggest that this theory-driven model can prompt the initial field of study on P-SEI.

INFLUENCE OF INJURY ON DYNAMIC POSTURAL CONTROL IN RUNNERS

PubMed Central

Klusendorf, Anna; Kernozek, Thomas

2016-01-01

ABSTRACT Background Injury has been linked with altered postural control in active populations. The association between running injury and dynamic postural control has not been examined. Hypothesis/Purpose The purpose of this study was to examine dynamic postural control in injured and uninjured runners using the Star Excursion Balance Test (SEBT), Time to Stabilization (TTS) of ground reaction forces following a single-leg landing, and postural stability indices reflecting the fluctuations in GRFs during single-leg landing and stabilization tasks (forward and lateral hop). It was hypothesized that dynamic postural control differences would exist between runners with a history of injury that interrupted training for ≥7 days (INJ) when compared to runners without injury (CON). Design Case-control study Methods Twenty-two INJ (14 F, 8 M; 23.7 ± 2.1 y; 22.3 ± 2.8 kg/m2; 29.5 ± 16.3 mi/wk) currently running > 50% pre-injury mileage without pain were compared with twenty-two matched CON (14F, 8M; 22.7 ± 1.2 y; 22.7 ± 2.7 kg/m2; 31.2 ± 19.6 mi/wk). INJ group was stratified by site of injury into two groups (Hip/Thigh/Knee and Lower Leg/Ankle/Foot) for secondary analysis. Leg length-normalized anterior, posterolateral, and posteromedial reach distances on the SEBT, medial/lateral and anterior/posterior ground reaction force TTS, directional postural stability indices, and a composite dynamic postural stability index (DPSI), were assessed using mixed model ANOVA (α=0.05) and effect sizes (d). Results No group X direction interaction or group differences were observed for the SEBT (p=0.51, 0.71) or TTS (p=0.83, 0.72) measures. A group X direction interaction was found for postural stability indices during the forward landing task (p<0.01). Both Hip/Thigh/Knee and Lower leg/Ankle/Foot INJ groups demonstrated a greater vertical postural stability index (VPSI) (p=0.01 for both, d=0.80, 0.95) and DPSI (p=0.01, 0.02, d=0.75, 0.93) when compared to CON suggesting impaired balance control. A group X direction interaction was also found for postural stability indices during the lateral landing task (p=0.03). Only the Hip/Thigh/Knee INJ runners displayed a greater VPSI (p=0.01, d=0.91) and DPSI (p=0.017, d=0.89) when compared to CON. Conclusions When compared to CON, INJ runners demonstrated impaired dynamic control of vertical forces when performing the single leg landing and stabilization tasks. Clinicians should consider addressing dynamic control of vertical loads through functional tasks during the rehabilitation of running injury. Level of Evidence Level 3 PMID:27274423

A preliminary study of static and dynamic balance in sedentary obese young adults: the relationship between BMI, posture and postural balance.

PubMed

do Nascimento, J A; Silva, C C; Dos Santos, H H; de Almeida Ferreira, J J; de Andrade, P R

2017-12-01

The aim of this study was to evaluate the postural control of obese young adults with normal body mass index during different static (bipedic and unipedic support) and dynamic postural conditions (gait velocity and limits of stability) in order to compare the static and dynamic balance of these individuals. A cross-sectional quantitative study was carried out to evaluate static and dynamic balance in 25 sedentary individuals. The sample was divided into two groups, 10 in the normal-weight group (24.70 ± 3.89 years and 21.5 ± 1.66 kg m -2 ) and 15 in the obese group (26.80 ± 5.16 years and 35.66 ± 4.29 kg m -2 ). Postural evaluation was performed through visual inspection, and balance analyses were performed using the Timed Up & Go test (TUGT) and Balance System (Biodex). Descriptive analyses, Fisher's exact test and Mann Whitney U-tests were performed using the Statistical Package for Social Sciences (SPSS - 20.0, Armonk, NY) software. Most of the obese volunteers presented postural alterations, such as head protrusion (47.6%), hyperkyphosis (46.7%) and hyperlordosis (26.7%). Medial-lateral dynamic displacement, risk of falls and mean time to perform the limits of stability test and TUGT were higher for obese subjects (P < 0.05), while there were no significant differences between the groups (P > 0.05) for static balance tests for either bipedal or unipedal tasks. The disadvantage presented by the young obese subjects occurs in dynamic activities, representing worse balance and an increase in time needed to accomplish these activities. © 2017 World Obesity Federation.

More falls in cerebellar ataxia when standing on a slow up-moving tilt of the support surface

PubMed Central

PAQUETTE, Caroline; FRANZÉN, Erika; HORAK, Fay B

2016-01-01

We investigated how subjects with cerebellar ataxia (CA) adapt their postural stability and alignment to a slow and small tilt of the support surface allowing for online postural corrections. Eight subjects with CA and eight age- and gender-matched healthy control subjects participated in the study. Subjects stood eyes closed for 1 minute after which the support surface was tilted 5° toes-up at a ramp velocity of 1°/s. The toes-up position was held for 2.5 minutes after which the surface rotated back down to level with identical tilt characteristics. As reflected by the large number of falls, subjects with CA had marked difficulty adapting their posture to the up-moving incline in contrast to control subjects. Subjects with CA who lost their balance had faster trunk velocity and excessive backward trunk reorientation beginning within the first second after onset of the tilting surface. In contrast, the down-moving tilt to level did not result in instability in CA subjects. These results suggest that instability and falls associated with CA derives from an inability to maintain trunk orientation to vertical while standing on a slow-moving or unstable surface. This study underscores the importance of the cerebellum in the online sensory control of the upper body orientation during small amplitude and slow velocity movements of the support surface. PMID:26202671

The effect of pramipexole therapy on balance disorder and fall risk in Parkinson's disease at early stage: clinical and posturographic assessment.

PubMed

Güler, Sibel; Bir, Levent Sinan; Akdag, Beyza; Ardıc, Fusun

2012-01-01

The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson's patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson's patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson's disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

More Falls in Cerebellar Ataxia When Standing on a Slow Up-Moving Tilt of the Support Surface.

PubMed

Paquette, Caroline; Franzén, Erika; Horak, Fay B

2016-06-01

We investigated how subjects with cerebellar ataxia (CA) adapt their postural stability and alignment to a slow and small tilt of the support surface allowing for online postural corrections. Eight subjects with CA and eight age- and gender-matched healthy control subjects participated in the study. Subjects stood eyes closed for 1 min after which the support surface was tilted 5° toes-up at a ramp velocity of 1°/s. The toes-up position was held for 2.5 min after which the surface rotated back down to level with identical tilt characteristics. As reflected by the large number of falls, subjects with CA had marked difficulty adapting their posture to the up-moving incline in contrast to control subjects. Subjects with CA who lost their balance had faster trunk velocity and excessive backward trunk reorientation beginning within the first second after onset of the tilting surface. In contrast, the down-moving tilt to level did not result in instability in CA subjects. These results suggest that instability and falls associated with CA derive from an inability to maintain trunk orientation to vertical while standing on a slow-moving or unstable surface. This study underscores the importance of the cerebellum in the online sensory control of the upper body orientation during small amplitude and slow velocity movements of the support surface.

Modeling Parkinson's disease falls associated with brainstem cholinergic systems decline.

PubMed

Kucinski, Aaron; Sarter, Martin

2015-04-01

In addition to the primary disease-defining symptoms, approximately half of patients with Parkinson's disease (PD) suffer from postural instability, impairments in gait control and a propensity for falls. Consistent with evidence from patients, we previously demonstrated that combined striatal dopamine (DA) and basal forebrain (BF) cholinergic cell loss causes falls in rats traversing dynamic surfaces. Because evidence suggests that degeneration of brainstem cholinergic neurons arising from the pedunculopontine nucleus (PPN) also contributes to impaired gait and falls, here we assessed the effects of selective cholinergic PPN lesions in combination with striatal DA loss or BF cholinergic cells loss as well as losses in all 3 regions. Results indicate that all combination losses that included the BF cholinergic system slowed traversal and increased slips and falls. However, the performance of rats with losses in all 3 regions (PPN, BF, and DA) was not more severely impaired than following combined BF cholinergic and striatal DA lesions. These results confirm the hypothesis that BF cholinergic-striatal disruption of attentional-motor interactions is a primary source of falls. Additional losses of PPN cholinergic neurons may worsen posture and gait control in situations not captured by the current testing conditions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Use of Mobile Device Accelerometry to Enhance Evaluation of Postural Instability in Parkinson Disease.

PubMed

Ozinga, Sarah J; Linder, Susan M; Alberts, Jay L

2017-04-01

To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson disease (PD). Criterion standard. Motor control laboratory at a clinic. A sample (N=28) of individuals with mild to moderate PD (n=14) and age-matched community-dwelling individuals without PD (n=14) completed the study. Not applicable. Center of mass (COM) acceleration measures were compared between the mobile device and the NeuroCom force platform to determine the accuracy of mobile device measurements during performance of the Sensory Organization Test (SOT). Analyses examined test-retest reliability of both systems and sensitivity of (1) the equilibrium score from the SOT and (2) COM acceleration measures from the force platform and mobile device to quantify postural stability across populations. Metrics of COM acceleration from inertial measurement unit data and the NeuroCom force platform were significantly correlated across balance conditions and groups (Pearson r range, .35 to .97). The SOT equilibrium scores failed to discriminate individuals with and without PD. However, the multiplanar measures of COM acceleration from the mobile device exhibited good to excellent reliability across SOT conditions and were able to discriminate individuals with and without PD in conditions with the greatest balance demands. Metrics employing medial-lateral movement produce a more sensitive outcome than the equilibrium score in identifying postural instability associated with PD. Overall, the output from the mobile device provides an accurate and reliable method of rapidly quantifying balance in individuals with PD. The portable and affordable nature of a mobile device with the application makes it ideally suited to use biomechanical data to aid in clinical decision making. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Does robotic gait training improve balance in Parkinson's disease? A randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Gimigliano, Raffaele; Smania, Nicola

2012-09-01

Treadmill training (with or without robotic assistance) has been reported to improve balance skills in patients with Parkinson's disease (PD). However, its effectiveness on postural instability has been evaluated mainly in patients with mild to moderate PD (Hoehn & Yahr stage ≤3). Patients with more severe disease may benefit from robot-assisted gait training performed by the Gait-Trainer GT1, as a harness supports them with their feet placed on motor-driven footplates. The aim of this study was to determine whether robot-assisted gait training could have a positive influence on postural stability in patients with PD at Hoehn & Yahr stage 3-4. Thirty-four patients with PD at Hoehn & Yahr stage 3-4 were randomly assigned into two groups. All patients received twelve, 40-min treatment sessions, three days/week, for four consecutive weeks. The Robotic Training group (n = 17) underwent robot-assisted gait training, while the Physical Therapy group (n = 17) underwent a training program not specifically aimed at improving postural stability. Patients were evaluated before, immediately after and 1-month post-treatment. Primary outcomes were: Berg Balance scale; Nutt's rating. A significant improvement was found after treatment on the Berg Balance Scale and the Nutt's rating in favor of the Robotic Training group (Berg: 43.44 ± 2.73; Nutt: 1.38 ± 0.50) compared to the Physical Therapy group (Berg: 37.27 ± 5.68; Nutt: 2.07 ± 0.59). All improvements were maintained at the 1-month follow-up evaluation. Robot-assisted gait training may improve postural instability in patients with PD at Hoehn & Yahr stage 3-4. Copyright © 2012 Elsevier Ltd. All rights reserved.

Attention is associated with postural control in those with chronic ankle instability.

PubMed

Rosen, Adam B; Than, Nicholas T; Smith, William Z; Yentes, Jennifer M; McGrath, Melanie L; Mukherjee, Mukul; Myers, Sara A; Maerlender, Arthur C

2017-05-01

Chronic ankle instability (CAI) is often debilitating and may be affected by a number of intrinsic and environmental factors. Alterations in neurocognitive function and attention may contribute to repetitive injury in those with CAI and influence postural control strategies. Thus, the purpose of this study was to determine if there was a difference in attentional functioning and static postural control among groups of Comparison, Coper and CAI participants and assess the relationship between them within each of the groups. Recruited participants performed single-limb balance trials and completed the CNS Vital Signs (CNSVS) computer-based assessment to assess their attentional function. Center of pressure (COP) velocity (COPv) and maximum range (COPr), in both the anteroposterior (AP) and mediolateral (ML) directions were calculated from force plate data. Simple attention (SA), which measures self-regulation and attention control was extracted from the CNSVS. Data from 45 participants (15 in each group, 27=female, 18=male) was analyzed for this study. No significant differences were observed between attention or COP variables among each of the groups. However, significant relationships were present between attention and COP variables within the CAI group. CAI participants displayed significant moderate to large correlations between SA and AP COPr (r=-0.59, p=0.010), AP COPv (r=-0.48, p=0.038) and ML COPr (r=-0.47, p=0.034). The results suggest a linear relationship of stability and attention in the CAI group. Attentional self-regulation may moderate how those with CAI control postural stability. Incorporating neurocognitive training focused on attentional control may improve outcomes in those with CAI. Copyright © 2017 Elsevier B.V. All rights reserved.

Intermittent control with ankle, hip, and mixed strategies during quiet standing: a theoretical proposal based on a double inverted pendulum model.

PubMed

Suzuki, Yasuyuki; Nomura, Taishin; Casadio, Maura; Morasso, Pietro

2012-10-07

Human upright posture, as a mechanical system, is characterized by an instability of saddle type, involving both stable and unstable dynamic modes. The brain stabilizes such system by generating active joint torques, according to a time-delayed neural feedback control. What is still unsolved is a clear understanding of the control strategies and the control mechanisms that are used by the central nervous system in order to stabilize the unstable posture in a robust way while maintaining flexibility. Most studies in this direction have been limited to the single inverted pendulum model, which is useful for formalizing fundamental mechanical aspects but insufficient for addressing more general issues concerning neural control strategies. Here we consider a double inverted pendulum model in the sagittal plane with small passive viscoelasticity at the ankle and hip joints. Despite difficulties in stabilizing the double pendulum model in the presence of the large feedback delay, we show that robust and flexible stabilization of the upright posture can be established by an intermittent control mechanism that achieves the goal of stabilizing the body posture according to a "divide and conquer strategy", which switches among different controllers in different parts of the state space of the double inverted pendulum. Remarkably, it is shown that a global, robust stability is achieved even if the individual controllers are unstable and the information exploited for switching from one controller to another is severely delayed, as it happens in biological reality. Moreover, the intermittent controller can automatically resolve coordination among multiple active torques associated with the muscle synergy, leading to the emergence of distinct temporally coordinated active torque patterns, referred to as the intermittent ankle, hip, and mixed strategies during quiet standing, depending on the passive elasticity at the hip joint. Copyright © 2012 Elsevier Ltd. All rights reserved.

Understanding Cognitive Deficits in Parkinson's Disease: Lessons from Preclinical Animal Models

ERIC Educational Resources Information Center

Solari, Nicola; Bonito-Oliva, Alessandra; Fisone, Gilberto; Brambilla, Riccardo

2013-01-01

Parkinson's disease (PD) has been, until recently, mainly defined by the presence of characteristic motor symptoms, such as rigidity, tremor, bradykinesia/akinesia, and postural instability. Accordingly, pharmacological and surgical treatments have so far addressed these motor disturbances, leaving nonmotor, cognitive deficits an unmet…

Dynamic Postural Control in Female Athletes and Nonathletes After a Whole-Body Fatigue Protocol.

PubMed

Baghbani, Fatemeh; Woodhouse, Linda J; Gaeini, Abbas A

2016-07-01

Baghbani, F, Woodhouse, LJ, and Gaeini, AA. Dynamic postural control in female athletes and nonathletes after a whole-body fatigue protocol. J Strength Cond Res 30(7): 1942-1947, 2016-Postural control is a crucial element in regular training of athletes, development of complex technical movement, and injury prevention; however, distributing factor of the postural control such as fatigue has been neglected by athletic trainers in novice and inexperienced athletes. The objective of this study was to compare changes in dynamic postural control of young female athletes and nonathletes after a fatigue protocol. Thirty females (15 athletes and 15 nonathletes) with no orthopedic problems were recruited to participate in this study. All participants completed the pre-SEBT (star excursion balance test) in 8 directions at baseline; then, they performed a 20-minute fatigue protocol after which post-SEBT was measured. Rating of perceived exertion was measured using the Borg scale immediately before, mid-way through (i.e., after the third station), and after performing the fatigue protocol (i.e., immediately before the post-SEBT). Female nonathlete groups had significant differences in dynamic balance performance after fatigue in the medial, posteromedial, and posterior directions (p < 0.01) measured by SEBT. Athletes, however, showed no significant changes after the fatigue protocol. Our results indicates the importance of evaluation and monitoring of dynamic postural control of the novice with progressing the exercise time. Our findings could also help coaches to develop trainings focused on the 3 directions of medial, posteromedial, and posterior directions and aimed at exercises increasing fatigue resistance.

Correlation between Mechanical Properties of the Ankle Muscles and Postural Sway during the Menstrual Cycle.

PubMed

Yim, JongEun; Petrofsky, Jerrold; Lee, Haneul

2018-03-01

Ankle and foot injuries are common among athletes and physically active individuals. The most common residual disability, ankle sprain, is characterized by instability along with postural sway. If the supporting structures around a joint become lax, posture stability and balance are also affected. Previous studies have examined muscle stiffness and elasticity and postural sway separately; however, the relationship between these factors is yet unknown. It is well known that the levels of sex hormones, especially estrogen, change in women over the phase of the menstrual cycle. Therefore, this study examined the relationship between the mechanical properties of tissue and balance activity using a non-invasive digital palpation device to determine if they undergo any changes over the menstrual cycle in young women. Sixteen young women with regular menstrual cycles completed the study. Tone, stiffness, and elasticity of the ankle muscles (lateral gastrocnemius, peroneus longus, and tibialis anterior) were measured using a non-invasive digital palpation device. Postural sway was recorded while the participants performed balance tasks during ovulation and menstruation. Significantly greater posture sway characteristics and ankle muscle elasticity were found during ovulation than during menstruation; lower tone and stiffness of the ankle muscles were observed at ovulation (p < 0.05). Additionally, weak-to-strong relationships between ankle muscle mechanical properties and postural sway characteristics were found (p < 0.05). These results suggest the effect of estrogen on human connective tissues. We therefore postulate that estrogen increases joint and muscle laxity and affects posture stability according to the phase of the menstrual cycle.

Postural control and balance self-efficacy in women with fibromyalgia: are there differences?

PubMed

Muto, L H A; Sauer, J F; Yuan, S L K; Sousa, A; Mango, P C; Marques, A P

2015-04-01

Fibromyalgia (FM) is a rheumatic disease characterized by chronic widespread pain and symptoms such as fatigue, sleep disturbances, cognitive difficulties, and depression. Postural instability is a debilitating disorder increasingly recognized as part of FM. To assess and compare postural control and balance self-efficacy in women with and without FM and verify the association of these variables with pain, symptom severity, and strength. Case-control study Physiotherapeutic Clinical Research and Electromyography Laboratory Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Case-control study of 117 women ranging from age 35 to 60 years. Of these, 67 had FM. Posture control was assessed with the modified clinical test of sensory interaction on balance with patients in forceplates, balance self-efficacy with the Activities-specific Balance Confidence Scale, pain severity with the Visual Analog Scale, tender point pain threshold with digital algometry, symptom severity with the fibromyalgia impact questionnaire, and lower limb strength with a dynamometer. Individuals with FM had impaired postural control showing increased speed of oscillation of the center of gravity (P=0.004) and decreased balance self-efficacy (P<0.001). They had moderate to excellent correlations of balance self-efficacy with pain (r=0.7, P<0.01), muscle strength (r=0.52, P<0.01), and symptom severity (r=0.78, P<0.10) compared with the control group. Correlation of postural control with the same variables was weak. Patients with FM have impaired postural control and low balance self-efficacy that are associated with pain, muscle strength, and symptom severity. Postural control and balance self-efficacy needs to be assessed in patients with FM and the treatment goals should be the improvement of postural control and balance self-efficacy.

Body measurements of Chinese males in dynamic postures and application.

PubMed

Wang, Y J; Mok, P Y; Li, Y; Kwok, Y L

2011-11-01

It is generally accepted that there is a relationship between body dimensions, body movement and clothing wearing ease design, and yet previous research in this area has been neither sufficient nor systematic. This paper proposes a method to measure the human body in the static state and in 17 dynamic postures, so as to understand dimensional changes of different body parts during dynamic movements. Experimental work is carried out to collect 30 measurements of 10 male Chinese subjects in both static and dynamic states. Factor analysis is used to analyse body measurement data in a static state, and such key measurements describe the characteristics of different body figures. Moreover, one-way ANOVA is used to analyse how dynamic postures affect these key body measurements. Finally, an application of the research results is suggested: a dynamic block patternmaking method for high-performance clothing design. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Postural Stability Margins as a Function of Support Surface Slopes.

PubMed

Dutt-Mazumder, Aviroop; Slobounov, Seymon M; Challis, John Henry; Newell, Karl Maxim

2016-01-01

This investigation examined the effects of slope of the surface of support (35°, 30°, 20°, 10° Facing(Toe) Down, 0° Flat and 10°, 20°, 25° Facing (Toe) Up) and postural orientation on the margins of postural stability in quiet standing of young adults. The findings showed that the center of pressure-CoP (displacement, area and length) had least motion at the baseline (0° Flat) platform condition that progressively increased as a function of platform angle in both facing up and down directions. The virtual time to collision (VTC) dynamics revealed that the spatio-temporal margins to the functional stability boundary were progressively smaller and the VTC time series also more regular (SampEn-Sample Entropy) as slope angle increased. Surface slope induces a restricted stability region with lower dimension VTC dynamics that is more constrained when postural orientation is facing down the slope. These findings provide further evidence that VTC acts as a control variable in standing posture that is influenced by the emergent dynamics of the individual-environment-task interaction.

Evaluation of the lambda model for human postural control during ankle strategy.

PubMed

Micheau, Philippe; Kron, Aymeric; Bourassa, Paul

2003-09-01

An accurate modeling of human stance might be helpful in assessing postural deficit. The objective of this article is to validate a mathematical postural control model for quiet standing posture. The postural dynamics is modeled in the sagittal plane as an inverted pendulum with torque applied at the ankle joint. The torque control system is represented by the physiological lambda model. Two neurophysiological command variables of the central nervous system, designated lambda and micro, establish the dynamic threshold muscle at which motoneuron recruitment begins. Kinematic data and electromyographic signals were collected on four young males in order to measure small voluntary sway and quiet standing posture. Validation of the mathematical model was achieved through comparison of the experimental and simulated results. The mathematical model allows computation of the unmeasurable neurophysiological commands lambda and micro that control the equilibrium position and stability. Furthermore, with the model it is possible to conclude that low-amplitude body sway during quiet stance is commanded by the central nervous system.

Learning effects of dynamic postural control by auditory biofeedback versus visual biofeedback training.

PubMed

Hasegawa, Naoya; Takeda, Kenta; Sakuma, Moe; Mani, Hiroki; Maejima, Hiroshi; Asaka, Tadayoshi

2017-10-01

Augmented sensory biofeedback (BF) for postural control is widely used to improve postural stability. However, the effective sensory information in BF systems of motor learning for postural control is still unknown. The purpose of this study was to investigate the learning effects of visual versus auditory BF training in dynamic postural control. Eighteen healthy young adults were randomly divided into two groups (visual BF and auditory BF). In test sessions, participants were asked to bring the real-time center of pressure (COP) in line with a hidden target by body sway in the sagittal plane. The target moved in seven cycles of sine curves at 0.23Hz in the vertical direction on a monitor. In training sessions, the visual and auditory BF groups were required to change the magnitude of a visual circle and a sound, respectively, according to the distance between the COP and target in order to reach the target. The perceptual magnitudes of visual and auditory BF were equalized according to Stevens' power law. At the retention test, the auditory but not visual BF group demonstrated decreased postural performance errors in both the spatial and temporal parameters under the no-feedback condition. These findings suggest that visual BF increases the dependence on visual information to control postural performance, while auditory BF may enhance the integration of the proprioceptive sensory system, which contributes to motor learning without BF. These results suggest that auditory BF training improves motor learning of dynamic postural control. Copyright © 2017 Elsevier B.V. All rights reserved.

Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-01-01

Low back pain (LBP) is a common musculoskeletal disorder and prolonged sitting often aggravates LBP. A novel dynamic ergonomic chair ('Back App'), which facilitates less hip flexion while sitting on an unstable base has been developed. This study compared lumbar posture and trunk muscle activation on this novel chair with a standard backless office chair. Twelve painfree participants completed a typing task on both chairs. Lumbar posture and trunk muscle activation were collected simultaneously and were analysed using paired t-tests. Sitting on the novel dynamic chair significantly (p < 0.05) reduced both lumbar flexion and the activation of one back muscle (Iliocostalis Lumborum pars Thoracis). The discomfort experienced was mild and was similar (p > 0.05) between chairs. Maintaining lordosis with less muscle activation during prolonged sitting could reduce the fatigue associated with upright sitting postures. Studies with longer sitting durations, and in people with LBP, are required. Sitting on a novel dynamic chair resulted in less lumbar flexion and less back muscle activation than sitting on a standard backless office chair during a typing task among pain-free participants. Facilitating lordotic sitting with less muscle activation may reduce the fatigue and discomfort often associated with lordotic sitting postures.

Evaluation of Postural Control in Patients with Glaucoma Using a Virtual Reality Environment.

PubMed

Diniz-Filho, Alberto; Boer, Erwin R; Gracitelli, Carolina P B; Abe, Ricardo Y; van Driel, Nienke; Yang, Zhiyong; Medeiros, Felipe A

2015-06-01

To evaluate postural control using a dynamic virtual reality environment and the relationship between postural metrics and history of falls in patients with glaucoma. Cross-sectional study. The study involved 42 patients with glaucoma with repeatable visual field defects on standard automated perimetry (SAP) and 38 control healthy subjects. Patients underwent evaluation of postural stability by a force platform during presentation of static and dynamic visual stimuli on stereoscopic head-mounted goggles. The dynamic visual stimuli presented rotational and translational ecologically valid peripheral background perturbations. Postural stability was also tested in a completely dark field to assess somatosensory and vestibular contributions to postural control. History of falls was evaluated by a standard questionnaire. Torque moments around the center of foot pressure on the force platform were measured, and the standard deviations of the torque moments (STD) were calculated as a measurement of postural stability and reported in Newton meters (Nm). The association with history of falls was investigated using Poisson regression models. Age, gender, body mass index, severity of visual field defect, best-corrected visual acuity, and STD on dark field condition were included as confounding factors. Patients with glaucoma had larger overall STD than controls during both translational (5.12 ± 2.39 Nm vs. 3.85 ± 1.82 Nm, respectively; P = 0.005) and rotational stimuli (5.60 ± 3.82 Nm vs. 3.93 ± 2.07 Nm, respectively; P = 0.022). Postural metrics obtained during dynamic visual stimuli performed better in explaining history of falls compared with those obtained in static and dark field condition. In the multivariable model, STD values in the mediolateral direction during translational stimulus were significantly associated with a history of falls in patients with glaucoma (incidence rate ratio, 1.85; 95% confidence interval, 1.30-2.63; P = 0.001). The study presented and validated a novel paradigm for evaluation of balance control in patients with glaucoma on the basis of the assessment of postural reactivity to dynamic visual stimuli using a virtual reality environment. The newly developed metrics were associated with a history of falls and may help to provide a better understanding of balance control in patients with glaucoma. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Evaluation of Postural Control in Glaucoma Patients Using a Virtual 1 Reality Environment

PubMed Central

Diniz-Filho, Alberto; Boer, Erwin R.; Gracitelli, Carolina P. B.; Abe, Ricardo Y.; van Driel, Nienke; Yang, Zhiyong; Medeiros, Felipe A.

2015-01-01

Purpose To evaluate postural control using a dynamic virtual reality environment and the relationship between postural metrics and history of falls in glaucoma patients. Design Cross-sectional study. Participants The study involved 42 glaucoma patients with repeatable visual field defects on standard automated perimetry (SAP) and 38 control healthy subjects. Methods Patients underwent evaluation of postural stability by a force platform during presentation of static and dynamic visual stimuli on stereoscopic head-mounted goggles. The dynamic visual stimuli presented rotational and translational ecologically valid peripheral background perturbations. Postural stability was also tested in a completely dark field to assess somatosensory and vestibular contributions to postural control. History of falls was evaluated by a standard questionnaire. Main Outcome Measures Torque moments around the center of foot pressure on the force platform were measured and the standard deviations (STD) of these torque moments were calculated as a measurement of postural stability and reported in Newton meter (Nm). The association with history of falls was investigated using Poisson regression models. Age, gender, body mass index, severity of visual field defect, best-corrected visual acuity, and STD on dark field condition were included as confounding factors. Results Glaucoma patients had larger overall STD than controls during both translational (5.12 ± 2.39 Nm vs. 3.85 ± 1.82 Nm, respectively; P = 0.005) as well as rotational stimuli (5.60 ± 3.82 Nm vs. 3.93 ± 2.07 Nm, respectively; P = 0.022). Postural metrics obtained during dynamic visual stimuli performed better in explaining history of falls compared to those obtained in static and dark field condition. In the multivariable model, STD values in the mediolateral direction during translational stimulus were significantly associated with history of falls in glaucoma patients (incidence-rate ratio = 1.85; 95% CI: 1.30 – 2.63; P = 0.001). Conclusions The study presented and validated a novel paradigm for evaluation of balance control in glaucoma patients based on the assessment of postural reactivity to dynamic visual stimuli using a virtual reality environment. The newly developed metrics were associated with history of falls and may help to provide a better understanding of balance control in glaucoma patients. PMID:25892017

Vibrotactile Feedback Alters Dynamics Of Static Postural Control In Persons With Parkinson's Disease But Not Older Adults At High Fall Risk.

PubMed

High, Carleigh M; McHugh, Hannah F; Mills, Stephen C; Amano, Shinichi; Freund, Jane E; Vallabhajosula, Srikant

2018-06-01

Aging and Parkinson's disease are often associated with impaired postural control. Providing extrinsic feedback via vibrotactile sensation could supplement intrinsic feedback to maintain postural control. We investigated the postural control response to vibrotactile feedback provided at the trunk during challenging stance conditions in older adults at high fall risk and individuals with Parkinson's disease compared to healthy older adults. Nine older adults at high fall risk, 9 persons with Parkinson's disease and 10 healthy older adults performed 30s quiet standing on a force platform under five challenging stance conditions with eyes open/closed and standing on firm/foam surface with feet together, each with and without vibrotactile feedback. During vibrotactile feedback trials, feedback was provided when participants swayed >10% over the center of their base of support. Participants were instructed vibrations would be in response to their movement. Magnitude of postural sway was estimated using center of pressure path length, velocity, and sway area. Dynamics of individuals' postural control was evaluated using detrended fluctuation analysis. Results showed that vibrotactile feedback induced a change in postural control dynamics among persons with Parkinson's disease when standing with intact intrinsic visual input and altered intrinsic somatosensory input, but there was no change in sway magnitude. However, use of vibrotactile feedback did not significantly alter dynamics of postural control in older adults with high risk of falling or reduce the magnitude of sway. Considering the effects of vibrotactile feedback were dependent on the population and stance condition, designing an optimal therapeutic regimen for balance training should be carefully considered and be specific to a target population. Furthermore, our results suggest that explicit instructions on how to respond to the vibrotactile feedback could affect training outcome. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

A balance and proprioception intervention programme to enhance combat performance in military personnel.

PubMed

Funk, Shany; Jacob, T; Ben-Dov, D; Yanovich, E; Tirosh, O; Steinberg, N

2018-02-01

Optimal functioning of the lower extremities under repeated movements on unstable surfaces is essential for military effectiveness. Intervention training to promote proprioceptive ability should be considered in order to limit the risk for musculoskeletal injuries. The aim of this study was to assess the effect of a proprioceptive intervention programme on static and dynamic postural balance among Israel Defense Forces combat soldiers. Twenty-seven male soldiers, aged 18-20 years, from a physical fitness instructor's course, were randomly divided into two groups matched by age and army unit. The intervention group (INT) underwent 4 weeks of proprioceptive exercises for 10 min daily; the control group underwent 4 weeks of upper body stretching exercises for 10 min daily. All participants were tested pre and postintervention for both static and dynamic postural balance. Significant interaction (condition*pre-post-test*group) was found for static postural balance, indicating that for the INT group, in condition 3 (on an unstable surface-BOSU), the post-test result was significantly better compared with the pretest result (p<0.05). Following intervention, the INT group showed significant correlations between static postural stability in condition 2 (eyes closed) and the dynamic postural stability (length of time walked on the beam following fatigue) ( r ranged from 0.647 to 0.822; p<0.05). The proprioceptive intervention programme for combat soldiers improved static postural balance on unstable surfaces, and improved the correlation between static postural balance in the eyes closed condition and dynamic postural balance following fatigue. Further longitudinal studies are needed to verify the relationship between proprioception programmes, additional weight bearing and the reduction of subsequent injuries in combat soldiers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Balance Training Does Not Alter Reliance on Visual Information during Static Stance in Those with Chronic Ankle Instability: A Systematic Review with Meta-Analysis.

PubMed

Song, Kyeongtak; Rhodes, Evan; Wikstrom, Erik A

2018-04-01

Visual, vestibular, and somatosensory systems contribute to postural control. Chronic ankle instability (CAI) patients have been observed to have a reduced ability to dynamically shift their reliance among sources of sensory information and rely more heavily on visual information during a single-limb stance relative to uninjured controls. Balance training is proven to improve postural control but there is a lack of evidence regarding the ability of balance training programs to alter the reliance on visual information in CAI patients. Our objective was to determine if balance training alters the reliance on visual information during static stance in CAI patients. The PubMed, CINAHL, and SPORTDiscus databases were searched from their earliest available date to October 2017 using a combination of keywords. Study inclusion criteria consisted of (1) using participants with CAI; (2) use of a balance training intervention; and (3) calculation of an objective measure of static postural control during single-limb stance with eyes open and eyes closed. Sample sizes, means, and standard deviations of single-leg balance measures for eyes-open and eyes-closed testing conditions before and after balance training were extracted from the included studies. Eyes-open to eyes-closed effect sizes [Hedges' g and 95% confidence intervals (CI)] before and after balance training were calculated, and between-study variability for heterogeneity and potential risks of publication bias were examined. Six studies were identified. The overall eyes-open to eyes-closed effect size difference between pre- and post-intervention assessments was not significant (Hedges' g effect size = 0.151, 95% CI = - 0.151 to 0.453, p = 0.26). This result indicates that the utilization of visual information in individuals with CAI during the single-leg balance is not altered after balance training. Low heterogeneity (Q(5) = 2.96, p = 0.71, I 2  = 0%) of the included studies and no publication bias were found. On the basis of our systematic review with meta-analysis, it appears that traditional balance training protocols do not alter the reliance on visual information used by CAI patients during a single-leg stance.

Comparison of anti-siphon devices-how do they affect CSF dynamics in supine and upright posture?

PubMed

Gehlen, Manuel; Eklund, Anders; Kurtcuoglu, Vartan; Malm, Jan; Schmid Daners, Marianne

2017-08-01

Three different types of anti-siphon devices (ASDs) have been developed to counteract siphoning-induced overdrainage in upright posture. However, it is not known how the different ASDs affect CSF dynamics under the complex pressure environment seen in clinic due to postural changes. We investigated which ASDs can avoid overdrainage in upright posture best without leading to CSF accumulation. Three shunts each of the types Codman Hakim with SiphonGuard (flow-regulated), Miethke miniNAV with proSA (gravitational), and Medtronic Delta (membrane controlled) were tested. The shunts were compared on a novel in vitro setup that actively emulates the physiology of a shunted patient. This testing method allows determining the CSF drainage rates, resulting CSF volume, and intracranial pressure in the supine, sitting, and standing posture. The flow-regulated ASDs avoided increased drainage by closing their primary flow path when drainage exceeded 1.39 ± 0.42 mL/min. However, with intraperitoneal pressure increased in standing posture, we observed reopening of the ASD in 3 out of 18 experiment repetitions. The adjustable gravitational ASDs allow independent opening pressures in horizontal and vertical orientation, but they did not provide constant drainage in upright posture (0.37 ± 0.03 mL/min and 0.26 ± 0.03 mL/min in sitting and standing posture, respectively). Consequently, adaptation to the individual patient is critical. The membrane-controlled ASDs stopped drainage in upright posture. This eliminates the risk of overdrainage, but leads to CSF accumulation up to the volume observed without shunting when the patient is upright. While all tested ASDs reduced overdrainage, their actual performance will depend on a patient's specific needs because of the large variation in the way the ASDs influence CSF dynamics: while the flow-regulated shunts provide continuous drainage in upright posture, the gravitational ASDs allow and require additional adaptation, and the membrane-controlled ASDs show robust siphon prevention by a total stop of drainage.

Military personnel with self-reported ankle injuries do not demonstrate deficits in dynamic postural stability or landing kinematics.

PubMed

Bansbach, Heather M; Lovalekar, Mita T; Abt, John P; Rafferty, Deirdre; Yount, Darcie; Sell, Timothy C

2017-08-01

The odds of sustaining non-contact musculoskeletal injuries are higher in Special Operations Forces operators than in infantry soldiers. The ankle is one of the most commonly injured joints, and once injured can put individuals at risk for reinjury. The purpose of this study was to determine if any differences in postural stability and landing kinematics exist between operators with a self-reported ankle injury in the past one year and uninjured controls. A total of 55 Special Operations Forces operators were included in this analysis. Comparisons were made between operators with a self-reported ankle injury within one-year of their test date (n=11) and healthy matched controls (n=44). Comparisons were also made between injured and uninjured limbs within the injured group. Dynamic postural stability and landing kinematics at the ankle, knee, and hip were assessed during a single-leg jump-landing task. Comparisons were made between groups with independent t-tests and within the injured group between limbs using paired t-tests. There were no significant differences in dynamic postural stability index or landing kinematics between the injured and uninjured groups. Anterior-posterior stability index was significantly higher on the uninjured limb compared to the injured limb within the injured group (P=0.02). Single ankle injuries sustained by operators may not lead to deficits in dynamic postural stability. Dynamic postural stability index and landing kinematics within one year after injury were either not affected by the injuries reported, or injured operators were trained back to baseline measures through rehabilitation and daily activity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of Postural Adjustments in Persons with Intellectual Disability during Balance on the Seesaw

ERIC Educational Resources Information Center

Carvalho, R. L.; Almeida, G. L.

2009-01-01

Background: The purpose of this study was to investigate the kinematic and electromyography strategy used by individuals with intellectual disability to keep equilibrium during anterior-posterior balance on seesaws with different degrees of instability. Method: Six individuals with Down syndrome (DS) and six control group individuals (CG) balanced…

Sudden Sensorineural Hearing Loss: The Question of Perilymph Fistula.

ERIC Educational Resources Information Center

Backous, Douglas D.; Niparko, John K.

1997-01-01

Perilymph fistula (PLF) is an abnormal communication between the fluid-containing spaces of the inner ear and the air-containing spaces of the temporal bone that can cause hearing loss, tinnitus, aural fullness, vertigo, and postural instability. Diagnosis of PLF and management of those with presumed PLF are discussed. (Contains extensive…

(De)stabilization of Required and Spontaneous Postural Dynamics with Learning

ERIC Educational Resources Information Center

Faugloire, Elise; Bardy, Benoit G.; Stoffregen, Thomas A.

2009-01-01

The present research examined how learning a new ankle-hip coordination influenced the preexisting postural repertoire. Standing participants learned a new ankle-hip coordination mode (relative phase of 90[degrees]). Before and after practice, postural patterns were evaluated in two different tasks. In the required task, specific ankle-hip…

Training with a balance exercise assist robot is more effective than conventional training for frail older adults.

PubMed

Ozaki, Kenichi; Kondo, Izumi; Hirano, Satoshi; Kagaya, Hitoshi; Saitoh, Eiichi; Osawa, Aiko; Fujinori, Yoichi

2017-11-01

To examine the efficacy of postural strategy training using a balance exercise assist robot (BEAR) as compared with conventional balance training for frail older adults. The present study was designed as a cross-over trial without a washout term. A total of 27 community-dwelling frail or prefrail elderly residents (7 men, 20 women; age range 65-85 years) were selected from a volunteer sample. Two exercises were prepared for interventions: robotic exercise moving the center of gravity by the balance exercise assist robot system; and conventional balance training combining muscle-strengthening exercise, postural strategy training and applied motion exercise. Each exercise was carried out twice a week for 6 weeks. Participants were allocated randomly to either the robotic exercise first group or the conventional balance exercise first group. preferred and maximal gait speeds, tandem gait speeds, timed up-and-go test, functional reach test, functional base of support, center of pressure, and muscle strength of the lower extremities were assessed before and after completion of each exercise program. Robotic exercise achieved significant improvements for tandem gait speed (P = 0.012), functional reach test (P = 0.002), timed up-and-go test (P = 0.023) and muscle strength of the lower extremities (P = 0.001-0.030) compared with conventional exercise. In frail or prefrail older adults, robotic exercise was more effective for improving dynamic balance and lower extremity muscle strength than conventional exercise. These findings suggest that postural strategy training with the balance exercise assist robot is effective to improve the gait instability and muscle weakness often seen in frail older adults. Geriatr Gerontol Int 2017; 17: 1982-1990. © 2017 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation.

PubMed

Crews, Ryan T; Shen, Biing-Jiun; Campbell, Laura; Lamont, Peter J; Boulton, Andrew J M; Peyrot, Mark; Kirsner, Robert S; Vileikyte, Loretta

2016-08-01

Studies indicate that off-loading adherence is low in patients with diabetic foot ulcers (DFUs), which may subsequently delay healing. However, there is little empirical evidence for this relationship or the factors that influence adherence. This prospective, multicenter, international study of 79 (46 from the U.K. and 33 the U.S.) persons with type 2 diabetes and plantar DFUs assessed the association between off-loading adherence and DFU healing over a 6-week period. Additionally, potential demographic, disease, and psychological determinants of adherence were examined. DFUs were off-loaded with a removable device (77% a removable cast walker). Off-loading adherence was assessed objectively by activity monitors. Patient-reported measures included Hospital Anxiety and Depression Scale (HADS), Neuropathy and Foot Ulcer Quality of Life (NeuroQoL) instrument, and Revised Illness Perception Questionnaire (IPQ-R). Off-loading adherence was monitored for 35 ± 10 days, and devices were used during 59 ± 22% of subjects' activity. In multivariate analyses, smaller baseline DFU size, U.K. study site, and better off-loading adherence predicted smaller DFU size at 6 weeks (P < 0.05). Better off-loading adherence was, in turn, predicted by larger and more severe baseline DFUs, more severe neuropathy, and NeuroQoL foot pain (P < 0.05). In contrast, greater NeuroQoL postural instability predicted worse off-loading adherence (P < 0.001). HADS and IPQ-R measures were not significantly associated with off-loading adherence. Off-loading adherence is associated with the amount of DFU healing that occurs, while postural instability is a powerful predictor of nonadherence. Clinicians should take this neuropathic symptom into consideration when selecting an off-loading device, as off-loading-induced postural instability may further contribute to nonadherence. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Dopaminergic modulation of multi-muscle synergies in postural tasks performed by patients with Parkinson’s disease

PubMed Central

Falaki, Ali; Huang, Xuemei; Lewis, Mechelle M.; Latash, Mark L.

2017-01-01

Background Postural instability is one of most disabling motor symptoms in Parkinson’s disease. Indices of multi-muscle synergies are new measurements of postural stability. Objectives We explored the effects of dopamine-replacement drugs on multi-muscle synergies stabilizing center of pressure coordinate and their adjustments prior to a self-triggered perturbation in patients with Parkinson’s disease. We hypothesized that both synergy indices and synergy adjustments would be improved on dopaminergic drugs. Methods Patients at Hoehn-Yahr stages II and III performed whole-body tasks both off- and on-drugs while standing. Muscle modes were identified as factors in the muscle activation space. Synergy indices stabilizing center of pressure in the anterior-posterior direction were quantified in the muscle mode space during a load-release task. Results Dopamine-replacement drugs led to more consistent organization of muscles in stable groups (muscle modes). On-drugs patients showed larger indices of synergies and anticipatory synergy adjustments. In contrast, no medication effects were seen on anticipatory postural adjustments or other performance indices. Conclusions Dopamine-replacement drugs lead to significant changes in characteristics of multi-muscle synergies in Parkinson’s disease. Studies of synergies may provide a biomarker sensitive to problems with postural stability and agility and to efficacy of dopamine-replacement therapy. PMID:28110044

Resolving Sensory Conflict: the Effect of Muscle Vibration on Postural Stability

NASA Technical Reports Server (NTRS)

Layne, Charles S.

1991-01-01

The otolith-tilt reinterpretation hypothesis (OTTR) proposes that the central nervous system adapts to weightlessness by reinterpreting all otolith input as linear motion. While interpreting otolith input exclusively as linear motion is functionally useful in space, it is maladaptive upon return to Earth. Astronauts have reported experiencing illusory sensations during head movement which contributes to postural instability. The effect is assessed of muscle vibration in combination with a variety of sensory conflicts on postural equilibrium. The equilibrium of six healthy subjects was tested using the EquiTest sensory test protocol, with and without the confounding influence of triceps surea vibration. The data were analyzed with repeated measures with vibration, vision status, and platform status as independent variables. All main effects and an interaction between the presence of vision and platform sway referencing were found to be significant. Overall, a 4.5 pct. decrease in postural stability was observed with vibration. The trend of the difference scores between conditions with and without vibration suggests that vibration is most destabilizing when the triceps surea is able to change length during postural sway (i.e., conditions with a fixed support surface). The impact of sway referencing vision was virtually identical to that of eye closure, providing compelling evidence that sway referencing 'nulls out' useful cues about subject sway.

Altered characteristics of balance control in obese older adults.

PubMed

Melzer, Itshak; Oddsson, Lars I E

2016-01-01

Obesity is one of the most significant epidemiological trends of the last decades. Recently it was found that obese individuals show postural instability. Balance control mechanisms in obese older adults were less studied. Therefore we aimed to investigate the effect of obesity on balance control mechanisms in older adults. Parameters from Stabilogram-Diffusion Analysis (SDA) and measures from summary statistics of foot centre-of-pressure (COP) displacements along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions were used to characterize postural control in 22 obese (30-<35kg/m(2)), 26 overweight (25-<30kg/m(2)), and 18 normal weight subjects (18.5-<25kg/m(2)). Obese group subjects demonstrated significantly greater transition displacement, transition time interval, and short-term scaling exponent in the ML-direction compared with the normal weight group (eyes open and closed). In the AP-direction the obese group showed greater transition displacement (eyes open) and short-term scaling exponent (eyes open and closed). Average AP-COP and ML-COP ranges of COP sway were higher in the obese group compared with the normal weight group (eyes open and closed). This work indicates an altered postural control process in obese older adults. A greater sway displacement before closed-loop feedback mechanisms are called into play was seen in the ML direction that may lead to a higher risk of instability and fall events. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Evaluation of a smartphone-based assessment system in subjects with chronic ankle instability.

PubMed

Chiu, Ya-Lan; Tsai, Yi-Ju; Lin, Chueh-Ho; Hou, You-Ruei; Sung, Wen-Hsu

2017-02-01

Ankle sprain is the most common sports-related injury, and approximately 80% of patients studied suffered recurrent sprains. These repeated ankle injuries could cause chronic ankle instability, a decrease in sports performance, and a decrease in postural control ability. At the present time, smartphones have become very popular and powerful devices, and smartphone applications (apps) that have been shown to have good validity have been designed to measure human body motion. However, the app focusing on ankle function assessment and rehabilitation is still not widely used and has very limited functions. The purpose of this study is to evaluate the feasibility of smartphone-based systems in the assessment of postural control ability for patients with chronic ankle instability. Fifteen physically active adults (6 male, 9 female; aged = 23.4 ± 5.28 years; height = 167.13 ± 7.3 cm; weight = 62.06 ± 10.82 kg; BMI = 22.08 ± 2.57 kg/ m 2 ) were recruited, and these participants had at least one leg that was evaluated as scoring lower than 27 points according to the Cumberland Ankle Instability Tool (CAIT). The smartphone used in the study was ASUS Zenfone 2, and an app developed using MIT App Inventor was used to record built-in accelerometer data during the assessment process. Subjects were asked to perform single leg stance for 20 s in eyes-open and eyes-closed conditions with each leg. The smartphone was fixed in an upright position on the middle of the shin, using an exercise armband, with the screen facing forward. The average of recorded acceleration data was used to represent the postural control performance, and higher values indicated more instability. Data were analyzed with a paired t-test with SPSS 17.0, and the statistical significance was set as alpha <0.05. A significant difference was found between CAIT scores from the healthier leg and injured leg (healthier leg 23.07 ± 3.80 vs. injured leg 18.27 ± 3.92, p < 0.001). Significant differences were also found between the scores for the healthier leg and injured leg during both eyes-open and eyes-closed conditions (eyes-open: healthier leg 0.051 ± 0.018 vs. injured leg 0.072 ± 0.034, p = 0.027; eyes-closed: healthier leg 0.100 ± 0.031 vs. injured leg 0.123 ± 0.038, p = 0.001, unit: m/s 2 ). Significant differences were also found between eyes-open and eyes-closed conditions during both single leg standing with healthier leg and injured leg (healthier leg: eyes-open 0.051 ± 0.018 vs. eyes-closed 0.100 ± 0.031, p < 0.001; injured leg: eyes-open 0.072 ± 0.034 vs. eyes-closed 0.123 ± 0.038, p = 0.001, unit: m/s 2 ). The results demonstrate that the smartphone software can be used to discriminate between the different performances of the healthier leg and injured leg, and also between eyes-open and eyes-closed conditions. The smartphone may have the potential to be a convenient, easy-to-use, and feasible tool for the assessment of postural control ability on subjects with chronic ankle instability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Spatial Reorientation of Sensorimotor Balance Control in Altered Gravity

NASA Technical Reports Server (NTRS)

Paloski, W. H.; Black, F. L.; Kaufman, G. D.; Reschke, M. F.; Wood, S. J.

2007-01-01

Sensorimotor coordination of body segments following space flight are more pronounced after landing when the head is actively tilted with respect to the trunk. This suggests that central vestibular processing shifts from a gravitational frame of reference to a head frame of reference in microgravity. A major effect of such changes is a significant postural instability documented by standard head-erect Sensory Organization Tests. Decrements in functional performance may still be underestimated when head and gravity reference frames remained aligned. The purpose of this study was to examine adaptive changes in spatial processing for balance control following space flight by incorporating static and dynamic tilts that dissociate head and gravity reference frames. A second aim of this study was to examine the feasibility of altering the re-adaptation process following space flight by providing discordant visual-vestibular-somatosensory stimuli using short-radius pitch centrifugation.

Visual feedback training using WII Fit improves balance in Parkinson's disease.

PubMed

Zalecki, Tomasz; Gorecka-Mazur, Agnieszka; Pietraszko, Wojciech; Surowka, Artur D; Novak, Pawel; Moskala, Marek; Krygowska-Wajs, Anna

2013-01-01

Postural instability including imbalance is the most disabling long term problem in Parkinson's disease (PD) that does not respond to pharmacotherapy. This study aimed at investigating the effectiveness of a novel visual-feedback training method, using Wii Fit balance board in improving balance in patients with PD. Twenty four patients with moderate PD were included in the study which comprised of a 6-week home-based balance training program using Nintendo Wii Fit and balance board. The PD patients significantly improved their results in Berg Balance Scale, Tinnet's Performance-Oriented Mobility Assessment, Timed Up-and-Go, Sit-to-stand test, 10-Meter Walk test and Activities-specific Balance Confidence scale at the end of the programme. This study suggests that visual feedback training using Wii-Fit with balance board could improve dynamic and functional balance as well as motor disability in PD patients.

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

PubMed

Bonnet, Cédrick T; Delval, Arnaud; Defebvre, Luc

2014-11-15

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease. Copyright © 2014 the American Physiological Society.

Characteristics of hand tremor and postural sway in patients with fetal-type Minamata disease.

PubMed

Iwata, Toyoto; Takaoka, Shigeru; Sakamoto, Mineshi; Maeda, Eri; Nakamura, Masaaki; Liu, Xiao-Jie; Murata, Katsuyuki

2016-01-01

About forty certified patients aged around 50 years old existed as living witnesses to fetal-type Minamata disease (methylmercury poisoning due to in utero exposure) in Minamata, Japan in 2006. Computerized hand tremor and postural sway tests with spectral analysis were conducted for 24 of them and in matched control subjects to examine the pathophysiological feature of neuromotor function. The tremor intensities of the patients with fetal-type Minamata disease were significantly larger than those of the 67 controls at every frequency band for both hands. In the patients, proportions for intensity at 1-6 Hz of both hands were larger, but those of the intensity at 6-10 Hz were smaller compared with the controls. The center frequency of a tremor was significantly lower in the patients than in the controls. Only eight males of the 24 patients were examined to evaluate postural sway because of extremely low scores in activities of daily living in the remaining. Most of the postural sway parameters obtained with eyes open and closed were significantly larger in the patients than in the male controls. Likewise, Romberg quotients of postural sway in anterior-posterior direction were significantly higher in the patients. In conclusion, the patients with fetal-type Minamata disease of our study showed a larger tremor of low frequency at less than 6 Hz and postural instability. Spectral analyses of computerized hand tremor and postural sway are suggested to be useful for assessing the pathophysiological change, related to a lesion of the cerebellum, resulting from prenatal methylmercury exposure.

The Contribution of Proprioceptive Information to Postural Control in Elderly and Patients with Parkinson’s Disease with a History of Falls

PubMed Central

Bekkers, Esther M. J.; Dockx, Kim; Heremans, Elke; Vercruysse, Sarah; Verschueren, Sabine M. P.; Mirelman, Anat; Nieuwboer, Alice

2014-01-01

Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinson’s disease (PD) is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS) were derived from the differences between maximal center of pressure (CoP) displacement in anterior–posterior (AP) and medio-lateral (ML) direction during a maximal leaning task. Task conditions comprised standing with eyes open (EO) and eyes closed (EC): (1) on a stable surface; (2) an unstable surface; and (3) with Achilles tendon vibration. CoP displacements were calculated as a percentage of their respective LoS. Perceived LoS did not differ between groups. PD patients showed greater ML CoP displacement than elderly fallers (EF) across all conditions (p = 0.043) and tended to have higher postural sway in relation to the LoS (p = 0.050). Both groups performed worse on an unstable surface and during tendon vibration compared to standing on a stable surface with EO and even more so with EC. Both PD and EF had more AP sway in all conditions with EC compared to EO (p < 0.001) and showed increased CoP displacements when relying on proprioception only compared to standing with normal sensory input. This implies a similar role of the proprioceptive system in postural control in fallers with and without PD. PD fallers showed higher ML sway after sensory manipulations, as a result of which these values approached their perceived LoS more closely than in EF. We conclude that despite a similar fall history, PD patients showed more ML instability than EF, irrespective of sensory manipulation, but had a similar reliance on ankle proprioception. Hence, we recommend that rehabilitation and fall prevention for PD should focus on motor rather than on sensory aspects. PMID:25505395

Noise and poise: Enhancement of postural complexity in the elderly with a stochastic-resonance based therapy

NASA Astrophysics Data System (ADS)

Costa, M.; Priplata, A. A.; Lipsitz, L. A.; Wu, Z.; Huang, N. E.; Goldberger, A. L.; Peng, C.-K.

2007-03-01

Pathologic states are associated with a loss of dynamical complexity. Therefore, therapeutic interventions that increase physiologic complexity may enhance health status. Using multiscale entropy analysis, we show that the postural sway dynamics of healthy young and healthy elderly subjects are more complex than that of elderly subjects with a history of falls. Application of subsensory noise to the feet has been demonstrated to improve postural stability in the elderly. We next show that this therapy significantly increases the multiscale complexity of sway fluctuations in healthy elderly subjects. Quantification of changes in dynamical complexity of biologic variability may be the basis of a new approach to assessing risk and to predicting the efficacy of clinical interventions, including noise-based therapies.

Biomechanical investigation of thoracolumbar spine in different postures during ejection using a combined finite element and multi-body approach.

PubMed

Du, Chengfei; Mo, Zhongjun; Tian, Shan; Wang, Lizhen; Fan, Jie; Liu, Songyang; Fan, Yubo

2014-11-01

The aim of this study is to investigate the dynamic response of a multi-segment model of the thoracolumbar spine and determine how the sitting posture affects the response under the impact of ejection. A nonlinear finite element model of the thoracolumbar-pelvis complex (T9-S1) was developed and validated. A multi-body dynamic model of a pilot was also constructed so an ejection seat restraint system could be incorporated into the finite element model. The distribution of trunk mass on each vertebra was also considered in the model. Dynamics analysis showed that ejection impact induced obvious axial compression and anterior flexion of the spine, which may contribute to spinal injuries. Compared with a normal posture, the relaxed posture led to an increase in stress on the cortical wall, endplate, and intradiscal pressure of 43%, 10%, 13%, respectively, and accordingly increased the risk of inducing spinal injuries. Copyright © 2014 John Wiley & Sons, Ltd.

A Correlation-based Framework for Evaluating Postural Control Stochastic Dynamics

PubMed Central

Hernandez, Manuel E.; Snider, Joseph; Stevenson, Cory; Cauwenberghs, Gert; Poizner, Howard

2016-01-01

The inability to maintain balance during varying postural control conditions can lead to falls, a significant cause of mortality and serious injury among older adults. However, our understanding of the underlying dynamical and stochastic processes in human postural control have not been fully explored. To further our understanding of the underlying dynamical processes, we examine a novel conceptual framework for studying human postural control using the center of pressure (COP) velocity autocorrelation function (COP-VAF) and compare its results to Stabilogram Diffusion Analysis (SDA). Eleven healthy young participants were studied under quiet unipedal or bipedal standing conditions with eyes either opened or closed. COP trajectories were analyzed using both the traditional posturographic measure SDA and the proposed COP-VAF. It is shown that the COP-VAF leads to repeatable, physiologically meaningful measures that distinguish postural control differences in unipedal versus bipedal stance trials with and without vision in healthy individuals. More specifically, both a unipedal stance and lack of visual feedback increased initial values of the COP-VAF, magnitude of the first minimum, and diffusion coefficient, particularly in contrast to bipedal stance trials with open eyes. Use of a stochastic postural control model, based on an Ornstein-Uhlenbeck process that accounts for natural weight-shifts, suggests an increase in spring constant and decreased damping coefficient when fitted to experimental data. This work suggests that we can further extend our understanding of the underlying mechanisms behind postural control in quiet stance under varying stance conditions using the COP-VAF and provides a tool for quantifying future neurorehabilitative interventions. PMID:26011886

Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control

PubMed Central

Donker, Stella F.; Roerdink, Melvyn; Greven, An J.

2007-01-01

The influence of attention on the dynamical structure of postural sway was examined in 30 healthy young adults by manipulating the focus of attention. In line with the proposed direct relation between the amount of attention invested in postural control and regularity of center-of-pressure (COP) time series, we hypothesized that: (1) increasing cognitive involvement in postural control (i.e., creating an internal focus by increasing task difficulty through visual deprivation) increases COP regularity, and (2) withdrawing attention from postural control (i.e., creating an external focus by performing a cognitive dual task) decreases COP regularity. We quantified COP dynamics in terms of sample entropy (regularity), standard deviation (variability), sway-path length of the normalized posturogram (curviness), largest Lyapunov exponent (local stability), correlation dimension (dimensionality) and scaling exponent (scaling behavior). Consistent with hypothesis 1, standing with eyes closed significantly increased COP regularity. Furthermore, variability increased and local stability decreased, implying ineffective postural control. Conversely, and in line with hypothesis 2, performing a cognitive dual task while standing with eyes closed led to greater irregularity and smaller variability, suggesting an increase in the “efficiency, or “automaticity” of postural control”. In conclusion, these findings not only indicate that regularity of COP trajectories is positively related to the amount of attention invested in postural control, but also substantiate that in certain situations an increased internal focus may in fact be detrimental to postural control. PMID:17401553

Treatment of common deficits associated with chronic ankle instability.

PubMed

Holmes, Alison; Delahunt, Eamonn

2009-01-01

Lateral ankle sprains are amongst the most common injuries incurred by athletes, with the high rate of reoccurrence after initial injury becoming of great concern. Chronic ankle instability (CAI) refers to the development of repetitive ankle sprains and persistent residual symptoms post-injury. Some of the initial symptoms that occur in acute sprains may persist for at least 6 months post-injury in the absence of recurrent sprains, despite the athlete having returned to full functional activity. CAI is generally thought to be caused by mechanical instability (MI) or functional instability (FI), or both. Although previously discussed as separate entities, recent research has demonstrated that deficits associated with both MI and FI may co-exist to result in CAI. For clinicians, the main deficits associated with CAI include deficits in proprioception, neuromuscular control, strength and postural control. Based on the literature reviewed, it does seem that subjects with CAI have a deficit in frontal plane ankle joint positional sense. Subjects with CAI do not appear to exhibit any increased latency in the peroneal muscles in response to an external perturbation. Preliminary data suggest that feed-forward neuromuscular control may be more important than feed-back neuromuscular control and interventions are now required to address deficits in feed-forward neuromuscular control. Balance training protocols have consistently been shown to improve postural stability in subjects with CAI. Subjects with CAI do not experience decreased peroneus longus strength, but instead may experience strength deficits in the ankle joint invertor muscles. These findings are of great clinical significance in terms of understanding the mechanisms and deficits associated with CAI. An appreciation of these is vital to allow clinicians to develop effective prevention and treatment programmes in relation to CAI.

Assessing the Role of Dopamine in Limb and Cranial-Oromotor Control in a Rat Model of Parkinson's Disease

ERIC Educational Resources Information Center

Kane, Jacqueline R.; Ciucci, Michelle R.; Jacobs, Amber N.; Tews, Nathan; Russell, John A.; Ahrens, Allison M.; Ma, Sean T.; Britt, Joshua M.; Cormack, Lawrence K.; Schallert, Timothy

2011-01-01

Parkinson's disease (PD) is a neurodegenerative disorder primarily characterized by sensorimotor dysfunction. The neuropathology of PD includes a loss of dopamine (DA) neurons of the nigrostriatal pathway. Classic signs of the disease include rigidity, bradykinesia, and postural instability. However, as many as 90% of patients also experience…

Age-Related Differences in Cortical and Subcortical Activities during Observation and Motor Imagery of Dynamic Postural Tasks: An fMRI Study.

PubMed

Mouthon, A; Ruffieux, J; Mouthon, M; Hoogewoud, H-M; Annoni, J-M; Taube, W

2018-01-01

Age-related changes in brain activation other than in the primary motor cortex are not well known with respect to dynamic balance control. Therefore, the current study aimed to explore age-related differences in the control of static and dynamic postural tasks using fMRI during mental simulation of balance tasks. For this purpose, 16 elderly (72 ± 5 years) and 16 young adults (27 ± 5 years) were asked to mentally simulate a static and a dynamic balance task by motor imagery (MI), action observation (AO), or the combination of AO and MI (AO + MI). Age-related differences were detected in the form of larger brain activations in elderly compared to young participants, especially in the challenging dynamic task when applying AO + MI. Interestingly, when MI (no visual input) was contrasted to AO (visual input), elderly participants revealed deactivation of subcortical areas. The finding that the elderly demonstrated overactivation in mostly cortical areas in challenging postural conditions with visual input (AO + MI and AO) but deactivation in subcortical areas during MI (no vision) may indicate that elderly individuals allocate more cortical resources to the internal representation of dynamic postural tasks. Furthermore, it might be assumed that they depend more strongly on visual input to activate subcortical internal representations.

Age-Related Differences in Cortical and Subcortical Activities during Observation and Motor Imagery of Dynamic Postural Tasks: An fMRI Study

PubMed Central

Ruffieux, J.; Mouthon, M.; Hoogewoud, H.-M.; Taube, W.

2018-01-01

Age-related changes in brain activation other than in the primary motor cortex are not well known with respect to dynamic balance control. Therefore, the current study aimed to explore age-related differences in the control of static and dynamic postural tasks using fMRI during mental simulation of balance tasks. For this purpose, 16 elderly (72 ± 5 years) and 16 young adults (27 ± 5 years) were asked to mentally simulate a static and a dynamic balance task by motor imagery (MI), action observation (AO), or the combination of AO and MI (AO + MI). Age-related differences were detected in the form of larger brain activations in elderly compared to young participants, especially in the challenging dynamic task when applying AO + MI. Interestingly, when MI (no visual input) was contrasted to AO (visual input), elderly participants revealed deactivation of subcortical areas. The finding that the elderly demonstrated overactivation in mostly cortical areas in challenging postural conditions with visual input (AO + MI and AO) but deactivation in subcortical areas during MI (no vision) may indicate that elderly individuals allocate more cortical resources to the internal representation of dynamic postural tasks. Furthermore, it might be assumed that they depend more strongly on visual input to activate subcortical internal representations. PMID:29675037

Observations on the correlation between posture and jaw position: a pilot study.

PubMed

Bracco, P; Deregibus, A; Piscetta, R; Ferrario, G

1998-10-01

The aim of this pilot study was twofold. The first was to show a method for having an objective and dynamic analysis of body posture, evaluating weight distribution and its connections with different mandibular positions. The second was to verify if a neuromuscularly stimulated occlusal position, called myocentric occlusal position, is associated with a positive or negative postural charge. For the second aim a group of 20 subjects (including both males and females), was chosen. Posture of each subject was analyzed in three different conditions: centric occlusion, rest position and myocentric position. To evaluate the dynamic of posture a platform capable of measuring the weight on the feet supporting points and the related variations during time of observation and the swinging of body barycenter was used. The data showed that there is an improvement in the position of the barycenter from the centric occlusion to the myocentric position. Such an improvement can't be observed from the intercuspal position to the rest position. The results of this pilot study are discussed.

The contribution of postural balance analysis in older adult fallers: A narrative review.

PubMed

Pizzigalli, L; Micheletti Cremasco, M; Mulasso, A; Rainoldi, A

2016-04-01

Falls are a serious health problem for older adults. Several studies have identified the decline of postural balance as one of the main risk factors for falls. Contrary to what may be believed, the capability of force platform measurements to predict falls remains uncertain. The focus of this narrative review is the identification of postural characteristics of older adults at risk of falling using both static and dynamic postural balance assessments. The literature analysis was conducted on Medline/PubMed. The search ended in May 2015. Centre of pressure (CoP) path length, CoP velocity and sway in medial lateral and anterior-posterior are the variables that distinguish older adult fallers from non-fallers. Recommendations to medical personnel on how to provide efficient balance training for older adults are offered, discussing the relevance and limitations of postural stability on static and dynamic board in falling risk prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Rim and the Ancient Mariner: The Nautical Horizon Affects Postural Sway in Older Adults

PubMed Central

Wade, Michael G.; Stergiou, Nick

2016-01-01

On land, the spatial magnitude of postural sway (i.e., the amount of sway) tends to be greater when participants look at the horizon than when they look at nearby targets. By contrast, on ships at sea, the spatial magnitude of postural sway in young adults has been greater when looking at nearby targets and less when looking at the horizon. Healthy aging is associated with changes in the movement patterns of the standing body sway, and these changes typically are interpreted in terms of age-related declines in the ability to control posture. To further elucidate the mechanisms associated with these changes we investigated control of posture in a setting that poses substantial postural challenges; standing on a ship at sea. In particular, we explored postural sway on a ship at sea when older adults looked at the horizon or at nearby targets. We evaluated the kinematics of the center of pressure in terms of spatial magnitude (i.e., the amount of sway) and multifractality (a measure of temporal dynamics). We found that looking at the horizon significantly affected the multifractality of standing body, but did not systematically influence the spatial magnitude of sway. We discuss the results in terms of age-related changes in the perception and control of dynamic body orientation. PMID:27973576

Pre-impact fall detection system using dynamic threshold and 3D bounding box

NASA Astrophysics Data System (ADS)

Otanasap, Nuth; Boonbrahm, Poonpong

2017-02-01

Fall prevention and detection system have to subjugate many challenges in order to develop an efficient those system. Some of the difficult problems are obtrusion, occlusion and overlay in vision based system. Other associated issues are privacy, cost, noise, computation complexity and definition of threshold values. Estimating human motion using vision based usually involves with partial overlay, caused either by direction of view point between objects or body parts and camera, and these issues have to be taken into consideration. This paper proposes the use of dynamic threshold based and bounding box posture analysis method with multiple Kinect cameras setting for human posture analysis and fall detection. The proposed work only uses two Kinect cameras for acquiring distributed values and differentiating activities between normal and falls. If the peak value of head velocity is greater than the dynamic threshold value, bounding box posture analysis will be used to confirm fall occurrence. Furthermore, information captured by multiple Kinect placed in right angle will address the skeleton overlay problem due to single Kinect. This work contributes on the fusion of multiple Kinect based skeletons, based on dynamic threshold and bounding box posture analysis which is the only research work reported so far.

Effects of a salsa dance training on balance and strength performance in older adults.

PubMed

Granacher, Urs; Muehlbauer, Thomas; Bridenbaugh, Stephanie A; Wolf, Madeleine; Roth, Ralf; Gschwind, Yves; Wolf, Irene; Mata, Rui; Kressig, Reto W

2012-01-01

Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 ± 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 ± 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Programme compliance was excellent with participants of the INT group completing 92.5% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group × test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power. Copyright © 2012 S. Karger AG, Basel.

Locomotor sensory organization test: a novel paradigm for the assessment of sensory contributions in gait.

PubMed

Chien, Jung Hung; Eikema, Diderik-Jan Anthony; Mukherjee, Mukul; Stergiou, Nicholas

2014-12-01

Feedback based balance control requires the integration of visual, proprioceptive and vestibular input to detect the body's movement within the environment. When the accuracy of sensory signals is compromised, the system reorganizes the relative contributions through a process of sensory recalibration, for upright postural stability to be maintained. Whereas this process has been studied extensively in standing using the Sensory Organization Test (SOT), less is known about these processes in more dynamic tasks such as locomotion. In the present study, ten healthy young adults performed the six conditions of the traditional SOT to quantify standing postural control when exposed to sensory conflict. The same subjects performed these six conditions using a novel experimental paradigm, the Locomotor SOT (LSOT), to study dynamic postural control during walking under similar types of sensory conflict. To quantify postural control during walking, the net Center of Pressure sway variability was used. This corresponds to the Performance Index of the center of pressure trajectory, which is used to quantify postural control during standing. Our results indicate that dynamic balance control during locomotion in healthy individuals is affected by the systematic manipulation of multisensory inputs. The sway variability patterns observed during locomotion reflect similar balance performance with standing posture, indicating that similar feedback processes may be involved. However, the contribution of visual input is significantly increased during locomotion, compared to standing in similar sensory conflict conditions. The increased visual gain in the LSOT conditions reflects the importance of visual input for the control of locomotion. Since balance perturbations tend to occur in dynamic tasks and in response to environmental constraints not present during the SOT, the LSOT may provide additional information for clinical evaluation on healthy and deficient sensory processing.

Dynamic Determinants of the Uncontrolled Manifold during Human Quiet Stance

PubMed Central

Suzuki, Yasuyuki; Morimoto, Hiroki; Kiyono, Ken; Morasso, Pietro G.; Nomura, Taishin

2016-01-01

Human postural sway during stance arises from coordinated multi-joint movements. Thus, a sway trajectory represented by a time-varying postural vector in the multiple-joint-angle-space tends to be constrained to a low-dimensional subspace. It has been proposed that the subspace corresponds to a manifold defined by a kinematic constraint, such that the position of the center of mass (CoM) of the whole body is constant in time, referred to as the kinematic uncontrolled manifold (kinematic-UCM). A control strategy related to this hypothesis (CoM-control-strategy) claims that the central nervous system (CNS) aims to keep the posture close to the kinematic-UCM using a continuous feedback controller, leading to sway patterns that mostly occur within the kinematic-UCM, where no corrective control is exerted. An alternative strategy proposed by the authors (intermittent control-strategy) claims that the CNS stabilizes posture by intermittently suspending the active feedback controller, in such a way to allow the CNS to exploit a stable manifold of the saddle-type upright equilibrium in the state-space of the system, referred to as the dynamic-UCM, when the state point is on or near the manifold. Although the mathematical definitions of the kinematic- and dynamic-UCM are completely different, both UCMs play similar roles in the stabilization of multi-joint upright posture. The purpose of this study was to compare the dynamic performance of the two control strategies. In particular, we considered a double-inverted-pendulum-model of postural control, and analyzed the two UCMs defined above. We first showed that the geometric configurations of the two UCMs are almost identical. We then investigated whether the UCM-component of experimental sway could be considered as passive dynamics with no active control, and showed that such UCM-component mainly consists of high frequency oscillations above 1 Hz, corresponding to anti-phase coordination between the ankle and hip. We also showed that this result can be better characterized by an eigenfrequency associated with the dynamic-UCM. In summary, our analysis highlights the close relationship between the two control strategies, namely their ability to simultaneously establish small CoM variations and postural stability, but also make it clear that the intermittent control hypothesis better explains the spectral characteristics of sway. PMID:27999535

Dynamic Determinants of the Uncontrolled Manifold during Human Quiet Stance.

PubMed

Suzuki, Yasuyuki; Morimoto, Hiroki; Kiyono, Ken; Morasso, Pietro G; Nomura, Taishin

2016-01-01

Human postural sway during stance arises from coordinated multi-joint movements. Thus, a sway trajectory represented by a time-varying postural vector in the multiple-joint-angle-space tends to be constrained to a low-dimensional subspace. It has been proposed that the subspace corresponds to a manifold defined by a kinematic constraint, such that the position of the center of mass (CoM) of the whole body is constant in time, referred to as the kinematic uncontrolled manifold ( kinematic-UCM ). A control strategy related to this hypothesis ( CoM-control-strategy ) claims that the central nervous system (CNS) aims to keep the posture close to the kinematic-UCM using a continuous feedback controller, leading to sway patterns that mostly occur within the kinematic-UCM, where no corrective control is exerted. An alternative strategy proposed by the authors ( intermittent control-strategy ) claims that the CNS stabilizes posture by intermittently suspending the active feedback controller, in such a way to allow the CNS to exploit a stable manifold of the saddle-type upright equilibrium in the state-space of the system, referred to as the dynamic-UCM , when the state point is on or near the manifold. Although the mathematical definitions of the kinematic- and dynamic-UCM are completely different, both UCMs play similar roles in the stabilization of multi-joint upright posture. The purpose of this study was to compare the dynamic performance of the two control strategies. In particular, we considered a double-inverted-pendulum-model of postural control, and analyzed the two UCMs defined above. We first showed that the geometric configurations of the two UCMs are almost identical. We then investigated whether the UCM-component of experimental sway could be considered as passive dynamics with no active control, and showed that such UCM-component mainly consists of high frequency oscillations above 1 Hz, corresponding to anti-phase coordination between the ankle and hip. We also showed that this result can be better characterized by an eigenfrequency associated with the dynamic-UCM. In summary, our analysis highlights the close relationship between the two control strategies, namely their ability to simultaneously establish small CoM variations and postural stability, but also make it clear that the intermittent control hypothesis better explains the spectral characteristics of sway.

[Posturographic study of total prostheses in the leg. Apropos of 88 patients examined].

PubMed

Lord, G; Gentaz, R; Gagey, P M; Baron, J B

1976-01-01

By suppressing certain articular sensory receptors, the reconstructive surgery of joints using total prostheses modifies tonic postural activity and, by this means, alters the regulation of balance in the subjects of operation. This doubtless explains certain discrepancies between the apparently excellent results in respect of joint movement and muscle strength and poor utilisation of the joint in every day life (instability, use of sticks or failure to use the joint in walking). Drawing on the experience and basic work of specialists in posture, the authors have undertaken a study of tonic postural activity in patients who had received a total prosthesis in the lower limb, both from the clinical aspect and by graphic measurement using an electronic apparatus, the statokinesiometer. Fourteen normal subjects were tested to calibrate the apparatus and 8 patients suffering from established osteoarthritis of the hip were studied as controls. Analysis of tonic postural activity was made in 66 patients who had received total prostheses in the lower limb. The results showed significant disturbance in balance in ankle prostheses, minimal disturbance in knee prostheses and not significant disturbance in hip prostheses. Certain therapeutic implications are derived from this study.

The effect of vision on postural strategies in Prader-Willi patients.

PubMed

Cimolin, Veronica; Galli, Manuela; Vismara, Luca; Grugni, Graziano; Priano, Lorenzo; Capodaglio, Paolo

2011-01-01

The aim of this study was to quantify the role of visual contribution in patients with Prader-Willi syndrome (PWS) on balance maintenance using a force platform. We enrolled 14 individuals with PWS free from conditions associated with impaired balance, 44 obese (OG) and 20 healthy controls (CG). Postural sway was measured for 60s while standing on a force platform (Kistler, CH; acquisition frequency: 500 Hz) integrated with a video system. Patients maintained an upright standing position with Open Eyes (OE) and then with Closed Eyes (CE). The ratio between the value of the parameter under OE and CE conditions was measured. Under OE condition PWS and OG were characterized by higher postural instability than CG, with the PWS group showing poorer balance capacity than OG. The Romberg ratio showed that while OG and CG had lower balance without vision, PWS maintained the same performance changing from OE to CE. The integration of different sensory inputs appears similar in OG and CG with higher postural stability under OE than CE. Balance in PWS is not influenced by the elimination of visual input. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dynamic posture analysis of Spacelab-1 crew members

NASA Technical Reports Server (NTRS)

Anderson, D. J.; Reschke, M. F.; Homick, J. E.; Werness, S. A.

1986-01-01

Dynamic posture testing was conducted on the science crew of the Spacelab-1 mission on a single axis linear motion platform. Tests took place in pre- and post-flight sessions lasting approximately 20 min each. The pre-flight tests were widely spaced over the several months prior to the mission while the post-flight tests were conducted over the first, second, fourth, and sixth days after landing. Two of the crew members were also tested on the day of landing. Consistent with previous postural testing conducted on flight crews, these crew members were able to complete simple postural tasks to an acceptable level even in the first few hours after landing. Our tests were designed to induce dynamic postural responses using a variety of stimuli and from these responses, evaluate subtle changes in the postural control system which had occurred over the duration of the flight. Periodic sampling post-flight allowed us to observe the time course of readaptation to terrestrial life. Our observations of hip and shoulder position, when subjected to careful analysis, indicated modification of the postural response from pre- to post-flight and that demonstrable adjustments in the dynamic control of their postural systems were taking place in the first few days after flight. For transient stimuli where the platform on which they were asked to stand quickly moved a few centimeters fore or aft then stopped, ballistic or open loop 'programs' would closely characterize the response. During these responses the desired target position was not always achieved and of equal importance not always properly corrected some 15 seconds after the platform ceased to move. The persistent observation was that the subjects had a much stronger dependence on visual stabilization post-flight than pre-flight. This was best illustrated by a slow or only partial recovery to an upward posture after a transient base-of-support movement with eyes open. Postural responses to persistent wideband pseudorandom base-of-support translation were modeled as time invarient linear systems arrived at by Kalman adaptive filter techniques. Derived model parameters such as damping factor and fundamental frequency of the closed loop system showed significant modification between pre- and post-flight. This phenomenon is best characterized by movement of the poles toward increasing stability. While pre-flight data tended to show shoulders and hips moving in phase with each other, post-flight data showed a more disjoint behavior.(ABSTRACT TRUNCATED AT 400 WORDS).

Relationships between Task-Oriented Postural Control and Motor Ability in Children and Adolescents with Down Syndrome

ERIC Educational Resources Information Center

Wang, Hui-Yi; Long, I-Man; Liu, Mei-Fang

2012-01-01

Individuals with Down syndrome (DS) have been characterized by greater postural sway in quiet stance and insufficient motor ability. However, there is a lack of studies to explore the properties of dynamic postural sway, especially under conditions of task-oriented movement. The purpose of this study was to investigate the relationships between…

The Relationship with Balance, Foot Posture, and Foot Size in School of Physical Education and Sports Students

ERIC Educational Resources Information Center

Irez, Gonul Babayigit

2014-01-01

The aim of this study is to investigate the relationship of foot posture and foot size with balance. A hundred and thirteen healthy volunteers were recruited from undergraduate students (Male = 74, Female = 37, age range 18-22). The Foot Posture Index (FPI-6), anthropometric measurements, dynamic balance and static balance measurements were done…

Effects of visual motion consistent or inconsistent with gravity on postural sway.

PubMed

Balestrucci, Priscilla; Daprati, Elena; Lacquaniti, Francesco; Maffei, Vincenzo

2017-07-01

Vision plays an important role in postural control, and visual perception of the gravity-defined vertical helps maintaining upright stance. In addition, the influence of the gravity field on objects' motion is known to provide a reference for motor and non-motor behavior. However, the role of dynamic visual cues related to gravity in the control of postural balance has been little investigated. In order to understand whether visual cues about gravitational acceleration are relevant for postural control, we assessed the relation between postural sway and visual motion congruent or incongruent with gravity acceleration. Postural sway of 44 healthy volunteers was recorded by means of force platforms while they watched virtual targets moving in different directions and with different accelerations. Small but significant differences emerged in sway parameters with respect to the characteristics of target motion. Namely, for vertically accelerated targets, gravitational motion (GM) was associated with smaller oscillations of the center of pressure than anti-GM. The present findings support the hypothesis that not only static, but also dynamic visual cues about direction and magnitude of the gravitational field are relevant for balance control during upright stance.

Dynamic genetic linkage of intermediate blood pressure phenotypes during postural adaptations in a founder population

PubMed Central

Arenas, I. A.; Tremblay, J.; Deslauriers, B.; Sandoval, J.; Šeda, O.; Gaudet, D.; Merlo, E.; Kotchen, T.; Cowley, A. W.

2013-01-01

Blood pressure (BP) is a dynamic phenotype that varies rapidly to adjust to changing environmental conditions. Standing upright is a recent evolutionary trait, and genetic factors that influence postural adaptations may contribute to BP variability. We studied the effect of posture on the genetics of BP and intermediate BP phenotypes. We included 384 sib-pairs in 64 sib-ships from families ascertained by early-onset hypertension and dyslipidemia. Blood pressure, three hemodynamic and seven neuroendocrine intermediate BP phenotypes were measured with subjects lying supine and standing upright. The effect of posture on estimates of heritability and genetic covariance was investigated in full pedigrees. Linkage was conducted on 196 candidate genes by sib-pair analyses, and empirical estimates of significance were obtained. A permutation algorithm was implemented to study the postural effect on linkage. ADRA1A, APO, CAST, CORIN, CRHR1, EDNRB, FGF2, GC, GJA1, KCNB2, MMP3, NPY, NR3C2, PLN, TGFBR2, TNFRSF6, and TRHR showed evidence of linkage with any phenotype in the supine position and not upon standing, whereas AKR1B1, CD36, EDNRA, F5, MMP9, PKD2, PON1, PPARG, PPARGC1A, PRKCA, and RET were specifically linked to standing phenotypes. Genetic profiling was undertaken to show genetic interactions among intermediate BP phenotypes and genes specific to each posture. When investigators perform genetic studies exclusively on a single posture, important genetic components of BP are missed. Supine and standing BPs have distinct genetic signatures. Standardized maneuvers influence the results of genetic investigations into BP, thus reflecting its dynamic regulation. PMID:23269701

Is there a relationship between pain intensity and postural sway in patients with non-specific low back pain?

PubMed

Ruhe, Alexander; Fejer, René; Walker, Bruce

2011-07-15

Increased center of pressure excursions are well documented in patients suffering from non-specific low back pain, whereby the altered postural sway includes both higher mean sway velocities and larger sway area. No investigation has been conducted to evaluate a relationship between pain intensity and postural sway in adults (aged 50 or less) with non-specific low back pain. Seventy-seven patients with non-specific low back pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90 sec duration with eyes closed in narrow stance on a firm surface. The perceived pain intensity was assessed by a numeric rating scale (NRS-11), an equal number of patients (n = 11) was enrolled per pain score. Generally, our results confirmed increased postural instability in pain sufferers compared to healthy controls. In addition, regression analysis revealed a significant and linear increase in postural sway with higher pain ratings for all included COP parameters. Statistically significant changes in mean sway velocity in antero-posterior and medio-lateral direction and sway area were reached with an incremental change in NRS scores of two to three points. COP mean velocity and sway area are closely related to self-reported pain scores. This relationship may be of clinical use as an objective monitoring tool for patients under treatment or rehabilitation.

Effects of Age-Related Macular Degeneration on Postural Sway

PubMed Central

Chatard, Hortense; Tepenier, Laure; Jankowski, Olivier; Aussems, Antoine; Allieta, Alain; Beydoun, Talal; Salah, Sawsen; Bucci, Maria P.

2017-01-01

Purpose: To compare the impact of unilateral vs. bilateral age-related macular degeneration (AMD) on postural sway, and the influence of different visual conditions. The hypothesis of our study was that the impact of AMD will be different between unilateral and bilateral AMD subjects compared to age-matched healthy elderly. Methods: Postural stability was measured with a platform (TechnoConcept®) in 10 elderly unilateral AMD subjects (mean age: 71.1 ± 4.6 years), 10 elderly bilateral AMD subjects (mean age: 70.8 ± 6.1 years), and 10 healthy age-matched control subjects (mean age: 69.8 ± 6.3 years). Four visual conditions were tested: both eyes viewing condition (BEV), dominant eye viewing (DEV), non-dominant eye viewing (NDEV), and eyes closed (EC). We analyzed the surface area, the length, the mean speed, the anteroposterior (AP), and mediolateral (ML) displacement of the center of pressure (CoP). Results: Bilateral AMD subjects had a surface area (p < 0.05) and AP displacement of the CoP (p < 0.01) higher than healthy elderly. Unilateral AMD subjects had more AP displacement of the CoP (p < 0.05) than healthy elderly. Conclusions: We suggest that ADM subjects could have poor postural adaptive mechanisms leading to increase their postural instability. Further studies will aim to improve knowledge on such issue and to develop reeducation techniques in these patients. PMID:28408876

Effect of cognitive and motor tasks on postural stability in Parkinson's disease: a posturographic study.

PubMed

Marchese, Roberta; Bove, Marco; Abbruzzese, Giovanni

2003-06-01

To analyse the effect of concomitant cognitive or motor task performance on balance control in Parkinson's disease (PD), we performed a posturographic study in 24 PD patients and in 20 sex- and age-matched control subjects. Postural sway was measured with eyes open (EO) and eyes closed (EC) during quiet stance and during performance of calculation or motor sequence of thumb opposition to the other fingers. No difference of centre of foot pressure (COP) parameters was observed during quiet standing (either EO or EC) between patients and controls, but visual deprivation induced in both groups a worsening of postural stability. COP area was significantly increased in PD patients during dual task performance, whereas no difference of COP path and x-y axes was observed. The effects induced by the performance of cognitive or motor task were significantly more evident in PD patients with clinical evidence of postural instability (presence of prior falls in the history). This study demonstrates that dual task interference on postural control can be observed in PD patients during performance of cognitive as well as motor tasks. The balance deterioration during dual task performance was significantly enhanced in patients with history of prior falls. These findings have some implications for the strategies to be used in reducing the risk of fall in PD. Copyright 2003 Movement Disorder Society

Medio-lateral postural instability in subjects with tinnitus.

PubMed

Kapoula, Zoi; Yang, Qing; Lê, Thanh-Thuan; Vernet, Marine; Berbey, Nolwenn; Orssaud, Christophe; Londero, Alain; Bonfils, Pierre

2011-01-01

Many patients show modulation of tinnitus by gaze, jaw or neck movements, reflecting abnormal sensorimotor integration, and interaction between various inputs. Postural control is based on multi-sensory integration (visual, vestibular, somatosensory, and oculomotor) and indeed there is now evidence that posture can also be influenced by sound. Perhaps tinnitus influences posture similarly to external sound. This study examines the quality of postural performance in quiet stance in patients with modulated tinnitus. Twenty-three patients with highly modulated tinnitus were selected in the ENT service. Twelve reported exclusively or predominately left tinnitus, eight right, and three bilateral. Eighteen control subjects were also tested. Subjects were asked to fixate a target at 40 cm for 51 s; posturography was performed with the platform (Technoconcept, 40 Hz) for both the eyes open and eyes closed conditions. For both conditions, tinnitus subjects showed abnormally high lateral body sway (SDx). This was corroborated by fast Fourrier Transformation (FFTx) and wavelet analysis. For patients with left tinnitus only, medio-lateral sway increased significantly when looking away from the center. Similarly to external sound stimulation, tinnitus could influence lateral sway by activating attention shift, and perhaps vestibular responses. Poor integration of sensorimotor signals is another possibility. Such abnormalities would be accentuated in left tinnitus because of the importance of the right cerebral cortex in processing both auditory-tinnitus eye position and attention.

Abnormal gastric myoelectrical activity in postural tachycardia syndrome.

PubMed

Seligman, William H; Low, David A; Asahina, Masato; Mathias, Christopher J

2013-04-01

Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients. Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years). We performed spectral analysis of EGG recordings to obtain the dominant frequency of gastric pacemaker rhythm (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power. Instability coefficient of DF, an index of variability of gastric pacemaker rhythm, was significantly elevated both pre- and post-prandially (30-45 min after the meal) in the PoTS group (8.8 ± 6, 10.0 ± 8 %) compared with controls (4.0 ± 3, 4.0 ± 3 %; both p < 0.05). Patients with GI symptoms had significantly higher post-prandial ICDF (15.0 ± 5 %) than those without GI symptoms (5.6 ± 4 %; p < 0.05). There were no significant differences in DF, LFR%, NFR% and HFR% before and after the meal between the PoTS and control groups, or between PoTS patients with and without GI symptoms. Our study revealed increased variability of gastric pacemaker rhythm in PoTS, and these findings might be related to pathophysiology of functional GI symptoms in PoTS.

Postural instability at a simulated altitude of 5,000 m before and after an expedition to Mt. Cho-Oyu (8,201 m).

PubMed

Hoshikawa, Masako; Hashimoto, Shiori; Kawahara, Takashi; Ide, Rika

2010-10-01

To clarify the effects of altitude acclimatization on postural instability at altitudes, six female climbers stood with their eyes open or closed on a force-measuring platform under normoxia (NC) and hypobaric hypoxia, equivalent to a 5,000 m altitude (HC), before and after an expedition to Mt. Cho-Oyu (8,201 m). The expedition extended over 84 days. We recorded sways in the center of foot pressure, electromyograms (EMGs) of lower-leg muscles, blood components and arterial oxygen saturation (SpO(2)). Before the expedition, the maximum amplitude of sway with the eyes open and integrated EMG from the medial gastrocnemius increased for HC. After the expedition, red blood cell (from 423.4 ± 15.4 to 498.0 ± 24.5 × 10(4) μl(-1)), hemoglobin content (from 12.6 ± 0.32 to 14.5 ± 1.00 g/dl) and 2,3-diphosphoglycerate (from 1.93 ± 0.21 to 2.24 ± 0.34 μmol/ml) increased. The SpO(2) under HC increased from 69.2 ± 9.6 to 77.2 ± 10.0%. The maximum amplitude of sway with the eyes open decreased for HC. No difference in the sway path length and integrated EMGs was observed between NC and HC. These results suggest that acclimatization can improve the impaired postural stability on initial arrival at altitudes. However, it is still unclear how long acclimatization period is needed. Further studies are needed to reveal this point.

Variation in vocal-motor development in infant siblings of children with autism.

PubMed

Iverson, Jana M; Wozniak, Robert H

2007-01-01

In this study we examined early motor, vocal, and communicative development in a group of younger siblings of children diagnosed with autism (Infant Siblings). Infant Siblings and no-risk comparison later-born infants were videotaped at home with a primary caregiver each month from 5 to 14 months, with follow-up at 18 months. As a group, Infant Siblings were delayed in the onset of early developmental milestones and spent significantly less time in a greater number of postures, suggestive of relative postural instability. In addition, they demonstrated attenuated patterns of change in rhythmic arm activity around the time of reduplicated babble onset; and they were highly likely to exhibit delayed language development at 18 months.

Capture of fixation by rotational flow; a deterministic hypothesis regarding scaling and stochasticity in fixational eye movements

PubMed Central

Wilkinson, Nicholas M.; Metta, Giorgio

2014-01-01

Visual scan paths exhibit complex, stochastic dynamics. Even during visual fixation, the eye is in constant motion. Fixational drift and tremor are thought to reflect fluctuations in the persistent neural activity of neural integrators in the oculomotor brainstem, which integrate sequences of transient saccadic velocity signals into a short term memory of eye position. Despite intensive research and much progress, the precise mechanisms by which oculomotor posture is maintained remain elusive. Drift exhibits a stochastic statistical profile which has been modeled using random walk formalisms. Tremor is widely dismissed as noise. Here we focus on the dynamical profile of fixational tremor, and argue that tremor may be a signal which usefully reflects the workings of oculomotor postural control. We identify signatures reminiscent of a certain flavor of transient neurodynamics; toric traveling waves which rotate around a central phase singularity. Spiral waves play an organizational role in dynamical systems at many scales throughout nature, though their potential functional role in brain activity remains a matter of educated speculation. Spiral waves have a repertoire of functionally interesting dynamical properties, including persistence, which suggest that they could in theory contribute to persistent neural activity in the oculomotor postural control system. Whilst speculative, the singularity hypothesis of oculomotor postural control implies testable predictions, and could provide the beginnings of an integrated dynamical framework for eye movements across scales. PMID:24616670

Childhood obesity affects postural control and aiming performance during an upper limb movement.

PubMed

Boucher, François; Handrigan, Grant A; Mackrous, Isabelle; Hue, Olivier

2015-07-01

Obesity reduces the efficiency of postural and movement control mechanisms. However, the effects of obesity on a functional motor task and postural control in standing and seated position have not been closely quantified among children. The aim of this study is to examine the effects of obesity on the execution of aiming tasks performed in standing and seated conditions in children. Twelve healthy weight children and eleven obese children aged between 8 and 11 years pointed to a target in standing and seated position. The difficulty of the aiming task was varied by using 2 target sizes (1.0 cm and 5.0 cm width; pointing to the smaller target size needs a more precise movement and constitutes a more difficult task). Hand movement time (MT) and its phases were measured to quantify the aiming task. Mean speed of the center of pressure displacement (COP speed) was calculated to assess postural stability during the movement. Obese children had significantly higher MTs compared to healthy-weight children in seated and standing conditions explained by greater durations of deceleration phase when aiming. Concerning the COP speed during the movement, obese children showed significantly higher values when standing compared to healthy-weight children. This was also observed in the seated position. In conclusion, obesity adds a postural constraint during an aiming task in both seated and standing conditions and requires obese children to take more time to correct their movements due to a greater postural instability of the body when pointing to a target with the upper-limb. Copyright © 2015 Elsevier B.V. All rights reserved.

Potentially risky postural behaviors during worksite keyboard use

PubMed Central

Baker, Nancy A.; Redfern, Mark

2016-01-01

Objective This study describes the frequency and distribution of potentially risky postural behaviors of keyboard users. Method Forty-three subjects’ keyboard postural behaviors were rated with the Keyboard – Personal Computer Style instrument (K-PeCS) while they worked at their own workstations. The frequency and distribution of keyboard postural behaviors, and the associations and differences between the right and left sides were assessed. Results Generally, each static body posture had a single criterion that occurred most frequently, (e.g. elbow flexion posture 80 – 120 degrees), while dynamic postures of the wrists and hands were distributed throughout their criteria. Right and left side postural behaviors were significantly associated for shoulder flexion, elbow flexion, hand displacement, wrist extension, forearm rotation, isolated 5th digit, MCP hyperextension, and wrist support use, and significantly different for hand displacement, isolated thumb, number of digits used, and MCP hyperextension. Conclusion Potentially problematic keyboard postural behaviors are common among keyboard users. Our results suggest that occupational therapists must systematically assess body, arm, wrist, and hand postures on both the right and left sides to be able to develop the most effective intervention strategies. PMID:19708467

Comparison of jump-landing protocols with Biodex Balance System as measures of dynamic postural stability in athletes.

PubMed

Krkeljas, Zarko

2017-07-21

The objective of the study was to determine whether a relationship exists between the two common methods for assessing postural stability in athletes: the time-to-stabilisation (TTS) via force-plate and the Biodex Balance System (BBS). The conditions under which these measurements assess dynamic postural control may not provide sufficient feedback to practitioners. Fourty-four amateur soccer players with no history of musculoskeletal disorders volunteered for the study. Pearson correlation was used to compare the anterior-posterior (AP), medio-lateral (ML), and the overall stability indexes measured by BBS, with the corresponding parameters of TTS assessed via force plate. There was no significant correlation between any parameters of dynamic stability measured by force-plate and the stability indexes. However, there was a significant correlation between the resulting vectors and the AP component of TTS for each jump protocol. Furthermore, forward drop landing exhibited shortest TTS in AP direction, while lateral drop landing resulted in longer ML TTS relative to both forward jumps (p < 0.001). These results demonstrate that the TTS and BBS stability indexes should be used as distinct measures of dynamic postural stability. TTS protocols may be modified to target a specific training conditions or athletic population.

Robust dynamic mitigation of instabilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kawata, S.; Karino, T.

2015-04-15

A dynamic mitigation mechanism for instability growth was proposed and discussed in the paper [S. Kawata, Phys. Plasmas 19, 024503 (2012)]. In the present paper, the robustness of the dynamic instability mitigation mechanism is discussed further. The results presented here show that the mechanism of the dynamic instability mitigation is rather robust against changes in the phase, the amplitude, and the wavelength of the wobbling perturbation applied. Generally, instability would emerge from the perturbation of the physical quantity. Normally, the perturbation phase is unknown so that the instability growth rate is discussed. However, if the perturbation phase is known, themore » instability growth can be controlled by a superposition of perturbations imposed actively: If the perturbation is induced by, for example, a driving beam axis oscillation or wobbling, the perturbation phase could be controlled, and the instability growth is mitigated by the superposition of the growing perturbations.« less

Balance ability and posture in postmenopausal women with chronic pelvic pain.

PubMed

Fuentes-Márquez, Pedro; Rodríguez-Torres, Janet R; Valenza, Marie C; Ortíz-Rubio, Araceli; Ariza-Mateos, María J; Cabrera-Martos, Irene

2018-04-09

The aim of the present study was to analyze balance ability and posture in postmenopausal women with chronic pelvic pain (CPP). This study includes a sample of 48 women with CPP recruited from the Gynecology Service of Virgen de las Nieves and San Cecilio Hospitals in Granada (Spain) and 48 healthy control women matched with respect to age and anthropometric characteristics. Outcome variables collected included: balance ability (Mini-Balance Evaluation Systems Test and Timed Up an Go Test) and posture (photogrammetry and Spinal Mouse). Significant differences were found in all Mini Best Test subscales: total (P < 0.001), anticipatory (P = 0.002), reactive postural control (P < 0.001), sensory orientation (P < 0.001), and dynamic gait (P < 0.001), and all Timed Up and Go test subscales: alone (P < 0.001), with manual (P = 0.002) and cognitive task (P = 0.030). Significant differences were also found on spinal cervical angles with a forward head posture in women with CPP; global spine alignment exhibited more deviation in the women with CPP (P < 0.001); and a higher percentage of women with CPP (58%) presented with increased thoracic kyphosis and lumbar lordosis. Cohen's d was used to calculate the effect size. Some subscales of balance and posture tests showed a large effect size (d ≥0.8), indicating a more consistent result. Women with CPP presented poor balance including anticipatory, reactive postural control, sensory orientation, dynamic gait, and dual task-related conditions. Posture showed higher values on the dorsal angle and lower sacral inclination, less spine alignment, and a more prevalent posture with increased kyphosis and lumbar lordosis.

A link-segment model of upright human posture for analysis of head-trunk coordination

NASA Technical Reports Server (NTRS)

Nicholas, S. C.; Doxey-Gasway, D. D.; Paloski, W. H.

1998-01-01

Sensory-motor control of upright human posture may be organized in a top-down fashion such that certain head-trunk coordination strategies are employed to optimize visual and/or vestibular sensory inputs. Previous quantitative models of the biomechanics of human posture control have examined the simple case of ankle sway strategy, in which an inverted pendulum model is used, and the somewhat more complicated case of hip sway strategy, in which multisegment, articulated models are used. While these models can be used to quantify the gross dynamics of posture control, they are not sufficiently detailed to analyze head-trunk coordination strategies that may be crucial to understanding its underlying mechanisms. In this paper, we present a biomechanical model of upright human posture that extends an existing four mass, sagittal plane, link-segment model to a five mass model including an independent head link. The new model was developed to analyze segmental body movements during dynamic posturography experiments in order to study head-trunk coordination strategies and their influence on sensory inputs to balance control. It was designed specifically to analyze data collected on the EquiTest (NeuroCom International, Clackamas, OR) computerized dynamic posturography system, where the task of maintaining postural equilibrium may be challenged under conditions in which the visual surround, support surface, or both are in motion. The performance of the model was tested by comparing its estimated ground reaction forces to those measured directly by support surface force transducers. We conclude that this model will be a valuable analytical tool in the search for mechanisms of balance control.

Exploring the dynamics of balance data — movement variability in terms of drift and diffusion

NASA Astrophysics Data System (ADS)

Gottschall, Julia; Peinke, Joachim; Lippens, Volker; Nagel, Volker

2009-02-01

We introduce a method to analyze postural control on a balance board by reconstructing the underlying dynamics in terms of a Langevin model. Drift and diffusion coefficients are directly estimated from the data and fitted by a suitable parametrization. The governing parameters are utilized to evaluate balance performance and the impact of supra-postural tasks on it. We show that the proposed method of analysis gives not only self-consistent results but also provides a plausible model for the reconstruction of balance dynamics.

Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Maw Pin

2017-03-06

To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls. Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control. A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)). Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.

Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint.

PubMed

Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F; McGroarty, Mark; Delahunt, Eamonn

2015-09-01

Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Controlled laboratory study. University biomechanics laboratory. A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P < .05). No differences were observed in hip-, knee-, or ankle-joint sagittal-plane kinematics (P > .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P < .05) in all reach directions. Dynamic postural stability was adversely affected immediately after cryotherapy to the ankle joint.

Age-Related Differences in Maximal and Rapid Torque Characteristics of the Hip Extensors and Dynamic Postural Balance in Healthy, Young and Old Females.

PubMed

Palmer, Ty B; Thiele, Ryan M; Thompson, Brennan J

2017-02-01

Palmer, TB, Thiele, RM, and Thompson, BJ. Age-related differences in maximal and rapid torque characteristics of the hip extensors and dynamic postural balance in healthy, young and old females. J Strength Cond Res 31(2): 480-488, 2017-The purpose of this study was to examine age-related differences in maximal and rapid torque characteristics of the hip extensor muscles and dynamic postural balance in healthy, young and older females. Eleven younger (age, 26 ± 8 years) and 11 older (age, 67 ± 8 years) females performed 2 isometric maximal voluntary contractions (MVCs) of the hip extensor muscles. Absolute and relative peak torque (PT) and rate of torque development (RTD) at early (0-50 ms) and late (0-200 ms) phases of muscle contraction were examined during each MVC. Dynamic postural balance was assessed using a commercially designed balance testing device, which provides a measurement of dynamic stability based on the overall stability index (OSI). Results indicated that absolute PT and early (RTD50) and late (RTD200) RTD variables were lower (p = 0.009-0.050), and postural OSI was higher (p = 0.011) in the old compared with the younger females; however, no differences were observed for relative PT or RTD variables (p = 0.113-0.895). A significant relationship was also observed in the older (r = -0.601; p = 0.050) but not the younger (r = -0.132; p = 0.698) females between RTD50 and OSI. The lower absolute PT and RTD and higher OSI values for the old females may contribute to the increased functional limitations often observed in older adults. The significant relationship observed in the older females between OSI and RTD50 perhaps suggests that these age-related declines in explosive strength may be an important characteristic relevant to dynamic balance scores, especially in older populations.

On the Brink: Instability and the Prospect of State Failure in Pakistan

DTIC Science & Technology

2010-04-12

unpredictable posture. Most importantly, these historical events, coupled with current political , economic, and security related issues, have created a...current political , economic, and security related issues, have created a fragile state with the propensity to fail. Therefore, this monograph highlights...hardships that have affected the state’s political stability, economic performance, and security. These unrelenting problems lie at the foundation

Application of Acute Maximal Exercise to Enhance Mechanisms Underlying Blood Pressure Regulation and Orthostatic Tolerance After Exposure to Simulated Microgravity

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Engelke, K. A.; Doerr, D. F.

1999-01-01

Development of orthostatic hypotension and intolerance in astronauts who return to earth following a spaceflight mission represents a significant operational concern to NASA. Reduced plasma volume, vascular resistance, and baroreflex responsiveness following exposure to actual and ground-based analogs of microgravity have been associated with orthostatic instability, suggesting that these mechanisms may contribute alone or in combination to compromise of blood pressure regulation after spaceflight. It therefore seems reasonable that development of procedures designed to reverse or restore the effects of microgravity on regulatory mechanisms of blood volume, vascular resistance and cardiac function should provide some protection against postflight orthostatic intolerance. Several investigations have provided evidence that a single bout of exhaustive dynamic exercise enhances functions of mechanisms responsible for blood pressure stability. Therefore, the purpose of our research project was to conduct a series of experiments using ground-based analogs of reduced gravity (i.e., prolonged restriction to the upright standing posture) in human subjects to investigate the hypothesis that a single bout of dynamic maximal exercise would restore blood volume, vascular resistance and cardiac function and improve blood pressure stability.

Cognitive predictors of balance in Parkinson's disease.

PubMed

Fernandes, Ângela; Mendes, Andreia; Rocha, Nuno; Tavares, João Manuel R S

2016-06-01

Postural instability is one of the most incapacitating symptoms of Parkinson's disease (PD) and appears to be related to cognitive deficits. This study aims to determine the cognitive factors that can predict deficits in static and dynamic balance in individuals with PD. A sociodemographic questionnaire characterized 52 individuals with PD for this work. The Trail Making Test, Rule Shift Cards Test, and Digit Span Test assessed the executive functions. The static balance was assessed using a plantar pressure platform, and dynamic balance was based on the Timed Up and Go Test. The results were statistically analysed using SPSS Statistics software through linear regression analysis. The results show that a statistically significant model based on cognitive outcomes was able to explain the variance of motor variables. Also, the explanatory value of the model tended to increase with the addition of individual and clinical variables, although the resulting model was not statistically significant The model explained 25-29% of the variability of the Timed Up and Go Test, while for the anteroposterior displacement it was 23-34%, and for the mediolateral displacement it was 24-39%. From the findings, we conclude that the cognitive performance, especially the executive functions, is a predictor of balance deficit in individuals with PD.

Diurnal changes in postural control in normal children: Computerized static and dynamic assessments.

PubMed

Bourelle, Sophie; Taiar, Redha; Berge, Benoit; Gautheron, Vincent; Cottalorda, Jerome

2014-01-01

Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7-8 a.m. in the morning) and after (4-7 p.m. in the afternoon) school on regular school days using the Balance Master® evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05). By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05). In summary, most of our findings are inconsistent with results from previous studies in adults, suggesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.

[Research on the reliability and validity of postural workload assessment method and the relation to work-related musculoskeletal disorders of workers].

PubMed

Qin, D L; Jin, X N; Wang, S J; Wang, J J; Mamat, N; Wang, F J; Wang, Y; Shen, Z A; Sheng, L G; Forsman, M; Yang, L Y; Wang, S; Zhang, Z B; He, L H

2018-06-18

To form a new assessment method to evaluate postural workload comprehensively analyzing the dynamic and static postural workload for workers during their work process to analyze the reliability and validity, and to study the relation between workers' postural workload and work-related musculoskeletal disorders (WMSDs). In the study, 844 workers from electronic and railway vehicle manufacturing factories were selected as subjects investigated by using the China Musculoskeletal Questionnaire (CMQ) to form the postural workload comprehensive assessment method. The Cronbach's α, cluster analysis and factor analysis were used to assess the reliability and validity of the new assessment method. Non-conditional Logistic regression was used to analyze the relation between workers' postural workload and WMSDs. Reliability of the assessment method for postural workload: internal consistency analysis results showed that Cronbach's α was 0.934 and the results of split-half reliability indicated that Spearman-Brown coefficient was 0.881 and the correlation coefficient between the first part and the second was 0.787. Validity of the assessment method for postural workload: the results of cluster analysis indicated that square Euclidean distance between dynamic and static postural workload assessment in the same part or work posture was the shortest. The results of factor analysis showed that 2 components were extracted and the cumulative percentage of variance achieved 65.604%. The postural workload score of the different occupational workers showed significant difference (P<0.05) by covariance analysis. The results of nonconditional Logistic regression indicated that alcohol intake (OR=2.141, 95%CI 1.337-3.428) and obesity (OR=3.408, 95%CI 1.629-7.130) were risk factors for WMSDs. The risk for WMSDs would rise as workers' postural workload rose (OR=1.035, 95%CI 1.022-1.048). There was significant different risk for WMSDs in the different groups of workers distinguished by work type, gender and age. Female workers exhibited a higher prevalence for WMSDs (OR=2.626, 95%CI 1.414-4.879) and workers between 30-40 years of age (OR=1.909, 95%CI 1.237-2.946) as compared with those under 30. This method for comprehensively assessing postural workload is reliable and effective when used in assembling workers, and there is certain relation between the postural workload and WMSDs.

Effects of Spaceflight and Hindlimb Suspension on the Posture and Gait of Rats

NASA Technical Reports Server (NTRS)

Fox, R. A.; Corcoran, M.; Daunton, N. G.; Morey-Holton, E.

1994-01-01

Instability of posture and gait in astronauts following spaceflight (SF) is thought to result from muscle atrophy and from changes in sensory-motor integration in the CNS (central nervous system) that occur during adaptation to microgravity (micro-G). Individuals are thought to have developed, during SF, adaptive changes for the processing of proprioceptive, vestibular and visual sensory inputs with reduced weighting of gravity-based signals and increased weighting of visual and tactile cues. This sensory-motor rearrangement in the CNS apparently occurs to optimize neuromuscular system function for effective movement and postural control in micro-G. However, these adaptive changes are inappropriate for the 1 g environment and lead to disruptions in posture and gait on return to Earth. Few reports are available on the effects of SF on the motor behavior of animals. Rats studied following 18.5 - 19.5 days of SF in the COSMOS program were described as being ..'inert, apathetic, slow'.. and generally unstable. The hindlimbs of these rats were ..'thrust out from the body with fingers pulled apart and the shin unnaturally pronated'. On the 6th postflight day motor behavior was described as similar to that observed in preflight observations. Improved understanding of the mechanisms leading to these changes can be obtained in animal models through detailed analysis of neural and molecular mechanisms related to gait. To begin this process the posture and gait of rats were examined following exposure to either SF or hindlimb suspension (HLS), and during recovery from these conditions.

The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

PubMed

Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Muñoz-Tomás, María-Teresa; Gil-Gómez, Hermenegildo; Vial-Escolano, Raquel; Lozano-Quilis, José-Antonio

2017-03-23

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.

Effect of expertise in shooting and Taekwondo on bipedal and unipedal postural control isolated or concurrent with a reaction-time task.

PubMed

Negahban, Hossein; Aryan, Najmolhoda; Mazaheri, Masood; Norasteh, Ali Asghar; Sanjari, Mohammad Ali

2013-06-01

It was hypothesized that training in 'static balance' or 'dynamic balance' sports has differential effects on postural control and its attention demands during quiet standing. In order to test this hypothesis, two groups of female athletes practicing shooting, as a 'static balance' sport, and Taekwondo, as a 'dynamic balance' sport, and a control group of non-physically active females voluntarily participated in this study. Postural control was assessed during bipedal and unipedal stance with and without performing a Go/No-go reaction time task. Visual and/or support surface conditions were manipulated in bipedal and unipedal stances in order to modify postural difficulty. Mixed model analysis of variance was used to determine the effects of dual tasking on postural and cognitive performance. Similar pattern of results were found in bipedal and unipedal stances, with Taekwondo practitioners displaying larger sway, shooters displaying lower sway and non-athletes displaying sway characteristics intermediate to Taekwondo and shooting athletes. Larger effect was found in bipedal stance. Single to dual-task comparison of postural control showed no significant effect of mental task on sway velocity in shooters, indicating less cognitive effort invested in balance control during bipedal stance. We suggest that expertise in shooting has a more pronounced effect on decreased sway in static balance conditions. Furthermore, shooters invest less attention in postures that are more specific to their training, i.e. bipedal stance. Copyright © 2012 Elsevier B.V. All rights reserved.

Posture analysis on young women before and after 60 days of -6 degrees head down bed rest (Wise 2005).

PubMed

Viguier, Marion; Dupui, Philippe; Montoya, Richard

2009-02-01

Twenty-four women divided into three groups: control, exercise and nutrition, have been involved in a -6 degrees head down bed rest (HDBR) experiment for 60 days. The objective was to analyse the effects of microgravity on balance function regulation. Group comparisons assessed the efficiency of countermeasures (specific exercises and in particular diet) on the deleterious effects of simulated microgravity. Measurements of orthostatic and dynamic balance were taken 9 and 2 days prior to the experiment, on the first day of getting up, the following day and 4 and 10 days after, under two visual conditions: eyes open and eyes closed. The results confirmed that, as in any other test performed with ordinary subjects, the postural balance performances are better with eyes open than with eyes closed. The static and dynamic postural performances were impaired on the first day of recovery (R0) following HDBR. This impairment lasted up to 4 days after getting up and, afterwards the volunteers recovered their initial performances. The exercise group recovered static postural performances more quickly than the other groups whereas there were no differences in the recovery of the dynamic balance performances.

Bilateral improvements in lower extremity function after unilateral balance training in individuals with chronic ankle instability.

PubMed

Hale, Sheri A; Fergus, Andrea; Axmacher, Rachel; Kiser, Kimberly

2014-01-01

Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Cohort study. University clinical research laboratory. A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Balance training twice weekly for 4 weeks. Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation.

Effect of complete dentures on dynamic measurement of changing head position: A pilot study.

PubMed

Usumez, Aslihan; Usumez, Serdar; Orhan, Metin

2003-10-01

Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited. The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking. The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05). Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015). The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically significant change. The overall effect of wearing dentures was an irregular flexion or extension pattern on dynamic head posture.

Postural control and freezing of gait in Parkinson's disease.

PubMed

Schlenstedt, Christian; Muthuraman, Muthuraman; Witt, Karsten; Weisser, Burkhard; Fasano, Alfonso; Deuschl, Günther

2016-03-01

The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. 31 PD patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured with the Fullerton Advanced Balance (FAB) scale and with center of pressure (COP) analysis during quiet stance and maximal voluntary forward/backward leaning. The groups were balanced concerning age, disease duration and disease severity. PD+FOG performed significantly worse in the FAB scale (21.8 ± 5.8) compared to PD-FOG (25.6 ± 5.0) and HC (34.9 ± 2.4) (mean ± SD, p < 0.01). PD+FOG had impaired ability to voluntary lean forward, difficulties to stand on foam with eyes closed and reduced limits of stability compared to PD-FOG (p < 0.05). During quiet stance the average anterior-posterior COP position was significantly displaced towards posterior in PD+FOG in comparison to PD-FOG and HC (p < 0.05). The COP position correlated with severity of FOG (p < 0.01). PD+FOG and PD-FOG did not differ in average COP sway excursion, sway velocity, sway regularity and postural control asymmetry. PD+FOG have reduced postural control compared to PD-FOG and HC. Our results show a relationship between the anterior-posterior COP position during quiet stance and FOG. The COP shift towards posterior in PD+FOG leads to a restricted precondition to generate forward progression during gait initiation. This may contribute to the occurrence of FOG or might be a compensatory strategy to avoid forward falls. Copyright © 2015 Elsevier Ltd. All rights reserved.

Balance rehabilitation: promoting the role of virtual reality in patients with diabetic peripheral neuropathy.

PubMed

Grewal, Gurtej S; Sayeed, Rashad; Schwenk, Michael; Bharara, Manish; Menzies, Robert; Talal, Talal K; Armstrong, David G; Najafi, Bijan

2013-01-01

Individuals with diabetic peripheral neuropathy frequently experience concomitant impaired proprioception and postural instability. Conventional exercise training has been demonstrated to be effective in improving balance but does not incorporate visual feedback targeting joint perception, which is an integral mechanism that helps compensate for impaired proprioception in diabetic peripheral neuropathy. This prospective cohort study recruited 29 participants (mean ± SD: age, 57 ± 10 years; body mass index [calculated as weight in kilograms divided by height in meters squared], 26.9 ± 3.1). Participants satisfying the inclusion criteria performed predefined ankle exercises through reaching tasks, with visual feedback from the ankle joint projected on a screen. Ankle motion in the mediolateral and anteroposterior directions was captured using wearable sensors attached to the participant's shank. Improvements in postural stability were quantified by measuring center of mass sway area and the reciprocal compensatory index before and after training using validated body-worn sensor technology. Findings revealed a significant reduction in center of mass sway after training (mean, 22%; P = .02). A higher postural stability deficit (high body sway) at baseline was associated with higher training gains in postural balance (reduction in center of mass sway) (r = -0.52, P < .05). In addition, significant improvement was observed in postural coordination between the ankle and hip joints (mean, 10.4%; P = .04). The present research implemented a novel balance rehabilitation strategy based on virtual reality technology. The method included wearable sensors and an interactive user interface for real-time visual feedback based on ankle joint motion, similar to a video gaming environment, for compensating impaired joint proprioception. These findings support that visual feedback generated from the ankle joint coupled with motor learning may be effective in improving postural stability in patients with diabetic peripheral neuropathy.

Immediate effects of Pilates based therapeutic exercise on postural control of young individuals with non-specific low back pain: A randomized controlled trial.

PubMed

Lopes, Susana; Correia, Christophe; Félix, Gonçalo; Lopes, Mário; Cruz, Ana; Ribeiro, Fernando

2017-10-01

Low back pain affects the person's ability to keep balance, especially in challenging conditions. The purpose of this study was to determine the immediate effects of Pilates exercises on postural sway and dynamic balance of young individuals with non-specific low back pain. Controlled laboratory design. Forty-six participants with non-specific low back pain were randomized to a Pilates (n=23, 10 males; age: 21.8±3.2years) and a control group (n=23, 9 males; age: 22.8±3.6years). Postural sway was assessed with a force platform and dynamic balance with the Star Excursion Balance Test, before and after the intervention or rest period. To assess postural sway, participants stood still on an unstable surface set on the force plate for 90s, with eyes closed. The intervention lasted 20min and consisted on four Pilates exercises: single leg stretch (level 1), pelvic press (level 1), swimming (level 1) and kneeling opposite arm and leg reach. At baseline, no differences were found between groups. The Pilates group improved in all the postural sway values (area of CoP: 11.5±3.4 to 9.7±2.7cm 2 , p=0.002 and CoP velocity: 2.8±0.6 to 2.3±0.5cm/s, p<0.001) and in the Star Excursion Balance Test. Control group only improved in CoP velocity, however, this improvement was significantly inferior compared to the Pilates group. Pilates exercises immediately improved postural sway and dynamic balance in young adults with non-specific low back pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dynamic postural stability during advancing pregnancy.

PubMed

McCrory, J L; Chambers, A J; Daftary, A; Redfern, M S

2010-08-26

Pregnant women are at an increased risk of experiencing a fall. Numerous anatomical, physiological, and hormonal alterations occur during pregnancy, but the influence of these factors on dynamic postural stability has not been explored. The purpose of this study was to examine dynamic postural stability in pregnant women during their second and third trimesters as well as in a group of non-pregnant control women. Eighty-one women (41 pregnant, 40 controls) participated stood on a force plate that translated anteroposteriorly at small, medium, and large magnitudes. Reaction time and center of pressure (COP) movement during the translations were analyzed. Trimester, perturbation direction, and perturbation magnitude were the independent variables in a mixed-model analysis of variance on each of the following dependent variables: reaction time, initial sway, total sway, and sway velocity. Reaction time to the perturbation was not significantly different between the groups. Initial sway, total sway, and sway velocity were significantly less during the third trimester than during the second trimester and when compared to the non-pregnant controls (P<0.05). No differences were found in any of the measures between the pregnant women in their second trimesters and the control group. Alterations in sway responses to perturbations are seen in the third trimester in healthy women with uncomplicated pregnancies. Further study is needed to examine the biomechanical and physiological reasons behind this altered dynamic postural stability. 2010 Elsevier Ltd. All rights reserved.

Trunk posture monitoring with inertial sensors

PubMed Central

Wong, Man Sang

2008-01-01

Measurement of human posture and movement is an important area of research in the bioengineering and rehabilitation fields. Various attempts have been initiated for different clinical application goals, such as diagnosis of pathological posture and movements, assessment of pre- and post-treatment efficacy and comparison of different treatment protocols. Image-based methods for measurements of human posture and movements have been developed, such as the radiography, photogrammetry, optoelectric technique and video analysis. However, it is found that these methods are complicated to set up, time-consuming to operate and could only be applied in laboratory environments. This study introduced a method of using a posture monitoring system in estimating the spinal curvature changes during trunk movements on the sagittal and coronal planes and providing trunk posture monitoring during daily activities. The system consisted of three sensor modules, each with one tri-axial accelerometer and three uni-axial gyroscopes orthogonally aligned, and a digital data acquisition and feedback system. The accuracy of this system was tested with a motion analysis system (Vicon 370) in calibration with experimental setup and in trunk posture measurement with nine human subjects, and the performance of the posture monitoring system during daily activities with two human subjects was reported. The averaged root mean squared differences between the measurements of the system and motion analysis system were found to be <1.5° in dynamic calibration, and <3.1° for the sagittal plane and ≤2.1° for the coronal plane in estimation of the trunk posture change during trunk movements. The measurements of the system and the motion analysis system was highly correlated (>0.999 for dynamic calibration and >0.829 for estimation of spinal curvature change in domain planes of movement during flexion and lateral bending). With the sensing modules located on the upper trunk, mid-trunk and the pelvic levels, the inclination of trunk segment and the change of spinal curvature in trunk movements could be estimated. The posture information of five subjects was recorded at 30 s intervals during daily activity over a period of 3 days and 2 h a day. The preliminary results demonstrated that the subjects could improve their posture when feedback signals were provided. The posture monitoring system could be used for the purpose of posture monitoring during daily activity. PMID:18196296

Trunk posture monitoring with inertial sensors.

PubMed

Wong, Wai Yin; Wong, Man Sang

2008-05-01

Measurement of human posture and movement is an important area of research in the bioengineering and rehabilitation fields. Various attempts have been initiated for different clinical application goals, such as diagnosis of pathological posture and movements, assessment of pre- and post-treatment efficacy and comparison of different treatment protocols. Image-based methods for measurements of human posture and movements have been developed, such as the radiography, photogrammetry, optoelectric technique and video analysis. However, it is found that these methods are complicated to set up, time-consuming to operate and could only be applied in laboratory environments. This study introduced a method of using a posture monitoring system in estimating the spinal curvature changes during trunk movements on the sagittal and coronal planes and providing trunk posture monitoring during daily activities. The system consisted of three sensor modules, each with one tri-axial accelerometer and three uni-axial gyroscopes orthogonally aligned, and a digital data acquisition and feedback system. The accuracy of this system was tested with a motion analysis system (Vicon 370) in calibration with experimental setup and in trunk posture measurement with nine human subjects, and the performance of the posture monitoring system during daily activities with two human subjects was reported. The averaged root mean squared differences between the measurements of the system and motion analysis system were found to be < 1.5 degrees in dynamic calibration, and < 3.1 degrees for the sagittal plane and < or = 2.1 degrees for the coronal plane in estimation of the trunk posture change during trunk movements. The measurements of the system and the motion analysis system was highly correlated (> 0.999 for dynamic calibration and > 0.829 for estimation of spinal curvature change in domain planes of movement during flexion and lateral bending). With the sensing modules located on the upper trunk, mid-trunk and the pelvic levels, the inclination of trunk segment and the change of spinal curvature in trunk movements could be estimated. The posture information of five subjects was recorded at 30 s intervals during daily activity over a period of 3 days and 2 h a day. The preliminary results demonstrated that the subjects could improve their posture when feedback signals were provided. The posture monitoring system could be used for the purpose of posture monitoring during daily activity.

Quantification of Trunk Postural Stability Using Convex Polyhedron of the Time-Series Accelerometer Data

PubMed Central

Melecky, Roman; Socha, Vladimir; Kutilek, Patrik; Hanakova, Lenka; Takac, Peter; Schlenker, Jakub; Svoboda, Zdenek

2016-01-01

Techniques to quantify postural stability usually rely on the evaluation of only two variables, that is, two coordinates of COP. However, by using three variables, that is, three components of acceleration vector, it is possible to describe human movement more precisely. For this purpose, a single three-axis accelerometer was used, making it possible to evaluate 3D movement by use of a novel method, convex polyhedron (CP), together with a traditional method, based on area of the confidence ellipse (ACE). Ten patients (Pts) with cerebellar ataxia and eleven healthy individuals of control group (CG) participated in the study. The results show a significant increase of volume of the CP (CPV) in Pts or CG standing on foam surface with eyes open (EO) and eyes closed (EC) after the EC phase. Significant difference between Pts and CG was found in all cases as well. Correlation coefficient indicates strong correlation between the CPV and ACE in most cases of patient examinations, thus confirming the possibility of quantification of postural instability by the introduced method of CPV. PMID:27195465

Quantification of Trunk Postural Stability Using Convex Polyhedron of the Time-Series Accelerometer Data.

PubMed

Melecky, Roman; Socha, Vladimir; Kutilek, Patrik; Hanakova, Lenka; Takac, Peter; Schlenker, Jakub; Svoboda, Zdenek

2016-01-01

Techniques to quantify postural stability usually rely on the evaluation of only two variables, that is, two coordinates of COP. However, by using three variables, that is, three components of acceleration vector, it is possible to describe human movement more precisely. For this purpose, a single three-axis accelerometer was used, making it possible to evaluate 3D movement by use of a novel method, convex polyhedron (CP), together with a traditional method, based on area of the confidence ellipse (ACE). Ten patients (Pts) with cerebellar ataxia and eleven healthy individuals of control group (CG) participated in the study. The results show a significant increase of volume of the CP (CPV) in Pts or CG standing on foam surface with eyes open (EO) and eyes closed (EC) after the EC phase. Significant difference between Pts and CG was found in all cases as well. Correlation coefficient indicates strong correlation between the CPV and ACE in most cases of patient examinations, thus confirming the possibility of quantification of postural instability by the introduced method of CPV.

Comorbid Normal Pressure Hydrocephalus with Parkinsonism: A Clinical Challenge and Call for Awareness.

PubMed

Cucca, A; Biagioni, M C; Sharma, K; Golomb, J; Gilbert, R M; Di Rocco, A; Fleisher, J E

2018-01-01

Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly. Both conditions have their peak prevalence between the 6th and the 7th decade. Importantly, postural instability and gait dysfunction are core clinical features in both iNPH and PD. Therefore, diagnosing iNPH where diagnostic criteria of PD have been met represents an additional clinical challenge. Here, we report a patient with parkinsonism initially consistent with PD who subsequently displayed rapidly progressive postural instability and gait dysfunction leading to the diagnosis of concomitant iNPH. In the following sections, we will review the clinical features of iNPH, as well as the overlapping and discriminating features when degenerative parkinsonism is in the differential diagnosis. Understanding and recognizing the potential for concomitant disease are critical when treating both conditions.

Back posture education in elementary schoolchildren: stability of two-year intervention effects.

PubMed

Geldhof, E; Cardon, G; De Bourdeaudhuij, I; De Clercq, D

2007-09-01

The study's first objective was to evaluate class teachers' efforts to promote good body mechanics after a structured back education program was finished and to evaluate whether their support during follow-up resulted in better intervention effects at 1-year follow-up. Secondary, the stability of intervention effects on children's back posture knowledge, fear-avoidance beliefs and back pain reports following a 2-school-year multi-factorial back education program was evaluated at 1-year follow-up. An additional focus was put on what young children learned about good body mechanics in the obligatory school curriculum compared to intensive back posture promotion. The quasi-experimental study included at baseline 398 elementary schoolchildren aged 8-11 years. The back education program consisted of 13 h back education and the stimulation of postural dynamism in the class through support and environmental changes lasting 2 school-years. Controls received the obligatory curriculum, not including back education. Evaluation consisted of a questionnaire, which was filled out by 121 intervention children and 124 controls at baseline, post-test and follow-up. Teachers were interviewed at the end of the follow-up school-year. Teachers continued with initiatives to increase postural dynamism in the class when they had been instructed about that matter. However, teachers' efforts to continue the promotion of good body mechanics showed no additional effect on children's knowledge. Improved back posture knowledge demonstrated stability at 1-year follow-up. Whereas the obligatory curriculum provided children with fundamental postural knowledge, the back posture program added important aspects. Fear-avoidance beliefs and self-reported pain were not increased at 1-year follow-up. The stable intervention effects point out that intensive implementation of a structured multifactorial back education program in the elementary school curriculum is effective.

Dynamic properties of combustion instability in a lean premixed gas-turbine combustor.

PubMed

Gotoda, Hiroshi; Nikimoto, Hiroyuki; Miyano, Takaya; Tachibana, Shigeru

2011-03-01

We experimentally investigate the dynamic behavior of the combustion instability in a lean premixed gas-turbine combustor from the viewpoint of nonlinear dynamics. A nonlinear time series analysis in combination with a surrogate data method clearly reveals that as the equivalence ratio increases, the dynamic behavior of the combustion instability undergoes a significant transition from stochastic fluctuation to periodic oscillation through low-dimensional chaotic oscillation. We also show that a nonlinear forecasting method is useful for predicting the short-term dynamic behavior of the combustion instability in a lean premixed gas-turbine combustor, which has not been addressed in the fields of combustion science and physics.

Comparative Effects of Different Balance-Training-Progression Styles on Postural Control and Ankle Force Production: A Randomized Controlled Trial.

PubMed

Cuğ, Mutlu; Duncan, Ashley; Wikstrom, Erik

2016-02-01

Despite the effectiveness of balance training, the exact parameters needed to maximize the benefits of such programs remain unknown. One such factor is how individuals should progress to higher levels of task difficulty within a balance-training program. Yet no investigators have directly compared different balance-training-progression styles. To compare an error-based progression (ie, advance when proficient at a task) with a repetition-based progression (ie, advance after a set amount of repetitions) style during a balance-training program in healthy individuals. Randomized controlled trial. Research laboratory. A total of 28 (16 women, 12 men) physically healthy young adults (age = 21.57 ± 3.95 years, height = 171.60 ± 11.03 cm, weight = 72.96 ± 16.18 kg, body mass index = 24.53 ± 3.7). All participants completed 12 supervised balance-training sessions over 4 weeks. Each session consisted of a combination of dynamic unstable-surface tasks that incorporated a BOSU ball and lasted about 30 minutes. Static balance from an instrumented force plate, dynamic balance as measured via the Star Excursion Balance Test, and ankle force production in all 4 cardinal planes of motion as measured with a handheld dynamometer before and after the intervention. Selected static postural-control outcomes, dynamic postural control, and ankle force production in all planes of motion improved (P < .05). However, no differences between the progression styles were observed (P > .05) for any of the outcome measures. A 4-week balance-training program consisting of dynamic unstable-surface exercises on a BOSU ball improved dynamic postural control and ankle force production in healthy young adults. These results suggest that an error-based balance-training program is comparable with but not superior to a repetition-based balance-training program in improving postural control and ankle force production in healthy young adults.

Spherical Lenses and Prisms Lead to Postural Instability in Both Dyslexic and Non Dyslexic Adolescents

PubMed Central

Kapoula, Zoi; Gaertner, Chrystal; Matheron, Eric

2012-01-01

There is controversy as to whether dyslexic children present systematic postural deficiency. Clinicians use a combination of ophthalmic prisms and proprioceptive soles to improve postural performances. This study examines the effects of convergent prisms and spherical lenses on posture. Fourteen dyslexics (13–17 years-old) and 11 non dyslexics (13–16 years-old) participated in the study. Quiet stance posturography was performed with the TechnoConcept device while subjects fixated a target at eye-level from a distance of 1_m. Four conditions were run: normal viewing; viewing the target with spherical lenses of −1 diopter (ACCOM1) over each eye; viewing with −3 diopters over each eye (ACCOM3); viewing with a convergent prism of 8 diopters per eye. Relative to normal viewing, the −1 lenses increased the surface of body sway significantly whereas the −3 diopter lenses only resulted in a significant increase of antero-posterior body sway. Thus, adolescents would appear to cope more effectively with stronger conflicts rather than subtle ones. The prism condition resulted in a significant increase in both the surface and the antero-posterior body sway. Importantly, all of these effects were similar for the two groups. Wavelet analysis (time frequency domain) revealed high spectral power of antero-posterior sway for the prism condition in both groups. In the ACCOM3 condition, the spectral power of antero-posterior sway decreased for non dyslexics but increased for dyslexics suggesting that dyslexics encounter more difficulty with accommodation. The cancelling time for medium range frequency (believed to be controlled by the cerebellum), was shorter in dyslexics, suggesting fewer instances of optimal control. We conclude that dyslexics achieve similar postural performances albeit less efficiently. Prisms and lenses destabilize posture for all teenagers. Thus, contrary to adults, adolescents do not seem to use efferent, proprioceptive ocular motor signals to improve their posture, at least not immediately when confronted to convergence accommodation conflict. PMID:23144786

Benefit of bi-ocular visual stimulation for postural control in children with strabismus.

PubMed

Gaertner, Chrystal; Creux, Charlotte; Espinasse-Berrod, Marie-Andrée; Orssaud, Christophe; Dufier, Jean-Louis; Kapoula, Zoï

2013-01-01

Vision is important for postural control as is shown by the Romberg quotient (RQ): with eyes closed, postural instability increases relative to eyes open (RQ = 2). Yet while fixating at far distance, postural stability is similar with eyes open and eyes closed (RQ = 1). Postural stability can be better with both eyes viewing than one eye, but such effect is not consistent among healthy subjects. The first goal of the study is to test the RQ as a function of distance for children with convergent versus divergent strabismus. The second goal is to test whether vision from two eyes relative to vision from one eye provides better postural stability. Thirteen children with divergent strabismus and eleven with convergent strabismus participated in this study. Posturtography was done with the Techno concept device. Experiment 1, four conditions: fixation at 40 cm and at 200 cm both with eyes open and eyes covered (evaluation of RQ). Experiment 2, six conditions: fixation at 40 cm and at 200 cm, with both eyes viewing or under monocular vision (dominant and non-dominant eye). For convergent strabismus, the groups mean value of RQ was 1.3 at near and 0.94 at far distance; for divergent, it was 1.06 at near and 1.68 at far. For all children, the surface of body sway was significantly smaller under both eyes viewing than monocular viewing (either eye). Increased RQ value at near for convergent and at far for divergent strabismus is attributed to the influence of the default strabismus angle and to better use of ocular motor signals. Vision with the two eyes improves postural control for both viewing distances and for both types of strabismus. Such benefit can be due to complementary mechanisms: larger visual field, better quality of fixation and vergence angle due to the use of visual inputs from both eyes.

An 8-week thoracic spine stabilization exercise program improves postural back pain, spine alignment, postural sway, and core endurance in university students:a randomized controlled study.

PubMed

Toprak Çelenay, Şeyda; Özer Kaya, Derya

2017-04-18

To investigate the effects of an 8-week thoracic stabilization exercise program on back pain, spinal alignment, postural sway, and core endurance in university students. University students were randomly allocated into exercise (n: 28) and control (n: 25) groups. The exercise program was carried out 3 days a week for 8 weeks. Postural pain, spinal alignment, postural sway, and core endurance were assessed via visual analogue scale, Spinal Mouse, Biodex Balance System, and McGill's trunk muscle endurance tests at the baseline and after 8 weeks of training. Differences were observed for postural pain, thoracic and lumbar curvature, dynamic stability index (eyes closed), and core endurance scores in the exercise group between baseline and week 8 (P < 0.05) and all the parameters were significantly different when compared to those of the control group (P < 0.05). The program decreased postural pain, spinal curvatures, and postural sway, and increased core endurance in university students. The program can be effective in postural pain and misalignment of spine problems related to core weakness and balance disorders.

Interdependency of the maximum range of flexion-extension of hand metacarpophalangeal joints.

PubMed

Gracia-Ibáñez, V; Vergara, M; Sancho-Bru, J-L

2016-12-01

Mobility of the fingers metacarpophalangeal (MCP) joints depends on the posture of the adjacent ones. Current Biomechanical hand models consider fixed ranges of movement at joints, regardless of the posture, thus allowing for non-realistic postures, generating wrong results in reach studies and forward dynamic analyses. This study provides data for more realistic hand models. The maximum voluntary extension (MVE) and flexion (MVF) of different combinations of MCP joints were measured covering their range of motion. Dependency of the MVF and MVE on the posture of the adjacent MCP joints was confirmed and mathematical models obtained through regression analyses (RMSE 7.7°).

Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

PubMed

Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

2017-09-01

To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

Physiological complexity and system adaptability: evidence from postural control dynamics of older adults.

PubMed

Manor, Brad; Costa, Madalena D; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C K; Novak, Vera; Lipsitz, Lewis A

2010-12-01

The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (<20/40 vision, n = 81, 77 ± 4 yr old), somatosensory impairment only (inability to perceive 5.07 monofilament on plantar halluxes, n = 48, 80 ± 5 yr old), and combined impairments (n = 25, 80 ± 4 yr old). Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P < 0.01). Lower complexity during quiet standing correlated with greater absolute (R = -0.34, P = 0.002) and percent (R = -0.45, P < 0.001) increases in postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.

Physiological complexity and system adaptability: evidence from postural control dynamics of older adults

PubMed Central

Costa, Madalena D.; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C. K.; Novak, Vera; Lipsitz, Lewis A.

2010-01-01

The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (<20/40 vision, n = 81, 77 ± 4 yr old), somatosensory impairment only (inability to perceive 5.07 monofilament on plantar halluxes, n = 48, 80 ± 5 yr old), and combined impairments (n = 25, 80 ± 4 yr old). Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P < 0.01). Lower complexity during quiet standing correlated with greater absolute (R = −0.34, P = 0.002) and percent (R = −0.45, P < 0.001) increases in postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors. PMID:20947715

Gravitational and Dynamic Components of Muscle Torque Underlie Tonic and Phasic Muscle Activity during Goal-Directed Reaching.

PubMed

Olesh, Erienne V; Pollard, Bradley S; Gritsenko, Valeriya

2017-01-01

Human reaching movements require complex muscle activations to produce the forces necessary to move the limb in a controlled manner. How gravity and the complex kinetic properties of the limb contribute to the generation of the muscle activation pattern by the central nervous system (CNS) is a long-standing and controversial question in neuroscience. To tackle this issue, muscle activity is often subdivided into static and phasic components. The former corresponds to posture maintenance and transitions between postures. The latter corresponds to active movement production and the compensation for the kinetic properties of the limb. In the present study, we improved the methodology for this subdivision of muscle activity into static and phasic components by relating them to joint torques. Ten healthy subjects pointed in virtual reality to visual targets arranged to create a standard center-out reaching task in three dimensions. Muscle activity and motion capture data were synchronously collected during the movements. The motion capture data were used to calculate postural and dynamic components of active muscle torques using a dynamic model of the arm with 5 degrees of freedom. Principal Component Analysis (PCA) was then applied to muscle activity and the torque components, separately, to reduce the dimensionality of the data. Muscle activity was also reconstructed from gravitational and dynamic torque components. Results show that the postural and dynamic components of muscle torque represent a significant amount of variance in muscle activity. This method could be used to define static and phasic components of muscle activity using muscle torques.

Gravitational and Dynamic Components of Muscle Torque Underlie Tonic and Phasic Muscle Activity during Goal-Directed Reaching

PubMed Central

Olesh, Erienne V.; Pollard, Bradley S.; Gritsenko, Valeriya

2017-01-01

Human reaching movements require complex muscle activations to produce the forces necessary to move the limb in a controlled manner. How gravity and the complex kinetic properties of the limb contribute to the generation of the muscle activation pattern by the central nervous system (CNS) is a long-standing and controversial question in neuroscience. To tackle this issue, muscle activity is often subdivided into static and phasic components. The former corresponds to posture maintenance and transitions between postures. The latter corresponds to active movement production and the compensation for the kinetic properties of the limb. In the present study, we improved the methodology for this subdivision of muscle activity into static and phasic components by relating them to joint torques. Ten healthy subjects pointed in virtual reality to visual targets arranged to create a standard center-out reaching task in three dimensions. Muscle activity and motion capture data were synchronously collected during the movements. The motion capture data were used to calculate postural and dynamic components of active muscle torques using a dynamic model of the arm with 5 degrees of freedom. Principal Component Analysis (PCA) was then applied to muscle activity and the torque components, separately, to reduce the dimensionality of the data. Muscle activity was also reconstructed from gravitational and dynamic torque components. Results show that the postural and dynamic components of muscle torque represent a significant amount of variance in muscle activity. This method could be used to define static and phasic components of muscle activity using muscle torques. PMID:29018339

Contributions of Microtubule Dynamic Instability and Rotational Diffusion to Kinetochore Capture.

PubMed

Blackwell, Robert; Sweezy-Schindler, Oliver; Edelmaier, Christopher; Gergely, Zachary R; Flynn, Patrick J; Montes, Salvador; Crapo, Ammon; Doostan, Alireza; McIntosh, J Richard; Glaser, Matthew A; Betterton, Meredith D

2017-02-07

Microtubule dynamic instability allows search and capture of kinetochores during spindle formation, an important process for accurate chromosome segregation during cell division. Recent work has found that microtubule rotational diffusion about minus-end attachment points contributes to kinetochore capture in fission yeast, but the relative contributions of dynamic instability and rotational diffusion are not well understood. We have developed a biophysical model of kinetochore capture in small fission-yeast nuclei using hybrid Brownian dynamics/kinetic Monte Carlo simulation techniques. With this model, we have studied the importance of dynamic instability and microtubule rotational diffusion for kinetochore capture, both to the lateral surface of a microtubule and at or near its end. Over a range of biologically relevant parameters, microtubule rotational diffusion decreased capture time, but made a relatively small contribution compared to dynamic instability. At most, rotational diffusion reduced capture time by 25%. Our results suggest that while microtubule rotational diffusion can speed up kinetochore capture, it is unlikely to be the dominant physical mechanism for typical conditions in fission yeast. In addition, we found that when microtubules undergo dynamic instability, lateral captures predominate even in the absence of rotational diffusion. Counterintuitively, adding rotational diffusion to a dynamic microtubule increases the probability of end-on capture. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Multiple balance tests improve the assessment of postural stability in subjects with Parkinson's disease

PubMed Central

Jacobs, J V; Horak, F B; Tran, V K; Nutt, J G

2006-01-01

Objectives Clinicians often base the implementation of therapies on the presence of postural instability in subjects with Parkinson's disease (PD). These decisions are frequently based on the pull test from the Unified Parkinson's Disease Rating Scale (UPDRS). We sought to determine whether combining the pull test, the one‐leg stance test, the functional reach test, and UPDRS items 27–29 (arise from chair, posture, and gait) predicts balance confidence and falling better than any test alone. Methods The study included 67 subjects with PD. Subjects performed the one‐leg stance test, the functional reach test, and the UPDRS motor exam. Subjects also responded to the Activities‐specific Balance Confidence (ABC) scale and reported how many times they fell during the previous year. Regression models determined the combination of tests that optimally predicted mean ABC scores or categorised fall frequency. Results When all tests were included in a stepwise linear regression, only gait (UPDRS item 29), the pull test (UPDRS item 30), and the one‐leg stance test, in combination, represented significant predictor variables for mean ABC scores (r2 = 0.51). A multinomial logistic regression model including the one‐leg stance test and gait represented the model with the fewest significant predictor variables that correctly identified the most subjects as fallers or non‐fallers (85% of subjects were correctly identified). Conclusions Multiple balance tests (including the one‐leg stance test, and the gait and pull test items of the UPDRS) that assess different types of postural stress provide an optimal assessment of postural stability in subjects with PD. PMID:16484639

Influence of temporal pressure constraint on the biomechanical organization of gait initiation made with or without an obstacle to clear.

PubMed

Yiou, Eric; Fourcade, Paul; Artico, Romain; Caderby, Teddy

2016-06-01

Many daily motor tasks have to be performed under a temporal pressure constraint. This study aimed to explore the influence of such constraint on motor performance and postural stability during gait initiation. Young healthy participants initiated gait at maximal velocity under two conditions of temporal pressure: in the low-pressure condition, gait was self-initiated (self-initiated condition, SI); in the high-pressure condition, it was initiated as soon as possible after an acoustic signal (reaction-time condition, RT). Gait was initiated with and without an environmental constraint in the form of an obstacle to be cleared placed in front of participants. Results showed that the duration of postural adjustments preceding swing heel-off ("anticipatory postural adjustments", APAs) was shorter, while their amplitude was larger in RT compared to SI. These larger APAs allowed the participants to reach equivalent postural stability and motor performance in both RT and SI. In addition, the duration of the execution phase of gait initiation increased greatly in the condition with an obstacle to be cleared (OBST) compared to the condition without an obstacle (NO OBST), thereby increasing lateral instability and thus involving larger mediolateral APA. Similar effects of temporal pressure were obtained in NO OBST and OBST. This study shows the adaptability of the postural system to temporal pressure in healthy young adults initiating gait. The outcome of this study may provide a basis for better understanding the aetiology of balance impairments with the risk of falling in frail populations while performing daily complex tasks involving a whole-body progression.

Postural Instability Caused by Extended Bed Rest Is Alleviated by Brief Daily Exposure to Low Magnitude Mechanical Signals

PubMed Central

Muir, Jesse; Judex, Stefan; Qin, Yi-Xian; Rubin, Clinton

2011-01-01

Loss of postural stability, as exacerbated by chronic bed rest, aging, neuromuscular injury or disease, results in a marked increase in the risk of falls, potentiating severe injury and even death. To investigate the capacity of low magnitude mechanical signals (LMMS) to retain postural stability under conditions conducive to its decline, twenty-nine healthy adult subjects underwent 90 days of 6-degree head down tilt bed-rest. Treated subjects underwent a daily 10 minute regimen of 30 Hz LMMS at either a 0.3g-force (n=12) or 0.5g force (n=5). Control subjects (n=13) received no LMMS treatment. Postural stability, quantified by dispersions of the plantar-based center of pressure, deteriorated significantly from baseline in control subjects, with displacement and velocity at 60d increasing 98.7% and 193% respectively, while the LMMS group increased only 26.7% and 6.4%, reflecting a 73% and 97% relative retention in stability as compared to control. Increasing LMMS magnitude from 0.3 to 0.5g had no significant influence on outcomes. LMMS failed to spare loss of muscle extension strength, but helped to retain flexion strength (e.g., 46.2% improved retention of baseline concentric flexion strength vs. untreated controls; p=0.01). These data suggest the potential of extremely small mechanical signals as a non-invasive means of preserving postural control under the challenge of chronic bed rest, and may ultimately represent non-pharmacologic means of reducing the risk of debilitating falls in elderly and infirm. PMID:21273076

Effect of six weeks of dura disc and mini-trampoline balance training on postural sway in athletes with functional ankle instability.

PubMed

Kidgell, Dawson J; Horvath, Deanna M; Jackson, Brendan M; Seymour, Philip J

2007-05-01

Lateral ankle sprain (LAS) is one of the most common injuries incurred during sporting activities, and effective rehabilitation programs for this condition are challenging to develop. The purpose of this research was to compare the effect of 6 weeks of balance training on either a mini-trampoline or a dura disc on postural sway and to determine if the mini-trampoline or the dura disc is more effective in improving postural sway. Twenty subjects (11 men, 9 women) with a mean age of 25.4 +/- 4.2 years were randomly allocated into a control group, a dura disc training (DT) group, or a mini-trampoline (MT) group. Subjects completed 6 weeks of balance training. Postural sway was measured by subjects performing a single limb stance on a force plate. The disbursement of the center of pressure was obtained from the force plate in the medial-lateral and the anterior-posterior sway path and was subsequently used for pretest and posttest analysis. After the 6-week training intervention, there was a significant (p < 0.05) difference in postural sway between pre- and posttesting for both the MT (pretest = 56.8 +/- 20.5 mm, posttest = 33.3 +/- 8.5 mm) and DT (pretest = 41.3 +/- 2.6 mm, posttest = 27.2 +/- 4.8 mm) groups. There was no significant (p > 0.05) difference detected for improvements between the MT and DT groups. These results indicate that not only is the mini-trampoline an effective tool for improving balance after LAS, but it is equally as effective as the dura disc.

Clinical differentiation of parkinsonian syndromes: prognostic and therapeutic relevance.

PubMed

Christine, Chadwick W; Aminoff, Michael J

2004-09-15

Parkinson disease is the most common cause of parkinsonism, but other causes should always be excluded because they have a different prognosis, respond differently to medical treatment, and should not be managed by surgical means. However, diagnosis, even by experts, is challenging; one autopsy series showed an error rate of 24%. Distinction between various diagnostic possibilities depends on the history and examination findings. The use of certain medications, the rapid rate of disease progression, early onset of falling, the presence of certain dysautonomic symptoms, cognitive or behavioral changes, or a history of poor response to dopaminergic therapy may suggest an atypical form of parkinsonism. Postural hypotension, dementia, supranuclear ophthalmoparesis, or early postural instability should alert the examiner to consider an atypical cause of parkinsonism. Tests of autonomic function and brain imaging are often helpful in distinguishing these diseases. Copyright 2004 Elsevier Inc.

Measuring postural control during mini-squat posture in men with early knee osteoarthritis.

PubMed

Petrella, M; Gramani-Say, K; Serrão, P R M S; Lessi, G C; Barela, J A; Carvalho, R P; Mattiello, S M

2017-04-01

Studies have suggested a compromised postural control in individuals with knee osteoarthritis (OA) evidenced by larger and faster displacement of center of pressure (COP). However, quantification of postural control in the mini-squat posture performed by patients with early knee OA and its relation to muscle strength and self-reported symptoms have not been investigated. The main aim of this cross-sectional, observational, controlled study was to determine whether postural control in the mini-squat posture differs between individuals with early knee OA and a control group (CG) and verify the relation among knee extensor torque (KET) and self-reported physical function, stiffness and pain. Twenty four individuals with knee OA grades I and II (OAG) (mean age: 52.35±5.00) and twenty subjects without knee injuries (CG) (mean age: 51.40±8.07) participated in this study. Participants were assessed in postural control through a force plate (Bertec Mod. USA), which provided information about the anterior-posterior (AP) and medial-lateral (ML) COP displacement during the mini-squat, in isometric, concentric and eccentric knee extensor torque (KET) (90°/s) through an isokinetic dynamometer (BiodexMulti-Joint System3, Biodex Medical Incorporation, New York, NY, USA), and in self-reported symptoms through the WOMAC questionnaire. The main outcomes measured were the AP and ML COP amplitude and velocity of displacement; isometric, concentric, and eccentric KET and self-reported physical function, stiffness and pain. No significant differences were found between groups for postural control (p>0.05). Significant lower eccentric KET (p=0.01) and higher scores for the WOMAC subscales of pain (p=<0.001), stiffness (p=0.001) and physical function (p<0.001) were found for the OAG. Moderate and negative correlations were found between the AP COP amplitude of displacement and physical function (ρ=-0.40, p=0.02). Moderate and negative correlations were observed between the AP COP velocity of displacement and physical function (ρ=0.47, p=0.01) and stiffness (ρ=-0.45, p=0.02). The findings of the present study emphasize the importance of rehabilitation from the early degrees of knee OA to prevent postural instability and the need to include quadriceps muscle strengthening, especially by eccentric contractions. The relationship between the self-reported symptoms and a lower and slower COP displacement suggest that the postural control strategy during tasks with a semi-flexed knee should be further investigated. Copyright © 2017 Elsevier B.V. All rights reserved.

Differences of muscle co-contraction of the ankle joint between young and elderly adults during dynamic postural control at different speeds.

PubMed

Iwamoto, Yoshitaka; Takahashi, Makoto; Shinkoda, Koichi

2017-08-02

Agonist and antagonist muscle co-contractions during motor tasks are greater in the elderly than in young adults. During normal walking, muscle co-contraction increases with gait speed in young adults, but not in elderly adults. However, no study has compared the effects of speed on muscle co-contraction of the ankle joint during dynamic postural control in young and elderly adults. We compared muscle co-contractions of the ankle joint between young and elderly subjects during a functional stability boundary test at different speeds. Fifteen young adults and 16 community-dwelling elderly adults participated in this study. The task was functional stability boundary tests at different speeds (preferred and fast). Electromyographic evaluations of the tibialis anterior and soleus were recorded. The muscle co-contraction was evaluated using the co-contraction index (CI). There were no statistically significant differences in the postural sway parameters between the two age groups. Elderly subjects showed larger CI in both speed conditions than did the young subjects. CI was higher in the fast speed condition than in the preferred speed condition in the young subjects, but there was no difference in the elderly subjects. Moreover, after dividing the analytical range into phases (acceleration and deceleration phases), the CI was larger in the deceleration phase than in the acceleration phase in both groups, except for the young subjects in the fast speed conditions. Our results showed a greater muscle co-contraction of the ankle joint during dynamic postural control in elderly subjects than in young subjects not only in the preferred speed condition but also in the fast speed condition. In addition, the young subjects showed increased muscle co-contraction in the fast speed condition compared with that in the preferred speed condition; however, the elderly subjects showed no significant difference in muscle co-contraction between the two speed conditions. This indicates that fast movements cause different influences on dynamic postural control in elderly people, particularly from the point of view of muscle activation. These findings highlight the differences in the speed effects on muscle co-contraction of the ankle joint during dynamic postural control between the two age groups.

Comparison of Human and Humanoid Robot Control of Upright Stance

PubMed Central

Peterka, Robert J.

2009-01-01

There is considerable recent interest in developing humanoid robots. An important substrate for many motor actions in both humans and biped robots is the ability to maintain a statically or dynamically stable posture. Given the success of the human design, one would expect there are lessons to be learned in formulating a postural control mechanism for robots. In this study we limit ourselves to considering the problem of maintaining upright stance. Human stance control is compared to a suggested method for robot stance control called zero moment point (ZMP) compensation. Results from experimental and modeling studies suggest there are two important subsystems that account for the low- and mid-frequency (DC to ~1 Hz) dynamic characteristics of human stance control. These subsystems are 1) a “sensory integration” mechanism whereby orientation information from multiple sensory systems encoding body kinematics (i.e. position, velocity) is flexibly combined to provide an overall estimate of body orientation while allowing adjustments (sensory re-weighting) that compensate for changing environmental conditions, and 2) an “effort control” mechanism that uses kinetic-related (i.e., force-related) sensory information to reduce the mean deviation of body orientation from upright. Functionally, ZMP compensation is directly analogous to how humans appear to use kinetic feedback to modify the main sensory integration feedback loop controlling body orientation. However, a flexible sensory integration mechanism is missing from robot control leaving the robot vulnerable to instability in conditions were humans are able to maintain stance. We suggest the addition of a simple form of sensory integration to improve robot stance control. We also investigate how the biological constraint of feedback time delay influences the human stance control design. The human system may serve as a guide for improved robot control, but should not be directly copied because the constraints on robot and human control are different. PMID:19665564

Comparison of human and humanoid robot control of upright stance.

PubMed

Peterka, Robert J

2009-01-01

There is considerable recent interest in developing humanoid robots. An important substrate for many motor actions in both humans and biped robots is the ability to maintain a statically or dynamically stable posture. Given the success of the human design, one would expect there are lessons to be learned in formulating a postural control mechanism for robots. In this study we limit ourselves to considering the problem of maintaining upright stance. Human stance control is compared to a suggested method for robot stance control called zero moment point (ZMP) compensation. Results from experimental and modeling studies suggest there are two important subsystems that account for the low- and mid-frequency (DC to approximately 1Hz) dynamic characteristics of human stance control. These subsystems are (1) a "sensory integration" mechanism whereby orientation information from multiple sensory systems encoding body kinematics (i.e. position, velocity) is flexibly combined to provide an overall estimate of body orientation while allowing adjustments (sensory re-weighting) that compensate for changing environmental conditions and (2) an "effort control" mechanism that uses kinetic-related (i.e., force-related) sensory information to reduce the mean deviation of body orientation from upright. Functionally, ZMP compensation is directly analogous to how humans appear to use kinetic feedback to modify the main sensory integration feedback loop controlling body orientation. However, a flexible sensory integration mechanism is missing from robot control leaving the robot vulnerable to instability in conditions where humans are able to maintain stance. We suggest the addition of a simple form of sensory integration to improve robot stance control. We also investigate how the biological constraint of feedback time delay influences the human stance control design. The human system may serve as a guide for improved robot control, but should not be directly copied because the constraints on robot and human control are different.

Dynamic Postural-Stability Deficits After Cryotherapy to the Ankle Joint

PubMed Central

Fullam, Karl; Caulfield, Brian; Coughlan, Garrett F.; McGroarty, Mark; Delahunt, Eamonn

2015-01-01

Context  Decreased postural stability is a primary risk factor for lower limb musculoskeletal injuries. During athletic competitions, cryotherapy may be applied during short breaks in play or during half-time; however, its effects on postural stability remain unclear. Objective  To investigate the acute effects of a 15-minute ankle-joint cryotherapy application on dynamic postural stability. Design  Controlled laboratory study. Setting  University biomechanics laboratory. Patients or Other Participants  A total of 29 elite-level collegiate male field-sport athletes (age = 20.8 ± 1.12 years, height = 1.80 ± 0.06 m, mass = 81.89 ± 8.59 kg) participated. Intervention(s)  Participants were tested on the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions of the Star Excursion Balance Test before and after a 15-minute ankle-joint cryotherapy application. Main Outcome Measure(s)  Normalized reach distances; sagittal-plane kinematics of the hip, knee, and ankle joints; and associated mean velocity of the center-of-pressure path during performance of the ANT, PL, and PM reach directions of the Star Excursion Balance Test. Results  We observed a decrease in reach-distance scores for the ANT, PL, and PM reach directions from precryotherapy to postcryotherapy (P < .05). No differences were observed in hip-, knee-, or ankle-joint sagittal-plane kinematics (P > .05). We noted a decrease in mean velocity of the center-of-pressure path from precryotherapy to postcryotherapy (P < .05) in all reach directions. Conclusions  Dynamic postural stability was adversely affected immediately after cryotherapy to the ankle joint. PMID:26285088

Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan.

PubMed

Wong, A M; Lin, Y C; Chou, S W; Tang, F T; Wong, P Y

2001-05-01

To evaluate the effects of coordination exercise on postural stability in older individuals by Chinese shadow boxing, Tai Chi Chuan (TCC). Cross-sectional study. Research project in a hospital-based biomechanical laboratory. The TCC group (n = 25) had been practicing TCC regularly for 2 to 35 years. The control group (n = 14) included healthy and active older subjects. Static postural stability test: progressively harder sequential tests with 6 combinations of vision (eyes open, eyes closed, sway-referenced) and support (fixed, sway-referenced); and dynamic balance test: 3 tests of weight shifting (left to right, forward-backward, multidirectional) at 3 speeds. Static and dynamic balance of Sensory Organization Testing (SOT) of the Smart Balance Master System. In static postural control, the results showed no differences between the TCC or control group in the more simple conditions, but in the more complicated SOT (eyes closed with sway surface, sway vision with sway surface), the TCC group had significantly better results than the control group. The TCC group also had significantly better results in the rhythmic forward-backward weight-shifting test. Duration of practice did not seem to affect the stability of elder people. The elderly people who regularly practiced TCC showed better postural stability in the more challenged conditions than those who do not (eg, the condition with simultaneous disturbance of vision and proprioception). TCC as a coordination exercise may reduce the risk of a fall through maintaining the ability of posture control.

Implied motion because of instability in Hokusai Manga activates the human motion-sensitive extrastriate visual cortex: an fMRI study of the impact of visual art.

PubMed

Osaka, Naoyuki; Matsuyoshi, Daisuke; Ikeda, Takashi; Osaka, Mariko

2010-03-10

The recent development of cognitive neuroscience has invited inference about the neurosensory events underlying the experience of visual arts involving implied motion. We report functional magnetic resonance imaging study demonstrating activation of the human extrastriate motion-sensitive cortex by static images showing implied motion because of instability. We used static line-drawing cartoons of humans by Hokusai Katsushika (called 'Hokusai Manga'), an outstanding Japanese cartoonist as well as famous Ukiyoe artist. We found 'Hokusai Manga' with implied motion by depicting human bodies that are engaged in challenging tonic posture significantly activated the motion-sensitive visual cortex including MT+ in the human extrastriate cortex, while an illustration that does not imply motion, for either humans or objects, did not activate these areas under the same tasks. We conclude that motion-sensitive extrastriate cortex would be a critical region for perception of implied motion in instability.

Ergonomic study on wrist posture when using laparoscopic tools in four different techniques regarding minimally invasive surgery.

PubMed

Bartnicka, Joanna; Zietkiewicz, Agnieszka A; Kowalski, Grzegorz J

2018-03-19

With reference to four different minimally invasive surgery (MIS) cholecystectomy the aims were: to recognize the factors influencing dominant wrist postures manifested by the surgeon; to detect risk factors involved in maintaining deviated wrist postures; to compare the wrist postures of surgeons while using laparoscopic tools. Video films were recorded during live surgeries. The films were synchronized with wrist joint angles obtained from wireless electrogoniometers placed on the surgeon's hand. The analysis was conducted for five different laparoscopic tools used during all surgical techniques. The most common wrist posture was extension. In the case of one laparoscopic tool, the mean values defining extended wrist posture were distinct in all four surgical techniques. For one type of surgical technique, considered to be the most beneficial for patients, more extreme postures were noticed regarding all laparoscopic tools. We recognized a new factor, apart from the tool's handle design, that influences extreme and deviated wrist postures. It involves three areas of task specification including the type of action, type of motion patterns and motion dynamism. The outcomes proved that the surgical technique which is most beneficial for the patient imposes the greatest strain on the surgeon's wrist.

Characterization of postural control deficit in whiplash patients by means of linear and nonlinear analyses - A pilot study.

PubMed

Madeleine, Pascal; Nielsen, Mogens; Arendt-Nielsen, Lars

2011-04-01

The ability to maintain balance is diminished in patients suffering from a whiplash injury. The aim of this study was to characterize the variability of postural control in patients with chronic whiplash injury. For this purpose, we analyzed static postural recordings from 11 whiplash patients and sex- and age-matched asymptomatic healthy volunteers. Static postural recordings were performed randomly with eyes open, eyes closed, and eyes open and speaking (dual task). Spatial-temporal changes of the center of pressure displacement were analyzed to assess the amplitude and structure of postural variability by computing, respectively, the standard deviation/coefficient of variation and sample entropy/fractal dimension of the time series. The amplitude of variability of the center of pressure was larger among whiplash patients compared with controls (P<0.001) while fractal dimension was lower (P<0.001). The sample entropy increased during both eyes closed and a simple dual task compared with eyes open (P<0.05). The analysis of postural control dynamics revealed increased amplitude of postural variability and decreased signal dimensionality related to the deficit in postural stability found in whiplash patients. Linear and nonlinear analyses can thus be helpful for the quantification of postural control in normal and pathological conditions. Copyright © 2010 Elsevier Ltd. All rights reserved.

Children's catching performance when the demands on the postural system is altered.

PubMed

Angelakopoulos, Georgios T; Tsorbatzoudis, Haralambos; Grouios, George

2014-07-01

In many dynamic interceptive actions performers need to integrate activity of manual and postural subsystems for successful performance. Groups of different skill level (poor and good catchers), (mean age = 9.1 and 9.4 respectively) were required to perform one-handed catches under different postural constraints: standing; standing in contact with a postural support aid by their side (PSAS) or to the left of their trunk (PSAF); Tandem; and sitting (control). Results revealed that, for poor catchers, the number of successful catches increased and grasp errors decreased significantly when sitting and with both postural aids in comparison with standing alone and Tandem conditions. Kinematic analyses showed that the postural aid devices reduced head sway in the anterior-posterior direction, while the PSAF reduced lateral head sway. The poor catchers' performance benefited from an enlarged support surface, and reduction of lateral sway. Good catchers performed successfully under all task constraints, signifying the existence of a functional relationship between postural and grasping subsystems during performance. The results are discussed in the frame of Bernstein's (1967) and Newell's (1986) theory.

Physiological Motion Axis for the Seat of a Dynamic Office Chair.

PubMed

Kuster, Roman Peter; Bauer, Christoph Markus; Oetiker, Sarah; Kool, Jan

2016-09-01

The aim of this study was to determine and verify the optimal location of the motion axis (MA) for the seat of a dynamic office chair. A dynamic seat that supports pelvic motion may improve physical well-being and decrease the risk of sitting-associated disorders. However, office work requires an undisturbed view on the work task, which means a stable position of the upper trunk and head. Current dynamic office chairs do not fulfill this need. Consequently, a dynamic seat was adapted to the physiological kinematics of the human spine. Three-dimensional motion tracking in free sitting helped determine the physiological MA of the spine in the frontal plane. Three dynamic seats with physiological, lower, and higher MA were compared in stable upper body posture (thorax inclination) and seat support of pelvic motion (dynamic fitting accuracy). Spinal kinematics during sitting and walking were compared. The physiological MA was at the level of the 11th thoracic vertebra, causing minimal thorax inclination and high dynamic fitting accuracy. Spinal motion in active sitting and walking was similar. The physiological MA of the seat allows considerable lateral flexion of the spine similar to walking with a stable upper body posture and a high seat support of pelvic motion. The physiological MA enables lateral flexion of the spine, similar to walking, without affecting stable upper body posture, thus allowing active sitting while focusing on work. © 2016, Human Factors and Ergonomics Society.

Anatomy and histochemistry of hindlimb flight posture in birds. I. The extended hindlimb posture of shorebirds.

PubMed

McFarland, Joshua C; Meyers, Ron A

2008-08-01

Birds utilize one of two hindlimb postures during flight: an extended posture (with the hip and knee joints flexed, while the ankle joint is extended caudally) or a flexed posture (with the hip, knee, and ankle joints flexed beneath the body). American Avocets (Recurvirostra americana) and Black-necked Stilts (Himantopus mexicanus) extend their legs caudally during flight and support them for extended periods. Slow tonic and slow twitch muscle fibers are typically found in muscles functioning in postural support due to the fatigue resistance of these fibers. We hypothesized that a set of small muscles composed of high percentages of slow fibers and thus dedicated to postural support would function in securing the legs in the extended posture during flight. This study examined the anatomy and histochemical profile of eleven hindlimb muscles to gain insight into their functional roles during flight. Contrary to our hypothesis, all muscles possessed both fast twitch and slow twitch or slow tonic fibers. We believe this finding is due to the versatility of dynamic and postural functions the leg muscles must facilitate, including standing, walking, running, swimming, and hindlimb support during flight. Whether birds use an extended or flexed hindlimb flight posture may be related to the aerodynamic effect of leg position or may reflect evolutionary history. (c) 2008 Wiley-Liss, Inc.

Comparison of Biodynamic Responses in Standing and Seated Human Bodies

NASA Astrophysics Data System (ADS)

MATSUMOTO, Y.; GRIFFIN, M. J.

2000-12-01

The dynamic responses of the human body in a standing position and in a sitting position have been compared. The apparent mass and transmissibilities to the head, six locations along the spine, and the pelvis were measured with eight male subjects exposed to vertical whole-body vibration. In both postures, the principal resonance in the apparent mass occurred in the range 5-6 Hz, with slightly higher frequencies and lower apparent mass in the standing posture. There was greater transmission of vertical vibration to the pelvis and the lower spine and greater relative motion within the lower spine in the standing posture than in the sitting posture at the principal resonance and at higher frequencies. Transmissibilities from the supporting surface (floor or seat) to the thoracic region had similar magnitudes for both standing and sitting subjects. The lumbar spine has less lordosis and may be more compressed and less flexible in the sitting posture than in the standing posture. This may have reduced the relative motions between lumbar vertebrae and both the supporting vibrating surface and the other vertebrae in the sitting posture. The characteristics of the vibration transmitted to the pelvis may have differed in the two postures due to different transmission paths. Increased forward rotation of the pelvis in the standing posture may have caused the differences in responses of the pelvis and the lower spine that were observed between the two postures.

Tensiomygraphic Measurement of Atrophy Related Processes During Bed Rest and Recovery

NASA Astrophysics Data System (ADS)

Simunic, B. ostjan; Degens, Hans; Rittweger, Jorn; Narici, Marcco; Pisot, Venceslav; Mekjavic, Igor B.; Pisot, Rado

2013-02-01

Tensiomyographic (TMG) parameters were recently proposed for a non-invasive estimation of MHC distribution in human vastus lateralis muscle. However, TMG potential is even higher, offers additional insight into the skeletal muscle physiology, especially in the field of atrophy and hypertrophy. The purpose of this study is in developing time dynamics of TMG-measured contraction time (Tc) and maximal response amplitude (Dm), together with muscle belly thickness, measure thoroughly during 35-day bed rest and followed in 30-day recovery (N = 10 males; age 24.3 ± 2.6 years). Measurements were performed in two postural muscles (vastus medialis and lateralis) and one non-postural muscle (biceps femoris). During bed rest period we found different dynamics of muscle thickness decrease and Dm increase. Tc was unchanged in postural muscles, but in non-postural muscle increased significantly and stayed as such even at the end of recovery. We could conclude that TMG related parameters are more sensitive in measuring muscle atrophic and hypertrophic processes than biomedical imaging technique. However, a mechanism that regulates Dm still needs to be identified.

Postural Coordination during Socio-motor Improvisation

PubMed Central

Gueugnon, Mathieu; Salesse, Robin N.; Coste, Alexandre; Zhao, Zhong; Bardy, Benoît G.; Marin, Ludovic

2016-01-01

Human interaction often relies on socio-motor improvisation. Creating unprepared movements during social interaction is not a random process but relies on rules of synchronization. These situations do not only involve people to be coordinated, but also require the adjustment of their posture in order to maintain balance and support movements. The present study investigated posture in such a context. More precisely, we first evaluated the impact of amplitude and complexity of arm movements on posture in solo situation. Then, we assessed the impact of interpersonal coordination on posture using the mirror game in which dyads performed improvised and synchronized movements (i.e., duo situation). Posture was measured through ankle-hip coordination in medio-lateral and antero-posterior directions (ML and AP respectively). Our results revealed the spontaneous emergence of in-phase pattern in ML direction and antiphase pattern in AP direction for solo and duo situations. These two patterns respectively refer to the simultaneous flexion/extension of the ankles and the hips in the same or opposite direction. It suggests different functional roles of postural coordination patterns in each direction, with in-phase supporting task performance in ML (dynamical stability) and antiphase supporting postural control in AP (mechanical stability). Although amplitude of movement did not influence posture, movement complexity disturbed postural stability in both directions. Conversely, interpersonal coordination promoted postural stability in ML but not in AP direction. These results are discussed in terms of the difference in coupling strength between ankle-hip coordination and interpersonal coordination. PMID:27547193

Postural Coordination during Socio-motor Improvisation.

PubMed

Gueugnon, Mathieu; Salesse, Robin N; Coste, Alexandre; Zhao, Zhong; Bardy, Benoît G; Marin, Ludovic

2016-01-01

Human interaction often relies on socio-motor improvisation. Creating unprepared movements during social interaction is not a random process but relies on rules of synchronization. These situations do not only involve people to be coordinated, but also require the adjustment of their posture in order to maintain balance and support movements. The present study investigated posture in such a context. More precisely, we first evaluated the impact of amplitude and complexity of arm movements on posture in solo situation. Then, we assessed the impact of interpersonal coordination on posture using the mirror game in which dyads performed improvised and synchronized movements (i.e., duo situation). Posture was measured through ankle-hip coordination in medio-lateral and antero-posterior directions (ML and AP respectively). Our results revealed the spontaneous emergence of in-phase pattern in ML direction and antiphase pattern in AP direction for solo and duo situations. These two patterns respectively refer to the simultaneous flexion/extension of the ankles and the hips in the same or opposite direction. It suggests different functional roles of postural coordination patterns in each direction, with in-phase supporting task performance in ML (dynamical stability) and antiphase supporting postural control in AP (mechanical stability). Although amplitude of movement did not influence posture, movement complexity disturbed postural stability in both directions. Conversely, interpersonal coordination promoted postural stability in ML but not in AP direction. These results are discussed in terms of the difference in coupling strength between ankle-hip coordination and interpersonal coordination.

Static and dynamic postural control in low-vision and normal-vision adults.

PubMed

Tomomitsu, Mônica S V; Alonso, Angelica Castilho; Morimoto, Eurica; Bobbio, Tatiana G; Greve, Julia M D

2013-04-01

This study aimed to evaluate the influence of reduced visual information on postural control by comparing low-vision and normal-vision adults in static and dynamic conditions. Twenty-five low-vision subjects and twenty-five normal sighted adults were evaluated for static and dynamic balance using four protocols: 1) the Modified Clinical Test of Sensory Interaction on Balance on firm and foam surfaces with eyes opened and closed; 2) Unilateral Stance with eyes opened and closed; 3) Tandem Walk; and 4) Step Up/Over. The results showed that the low-vision group presented greater body sway compared with the normal vision during balance on a foam surface (p≤0.001), the Unilateral Stance test for both limbs (p≤0.001), and the Tandem Walk test. The low-vision group showed greater step width (p≤0.001) and slower gait speed (p≤0.004). In the Step Up/Over task, low-vision participants were more cautious in stepping up (right p≤0.005 and left p≤0.009) and in executing the movement (p≤0.001). These findings suggest that visual feedback is crucial for determining balance, especially for dynamic tasks and on foam surfaces. Low-vision individuals had worse postural stability than normal-vision adults in terms of dynamic tests and balance on foam surfaces.

[The glider. Postural kinetic behavior during the pre-locomotor period in infants].

PubMed

Auzias, M; de Ajuriaguerra, J

1980-01-01

Soaring movements-in an opisthotonic posture-which appear between 3 and 10 months when the infant is in a prone position, have been observed with cinematographic recordings. This is a postural and kinetic activity which takes place during the first year's development; i is a transitional stage leading to intentional propulsive movements. This activity may become a repetitive one for some children, especially between 4 and 7 months; at this peak period, it takes on an unusual aspect, not only because of the "aerial" attitude but also because of the rhythmicity of the postural changes which characterize it. This behavior has been studied in its evolutionary forms, its individual characteristics, and its emotional expressions. Hovering movements are localized in the neuro-psychological evolution of the infant (tonico-postural evolution, acquisition of balance in a prone position, alternating postures, propulsive movements). The conditions which set off and quieten this activity explain the dynamics of its functioning between movements to which the baby is submitted and deliberate ones, between constraint and pleasure.

Foot Pain and Pronated Foot Type are Associated with Self-Reported Mobility Limitations in Older Adults: the Framingham Foot Study

PubMed Central

Menz, Hylton B.; Dufour, Alyssa B.; Katz, Patricia; Hannan, Marian T.

2015-01-01

Background The foot plays an important role in supporting the body when undertaking weight bearing activities. Aging is associated with an increased prevalence of foot pain and a lowering of the arch of the foot, both of which may impair mobility. Objective To examine the associations of foot pain, foot posture and dynamic foot function with self-reported mobility limitations in community-dwelling older adults. Methods Foot examinations were conducted on 1,860 members of the Framingham Study in 2002–2005. Foot posture was categorized as normal, planus or cavus using static pressure measurements, and foot function was categorized as normal, pronated or supinated using dynamic pressure measurements. Participants were asked whether they had foot pain and any difficulty performing a list of nine weight bearing tasks. Multivariate logistic regression and linear regression models were used to examine the associations of foot pain, posture, function and ability to perform these activities. Results After adjusting for age, sex, height and weight, foot pain was significantly associated with difficulty performing all nine weight bearing activities. Compared to those with normal foot posture and function, participants with planus foot posture were more likely to report difficulty remaining balanced (odds ratio [OR] = 1.40, 95% confidence interval [CI] 1.06 to 1.85; p=0.018) and individuals with pronated foot function were more likely to report difficulty walking across a small room (OR = 2.07, 95% CI 1.02 to 4.22; p=0.045). Foot pain and planus foot posture were associated with an overall mobility limitation score combining performances on each measure. Conclusion Foot pain, planus foot posture and pronated foot function are associated with self-reported difficulty undertaking common weight bearing tasks. Interventions to reduce foot pain and improve foot posture and function may therefore have a role in improving mobility in older adults. PMID:26645379

The lumbosacral segment as a vulnerable region in various postures

NASA Technical Reports Server (NTRS)

Rosemeyer, B.

1978-01-01

The lumbosacral region in man is exposed to special static and dynamic load. In a supine position, the disc size increases because of the absence of axial load. In a standing position, with physiological posture of the spine, strain discomfort occurs which is increased even more in the sitting position due to the curvature of the lumbar region of the spine and the irregular distribution of pressure in the discs as a result of this. This special problem of sitting posture can be confirmed by examinations.

Vortex-Surface Interactions: Vortex Dynamics and Instabilities

DTIC Science & Technology

2015-10-16

31 May 2015 4. TITLE AND SUBTITLE VORTEX -SURFACE INTERACTIONS: VORTEX DYNAMICS AND INSTABILITIES Sa. CONTRACT NUMBER Sb. GRANT NUMBER N00014-12...new natural instabilities coming from vortex - vortex or vortex -surface interactions, but also ultimately the possibility to control these flows...design of vortex generators to modify surface pressures. We find a short wave instability of the secondary vortices that are created by the

Model-based and Model-free Machine Learning Techniques for Diagnostic Prediction and Classification of Clinical Outcomes in Parkinson's Disease.

PubMed

Gao, Chao; Sun, Hanbo; Wang, Tuo; Tang, Ming; Bohnen, Nicolaas I; Müller, Martijn L T M; Herman, Talia; Giladi, Nir; Kalinin, Alexandr; Spino, Cathie; Dauer, William; Hausdorff, Jeffrey M; Dinov, Ivo D

2018-05-08

In this study, we apply a multidisciplinary approach to investigate falls in PD patients using clinical, demographic and neuroimaging data from two independent initiatives (University of Michigan and Tel Aviv Sourasky Medical Center). Using machine learning techniques, we construct predictive models to discriminate fallers and non-fallers. Through controlled feature selection, we identified the most salient predictors of patient falls including gait speed, Hoehn and Yahr stage, postural instability and gait difficulty-related measurements. The model-based and model-free analytical methods we employed included logistic regression, random forests, support vector machines, and XGboost. The reliability of the forecasts was assessed by internal statistical (5-fold) cross validation as well as by external out-of-bag validation. Four specific challenges were addressed in the study: Challenge 1, develop a protocol for harmonizing and aggregating complex, multisource, and multi-site Parkinson's disease data; Challenge 2, identify salient predictive features associated with specific clinical traits, e.g., patient falls; Challenge 3, forecast patient falls and evaluate the classification performance; and Challenge 4, predict tremor dominance (TD) vs. posture instability and gait difficulty (PIGD). Our findings suggest that, compared to other approaches, model-free machine learning based techniques provide a more reliable clinical outcome forecasting of falls in Parkinson's patients, for example, with a classification accuracy of about 70-80%.

Unilateral pedunculopontine stimulation improves falls in Parkinson's disease.

PubMed

Moro, Elena; Hamani, Clement; Poon, Yu-Yan; Al-Khairallah, Thamar; Dostrovsky, Jonathan O; Hutchison, William D; Lozano, Andres M

2010-01-01

Postural instability and falls are a major source of disability in patients with advanced Parkinson's disease. These problems are currently not well addressed by either pharmacotherapy nor by subthalamic nucleus deep-brain stimulation surgery. The neuroanatomical substrates of posture and gait are poorly understood but a number of important observations suggest a major role for the pedunculopontine nucleus and adjacent areas in the brainstem. We conducted a double-blinded evaluation of unilateral pedunculopontine nucleus deep-brain stimulation in a pilot study in six advanced Parkinson's disease patients with significant gait and postural abnormalities. There was no significant difference in the double-blinded on versus off stimulation Unified Parkinson's Disease Rating Scale motor scores after 3 or 12 months of continuous stimulation and no improvements in the Unified Parkinson's Disease Rating Scale part III scores compared to baseline. In contrast, patients reported a significant reduction in falls in the on and off medication states both at 3 and 12 months after pedunculopontine nucleus deep-brain stimulation as captured in the Unified Parkinson's Disease Rating Scale part II scores. Our results suggest that pedunculopontine nucleus deep-brain stimulation may be effective in preventing falls in patients with advanced Parkinson's disease but that further evaluation of this procedure is required.

Lower Limb Kinematics and Dynamic Postural Stability in Anterior Cruciate Ligament-Reconstructed Female Athletes

PubMed Central

Delahunt, Eamonn; Chawke, Mark; Kelleher, Judy; Murphy, Katie; Prendiville, Anna; Sweeny, Lauren; Patterson, Matt

2013-01-01

Context: Deficits in lower limb kinematics and postural stability are predisposing factors to the development of knee ligamentous injury. The extent to which these deficits are present after anterior cruciate ligament (ACL) reconstruction is still largely unknown. The primary hypothesis of the present study was that female athletes who have undergone ACL reconstruction and who have returned to sport participation would exhibit deficits in dynamic postural stability as well as deficiencies in hip- and knee-joint kinematics when compared with an age-, activity-, and sex-matched uninjured control group. Objective: To investigate dynamic postural stability as quantified by the Star Excursion Balance Test (SEBT) and simultaneous hip- and knee-joint kinematic profiles in female athletes who have undergone ACL reconstruction. Design: Descriptive laboratory study. Setting: University motion-analysis laboratory. Patients or Other Participants: Fourteen female athletes who had previously undergone ACL reconstruction (ACL-R) and 17 age- and sex-matched uninjured controls. Intervention(s): Each participant performed 3 trials of the anterior, posterior-medial, and posterior-lateral directional components of the SEBT. Main Outcome Measure(s): Reach distances for each directional component were quantified and expressed as a percentage of leg length. Simultaneous hip- and knee-joint kinematic profiles were recorded using a motion-analysis system. Results: The ACL-R group had decreased reach distances on the posterior-medial (P < .01) and posterior-lateral (P < .01) directional components of the SEBT. During performance of the directional components of the SEBT, ACL-R participants demonstrated altered hip-joint frontal-, sagittal-, and transverse-plane kinematic profiles (P < .05), as well as altered knee-joint sagittal-plane kinematic profiles (P < .05). Conclusions: Deficits in dynamic postural stability and concomitant altered hip- and knee-joint kinematics are present after ACL reconstruction and return to competitive activity. The extent to which these deficits influence potential future injury is worthy of investigation. PMID:23672381

Neural basis of postural focus effect on concurrent postural and motor tasks: phase-locked electroencephalogram responses.

PubMed

Huang, Cheng-Ya; Zhao, Chen-Guang; Hwang, Ing-Shiou

2014-11-01

Dual-task performance is strongly affected by the direction of attentional focus. This study investigated neural control of a postural-suprapostural procedure when postural focus strategy varied. Twelve adults concurrently conducted force-matching and maintained stabilometer stance with visual feedback on ankle movement (visual internal focus, VIF) and on stabilometer movement (visual external focus, VEF). Force-matching error, dynamics of ankle and stabilometer movements, and event-related potentials (ERPs) were registered. Postural control with VEF caused superior force-matching performance, more complex ankle movement, and stronger kinematic coupling between the ankle and stabilometer movements than postural control with VIF. The postural focus strategy also altered ERP temporal-spatial patterns. Postural control with VEF resulted in later N1 with less negativity around the bilateral fronto-central and contralateral sensorimotor areas, earlier P2 deflection with more positivity around the bilateral fronto-central and ipsilateral temporal areas, and late movement-related potential commencing in the left frontal-central area, as compared with postural control with VIF. The time-frequency distribution of the ERP principal component revealed phase-locked neural oscillations in the delta (1-4Hz), theta (4-7Hz), and beta (13-35Hz) rhythms. The delta and theta rhythms were more pronounced prior to the timing of P2 positive deflection, and beta rebound was greater after the completion of force-matching in VEF condition than VIF condition. This study is the first to reveal the neural correlation of postural focusing effect on a postural-suprapostural task. Postural control with VEF takes advantage of efficient task-switching to facilitate autonomous postural response, in agreement with the "constrained-action" hypothesis. Copyright © 2014 Elsevier B.V. All rights reserved.

Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS.

PubMed

Pavão, Silvia Leticia; Ledebt, Annick; Savelsbergh, Geert J P; Rocha, Nelci Adriana C F

2017-08-01

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn't affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn't result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparative Effects of Different Balance-Training–Progression Styles on Postural Control and Ankle Force Production: A Randomized Controlled Trial

PubMed Central

Cuğ, Mutlu; Duncan, Ashley; Wikstrom, Erik

2016-01-01

Context:  Despite the effectiveness of balance training, the exact parameters needed to maximize the benefits of such programs remain unknown. One such factor is how individuals should progress to higher levels of task difficulty within a balance-training program. Yet no investigators have directly compared different balance-training–progression styles. Objective:  To compare an error-based progression (ie, advance when proficient at a task) with a repetition-based progression (ie, advance after a set amount of repetitions) style during a balance-training program in healthy individuals. Design:  Randomized controlled trial. Setting:  Research laboratory. Patients or Other Participants:  A total of 28 (16 women, 12 men) physically healthy young adults (age = 21.57 ± 3.95 years, height = 171.60 ± 11.03 cm, weight = 72.96 ± 16.18 kg, body mass index = 24.53 ± 3.7). Intervention(s):  All participants completed 12 supervised balance-training sessions over 4 weeks. Each session consisted of a combination of dynamic unstable-surface tasks that incorporated a BOSU ball and lasted about 30 minutes. Main Outcome Measure(s):  Static balance from an instrumented force plate, dynamic balance as measured via the Star Excursion Balance Test, and ankle force production in all 4 cardinal planes of motion as measured with a handheld dynamometer before and after the intervention. Results:  Selected static postural-control outcomes, dynamic postural control, and ankle force production in all planes of motion improved (P < .05). However, no differences between the progression styles were observed (P > .05) for any of the outcome measures. Conclusions:  A 4-week balance-training program consisting of dynamic unstable-surface exercises on a BOSU ball improved dynamic postural control and ankle force production in healthy young adults. These results suggest that an error-based balance-training program is comparable with but not superior to a repetition-based balance-training program in improving postural control and ankle force production in healthy young adults. PMID:26878257

Cortical-basal ganglionic degeneration.

PubMed

Riley, D E; Lang, A E; Lewis, A; Resch, L; Ashby, P; Hornykiewicz, O; Black, S

1990-08-01

We report our experience with 15 patients believed to have cortical-basal ganglionic degeneration. The clinical picture is distinctive, comprising features referable to both cortical and basal ganglionic dysfunction. Characteristic manifestations include cortical sensory loss, focal reflex myoclonus, "alien limb" phenomena, apraxia, rigidity and akinesia, a postural-action tremor, limb dystonia, hyperreflexia, and postural instability. The asymmetry of symptoms and signs is often striking. Brain imaging may demonstrate greater abnormalities contralateral to the more affected side. Postmortem studies in 2 patients revealed the characteristic pathologic features of swollen, poorly staining (achromatic) neurons and degeneration of cerebral cortex and substantia nigra. Biochemical analysis of 1 brain showed a severe, diffuse loss of dopamine in the striatum. This condition is more frequent than previously believed, and the diagnosis can be predicted during life on the basis of clinical findings. However, as with other "degenerative" diseases of the nervous system, a definitive diagnosis of cortical-basal ganglionic degeneration requires confirmation by autopsy.

Effects of space flight on locomotor control

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob J.; Layne, Charles S.; McDonald, P. Vernon; Peters, Brian T.; Huebner, William P.; Reschke, Millard F.; Berthoz, Alain; Glasauer, Stefan; Newman, Dava; Jackson, D. Keoki

1999-01-01

In the microgravity environment of spaceflight, the relationship between sensory input and motor output is altered. During prolonged missions, neural adaptive processes come into play to recalibrate central nervous system function, thereby permitting new motor control strategies to emerge in the novel sensory environment of microgravity. However, the adaptive state achieved during spaceflight is inappropriate for a unit gravity environment and leads to motor control alterations upon return to Earth that include disturbances in locomotion. Indeed, gait and postural instabilities following the return to Earth have been reported in both U.S. astronauts and Russian cosmonauts even after short duration (5- to 10-day) flights. After spaceflight, astronauts may: (1) experience the sensation of turning while attempting to walk a straight path, (2) encounter sudden loss of postural stability, especially when rounding corners, (3) perceive exaggerated pitch and rolling head movements during walking, (4) experience sudden loss of orientation in unstructured visual environments, or (5) experience significant oscillopsia during locomotion.

Congenital Partial Absence of Trapezius with Variant Pattern of Rectus Sheath.

PubMed

Tigga, Sarika Rachel; Goswami, Preeti; Khanna, Jugesh

2016-04-01

Musculocutaneous pedicled/free flaps are an essential prerequisite for reconstructive surgery. Amongst the trunk muscles commonly harvested for flaps, the trapezius and rectus abdominis provide satisfactory coverage for cranial and trunk defects. unilateral/bilateral or partial congenital absence of trapezius muscle is well documented and may result in muscular imbalances compromising posture and limb movements. During routine cadaveric dissection, we encountered a case of bilateral partial absence of occipital part of the trapezius muscle. Concurrently, the ventral abdominal musculature displayed the aponeurosis of transversus abdominis muscle solely forming the posterior wall of the rectus sheath. These conjointly occurring anomalies advocate a compensatory strengthening of the anterior wall of rectus sheath in response to the congenital absence of occipital part of the trapezius, probably to counteract the postural instability. The present study focuses on recognition of compensatory mechanisms resulting from congenital variations as identification of such processes may prevent chronic debilitating conditions.

Adaptive Gait Control for a Quadruped Robot on 3D Path Planning

NASA Astrophysics Data System (ADS)

Igarashi, Hiroshi; Kakikura, Masayoshi

A legged walking robot is able to not only move on irregular terrain but also change its posture. For example, the robot can pass under overhead obstacles by crouching. The purpose of our research is to realize efficient path planning with a quadruped robot. Therefore, the path planning is expected to extended in three dimensions because of the mobility. However, some issues of the quadruped robot, which are instability, workspace limitation, deadlock and slippage, complicate realizing such application. In order to improve these issues and reinforce the mobility, a new static gait pattern for a quadruped robot, called TFG: Trajectory Following Gait, is proposed. The TFG intends to obtain high controllability like a wheel robot. Additionally, the TFG allows to change it posture during the walk. In this paper, some experimental results show that the TFG improves the issues and it is available for efficient locomotion in three dimensional environment.

Population Differences in Postural Response Strategy Associated with Exposure to a Novel Continuous Perturbation Stimuli: Would Dancers Have Better Balance on a Boat?

PubMed

Duncan, Carolyn A; Ingram, Tony G J; Mansfield, Avril; Byrne, Jeannette M; McIlroy, William E

2016-01-01

Central or postural set theory suggests that the central nervous system uses short term, trial to trial adaptation associated with repeated exposure to a perturbation in order to improve postural responses and stability. It is not known if longer-term prior experiences requiring challenging balance control carryover as long-term adaptations that influence ability to react in response to novel stimuli. The purpose of this study was to determine if individuals who had long-term exposure to balance instability, such as those who train on specific skills that demand balance control, will have improved ability to adapt to complex continuous multidirectional perturbations. Healthy adults from three groups: 1) experienced maritime workers (n = 14), 2) novice individuals with no experience working in maritime environments (n = 12) and 3) individuals with training in dance (n = 13) participated in the study. All participants performed a stationary standing task while being exposed to five 6 degree of freedom motions designed to mimic the motions of a ship at sea. The balance reactions (change-in-support (CS) event occurrences and characteristics) were compared between groups. Results indicate dancers demonstrated significantly fewer CS events than novices during the first trial, but did not perform as well as those with offshore experience. Linear trend analyses revealed that short-term adaptation across all five trials was dependent on the nature of participant experience, with dancers achieving postural stability earlier than novices, but later than those with offshore experience. These results suggest that long term previous experiences also have a significant influence on the neural control of posture and balance in the development of compensatory responses.

Posture, head stability, and orientation recovery during vestibular regeneration in pigeons.

PubMed

Dickman, J David; Lim, Insook

2004-09-01

Compensatory behavior such as oculomotor, gaze, and postural responses that occur during movement largely depend upon a functioning vestibular system. In the present study, the initial loss and subsequent recovery of postural and head stability in pigeons undergoing vestibular regeneration were examined. Adult pigeons were trained to manipulate a straight run chamber to peck an illuminated key for fluid reward. Six behavioral measures assessing performance, posture, and head stability were quantified. These included run latency, steps (walking), path negotiation (lane changes), gaze saccades, head bobs, and head shakes. Once normative values were obtained for four birds, complete lesion of all receptor cells and denervation of the epithelia in the vestibular endorgans were produced using a single intralabyrinthine application of streptomycin sulfate. Each bird was then tested at specific times during regeneration and the same behavioral measures examined. At 7 days post-streptomycin treatment (PST), all birds exhibited severe postural and head instability, with tremors, head shakes, staggering, and circling predominating. No normal trial runs, walking, gaze saccades, or head bobs were present. Many of these dysfunctions persisted through 3-4 weeks PST. Gradually, tremor and head shakes diminished and were replaced with an increasing number of normal head bobs during steps and gaze saccades. Beginning at 4 weeks PST, but largely inaccurate, was the observed initiation of directed steps, less staggering, and some successful path negotiation. As regeneration progressed, spatial orientation and navigation ability increased and, by 49 days PST, most trials were successful. By 70 days PST, all birds had recovered to pretreatment levels. Thus, it was observed that ataxia must subside, coincident with normalized head and postural stability prior to the recovery of spatial orientation and path navigation recovery. Parallels in recovery were drawn to hair cell regeneration and afferent responsiveness, as inferred from present results and those in other investigations.

A research on the postural stability of a person wearing the lower limb exoskeletal robot by the HAT model.

PubMed

Chang, Minsu; Kim, Yeongmin; Lee, Yoseph; Jeon, Doyoung

2017-07-01

This paper proposes a method of detecting the postural stability of a person wearing the lower limb exoskeletal robot with the HAT(Head-Arm-Trunk) model. Previous studies have shown that the human posture is stable when the CoM(Center of Mass) of the human body is placed on the BoS(Base of Support). In the case of the lower limb exoskeletal robot, the motion data, which are used for the CoM estimation, are acquired by sensors in the robot. The upper body, however, does not have sensors in each segment so that it may cause the error of the CoM estimation. In this paper, the HAT(Head-Arm-Trunk) model which combines head, arms, and torso into a single segment is considered because the motion of head and arms are unknown due to the lack of sensors. To verify the feasibility of HAT model, the reflecting markers are attached to each segment of the whole human body and the exact motion data are acquired by the VICON to compare the COM of the full body model and HAT model. The difference between the CoM with full body and that with HAT model is within 20mm for the various motions of head and arms. Based on the HAT model, the XCoM(Extrapolated Center of Mass) which includes the velocity of the CoM is used for prediction of the postural stability. The experiment of making unstable posture shows that the XCoM of the whole body based on the HAT model is feasible to detect the instance of postural instability earlier than the CoM by 20-250 msec. This result may be used for the lower limb exoskeletal robot to prepare for any action to prevent the falling down.

Contributions of microtubule rotation and dynamic instability to kinetochore capture

NASA Astrophysics Data System (ADS)

Sweezy-Schindler, Oliver; Edelmaier, Christopher; Blackwell, Robert; Glaser, Matt; Betterton, Meredith

2014-03-01

The capture of lost kinetochores (KCs) by microtubules (MTs) is a crucial part of prometaphase during mitosis. Microtubule dynamic instability has been considered the primary mechanism of KC capture, but recent work discovered that lateral KC attachment to pivoting MTs enabled rapid capture even with significantly reduced MT dynamics. We aim to understand the relative contributions of MT rotational diffusion and dynamic instability to KC capture, as well as KC capture through end-on and/or lateral attachment. Our model consists of rigid MTs and a spherical KC, which are allowed to diffuse inside a spherical nuclear envelope consistent with the geometry of fission yeast. For simplicity, we include a single spindle pole body, which is anchored to the nuclear membrane, and its associated polar MTs. Brownian dynamics treats the diffusion of the MTs and KC and kinetic Monte Carlo models stochastic processes such as dynamic instability. NSF 1546021.

Dominant foot could affect the postural control in vestibular neuritis perceived by dynamic body balance.

PubMed

Yoshida, Tomoe; Tanaka, Toshitake; Tamura, Yuya; Yamamoto, Masahiko; Suzuki, Mitsuya

2018-01-01

During attacks of vestibular neuritis (VN), patients typically lose postural balance, with resultant postural inclination, gait deviation toward the lesion side, and tendency to fall. In this study, we examined and analyzed static and dynamic postural control during attacks of VN to characterize differences in postural control between right and left VN. Subjects were patients diagnosed with VN at the Department of Otolaryngology, Toho University Sakura Medical Center, and underwent in-patient treatment. Twenty-five patients who had spontaneous nystagmus were assessed within 3days after the onset; all were right-foot dominant. Right VN was detected in nine patients (men: 4, women: 5; mean age: 57.6±17.08years [range: 23-82]) and left VN in 16 patients (men: 10, women: 6; mean age: 58.4±14.08years [range: 23-85 years]); the percentages of canal paresis of right and left VN were 86.88±18.1% and 86.02±15.0%, respectively. Statistical comparisons were conducted using the independent t-test. In stabilometry, with eyes opened, no significant differences were found between patients with right and left VN. However, with eyes closed, the center of horizontal movement significantly shifted ipsilateral (p<0.01). The differences in the lateral and anteroposterior body tracking test (BTT) were statistically significant (p=0.0039 and p=0.0376, respectively), with greater changes in cases with right VN. Thus, the dominant foot might contribute to the postural control mechanism. Copyright © 2017 Elsevier B.V. All rights reserved.

A nonlinear dynamical system for combustion instability in a pulse model combustor

NASA Astrophysics Data System (ADS)

Takagi, Kazushi; Gotoda, Hiroshi

2016-11-01

We theoretically and numerically study the bifurcation phenomena of nonlinear dynamical system describing combustion instability in a pulse model combustor on the basis of dynamical system theory and complex network theory. The dynamical behavior of pressure fluctuations undergoes a significant transition from steady-state to deterministic chaos via the period-doubling cascade process known as Feigenbaum scenario with decreasing the characteristic flow time. Recurrence plots and recurrence networks analysis we adopted in this study can quantify the significant changes in dynamic behavior of combustion instability that cannot be captured in the bifurcation diagram.

DC dynamic pull-in instability of a dielectric elastomer balloon: an energy-based approach

NASA Astrophysics Data System (ADS)

Sharma, Atul Kumar; Arora, Nitesh; Joglekar, M. M.

2018-03-01

This paper reports an energy-based method for the dynamic pull-in instability analysis of a spherical dielectric elastomer (DE) balloon subjected to a quasi-statically applied inflation pressure and a Heaviside step voltage across the balloon wall. The proposed technique relies on establishing the energy balance at the point of maximum stretch in an oscillation cycle, followed by the imposition of an instability condition for extracting the threshold parameters. The material models of the Ogden family are employed for describing the hyperelasticity of the balloon. The accuracy of the critical dynamic pull-in parameters is established by examining the saddle-node bifurcation in the transient response of the balloon obtained by integrating numerically the equation of motion, derived using the Euler-Lagrange equation. The parametric study brings out the effect of inflation pressure on the onset of the pull-in instability in the DE balloon. A quantitative comparison between the static and dynamic pull-in parameters at four different levels of the inflation pressure is presented. The results indicate that the dynamic pull-in instability gets triggered at electric fields that are lower than those corresponding to the static instability. The results of the present investigation can find potential use in the design and development of the balloon actuators subjected to transient loading. The method developed is versatile and can be used in the dynamic instability analysis of other conservative systems of interest.

DC dynamic pull-in instability of a dielectric elastomer balloon: an energy-based approach.

PubMed

Sharma, Atul Kumar; Arora, Nitesh; Joglekar, M M

2018-03-01

This paper reports an energy-based method for the dynamic pull-in instability analysis of a spherical dielectric elastomer (DE) balloon subjected to a quasi-statically applied inflation pressure and a Heaviside step voltage across the balloon wall. The proposed technique relies on establishing the energy balance at the point of maximum stretch in an oscillation cycle, followed by the imposition of an instability condition for extracting the threshold parameters. The material models of the Ogden family are employed for describing the hyperelasticity of the balloon. The accuracy of the critical dynamic pull-in parameters is established by examining the saddle-node bifurcation in the transient response of the balloon obtained by integrating numerically the equation of motion, derived using the Euler-Lagrange equation. The parametric study brings out the effect of inflation pressure on the onset of the pull-in instability in the DE balloon. A quantitative comparison between the static and dynamic pull-in parameters at four different levels of the inflation pressure is presented. The results indicate that the dynamic pull-in instability gets triggered at electric fields that are lower than those corresponding to the static instability. The results of the present investigation can find potential use in the design and development of the balloon actuators subjected to transient loading. The method developed is versatile and can be used in the dynamic instability analysis of other conservative systems of interest.

The effect of height and BMI on computer dynamic posturography parameters in women.

PubMed

Olchowik, Grażyna; Tomaszewski, Marek; Olejarz, Piotr; Warchoł, Jan; Różańska-Boczula, Monika

2014-01-01

The human body's posture control is a complex system of organs and mechanisms which controls the body's centre of gravity (COG) over its base of support (BOS). Computerised Dynamic Posturography (CDP) allows for the quantitative and objective assessment of the sensory and motor components of the body's posture control system as well as of the integration and adaptation mechanisms in the central nervous system. The aim of this study was to assess the relationships between the body's height and BMI on CDP results in a group of young healthy women without any clinical symptoms of balance disorders. It was found that the MS depended significantly on the height and BMI of the subjects as well as on the SOT conditions. As the height and BMI increased the MS value decreased. The postural response latency (LC) in the MCT statistically significantly depended only on height and showed a positive correlation. The postural response latency increased with height. The postural response amplitude for both right and left lower limbs significantly depended on height and BMI, but only for the backward movement of the platform. The response amplitude for all platform translations under all MCT conditions increased with height and BMI. The body's resultant imbalance caused by the platform perturbations in the ADT was greater in shorter people and those with a lower BMI.

Bilateral Improvements in Lower Extremity Function After Unilateral Balance Training in Individuals With Chronic Ankle Instability

PubMed Central

Hale, Sheri A.; Fergus, Andrea; Axmacher, Rachel; Kiser, Kimberly

2014-01-01

Context: Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. Objective: To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Design: Cohort study. Setting: University clinical research laboratory. Patients or Other Participants: A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Intervention(s): Balance training twice weekly for 4 weeks. Main Outcome Measure(s): Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. Results: The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Conclusions: Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation. PMID:24568231

Detection and control of combustion instability based on the concept of dynamical system theory.

PubMed

Gotoda, Hiroshi; Shinoda, Yuta; Kobayashi, Masaki; Okuno, Yuta; Tachibana, Shigeru

2014-02-01

We propose an online method of detecting combustion instability based on the concept of dynamical system theory, including the characterization of the dynamic behavior of combustion instability. As an important case study relevant to combustion instability encountered in fundamental and practical combustion systems, we deal with the combustion dynamics close to lean blowout (LBO) in a premixed gas-turbine model combustor. The relatively regular pressure fluctuations generated by thermoacoustic oscillations transit to low-dimensional intermittent chaos owing to the intermittent appearance of burst with decreasing equivalence ratio. The translation error, which is characterized by quantifying the degree of parallelism of trajectories in the phase space, can be used as a control variable to prevent LBO.

Detection and control of combustion instability based on the concept of dynamical system theory

NASA Astrophysics Data System (ADS)

Gotoda, Hiroshi; Shinoda, Yuta; Kobayashi, Masaki; Okuno, Yuta; Tachibana, Shigeru

2014-02-01

We propose an online method of detecting combustion instability based on the concept of dynamical system theory, including the characterization of the dynamic behavior of combustion instability. As an important case study relevant to combustion instability encountered in fundamental and practical combustion systems, we deal with the combustion dynamics close to lean blowout (LBO) in a premixed gas-turbine model combustor. The relatively regular pressure fluctuations generated by thermoacoustic oscillations transit to low-dimensional intermittent chaos owing to the intermittent appearance of burst with decreasing equivalence ratio. The translation error, which is characterized by quantifying the degree of parallelism of trajectories in the phase space, can be used as a control variable to prevent LBO.

Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction.

PubMed

Brunetti, O; Filippi, G M; Lorenzini, M; Liti, A; Panichi, R; Roscini, M; Pettorossi, V E; Cerulli, G

2006-11-01

Surgical reconstruction of the anterior cruciate ligament (ACL) may reduce, but it does not always eliminate, knee and body instability because of a persisting proprioceptive deficit. In order to enhance body stability, a new protocol of treatment has been proposed consisting of mechanical vibration (100 Hz frequency and < 20 microm amplitude) of the quadriceps muscle in the leg that has undergone ACL reconstruction. In our trials, stimulation was performed when the quadriceps muscle was kept isometrically contracted. Treatment was started one month after surgery. Vibration was applied for short periods over three consecutive days. Nine months after treatment, postural stability was re-evaluated with the subjects standing on one leg with open and with closed eyes. The postural stability of the subjects having undergone vibration treatment, standing on the operated leg was significantly improved one day after treatment when evaluated as mean of speed and elliptic area of the center of pressure. The improvement persisted and increased during the following weeks. Peak torques of the operated leg extensor muscles also increased and reached values close to that of the leg, which had not been operated. Conversely, the balance of the untreated subjects standing on the operated leg did not improve and the restoration of the extensor muscle peak torque was poor. It is concluded that short lasting proprioceptive activation by vibration may lead to a faster and more complete equilibrium recovery probably by permanently changing the network controlling knee posture.

The effect of perindopril on postural instability in older people with a history of falls-a randomised controlled trial.

PubMed

Sumukadas, Deepa; Price, Rosemary; McMurdo, Marion E T; Rauchhaus, Petra; Struthers, Allan; McSwiggan, Stephen; Arnold, Graham; Abboud, Rami; Witham, Miles

2018-01-01

double-blind, parallel group, placebo-controlled randomised trial. we recruited people aged >65 years with at least one fall in the previous year. Participants received 4 mg perindopril or placebo daily for 15 weeks. The primary outcome was the between-group difference in force-plate measured anteroposterior (AP) sway at 15 weeks. Secondary outcomes included other measures of postural sway, limits of stability during maximal forward, right and left leaning, blood pressure, muscle strength, 6-min walk distance and falls. The primary outcome was assessed using two-way ANOVA, adjusted for baseline factors. we randomised 80 participants. Mean age was 78.0 (SD 7.4) years; 60 (75%) were female. About 77/80 (96%) completed the trial. At 15 weeks there were no significant between-group differences in AP sway with eyes open (mean difference 0 mm, 95% CI -8 to 7 mm, P = 0.91) or eyes closed (mean difference 2 mm, 95% CI -7 to 12 mm, P = 0.59); no differences in other measures of postural stability, muscle strength or function. About 16/40 (42%) of patients in each group had orthostatic hypotension at follow-up. The median number (IQR) of falls was 1 (0,4) in the perindopril versus 1 (0,2) in the placebo group (P = 0.24). perindopril did not improve postural sway in older people at risk of falls. ISRCTN58995463. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

[Posture and gait disorders and the incidence of falling in patients with Parkinson].

PubMed

Cano-de la Cuerda, R; Macías-Jiménez, A I; Cuadrado-Pérez, M L; Miangolarra-Page, J C; Morales-Cabezas, M

Although falls are one of the main causes of morbidity and mortality in patients with Parkinson's disease, studies about its incidence and predicting factors are scarce. Our study involved 25 patients with PD (15 males and 10 females; age: 75.8 +/- 6.5 years). A closed survey was used to determine a retrospective record of falls during the last year. An analysis was performed to examine whether there was a relationship with Hoehn and Yahr staging, the score on the Up and Go scale or the Barthel index and with possible risk factors for falls. All the patients had suffered falls at some time over the last year (mean number of falls: 6.5 +/- 3.8). 56% of the falls happened during the phases of the day when patient mobility was at its highest. A significant correlation was found between the number of falls and the Hoehn and Yahr and the Up and Go scores. The number of falls was significantly higher in patients with loss of postural reflexes, the need for help in order to walk, and blockage and festination phenomena. No association was found with fear of falling, visual alterations or postural lateralisation. Association with the Barthel index and dependence for activities of daily living reached almost significant levels. Postural instability and disorders affecting gait appear to be the factors that give patients with PD a greater propensity to fall. Patients who present such alterations should be submitted to rehabilitation therapy aimed at preventing them from falling.

The crack effect on instability in a machine tool spindle with gas bearings

NASA Astrophysics Data System (ADS)

Huang, Bo-Wun

2005-09-01

Gas-bearing spindles are required for increased spindle speed in precise machining. Due to manufacturing flaws or cyclic loading, cracks frequently appear in a rotating spindle systems. Cracks markedly affect the dynamic characteristics of rotating machinery. Hence, in this study, high-speed spindles with gas bearings and the crack effect on the instability dynamics are considered. Most investigations on dynamic characteristics of the spindle system were confined to ball-bearing-type spindles. This work examines the dynamic instability in a cracked rotating spindle system with gas bearings. A round Euler-Bernoulli beam is used to approximate the spindle. The Hamilton principle is applied to derive the equation of motion for the spindle system. The effects of crack depth, rotation speed and provided air pressure on the dynamic instability of a rotating spindle system are studied

Use of Video Analysis System for Working Posture Evaluations

NASA Technical Reports Server (NTRS)

McKay, Timothy D.; Whitmore, Mihriban

1994-01-01

In a work environment, it is important to identify and quantify the relationship among work activities, working posture, and workplace design. Working posture may impact the physical comfort and well-being of individuals, as well as performance. The Posture Video Analysis Tool (PVAT) is an interactive menu and button driven software prototype written in Supercard (trademark). Human Factors analysts are provided with a predefined set of options typically associated with postural assessments and human performance issues. Once options have been selected, the program is used to evaluate working posture and dynamic tasks from video footage. PVAT has been used to evaluate postures from Orbiter missions, as well as from experimental testing of prototype glove box designs. PVAT can be used for video analysis in a number of industries, with little or no modification. It can contribute to various aspects of workplace design such as training, task allocations, procedural analyses, and hardware usability evaluations. The major advantage of the video analysis approach is the ability to gather data, non-intrusively, in restricted-access environments, such as emergency and operation rooms, contaminated areas, and control rooms. Video analysis also provides the opportunity to conduct preliminary evaluations of existing work areas.

A comparison of low back kinetic estimates obtained through posture matching, rigid link modeling and an EMG-assisted model.

PubMed

Parkinson, R J; Bezaire, M; Callaghan, J P

2011-07-01

This study examined errors introduced by a posture matching approach (3DMatch) relative to dynamic three-dimensional rigid link and EMG-assisted models. Eighty-eight lifting trials of various combinations of heights (floor, 0.67, 1.2 m), asymmetry (left, right and center) and mass (7.6 and 9.7 kg) were videotaped while spine postures, ground reaction forces, segment orientations and muscle activations were documented and used to estimate joint moments and forces (L5/S1). Posture matching over predicted peak and cumulative extension moment (p < 0.0001 for all variables). There was no difference between peak compression estimates obtained with posture matching or EMG-assisted approaches (p = 0.7987). Posture matching over predicted cumulative (p < 0.0001) compressive loading due to a bias in standing, however, individualized bias correction eliminated the differences. Therefore, posture matching provides a method to analyze industrial lifting exposures that will predict kinetic values similar to those of more sophisticated models, provided necessary corrections are applied. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

An Extended Passive Motion Paradigm for Human-Like Posture and Movement Planning in Redundant Manipulators

PubMed Central

Tommasino, Paolo; Campolo, Domenico

2017-01-01

A major challenge in robotics and computational neuroscience is relative to the posture/movement problem in presence of kinematic redundancy. We recently addressed this issue using a principled approach which, in conjunction with nonlinear inverse optimization, allowed capturing postural strategies such as Donders' law. In this work, after presenting this general model specifying it as an extension of the Passive Motion Paradigm, we show how, once fitted to capture experimental postural strategies, the model is actually able to also predict movements. More specifically, the passive motion paradigm embeds two main intrinsic components: joint damping and joint stiffness. In previous work we showed that joint stiffness is responsible for static postures and, in this sense, its parameters are regressed to fit to experimental postural strategies. Here, we show how joint damping, in particular its anisotropy, directly affects task-space movements. Rather than using damping parameters to fit a posteriori task-space motions, we make the a priori hypothesis that damping is proportional to stiffness. This remarkably allows a postural-fitted model to also capture dynamic performance such as curvature and hysteresis of task-space trajectories during wrist pointing tasks, confirming and extending previous findings in literature. PMID:29249954

Finite elements and fluid dynamics. [instability effects on solution of nonlinear equations

NASA Technical Reports Server (NTRS)

Fix, G.

1975-01-01

Difficulties concerning a use of the finite element method in the solution of the nonlinear equations of fluid dynamics are partly related to various 'hidden' instabilities which often arise in fluid calculations. The instabilities are typically due to boundary effects or nonlinearities. It is shown that in certain cases these instabilities can be avoided if certain conservation laws are satisfied, and that the latter are often intimately related to finite elements.

Development of Testing Methodologies to Evaluate Postflight Locomotor Performance

NASA Technical Reports Server (NTRS)

Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Richards, J. T.; Miller, C. A.; Brady, R.; Warren, L. E.; Bloomberg, J. J.

2006-01-01

Crewmembers experience locomotor and postural instabilities during ambulation on Earth following their return from space flight. Gait training programs designed to facilitate recovery of locomotor function following a transition to a gravitational environment need to be accompanied by relevant assessment methodologies to evaluate their efficacy. The goal of this paper is to demonstrate the operational validity of two tests of locomotor function that were used to evaluate performance after long duration space flight missions on the International Space Station (ISS).

The Transition to an Independent Southern Sudan: How Should the U.S. Military Posture to Influence and Deter Factors that May Cause Regional Instability?

DTIC Science & Technology

2011-06-10

recognizes as freedom fighters (Ibid.). Most likely for the above reasons, the DOS has refrained from removing the 17 year old designation of State...extreme Islamic models as a way to fight the radicalism. Malwal believes the Egyptian government will continue to support the NCP post -referendum...system in support of its energy concerns (Dagne 2010). Furthermore, according to an April 2010 Congressional Reseach Paper, China not only has provided

Estimation of an Optimal Stimulus Amplitude for Using Vestibular Stochastic Stimulation to Improve Balance Function

NASA Technical Reports Server (NTRS)

Goel, R.; Kofman, I.; DeDios, Y. E.; Jeevarajan, J.; Stepanyan, V.; Nair, M.; Congdon, S.; Fregia, M.; Peters, B.; Cohen, H.;

Aquatic rehabilitation for the treatment of neurological disorders.

PubMed

Morris, D M

1994-01-01

Patients with neurological disorders present therapists with complex challenges for treatment, including weakness, hypertonicity, voluntary movement deficit, limited range of motion, sensory loss, incoordination, and postural instability. The presence of one or more of these impairments negatively influences these patients by contributing to problems in walking, transferring, and reaching. Aquatic rehabilitation offers a unique, versatile approach to the treatment of these disabilities. This article examines the problems encountered by patients with neurological disorders, general principles guiding neurotreatment, and aquatic neurorehabilitation approaches.

Human posture in microgravity: An experiment on EUROMIR '95 to verify and improve a simulation tool

NASA Astrophysics Data System (ADS)

Colford, Nicholas; Giorgi, Pier Luigi; Gaia, Enrico; Cotronei, Vittorio

1995-10-01

An anthropometric mannequin implemented in robotic modelling software has proved very useful in the simulation of static and semi-dynamic reachability envelopes. Its prediction of working postures has been verified to some extent during neutral buoyancy trials. While a robotic solution is useful for static analyses or rough estimates of simple movements, more realistic movement strategies need to be identified directly measuring astronauts' in-orbit behaviour. A set of experiments is to be performed as part of the EUROMIR '95 mission to the MIR orbiting station in which dynamic posture (i.e. posture and movement) measurements will be taken using the ELITE system. The data and analyses of the data will be used to animate the Alenia anthopometric mannequin and to develop movement algorithms more similar to those of a person in microgravity than the robotic solutions currently employed. This paper presents the experiments to be performed and the changes to Alenia's mannequin that will allow the model to effect movements according to the experimental results. It is aimed at expanding the dialog between the biomechanical and human factors disciplines started in this experiment to other potential end-users of the experimental results.

Minimalist, standard and no footwear on static and dynamic postural stability following jump landing.

PubMed

Zech, Astrid; Argubi-Wollesen, Andreas; Rahlf, Anna-Lina

2015-01-01

In recreational sports, uncushioned, light-weight and minimalist shoes are increasingly used to imitate barefoot situations. Uncertainty exists whether these shoes provide sufficient stability during challenging movements. In this randomised crossover study, 35 healthy distance runners performed jump landing stabilisation and single-leg stance tests on a force plate, using four conditions in random order: barefoot, uncushioned minimalist shoes, cushioned ultraflexible shoes and standard running shoes. Ground reaction force (GRF) and centre of pressure (COP) data were used to determine unilateral jump landing stabilisation time and COP sway velocity during single-leg stance. Repeated measures analysis of variance revealed significant footwear interactions for medial-lateral (p < 0.001) and anterior-posterior COP sway velocity during standing (p < 0.001). The barefoot condition produced significantly greater postural sway velocities (p < 0.001) compared to all footwear conditions. No significant effects were found for jump landing stabilisation time. In conclusion, the results of this study indicate that increased shoe flexibility and reduced sole support have no, or only minor influence on static and dynamic postural control, and therefore, may not increase the risk of traumatic events during sports activities. However, barefoot conditions should be considered carefully when adequate postural control is needed.

Management and prevention of acute and chronic lateral ankle instability in athletic patient populations

PubMed Central

McCriskin, Brendan J; Cameron, Kenneth L; Orr, Justin D; Waterman, Brian R

2015-01-01

Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significant long-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and non-anatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance. PMID:25793157

Management and prevention of acute and chronic lateral ankle instability in athletic patient populations.

PubMed

McCriskin, Brendan J; Cameron, Kenneth L; Orr, Justin D; Waterman, Brian R

2015-03-18

Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significant long-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and non-anatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.

TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia.

PubMed

Rasouli, Omid; Stensdotter, Ann-Katrin; Van der Meer, Audrey L H

2016-08-01

Impaired postural control has been reported in static conditions in chronic fatigue syndrome and fibromyalgia, but postural control in dynamic tasks have not yet been investigated. Thus, we investigated measurements from a force plate to evaluate dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia compared to matched healthy controls. Thirty female participants (10 per group) performed five trials of gait initiation. Center of pressure (CoP) trajectory of the initial weight shift onto the supporting foot in the mediolateral direction (CoPX) was analyzed using General Tau Theory. We investigated the hypothesis that tau of the CoPX motion-gap (τCoPx) is coupled onto an intrinsic tauG-guide (τG) by keeping the relation τCoPx=KτG, where K is a scaling factor that determines the relevant kinematics of a movement. Mean K values were 0.57, 0.55, and 0.50 in fibromyalgia, chronic fatigue syndrome, and healthy controls, respectively. Both patient groups showed K values significantly higher than 0.50 (P<0.05), indicating that patients showed poorer dynamic balance control, CoPX colliding with the boundaries of the base of support (K>0.5). The findings revealed a lower level of dynamic postural control in both fibromyalgia and chronic fatigue syndrome compared to controls. Copyright © 2016 Elsevier Ltd. All rights reserved.

Leisure sports and postural control: can a black belt protect your balance from aging?

PubMed

Krampe, Ralf T; Smolders, Caroline; Doumas, Michail

2014-03-01

To determine potential benefits of intensive leisure sports for age-related changes in postural control, we tested 3 activity groups comprising 70 young (M = 21.67 years, SD = 2.80) and 73 older (M = 62.60 years, SD = 5.19) men. Activity groups were martial artists, who held at least 1st Dan (black belt), sportive individuals exercising sports without explicit balance components, and nonsportive controls. Martial artists had an advantage over sportive individuals in dynamic posture tasks (upright stance on a sway-referenced platform), and these 2 active groups showed better postural control than nonsportive participants. Age-related differences in postural control were larger in nonsportive men compared with the 2 active groups, who were similar in this respect. In contrast, negative age differences in other sensorimotor and cognitive functions did not differ between activity groups. We concluded that individuals engaging in intensive recreational sports have long-term advantages in postural control. However, even in older martial artists with years of practice in their sports, we observed considerable differences favoring the young. (c) 2014 APA, all rights reserved.

Can Tai Chi and Qigong Postures Shape Our Mood? Toward an Embodied Cognition Framework for Mind-Body Research

PubMed Central

Osypiuk, Kamila; Thompson, Evan; Wayne, Peter M.

2018-01-01

Dynamic and static body postures are a defining characteristic of mind-body practices such as Tai Chi and Qigong (TCQ). A growing body of evidence supports the hypothesis that TCQ may be beneficial for psychological health, including management and prevention of depression and anxiety. Although a variety of causal factors have been identified as potential mediators of such health benefits, physical posture, despite its visible prominence, has been largely overlooked. We hypothesize that body posture while standing and/or moving may be a key therapeutic element mediating the influence of TCQ on psychological health. In the present paper, we summarize existing experimental and observational evidence that suggests a bi-directional relationship between body posture and mental states. Drawing from embodied cognitive science, we provide a theoretical framework for further investigation into this interrelationship. We discuss the challenges involved in such an investigation and propose suggestions for future studies. Despite theoretical and practical challenges, we propose that the role of posture in mind-body exercises such as TCQ should be considered in future research. PMID:29765313

Can Tai Chi and Qigong Postures Shape Our Mood? Toward an Embodied Cognition Framework for Mind-Body Research.

PubMed

Osypiuk, Kamila; Thompson, Evan; Wayne, Peter M

2018-01-01

Dynamic and static body postures are a defining characteristic of mind-body practices such as Tai Chi and Qigong (TCQ). A growing body of evidence supports the hypothesis that TCQ may be beneficial for psychological health, including management and prevention of depression and anxiety. Although a variety of causal factors have been identified as potential mediators of such health benefits, physical posture, despite its visible prominence, has been largely overlooked. We hypothesize that body posture while standing and/or moving may be a key therapeutic element mediating the influence of TCQ on psychological health. In the present paper, we summarize existing experimental and observational evidence that suggests a bi-directional relationship between body posture and mental states. Drawing from embodied cognitive science, we provide a theoretical framework for further investigation into this interrelationship. We discuss the challenges involved in such an investigation and propose suggestions for future studies. Despite theoretical and practical challenges, we propose that the role of posture in mind-body exercises such as TCQ should be considered in future research.

Rotordynamic Instability Problems in High-Performance Turbomachinery

NASA Technical Reports Server (NTRS)

1982-01-01

Rotor dynamic instability problems in high performance turbomachinery are reviewed. Mechanical instability mechanisms are discussed. Seal forces and working fluid forces in turbomachinery are discussed. Control of rotor instability is also investigated.

Reconstructed phase spaces of intrinsic mode functions. Application to postural stability analysis.

PubMed

Snoussi, Hichem; Amoud, Hassan; Doussot, Michel; Hewson, David; Duchêne, Jacques

2006-01-01

In this contribution, we propose an efficient nonlinear analysis method characterizing postural steadiness. The analyzed signal is the displacement of the centre of pressure (COP) collected from a force plate used for measuring postural sway. The proposed method consists of analyzing the nonlinear dynamics of the intrinsic mode functions (IMF) of the COP signal. The nonlinear properties are assessed through the reconstructed phase spaces of the different IMFs. This study shows some specific geometries of the attractors of some intrinsic modes. Moreover, the volume spanned by the geometric attractors in the reconstructed phase space represents an efficient indicator of the postural stability of the subject. Experiments results corroborate the effectiveness of the method to blindly discriminate young subjects, elderly subjects and subjects presenting a risk of falling.

Revisiting the body-schema concept in the context of whole-body postural-focal dynamics.

PubMed

Morasso, Pietro; Casadio, Maura; Mohan, Vishwanathan; Rea, Francesco; Zenzeri, Jacopo

2015-01-01

The body-schema concept is revisited in the context of embodied cognition, further developing the theory formulated by Marc Jeannerod that the motor system is part of a simulation network related to action, whose function is not only to shape the motor system for preparing an action (either overt or covert) but also to provide the self with information on the feasibility and the meaning of potential actions. The proposed computational formulation is based on a dynamical system approach, which is linked to an extension of the equilibrium-point hypothesis, called Passive Motor Paradigm: this dynamical system generates goal-oriented, spatio-temporal, sensorimotor patterns, integrating a direct and inverse internal model in a multi-referential framework. The purpose of such computational model is to operate at the same time as a general synergy formation machinery for planning whole-body actions in humanoid robots and/or for predicting coordinated sensory-motor patterns in human movements. In order to illustrate the computational approach, the integration of simultaneous, even partially conflicting tasks will be analyzed in some detail with regard to postural-focal dynamics, which can be defined as the fusion of a focal task, namely reaching a target with the whole-body, and a postural task, namely maintaining overall stability.

Revisiting the Body-Schema Concept in the Context of Whole-Body Postural-Focal Dynamics

PubMed Central

Morasso, Pietro; Casadio, Maura; Mohan, Vishwanathan; Rea, Francesco; Zenzeri, Jacopo

2015-01-01

The body-schema concept is revisited in the context of embodied cognition, further developing the theory formulated by Marc Jeannerod that the motor system is part of a simulation network related to action, whose function is not only to shape the motor system for preparing an action (either overt or covert) but also to provide the self with information on the feasibility and the meaning of potential actions. The proposed computational formulation is based on a dynamical system approach, which is linked to an extension of the equilibrium-point hypothesis, called Passive Motor Paradigm: this dynamical system generates goal-oriented, spatio-temporal, sensorimotor patterns, integrating a direct and inverse internal model in a multi-referential framework. The purpose of such computational model is to operate at the same time as a general synergy formation machinery for planning whole-body actions in humanoid robots and/or for predicting coordinated sensory–motor patterns in human movements. In order to illustrate the computational approach, the integration of simultaneous, even partially conflicting tasks will be analyzed in some detail with regard to postural-focal dynamics, which can be defined as the fusion of a focal task, namely reaching a target with the whole-body, and a postural task, namely maintaining overall stability. PMID:25741274

Spatiotemporal chaos in the dynamics of buoyantly and diffusively unstable chemical fronts

NASA Astrophysics Data System (ADS)

Baroni, M. P. M. A.; Guéron, E.; De Wit, A.

2012-03-01

Nonlinear dynamics resulting from the interplay between diffusive and buoyancy-driven Rayleigh-Taylor (RT) instabilities of autocatalytic traveling fronts are analyzed numerically for various values of the relevant parameters. These are the Rayleigh numbers of the reactant A and autocatalytic product B solutions as well as the ratio D =DB/DA between the diffusion coefficients of the two key chemical species. The interplay between the coarsening dynamics characteristic of the RT instability and the constant short wavelength modulation of the diffusive instability can lead in some regimes to complex dynamics dominated by irregular succession of birth and death of fingers. By using spectral entropy measurements, we characterize the transition between order and spatial disorder in this system. The analysis of the power spectrum and autocorrelation function, moreover, identifies similarities between the various spatial patterns. The contribution of the diffusive instability to the complex dynamics is discussed.

Prediction of postural risk of fall initiation based on a two-variable description of body dynamics: position and velocity of center of mass.

PubMed

Honarvar, Mohammad Hadi; Nakashima, Motomu

2013-10-01

This research addresses the question: what is the risk of fall initiation at a certain human posture? There are postures from which no one is able to keep their balance and a fall will surely initiate (risk=1), and others from which everyone may regain their stability (risk=0). In other postures, only a portion of people can control their stability. One may interpret risk to chance of a fall to be initiated, and based on the portion of fallers assign a risk value to a given human posture (postural risk). Human posture can be mapped to a point in a 2-dimensional space: the x-v plane, the axes of which are horizontal components of the position and velocity of the center of mass of the body. For every pair of (x, v), the outcome of the balance recovery problem defines whether a person with a given strength level is able to regain their stability when released from a posture corresponding to that point. Using strength distribution data, we estimated the portion of the population who will initiate a fall if starting at a certain posture. A fast calculation approach is also introduced to replace the time-consuming method of solving the recovery problem many times. Postural risk of fall initiation for situations expressed by (x, v) pairs for the entire x-v plane is calculated and shown in a color-map. Copyright © 2013 Elsevier B.V. All rights reserved.

Regulation of dynamic postural control to attend manual steadiness constraints.

PubMed

Teixeira, Luis Augusto; Coutinho, Joane Figueiredo Serpa; Coelho, Daniel Boari

2018-05-02

In daily living activities, performance of spatially accurate manual movements in upright stance depends on postural stability. In the present investigation, we aimed to evaluate the effect of the required manual steadiness (task constraint) on the regulation of dynamic postural control. A single group of young participants (n=20) were evaluated in the performance of a dual posturo-manual task of balancing on a platform oscillating in sinusoidal translations at 0.4 Hz (low) or 1 Hz (high) frequencies while stabilizing a cylinder on a handheld tray. Manual task constraint was manipulated by comparing the conditions of keeping the cylinder stationary on its flat or round side, corresponding to low and high manual task constraints, respectively. Results showed that in the low oscillation frequency the high manual task constraint led to lower oscillation amplitudes of the head, center of mass, and tray, in addition to higher relative phase values between ankle/hip-shoulder oscillatory rotations and between center of mass/center of pressure-feet oscillations as compared to values observed in the low manual task constraint. Further analyses showed that the high manual task constraint also affected variables related to both postural (increased amplitudes of center of pressure oscillation) and manual (increased amplitude of shoulder rotations) task components in the high oscillation frequency. These results suggest that control of a dynamic posturo-manual task is modulated in distinct parameters to attend the required manual steadiness in a complex and flexible way.

Postural Performance and Strategy in the Unipedal Stance of Soccer Players at Different Levels of Competition

PubMed Central

Paillard, Thierry; Noé, Frédéric; Rivière, Terence; Marion, Vincent; Montoya, Richard; Dupui, Philippe

2006-01-01

Context: Sport training enhances the ability to use somatosensory and otolithic information, which improves postural capabilities. Postural changes are different according to the sport practiced, but few authors have analyzed subjects' postural performances to discriminate the expertise level among highly skilled athletes within a specific discipline. Objective: To compare the postural performance and the postural strategy between soccer players at different levels of competition (national and regional). Design: Repeated measures with 1 between-groups factor (level of competition: national or regional) and 1 within-groups factor (vision: eyes open or eyes closed). Dependent variables were center-of-pressure surface area and velocity; total spectral energy; and percentage of low-, medium-, and high-frequency band. Setting: Sports performance laboratory. Patients or Other Participants: Fifteen national male soccer players (age = 24 ± 3 years, height = 179 ± 5 cm, mass = 72 ± 3 kg) and 15 regional male soccer players (age = 23 ± 3 years, height = 174 ± 4 cm, mass = 68 ± 5 kg) participated in the study. Intervention(s): The subjects performed posturographic tests with eyes open and closed. Main Outcome Measure(s): While subjects performed static and dynamic posturographic tests, we measured the center of foot pressure on a force platform. Spatiotemporal center-of-pressure measurements were used to evaluate the postural performance, and a frequency analysis of the center-of-pressure excursions (fast Fourier transform) was conducted to estimate the postural strategy. Results: Within a laboratory task, national soccer players produced better postural performances than regional players and had a different postural strategy. The national players were more stable than the regional players and used proprioception and vision information differently. Conclusions: In the test conditions specific to playing soccer, level of playing experience influenced postural control performance measures and strategies. PMID:16791302

Postural performance and strategy in the unipedal stance of soccer players at different levels of competition.

PubMed

Paillard, Thierry; Noé, Frédéric; Rivière, Terence; Marion, Vincent; Montoya, Richard; Dupui, Philippe

2006-01-01

Sport training enhances the ability to use somatosensory and otolithic information, which improves postural capabilities. Postural changes are different according to the sport practiced, but few authors have analyzed subjects' postural performances to discriminate the expertise level among highly skilled athletes within a specific discipline. To compare the postural performance and the postural strategy between soccer players at different levels of competition (national and regional). Repeated measures with 1 between-groups factor (level of competition: national or regional) and 1 within-groups factor (vision: eyes open or eyes closed). Dependent variables were center-of-pressure surface area and velocity; total spectral energy; and percentage of low-, medium-, and high-frequency band. Sports performance laboratory. Fifteen national male soccer players (age = 24 +/- 3 years, height = 179 +/- 5 cm, mass = 72 +/- 3 kg) and 15 regional male soccer players (age = 23 +/- 3 years, height = 174 +/- 4 cm, mass = 68 +/- 5 kg) participated in the study. The subjects performed posturographic tests with eyes open and closed. While subjects performed static and dynamic posturographic tests, we measured the center of foot pressure on a force platform. Spatiotemporal center-of-pressure measurements were used to evaluate the postural performance, and a frequency analysis of the center-of-pressure excursions (fast Fourier transform) was conducted to estimate the postural strategy. Within a laboratory task, national soccer players produced better postural performances than regional players and had a different postural strategy. The national players were more stable than the regional players and used proprioception and vision information differently. In the test conditions specific to playing soccer, level of playing experience influenced postural control performance measures and strategies.

Does Kinesiology tape counter exercise-related impairments of balance in the elderly?

PubMed

Hosp, Simona; Csapo, Robert; Heinrich, Dieter; Hasler, Michael; Nachbauer, Werner

2018-05-01

Maintaining balance is an essential requirement for the performance of daily tasks and sporting activities, particularly in older adults to prevent falls and associated injuries. Kinesiology tape has gained great popularity in sports and is frequently used as a tool for performance enhancement. However, there is little research investigating its influence on balance. The purpose of this study was to evaluate the effect of Kinesiology tape on dynamic balance, postural stability and knee proprioception after physical activity in healthy, older adults. Twelve physically active, healthy men aged 63-77 years performed the test on two separate days, with and without Kinesiology tape at the knee joint (prospective intervention with cross-over design). Dynamic balance during an obstacle-crossing task, postural stability in a single-leg stance test, and knee joint position sense as a measure of proprioception were examined before and after 30 min of downhill walking on a treadmill. The influences of taping condition and physical activity on all parameters were statistically tested using factorial ANOVAs. Factorial ANOVA revealed significant time × taping condition interaction effects on all performance parameters (p < 0.05), indicating that the exercise-related changes in dynamic balance, postural stability and knee proprioception differed between the two taping conditions. The deterioration of performance was always greater when no tape was used. This study demonstrated that physical exercise significantly deteriorated dynamic balance, postural stability and knee proprioception in older men. These effects can be attenuated through the usage of Kinesiology tape. By preventing exercise-related impairments of balance, Kinesiology tape might help reduce the risk of sports-associated falls and associated injuries. Copyright © 2018 Elsevier B.V. All rights reserved.

Relation between risk of falling and postural sway complexity in diabetes.

PubMed

Morrison, S; Colberg, S R; Parson, H K; Vinik, A I

2012-04-01

For older individuals with diabetes, any decline in balance control can be especially problematic since it is often a precursor to an increased risk of falling. This study was designed to evaluate differences in postural motion dynamics and falls risk for older individuals with type 2 diabetes (T2DM) classified as fallers/non-fallers and, to assess what impact exercise has on balance and falls risk. The results demonstrated that the risk of falling is greater for those older individuals with multiple risk factors including diabetes and a previous falls history. The postural motion features of the high-risk individuals (T2DM-fallers) were also different, being characterized by increased variability and complexity, increased AP-ML coupling, less overall COP motion and increased velocity. One suggestion is that these individuals evoked a stiffening strategy during the more challenging postural tasks. Following training, a decline in falls risk was observed for all groups, with this effect being most pronounced for the T2DM-fallers. Interestingly, the COP motion of this group became more similar to controls, exhibiting decreased complexity and variability, and decreased velocity. The reciprocal changes in COP complexity support the broader view that age/disease-related changes in physiological complexity are bi-directional. Overall, these results show that, even for older T2DM individuals at greater risk of falling, targeted interventions can positively enhance their postural dynamics. Further, the finding that the pattern of postural motion variability and complexity was altered highlights that a decline in physiological complexity may not always be negatively associated with aging and/or disease. Copyright © 2011 Elsevier B.V. All rights reserved.

Effects of physical and sporting activities on balance control in elderly people

PubMed Central

Perrin, P. P.; Gauchard, G. C.; Perrot, C.; Jeandel, C.

1999-01-01

OBJECTIVE: Balance disorders increase with aging and raise the risk of accidental falls in the elderly. It has been suggested that the practice of physical and sporting activities (PSA) efficiently counteracts these age related disorders, reducing the risk of falling significantly. METHODS: This study, principally based on a period during which the subjects were engaged in PSA, included 65 healthy subjects, aged over 60, who were living at home. Three series of posturographic tests (static, dynamic with a single and fast upward tilt, and dynamic with slow sinusoidal oscillations) analysing the centre of foot pressure displacements or electromyographic responses were conducted to determine the effects of PSA practice on balance control. RESULTS: The major variables of postural control were best in subjects who had always practised PSA (AA group). Those who did not take part in PSA at all (II group) had the worst postural performances, whatever the test. Subjects having lately begun PSA practice (IA group) had good postural performances, close to those of the AA group, whereas the subjects who had stopped the practice of PSA at an early age (AI group) did not perform as well. Overall, the postural control in the group studied decreased in the order AA > IA > AI > II. CONCLUSIONS: The period during which PSA are practised seems to be of major importance, having a positive bearing on postural control. It seems that recent periods of practice have greater beneficial effects on the subject's postural stability than PSA practice only at an early age. These data are compatible with the fact that PSA are extremely useful for elderly people even if it has not been a lifelong habit. 


 PMID:10205695

Ventricular dilation as an instability of intracranial dynamics

NASA Astrophysics Data System (ADS)

Bouzerar, R.; Ambarki, K.; Balédent, O.; Kongolo, G.; Picot, J. C.; Meyer, M. E.

2005-11-01

We address the question of the ventricles’ dilation as a possible instability of the intracranial dynamics. The ventricular system is shown to be governed by a dynamical equation derived from first principles. This general nonlinear scheme is linearized around a well-defined steady state which is mapped onto a pressure-volume model with an algebraic effective compliance depending on the ventricles’ geometry, the ependyma’s elasticity, and the cerebrospinal fluid (CSF) surface tension. Instabilities of different natures are then evidenced. A first type of structural instability results from the compelling effects of the CSF surface tension and the elastic properties of the ependyma. A second type of dynamical instability occurs for low enough values of the aqueduct’s conductance. This last case is then shown to be accompanied by a spontaneous ventricle’s dilation. A strong correlation with some active hydrocephalus is evidenced and discussed. The transfer function of the ventricles, compared to a low-pass filter, are calculated in both the stable and unstable regimes and appear to be very different.

Effects of a two-school-year multifactorial back education program in elementary schoolchildren.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-08-01

A quasi-experimental pre/post design. To investigate effects of a 2-school-year multifactorial back education program on back posture knowledge and postural behavior in elementary schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance beliefs were evaluated. Epidemiologic studies report mounting nonspecific back pain prevalence among youngsters, characterized by multifactorial risk factors. Study findings of school-based interventions are promising. Furthermore, biomechanical discomfort is found in the school environment. The study sample included 193 intervention children and 172 controls (baseline, 9-to-11-year-olds). The multifactorial intervention consisted of a back education program and the stimulation of postural dynamism in the class through support and environmental changes. Evaluation consisted of a questionnaire, an observation of postural behavior in the classroom, and an observation of material handling during a movement session. The intervention resulted in increased back posture knowledge (P < 0.001), improved postural behavior during material handling (P < 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P < 0.05) during lesson time. The intervention did not change fear-avoidance beliefs. There was a trend for decreased pain reports in boys of the intervention group (P < 0.09). The intervention resulted in improved postural aspects related to spinal loading. The long-term effect of improved postural behavior at young age on back pain prevalence later in life is of interest for future research.

Saw-tooth instability in storage rings: simulations and dynamical model

NASA Astrophysics Data System (ADS)

Migliorati, M.; Palumbo, L.; Dattoli, G.; Mezi, L.

1999-11-01

The saw-tooth instability in storage rings is studied by means of a time-domain simulation code which takes into account the self-induced wake fields. The results are compared with those from a dynamical heuristic model exploiting two coupled non-linear differential equations, accounting for the time behavior of the instability growth rate and for the anomalous growth of the energy spread. This model is shown to reproduce the characteristic features of the instability in a fairly satisfactory way.

Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability: A Prospective Cohort Analysis.

PubMed

Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

2016-04-01

Impairments in motor control may predicate the paradigm of chronic ankle instability (CAI) that can develop in the year after an acute lateral ankle sprain (LAS) injury. No prospective analysis is currently available identifying the mechanisms by which these impairments develop and contribute to long-term outcome after LAS. To identify the motor control deficits predicating CAI outcome after a first-time LAS injury. Cohort study (diagnosis); Level of evidence, 2. Eighty-two individuals were recruited after sustaining a first-time LAS injury. Several biomechanical analyses were performed for these individuals, who completed 5 movement tasks at 3 time points: (1) 2 weeks, (2) 6 months, and (3) 12 months after LAS occurrence. A logistic regression analysis of several "salient" biomechanical parameters identified from the movement tasks, in addition to scores from the Cumberland Ankle Instability Tool and the Foot and Ankle Ability Measure (FAAM) recorded at the 2-week and 6-month time points, were used as predictors of 12-month outcome. At the 2-week time point, an inability to complete 2 of the movement tasks (a single-leg drop landing and a drop vertical jump) was predictive of CAI outcome and correctly classified 67.6% of cases (sensitivity, 83%; specificity, 55%; P = .004). At the 6-month time point, several deficits exhibited by the CAI group during 1 of the movement tasks (reach distances and sagittal plane joint positions at the hip, knee and ankle during the posterior reach directions of the Star Excursion Balance Test) and their scores on the activities of daily living subscale of the FAAM were predictive of outcome and correctly classified 84.8% of cases (sensitivity, 75%; specificity, 91%; P < .001). An inability to complete jumping and landing tasks within 2 weeks of a first-time LAS and poorer dynamic postural control and lower self-reported function 6 months after a first-time LAS were predictive of eventual CAI outcome. © 2016 The Author(s).

Postural Change Effects on Infants' AB Task Performance: Visual, Postural, or Spatial?

ERIC Educational Resources Information Center

Lew, Adina R.; Hopkins, Brian; Owen, Laura H.; Green, Michael

2007-01-01

Smith and colleagues (Smith, L. B., Thelen, E., Titzer, R., & McLin, D. (1999). Knowing in the context of acting: The task dynamics of the A-not-B error. "Psychological Review, 106," 235-260) demonstrated that 10-month-olds succeed on a Piagetian AB search task if they are moved from a sitting position to a standing position between A and B…

Trunk muscle exercises as a means of improving postural stability in people with Parkinson's disease: a protocol for a randomised controlled trial.

PubMed

Hubble, Ryan P; Naughton, Geraldine A; Silburn, Peter A; Cole, Michael H

2014-12-31

Exercise has been shown to improve clinical measures of strength, balance and mobility, and in some cases, has improved symptoms of tremor and rigidity in people with Parkinson's disease (PD). However, to date, no research has examined whether improvements in trunk control can remedy deficits in dynamic postural stability in this population. The proposed randomised controlled trial aims to establish whether a 12-week exercise programme aimed at improving dynamic postural stability in people with PD; (1) is more effective than education; (2) is more effective when training frequency is increased; and (3) provides greater long-term benefits than education. Forty-five community-dwelling individuals diagnosed with idiopathic PD with a falls history will be recruited. Participants will complete baseline assessments including tests of cognition, vision, disease severity, fear of falling, mobility and quality of life. Additionally, participants will complete a series of standing balance tasks to evaluate static postural stability, while dynamic postural control will be measured during walking using head and trunk-mounted three-dimensional accelerometers. Following baseline testing, participants will be randomly-assigned to one of three intervention groups, who will receive either exercise once per week, exercise 3 days/week, or education. Participants will repeat the same battery of tests conducted at baseline after the 12-week intervention and again following a further 12-week sustainability period. This study has the potential to show that low-intensity and progressive trunk exercises can provide a non-invasive and effective means for maintaining or improving postural stability for people with PD. Importantly, if the programme is noted to be effective, it could be easily performed by patients within their home environment or under the guidance of available allied health professionals. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001175763). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Posture and equilibrium in orthopedic and rheumatologic diseases.

PubMed

Missaoui, B; Portero, P; Bendaya, S; Hanktie, O; Thoumie, P

2008-12-01

Posture and balance may be affected in many spine or lower-limb disorders. An extensive evaluation including clinical tests and movement analysis techniques may be necessary to characterize how rheumatologic or orthopedic diseases are related to static or dynamic changes in postural control. In lower limbs, unbalance may be related to a decreased stability following arthrosis or ligament injuries at knee or ankle levels, while hip lesions appear less associated with such troubles. Spinal diseases at cervical level are frequently associated with postural changes and impaired balance control, related to the major role of sensory inputs during stance and gait. At lower levels, changes are noticed in major scoliosis and may be related to pain intensity in patients with chronic low-back pain. Whatever the initial lesion and the affected level, improvement in clinical or instrumental tests following rehabilitation or brace wearing provides argument for a close relationship between rheumatologic or orthopedic diseases and related impairments in posture and balance control.

Computerized dynamic posturography: the influence of platform stability on postural control.

PubMed

Palm, Hans-Georg; Lang, Patricia; Strobel, Johannes; Riesner, Hans-Joachim; Friemert, Benedikt

2014-01-01

Postural stability can be quantified using posturography systems, which allow different foot platform stability settings to be selected. It is unclear, however, how platform stability and postural control are mathematically correlated. Twenty subjects performed tests on the Biodex Stability System at all 13 stability levels. Overall stability index, medial-lateral stability index, and anterior-posterior stability index scores were calculated, and data were analyzed using analysis of variance and linear regression analysis. A decrease in platform stability from the static level to the second least stable level was associated with a linear decrease in postural control. The overall stability index scores were 1.5 ± 0.8 degrees (static), 2.2 ± 0.9 degrees (level 8), and 3.6 ± 1.7 degrees (level 2). The slope of the regression lines was 0.17 for the men and 0.10 for the women. A linear correlation was demonstrated between platform stability and postural control. The influence of stability levels seems to be almost twice as high in men as in women.

Hemispheric mechanisms controlling voluntary and spontaneous facial expressions.

PubMed

Gazzaniga, M S; Smylie, C S

1990-01-01

The capacity of each disconnected cerebral hemisphere to control a variety of facial postures was examined in three split-brain patients. The dynamics of facial posturing were analyzed in 30-msec optical disc frames that were generated off videotape recordings of each patient's response to lateralized stimuli. The results revealed that commands presented to the left hemisphere effecting postures of the lower facial muscles showed a marked asymmetry, with the right side of the face sometimes responding up to 180 msec before the left side of the face. Commands presented to the right hemisphere elicited a response only if the posture involved moving the upper facial muscles. Spontaneous postures filmed during free conversation were symmetrical. The results suggest that while either hemisphere can generate spontaneous facial expressions only the left hemisphere is efficient at generating voluntaly expressions. This contrasts sharply with the fact that both hemispheres can carry out a wide variety of other voluntary movements with the hand and foot.

Learning an Intermittent Control Strategy for Postural Balancing Using an EMG-Based Human-Computer Interface

PubMed Central

Asai, Yoshiyuki; Tateyama, Shota; Nomura, Taishin

2013-01-01

It has been considered that the brain stabilizes unstable body dynamics by regulating co-activation levels of antagonist muscles. Here we critically reexamined this established theory of impedance control in a postural balancing task using a novel EMG-based human-computer interface, in which subjects were asked to balance a virtual inverted pendulum using visual feedback information on the pendulum's position. The pendulum was actuated by a pair of antagonist joint torques determined in real-time by activations of the corresponding pair of antagonist ankle muscles of subjects standing upright. This motor-task raises a frustrated environment; a large feedback time delay in the sensorimotor loop, as a source of instability, might favor adopting the non-reactive, preprogrammed impedance control, but the ankle muscles are relatively hard to co-activate, which hinders subjects from adopting the impedance control. This study aimed at discovering how experimental subjects resolved this frustrated environment through motor learning. One third of subjects adapted to the balancing task in a way of the impedance-like control. It was remarkable, however, that the majority of subjects did not adopt the impedance control. Instead, they acquired a smart and energetically efficient strategy, in which two muscles were inactivated simultaneously at a sequence of optimal timings, leading to intermittent appearance of periods of time during which the pendulum was not actively actuated. Characterizations of muscle inactivations and the pendulum¡Çs sway showed that the strategy adopted by those subjects was a type of intermittent control that utilizes a stable manifold of saddle-type unstable upright equilibrium that appeared in the state space of the pendulum when the active actuation was turned off. PMID:23717398

The Neural Basis of Postural Instability Gait Disorder Subtype of Parkinson's Disease: A PET and fMRI Study.

PubMed

Zhang, Li; Li, Tian-Nv; Yuan, Yong-Sheng; Jiang, Si-Ming; Tong, Qing; Wang, Min; Wang, Jian-Wei; Chen, Hua-Jun; Ding, Jian; Xu, Qin-Rong; Zhang, Ke-Zhong

2016-05-01

The aim of this study is to further uncover the neural basis of postural instability gait disorder (PIGD) subtype of Parkinson's disease. With F-18 fluorodeoxyglucose PET (FDG-PET), brain glucose metabolism of patients with PIGD (n = 15) was compared with healthy controls (n = 17) and tremor-dominant (TD) patients (n = 15), and the correlation between metabolism and PIGD symptoms was also assessed. Within PIGD symptom-correlated hypometabolic areas, the relationship of functional connectivity (FC) with motor and cognitive symptoms was examined by using functional MRI. Compared with controls, patients with PIGD displayed a distributed pattern of brain hypometabolism including striatal, frontal, and parietal areas. Relative to the pattern of TD patients, the pattern of patients with PIGD had additional metabolic decreases in caudate and inferior parietal lobule (IPL, Brodmann area [BA] 40). In PIGD group, the metabolic reductions in IPL (BA 40), middle frontal gyrus (MFG, BA 9) and fusiform gyrus (FG, BA 20) were associated with severe PIGD symptoms. Regions showing such correlation were chosen for further seed-based FC analysis. Decreased FC within the prefrontal-parietal network (between the MFG and IPL) was associated with severe PIGD symptoms. The involvement of the caudate, FG, and prefrontal-parietal network may be associated with the prominent gait impairments of PIGD subtype. Our findings expand the pathophysiological knowledge of PIGD subtype and provide valuable information for potential neuromodulation therapies alleviating gait disorders. © 2016 John Wiley & Sons Ltd.

The role of postural instability/gait difficulty and fear of falling in predicting falls in non-demented older adults.

PubMed

Allali, Gilles; Ayers, Emmeline I; Holtzer, Roee; Verghese, Joe

Postural instability/gait difficulty (PIGD) and fear of falling (FoF) frequently co-exist, but their individual predictive values for falls have not been compared in aging. This study aims to determine both independent and combined effect of PIGD and FoF to falls in older adults without dementia. PIGD and other extrapyramidal signs were systematically assessed in 449 community-dwelling participants without Parkinson's disease (76.48±6.61 ys; 56.8% female) enrolled in this longitudinal cohort study. Presence of FoF was measured by a single-item question (Do you have a FoF?) and self-confidence by the Activities-specific Balance Confidence scale (ABC scale). One hundred sixty-nine participants (38%) had an incident fall over a mean follow-up of 20.1±12.2months. PIGD was present in 32% and FoF in 23% of the participants. Both PIGD (adjusted hazard ratio (aHR): 2.28; p=0.016) and self-confidence (aHR: 0.99; p=0.040) predicted falls when entered simultaneously in the Cox model. However, presence of FoF (aHR: 1.99; p=0.021) and self-confidence (aHR: 0.98; p=0.006) predicted falls only in individuals with PIGD. PIGD and FoF were associated with future falls in older adults without dementia but FoF was a fall's predictor only in individuals with PIGD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Phenotype of postural instability/gait difficulty in Parkinson disease: relevance to cognitive impairment and mechanism relating pathological proteins and neurotransmitters

PubMed Central

Zuo, Li-Jun; Piao, Ying-Shan; Li, Li-Xia; Yu, Shu-Yang; Guo, Peng; Hu, Yang; Lian, Teng-Hong; Wang, Rui-Dan; Yu, Qiu-Jin; Jin, Zhao; Wang, Ya-Jie; Wang, Xiao-Min; Chan, Piu; Chen, Sheng-Di; Wang, Yong-Jun; Zhang, Wei

2017-01-01

Parkinson disease (PD) is identified as tremor-dominant (TD) and postural instability and gait difficulty (PIGD) phenotypes. The relationships between motor phenotypes and cognitive impairment and the underlying mechanisms relating pathological proteins and neurotransmitters in cerebrospinal fluid (CSF) are unknown. We evaluated the motor symptoms and cognitive function by scales, and detected the levels of pathological proteins and neurotransmitters in CSF. TD group and PIGD group had significantly higher levels of total tau, tau phosphorylated at the position of threonine 181(P-tau181t), threonine 231, serine 396, serine 199 and lower β amyloid (Aβ)1–42 level in CSF than those in control group; PIGD group had significantly higher P-tau181t level and lower Aβ1–42 level than those in TD group. In PD group, PIGD severity was negatively correlated with MoCA score and Aβ1–42 level in CSF, and positively correlated with Hoehn-Yahr stage and P-tau181t level in CSF. In PIGD group, PIGD severity was negatively correlated with homovanillic acid (HVA) level in CSF, and HVA level was positively correlated with Aβ1–42 level in CSF. PIGD was significantly correlated with cognitive impairment, which underlying mechanism might be involved in Aβ1–42 aggregation in brain and relevant neurochemical disturbance featured by the depletion of HVA in CSF. PMID:28332604

Instability analysis of expansion-free sphere in f(𝒢) gravity

NASA Astrophysics Data System (ADS)

Sharif, M.; Ikram, Ayesha

The aim of this paper is to study the dynamical instability of expansion-free spherically symmetric anisotropic fluid in the framework of f(𝒢) gravity. We apply perturbation scheme of the first-order to the metric functions as well as matter variables and construct modified field equations for both static and perturbed configurations using power-law f(𝒢) model. To discuss the instability dynamics, we use the contracted Bianchi identities to formulate the dynamical equations in both Newtonian and post-Newtonian regimes. It is found that the range of instability is independent of adiabatic index for expansion-free fluid but depends on anisotropic pressures, energy density and Gauss-Bonnet (GB) terms.

Electromyography of wrist and finger flexor muscles in olive baboons (Papio anubis).

PubMed

Patel, Biren A; Larson, Susan G; Stern, Jack T

2012-01-01

Some non-human primates use digitigrade hand postures when walking slowly on the ground. As a component of an extended limb, a digitigrade posture can help minimize wrist joint moments thereby requiring little force production directly from wrist flexors (and/or from the assistance of finger flexors) to maintain limb posture. As a consequence, less active muscle volume would be required from these anti-gravity muscles and overall metabolic costs associated with locomotion could be reduced. To investigate whether the use of digitigrade hand postures during walking in primates entails minimal use of anti-gravity muscles, this study examined electromyography (EMG) patterns in both the wrist and finger flexor muscles in facultatively digitigrade olive baboons (Papio anubis) across a range of speeds. The results demonstrate that baboons can adopt a digitigrade hand posture when standing and moving at slow speeds without requiring substantial EMG activity from distal anti-gravity muscles. Higher speed locomotion, however, entails increasing EMG activity and is accompanied by a dynamic shift to a more palmigrade-like limb posture. Thus, the ability to adopt a digitigrade hand posture by monkeys is an adaptation for ground living, but it was never co-opted for fast locomotion. Rather, digitigrady in primates appears to be related to energetic efficiency for walking long distances.

Body size and lower limb posture during walking in humans.

PubMed

Hora, Martin; Soumar, Libor; Pontzer, Herman; Sládek, Vladimír

2017-01-01

We test whether locomotor posture is associated with body mass and lower limb length in humans and explore how body size and posture affect net joint moments during walking. We acquired gait data for 24 females and 25 males using a three-dimensional motion capture system and pressure-measuring insoles. We employed the general linear model and commonality analysis to assess the independent effect of body mass and lower limb length on flexion angles at the hip, knee, and ankle while controlling for sex and velocity. In addition, we used inverse dynamics to model the effect of size and posture on net joint moments. At early stance, body mass has a negative effect on knee flexion (p < 0.01), whereas lower limb length has a negative effect on hip flexion (p < 0.05). Body mass uniquely explains 15.8% of the variance in knee flexion, whereas lower limb length uniquely explains 5.4% of the variance in hip flexion. Both of the detected relationships between body size and posture are consistent with the moment moderating postural adjustments predicted by our model. At late stance, no significant relationship between body size and posture was detected. Humans of greater body size reduce the flexion of the hip and knee at early stance, which results in the moderation of net moments at these joints.

Invariant density analysis: modeling and analysis of the postural control system using Markov chains.

PubMed

Hur, Pilwon; Shorter, K Alex; Mehta, Prashant G; Hsiao-Wecksler, Elizabeth T

2012-04-01

In this paper, a novel analysis technique, invariant density analysis (IDA), is introduced. IDA quantifies steady-state behavior of the postural control system using center of pressure (COP) data collected during quiet standing. IDA relies on the analysis of a reduced-order finite Markov model to characterize stochastic behavior observed during postural sway. Five IDA parameters characterize the model and offer physiological insight into the long-term dynamical behavior of the postural control system. Two studies were performed to demonstrate the efficacy of IDA. Study 1 showed that multiple short trials can be concatenated to create a dataset suitable for IDA. Study 2 demonstrated that IDA was effective at distinguishing age-related differences in postural control behavior between young, middle-aged, and older adults. These results suggest that the postural control system of young adults converges more quickly to their steady-state behavior while maintaining COP nearer an overall centroid than either the middle-aged or older adults. Additionally, larger entropy values for older adults indicate that their COP follows a more stochastic path, while smaller entropy values for young adults indicate a more deterministic path. These results illustrate the potential of IDA as a quantitative tool for the assessment of the quiet-standing postural control system.

Power-law scaling for macroscopic entropy and microscopic complexity: Evidence from human movement and posture

NASA Astrophysics Data System (ADS)

Hong, S. Lee; Bodfish, James W.; Newell, Karl M.

2006-03-01

We investigated the relationship between macroscopic entropy and microscopic complexity of the dynamics of body rocking and sitting still across adults with stereotyped movement disorder and mental retardation (profound and severe) against controls matched for age, height, and weight. This analysis was performed through the examination of center of pressure (COP) motion on the mediolateral (side-to-side) and anteroposterior (fore-aft) dimensions and the entropy of the relative phase between the two dimensions of motion. Intentional body rocking and stereotypical body rocking possessed similar slopes for their respective frequency spectra, but differences were revealed during maintenance of sitting postures. The dynamics of sitting in the control group produced lower spectral slopes and higher complexity (approximate entropy). In the controls, the higher complexity found on each dimension of motion was related to a weaker coupling between dimensions. Information entropy of the relative phase between the two dimensions of COP motion and irregularity (complexity) of their respective motions fitted a power-law function, revealing a relationship between macroscopic entropy and microscopic complexity across both groups and behaviors. This power-law relation affords the postulation that the organization of movement and posture dynamics occurs as a fractal process.

Effects of Peripheral Vestibular Dysfunction on Dynamic Postural Stability Measured by the Functional Reach Test and Timed Up and Go Test.

PubMed

Nishi, Toshiko; Kamogashira, Teru; Fujimoto, Chisato; Kinoshita, Makoto; Egami, Naoya; Sugasawa, Keiko; Yamasoba, Tatsuya; Iwasaki, Shinichi

2017-06-01

To investigate the influence of vestibular function on dynamic postural stability assessed by the functional reach test (FRT) and the timed up and go test (TUG). Retrospective study. Tertiary referral center. The FRT and TUG were performed in 399 patients with dizziness. The effects of peripheral vestibular dysfunction assessed by the caloric test and cervical vestibular evoked myogenic potentials (cVEMPs) to air-conducted sound (500 Hz, tone burst) on the results of FRT and TUG were analyzed. Neither FRT nor TUG scores showed significant differences in relation to the results of the caloric test ( P > .3). The FRT scores in patients who showed abnormal cVEMP responses on both sides were significantly smaller than those in patients who showed normal cVEMP responses ( P < .01). The TUG scores in patients who showed abnormal cVEMP responses on both sides were significantly greater than those in patients who showed normal cVEMP responses ( P < .05). The vestibulo-spinal reflex mediated by the saccule and its afferents is one of the factors that influence the maintenance of dynamic postural stability as measured by FRT and TUG.

The effects of shoulder stabilization exercises and pectoralis minor stretching on balance and maximal shoulder muscle strength of healthy young adults with round shoulder posture.

PubMed

Kim, Mi-Kyoung; Lee, Jung Chul; Yoo, Kyung-Tae

2018-03-01

[Purpose] The purpose of this study was to analyze the effects of pectoralis minor stretching and shoulder strengthening with an elastic band on balance and maximal shoulder muscle strength in young adults with rounded shoulder posture. [Subjects and Methods] Nineteen subjects with rounded shoulder posture were randomly divided into 2 groups: a shoulder stabilization exercise group and a stretching exercise group. The groups performed each exercise for 40 minutes, 3 times a week, for 4 weeks. Static balance (eyes open and closed), dynamic balance (the limits of stability in 4 directions) and shoulder muscle strength in 5 directions were measure before and after the exercises. [Results] The stretching exercise demonstrated a significant difference between the pre- and post-exercise in the static balance with eyes closed and extension and horizontal abduction strength while the stabilization exercise demonstrated significant difference in the left and right directions between the pre- and post-exercise of the dynamic balance and flexion strength. The stabilization exercise demonstrated significant differences shown in the flexion between the pre- and post-test. [Conclusion] The shoulder stabilization and stretching exercises improved the static balance, dynamic balance, and muscle strength.

THE EFFECT OF KINESIO® TAPE ON VERTICAL JUMP AND DYNAMIC POSTURAL CONTROL

PubMed Central

Baldridge, Carolann

2013-01-01

Introduction and Background: Ankle injuries are one of the most common injuries among physically active individuals. The role of prophylactic ankle taping and bracing has been studied extensively. Kinesio® Tape (KT) is a somewhat new type of taping technique gaining popularity as both treatment and performance enhancement tool. However, there is limited research on the effect of KT on functional performance. Purpose: The purpose of this study was to determine whether the application of Kinesio Tex® Tape had an effect on vertical jump and dynamic postural control in healthy young individuals. Methods: 52 healthy subjects free of ankle or lower extremity problems (28 males and 24 females; age: 22.12±2.08 years; height: 170.77±8.69 cm; weight: 69.90±12.03 kg) participated in the study. Subjects were randomly assigned to either the experimental group (KT with tension) or the control group (KT without tension). Vertical jump was measured using the VertiMetric device and dynamic postural control was assessed using the Star Excursion Balance Test (SEBT) under three conditions: (1) without taping; (2) immediately after taping; (3) 24 hours after taping with the taping remaining in situ. Results: Three-way repeated measure ANOVA was conducted in order to identify differences between the experimental and the control group during the three conditions. Overall, there were no differences between groups in vertical jump maximum height, vertical jump average height, or the SEBT scores for the three time periods (pre-test, post-test, 24hrs-post-test). However, the main effect of KT was moderated by a significant gender interaction, resulting in a statistically significant effect of KT for the SEBT scores in the posterior-medial direction, F(1.72, 82.57) = 4.50, p = 0.018 and the medial direction, F(1.75, 83.81) = 4.27, p = 0.021. Follow-up analyses indicated that female subjects in the KT group had increased SEBT scores between three time periods when compared to the placebo group. Discussion: KT application on the ankle neither decreased nor increased vertical jump height in healthy non-injured young individuals, but did increase dynamic postural control in females for certain directions. Additional study is warranted using different measures of balance to further investigate the effect of KT on dynamic postural control. Level of Evidence: 2b PMID:24175126

Dynamic gesture recognition using neural networks: a fundament for advanced interaction construction

NASA Astrophysics Data System (ADS)

Boehm, Klaus; Broll, Wolfgang; Sokolewicz, Michael A.

1994-04-01

Interaction in virtual reality environments is still a challenging task. Static hand posture recognition is currently the most common and widely used method for interaction using glove input devices. In order to improve the naturalness of interaction, and thereby decrease the user-interface learning time, there is a need to be able to recognize dynamic gestures. In this paper we describe our approach to overcoming the difficulties of dynamic gesture recognition (DGR) using neural networks. Backpropagation neural networks have already proven themselves to be appropriate and efficient for posture recognition. However, the extensive amount of data involved in DGR requires a different approach. Because of features such as topology preservation and automatic-learning, Kohonen Feature Maps are particularly suitable for the reduction of the high dimensional data space that is the result of a dynamic gesture, and are thus implemented for this task.

Gravity Wave Dynamics in a Mesospheric Inversion Layer: 2. Instabilities, Turbulence, Fluxes, and Mixing

NASA Astrophysics Data System (ADS)

Fritts, David C.; Wang, Ling; Laughman, Brian; Lund, Thomas S.; Collins, Richard L.

2018-01-01

A companion paper by Fritts, Laughman, et al. (2017) employed an anelastic numerical model to explore the dynamics of gravity waves (GWs) encountering a mesospheric inversion layer (MIL) having a moderate static stability enhancement and a layer of weaker static stability above. That study revealed that MIL responses, including GW transmission, reflection, and instabilities, are sensitive functions of GW parameters. This paper expands on two of the Fritts, Laughman, et al. (2017) simulations to examine GW instability dynamics and turbulence in the MIL; forcing of the mean wind and stability environments by GW, instability, and turbulence fluxes; and associated heat and momentum transports. These direct numerical simulations resolve turbulence inertial-range scales and yield the following results: GW breaking and turbulence in the MIL occur below where they would otherwise, due to enhancements of GW amplitudes and shears in the MIL. 2-D GW and instability heat and momentum fluxes are 20-30 times larger than 3-D instability and turbulence fluxes. Mean fields are driven largely by 2-D GW and instability dynamics rather than 3-D instabilities and turbulence. 2-D and 3-D heat fluxes in regions of strong turbulence yield small departures from initial T(z) and N2(z) profiles, hence do not yield nearly adiabatic "mixed" layers. Our MIL results are consistent with the relation between the turbulent vertical velocity variance and energy dissipation rate proposed by Weinstock (1981) for the limited intervals evaluated.

The use of instability to train the core musculature.

PubMed

Behm, David G; Drinkwater, Eric J; Willardson, Jeffrey M; Cowley, Patrick M

2010-02-01

Training of the trunk or core muscles for enhanced health, rehabilitation, and athletic performance has received renewed emphasis. Instability resistance exercises have become a popular means of training the core and improving balance. Whether instability resistance training is as, more, or less effective than traditional ground-based resistance training is not fully resolved. The purpose of this review is to address the effectiveness of instability resistance training for athletic, nonathletic, and rehabilitation conditioning. The anatomical core is defined as the axial skeleton and all soft tissues with a proximal attachment on the axial skeleton. Spinal stability is an interaction of passive and active muscle and neural subsystems. Training programs must prepare athletes for a wide variety of postures and external forces, and should include exercises with a destabilizing component. While unstable devices have been shown to be effective in decreasing the incidence of low back pain and increasing the sensory efficiency of soft tissues, they are not recommended as the primary exercises for hypertrophy, absolute strength, or power, especially in trained athletes. For athletes, ground-based free-weight exercises with moderate levels of instability should form the foundation of exercises to train the core musculature. Instability resistance exercises can play an important role in periodization and rehabilitation, and as alternative exercises for the recreationally active individual with less interest or access to ground-based free-weight exercises. Based on the relatively high proportion of type I fibers, the core musculature might respond well to multiple sets with high repetitions (e.g., >15 per set); however, a particular sport may necessitate fewer repetitions.

The relationship between the Activities-specific Balance Confidence Scale and the Dynamic Gait Index in peripheral vestibular dysfunction.

PubMed

Legters, Kristine; Whitney, Susan L; Porter, Rebecca; Buczek, Frank

2005-01-01

People with vestibular dysfunction experience dizziness, vertigo and postural instability. The persistence of these symptoms may result in decreased balance confidence. The purpose of the present study was to examine the relationship between decreased balance confidence and gait dysfunction in patients with unilateral peripheral vestibular dysfunction. A retrospective review of 137 charts with the Activities-specific Balance Confidence (ABC) Scale and the Dynamic Gait Index (DGI) scores was completed. Spearman rank-order correlation analysis was performed of the total sample, by age group and by degree of vestibular weakness. A moderate correlation of r = 0.58 (p < 0.001) was found between the ABC Scale score and the DGI score in the total sample. Those with mild or moderate vestibular weakness had a correlation of r = 0.72 (p < 0.001) between the ABC Scale score and the DGI score, compared with a correlation of r = 0.48 in those with severe or total vestibular weakness. Decreased balance confidence and increased fall risk are critical issues for people with vestibular dysfunction. The effects of aging did not have a significant impact on the relationship. The correlation between balance confidence and gait dysfunction was stronger in those with mild or moderate vestibular weakness, although those with severe or total weakness were more disabled by their vestibular symptoms.

“What Women Like”: Influence of Motion and Form on Esthetic Body Perception

PubMed Central

Cazzato, Valentina; Siega, Serena; Urgesi, Cosimo

2012-01-01

Several studies have shown the distinct contribution of motion and form to the esthetic evaluation of female bodies. Here, we investigated how variations of implied motion and body size interact in the esthetic evaluation of female and male bodies in a sample of young healthy women. Participants provided attractiveness, beauty, and liking ratings for the shape and posture of virtual renderings of human bodies with variable body size and implied motion. The esthetic judgments for both shape and posture of human models were influenced by body size and implied motion, with a preference for thinner and more dynamic stimuli. Implied motion, however, attenuated the impact of extreme body size on the esthetic evaluation of body postures, while body size variations did not affect the preference for more dynamic stimuli. Results show that body form and action cues interact in esthetic perception, but the final esthetic appreciation of human bodies is predicted by a mixture of perceptual and affective evaluative components. PMID:22866044

Mandibular position influence on pilots' postural balance analyzed under dynamic conditions.

PubMed

Baldini, Alberto; Nota, Alessandro; Cioffi, Clementina; Ballanti, Fabiana; Tecco, Simona

2017-11-01

The aim of this study is to evaluate the influence of the mandibular position on the postural stability in a sample of civilian and military pilots. Twenty military pilots (males, mean age 35.15 ± 3.14 years) and 17 civilian pilots (males, mean 34.91 ± 2.15 years) were enrolled in this study and underwent a Sensory Organization Test (SOT) using the EquiTest® (NeuroCom International Inc., Clackamas, OR, USA) computerized dynamic posturography. The composite parameter was recorded and analyzed. The equilibrium score (ES) recorded in centric occlusion is slightly higher than the ES recorded in mandibular rest position; civilian pilots showed ESs slightly higher than military pilots. The two-way ANOVA analysis shows these differences are not statistically significant. The findings of this study seem to suggest that the composite parameter of the SOT is not sensitive in analyzing the influence of the stomatognathic system on the postural balance of civilian and military pilots.

Effects of a cognitive dual task on variability and local dynamic stability in sustained repetitive arm movements using principal component analysis: a pilot study.

PubMed

Longo, Alessia; Federolf, Peter; Haid, Thomas; Meulenbroek, Ruud

2018-06-01

In many daily jobs, repetitive arm movements are performed for extended periods of time under continuous cognitive demands. Even highly monotonous tasks exhibit an inherent motor variability and subtle fluctuations in movement stability. Variability and stability are different aspects of system dynamics, whose magnitude may be further affected by a cognitive load. Thus, the aim of the study was to explore and compare the effects of a cognitive dual task on the variability and local dynamic stability in a repetitive bimanual task. Thirteen healthy volunteers performed the repetitive motor task with and without a concurrent cognitive task of counting aloud backwards in multiples of three. Upper-body 3D kinematics were collected and postural reconfigurations-the variability related to the volunteer's postural change-were determined through a principal component analysis-based procedure. Subsequently, the most salient component was selected for the analysis of (1) cycle-to-cycle spatial and temporal variability, and (2) local dynamic stability as reflected by the largest Lyapunov exponent. Finally, end-point variability was evaluated as a control measure. The dual cognitive task proved to increase the temporal variability and reduce the local dynamic stability, marginally decrease endpoint variability, and substantially lower the incidence of postural reconfigurations. Particularly, the latter effect is considered to be relevant for the prevention of work-related musculoskeletal disorders since reduced variability in sustained repetitive tasks might increase the risk of overuse injuries.

Reliability and Construct Validity of Limits of Stability Test in Adolescents Using a Portable Forceplate System.

PubMed

Alsalaheen, Bara; Haines, Jamie; Yorke, Amy; Broglio, Steven P

2015-12-01

To examine the reliability, convergent, and discriminant validity of the limits of stability (LOS) test to assess dynamic postural stability in adolescents using a portable forceplate system. Cross-sectional reliability observational study. School setting. Adolescents (N=36) completed all measures during the first session. To examine the reliability of the LOS test, a subset of 15 participants repeated the LOS test after 1 week. Not applicable. Outcome measurements included the LOS test, Balance Error Scoring System, Instrumented Balance Error Scoring System, and Modified Clinical Test for Sensory Interaction on Balance. A significant relation was observed among LOS composite scores (r=.36-.87, P<.05). However, no relation was observed between LOS and static balance outcome measurements. The reliability of the LOS composite scores ranged from moderate to good (intraclass correlation coefficient model 2,1=.73-.96). The results suggest that the LOS composite scores provide unique information about dynamic postural stability, and the LOS test completed at 100% of the theoretical limit appeared to be a reliable test of dynamic postural stability in adolescents. Clinicians should use dynamic balance measurement as part of their balance assessment and should not use static balance testing (eg, Balance Error Scoring System) to make inferences about dynamic balance, especially when balance assessment is used to determine rehabilitation outcomes, or when making return to play decisions after injury. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Postural threat differentially affects the feedforward and feedback components of the vestibular-evoked balance response.

PubMed

Osler, Callum J; Tersteeg, M C A; Reynolds, Raymond F; Loram, Ian D

2013-10-01

Circumstances may render the consequence of falling quite severe, thus maximising the motivation to control postural sway. This commonly occurs when exposed to height and may result from the interaction of many factors, including fear, arousal, sensory information and perception. Here, we examined human vestibular-evoked balance responses during exposure to a highly threatening postural context. Nine subjects stood with eyes closed on a narrow walkway elevated 3.85 m above ground level. This evoked an altered psycho-physiological state, demonstrated by a twofold increase in skin conductance. Balance responses were then evoked by galvanic vestibular stimulation. The sway response, which comprised a whole-body lean in the direction of the edge of the walkway, was significantly and substantially attenuated after ~800 ms. This demonstrates that a strong reason to modify the balance control strategy was created and subjects were highly motivated to minimise sway. Despite this, the initial response remained unchanged. This suggests little effect on the feedforward settings of the nervous system responsible for coupling pure vestibular input to functional motor output. The much stronger, later effect can be attributed to an integration of balance-relevant sensory feedback once the body was in motion. These results demonstrate that the feedforward and feedback components of a vestibular-evoked balance response are differently affected by postural threat. Although a fear of falling has previously been linked with instability and even falling itself, our findings suggest that this relationship is not attributable to changes in the feedforward vestibular control of balance. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Directional measures of postural sway as predictors of balance instability and accidental falls

PubMed Central

Janusz, Błaszczyk W.; Beck, Monika; Szczepańska, Justyna; Sadowska, Dorota; Bacik, Bogdan; Juras, Grzegorz

2016-01-01

Abstract Despite the obvious advantages and popularity of static posturography, universal standards for posturographic tests have not been developed thus far. Most of the center-of-foot pressure (COP) indices are strongly dependent on an individual experimental design, and are susceptible to distortions, which makes results of their analysis incomparable. In this research, we present a novel approach to the analysis of the COP trajectory based on the directional features of postural sway. Our novel output measures: the sway directional indices (DI) and sway vector (SV) were applied to assess the postural stability in the group of young able-bodied subjects. Towards this aim, the COP trajectories were recorded in 100 students standing still for 60 s, with eyes open (EO) and then, with eyes closed (EC). Each record was subdivided then into 20, 30 and 60 s samples. Interclass correlation coefficients were calculated from the samples. The controlled variables (visual conditions) uniquely affected the output measures, but only in case of proper signal pretreatment (low-pass filtering). In filtering below 6 Hz, the DI and SV provided a unique set of descriptors for postural control. Both sway measures were highly independent of the trial length and the sampling frequency, and were unaffected by the sampling noise. Directional indices of COP filtered at 6 Hz showed high to very high reliability, with ICC range of 0.7-0.9. Results of a single 60 s trial are sufficient to reach acceptable reliability for both DI and SV. In conclusion, the directional sway measures may be recommended as the primary standard in static posturography. PMID:28149395

Back posture education in elementary schoolchildren: a 2-year follow-up study.

PubMed

Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2007-06-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age 13.2 +/- 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential.

Construct Validity and Reliability of the SARA Gait and Posture Sub-scale in Early Onset Ataxia

PubMed Central

Lawerman, Tjitske F.; Brandsma, Rick; Verbeek, Renate J.; van der Hoeven, Johannes H.; Lunsing, Roelineke J.; Kremer, Hubertus P. H.; Sival, Deborah A.

2017-01-01

Aim: In children, gait and posture assessment provides a crucial marker for the early characterization, surveillance and treatment evaluation of early onset ataxia (EOA). For reliable data entry of studies targeting at gait and posture improvement, uniform quantitative biomarkers are necessary. Until now, the pediatric test construct of gait and posture scores of the Scale for Assessment and Rating of Ataxia sub-scale (SARA) is still unclear. In the present study, we aimed to validate the construct validity and reliability of the pediatric (SARAGAIT/POSTURE) sub-scale. Methods: We included 28 EOA patients [15.5 (6–34) years; median (range)]. For inter-observer reliability, we determined the ICC on EOA SARAGAIT/POSTURE sub-scores by three independent pediatric neurologists. For convergent validity, we associated SARAGAIT/POSTURE sub-scores with: (1) Ataxic gait Severity Measurement by Klockgether (ASMK; dynamic balance), (2) Pediatric Balance Scale (PBS; static balance), (3) Gross Motor Function Classification Scale -extended and revised version (GMFCS-E&R), (4) SARA-kinetic scores (SARAKINETIC; kinetic function of the upper and lower limbs), (5) Archimedes Spiral (AS; kinetic function of the upper limbs), and (6) total SARA scores (SARATOTAL; i.e., summed SARAGAIT/POSTURE, SARAKINETIC, and SARASPEECH sub-scores). For discriminant validity, we investigated whether EOA co-morbidity factors (myopathy and myoclonus) could influence SARAGAIT/POSTURE sub-scores. Results: The inter-observer agreement (ICC) on EOA SARAGAIT/POSTURE sub-scores was high (0.97). SARAGAIT/POSTURE was strongly correlated with the other ataxia and functional scales [ASMK (rs = -0.819; p < 0.001); PBS (rs = -0.943; p < 0.001); GMFCS-E&R (rs = -0.862; p < 0.001); SARAKINETIC (rs = 0.726; p < 0.001); AS (rs = 0.609; p = 0.002); and SARATOTAL (rs = 0.935; p < 0.001)]. Comorbid myopathy influenced SARAGAIT/POSTURE scores by concurrent muscle weakness, whereas comorbid myoclonus predominantly influenced SARAKINETIC scores. Conclusion: In young EOA patients, separate SARAGAIT/POSTURE parameters reveal a good inter-observer agreement and convergent validity, implicating the reliability of the scale. In perspective of incomplete discriminant validity, it is advisable to interpret SARAGAIT/POSTURE scores for comorbid muscle weakness. PMID:29326569

Back posture education in elementary schoolchildren: a 2-year follow-up study

PubMed Central

Geldhof, Elisabeth; De Bourdeaudhuij, Ilse; De Clercq, Dirk

2006-01-01

Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13–14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 ± 0.8 years) and 101 controls (mean age 13.2 ± 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early school-based back posture promotion in relation to the integration of back posture principles according to a biomechanical favorable lifestyle and back pain prevalence later in life is essential. PMID:17013655

Using Tri-Axial Accelerometers to Assess the Dynamic Control of Head Posture During Gait

NASA Technical Reports Server (NTRS)

Lawrence, John H., III

2003-01-01

Long duration spaceflight is known to cause a variety of biomedical stressors to the astronaut. One of the more functionally destabilizing effects of spaceflight involves microgravity-induced changes in vestibular or balance control. Balance control requires the integration of the vestibular, visual, and proprioceptive systems. In the microgravity environment, the normal gravity vector present on Earth no longer serves as a reference for the balance control system. Therefore, adaptive changes occur to the vestibular system to affect control of body orientation with altered, or non-present, gravity and/or proprioceptive inputs. Upon return to a gravity environment, the vestibular system must re-incorporate the gravity vector and gravity-induced proprioceptive inputs into the balance control regime. The result is often a period of postural instability, which may also be associated with space motion sickness (oscillopsia, nausea, and vertigo). Previous studies by the JSC Neuroscience group have found that returning astronauts often employ alterations in gait mechanics to maintain postural control during gait. It is believed that these gait alterations are meant to decrease the transfer of heel strike shock energy to the head, thus limiting the contradictory head and eye movements that lead to gait instability and motion sickness symptoms. We analyzed pre- and post-spaceflight tri-axial accelerometer data from the NASA/MIR long duration spaceflight missions to assess the heel to head transfer of heel strike shock energy during locomotion. Up to seven gait sessions (three preflight, four postflight) of head and shank (lower leg) accelerometer data was previously collected from six astronauts who engaged in space flights of four to six months duration. In our analysis, the heel to head transmission of shock energy was compared using peak vertical acceleration (a), peak jerk (j) ratio, and relative kinetic energy (a). A host of generalized movement variables was produced in an effort to isolate those that best highlighted vestibular adaptation due to spaceflight. Data suggest that astronauts used either head or body centered control to reduce the effects of heel strike shock on head position during normal walking at self-selected speeds. Moreover, the form of that control appears to fall under one of two categories: homeostatic or adaptive. Homeostatic control refers to tight constraint (small error) over the value of a given variable before and after spaceflight with little or no adaptive changes. Adaptive control refers to lesser constraint over a given movement variable with clear adaptation to earth gravity upon return from spaceflight. Heel strike shock absorption (ratio of heel to head peak acceleration) best-discriminated head and body centered control strategies. Further, peak jerk data was useful for illustrating pre- and postflight differences in segmental (shank versus head) movement energy. Results from kinetic energy analysis show high consistency between subjects and across test dates. Whether this result highlights a control strategy or is an artifact of approximating body segments using anthropometric tables is, at this point, unclear.

Postural Stability Assessment of University Marching Musicians Using Force Platform Measures.

PubMed

Magnotti, Trevor D; McElhiney, Danielle; Russell, Jeffrey A

2016-09-01

Lower extremity injury is prevalent in marching musicians, and poor postural stability is a possible risk factor for this. The external load of an instrument may predispose these performers to injury by decreasing postural stability. The purpose of this study was to determine the relationship between instrument load and static and dynamic postural stability in this population. Fourteen university marching musicians were recruited and completed a balance assessment protocol on a force platform with and without their instrument. Mean center of pressure (CoP) displacement was then calculated for each exercise in the anterior/posterior and medial/lateral planes. Mean anterior/posterior CoP displacement significantly increased in the instrument condition for the static surface, eyes closed, 2 feet condition (p≤0.005; d=0.89). No significant differences were found in the medial/lateral plane between non-instrument and instrument conditions. Significant differences were not found between test stance conditions independent of group. Comparisons between the non-instrument-loaded and instrument-loaded conditions revealed possible significance of instrument load on postural stability in the anterior/posterior plane. Mean differences indicated that an unstable surface created a greater destabilizing effect on postural stability than instrument load.

Dynamic stability of electrodynamic maglev systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cai, Y.; Chen, S.S.; Mulcahy, T.M.

1997-01-01

Because dynamic instabilities are not acceptable in any commercial maglev system, it is important to consider dynamic instability in the development of all maglev systems. This study considers the stability of maglev systems based on mathematical models and experimental data. Divergence and flutter are obtained for coupled vibration of a three-degree-of-freedom maglev vehicle on a guideway consisting of double L-shaped aluminum segments. The theory and analysis for motion-dependent magnetic-force-induced instability developed in this study provides basic stability characteristics and identifies future research needs for maglev systems.

Integration of robotics and neuroscience beyond the hand: What kind of synergies?. Comment on "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by Marco Santello et al.

NASA Astrophysics Data System (ADS)

d'Avella, Andrea

2016-07-01

Santello et al. [1] review an impressive amount of work on the control of biological and artificial hands that demonstrates how the concept of synergies can lead to a successful integration of robotics and neuroscience. Is it possible to generalize the same approach to the control of biological and artificial limbs and bodies beyond the hand? The human hand synergies that appear most relevant for robotic hands are those defined at the kinematic level, i.e. postural synergies [2]. Postural synergies capture the geometric relations among the many joints of the hand and allow for a low dimensional characterization and synthesis of the static hand postures involved in grasping and manipulating a large set of objects. However, many other complex motor skills such as walking, reaching, throwing, and catching require controlling multi-articular time-varying trajectories rather than static postures. Dynamic control of biological and artificial limbs and bodies, especially when geometric and inertial parameters are uncertain and the joints are compliant, poses great challenges. What kind of synergies might simplify the dynamic control of motor skills involving upper and lower limbs as well as the whole body?

How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations.

PubMed

Young, William R; Mark Williams, A

2015-01-01

It is widely reported that fear of falling (FOF) has a profound and largely detrimental effect on balance performance in older adults. However, the mechanisms by which FOF influence postural stability are poorly understood. In the current article, we use psychological theory to explain FOF-related changes to postural control. First, we review literature describing associations between FOF and the 'stiffening' strategies observed during control of posture, including observations of eye and head movements. Second, we present a framework illustrating the interactions between increased age, FOF, and altered attentional processes, which in turn influence balance performance and fall-risk. Psychological theory predicts that anxiety can cause attentional bias for threatening and task-irrelevant stimuli and compromise the efficiency of working memory resources. We argue that while the adoption of stiffening strategies is likely to be beneficial in avoiding a loss of balance during simple postural tasks, it will ultimately compromise performance in dynamic and highly demanding functional tasks. The adoption of stiffening strategies leads to inadequate acquisition of the sensory information necessary to plan and execute dynamic and interactive movements. We conclude with some suggestions for future research. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults †.

PubMed

Frames, Christopher W; Soangra, Rahul; Lockhart, Thurmon E; Lach, John; Ha, Dong Sam; Roberto, Karen A; Lieberman, Abraham

2018-05-24

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m², using a force plate and an inertial measurement unit affixed at the sternum. Participants' fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance.

Regional volumes in brain stem and cerebellum are associated with postural impairments in young brain-injured patients.

PubMed

Drijkoningen, David; Leunissen, Inge; Caeyenberghs, Karen; Hoogkamer, Wouter; Sunaert, Stefan; Duysens, Jacques; Swinnen, Stephan P

2015-12-01

Many patients with traumatic brain injury (TBI) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients (n = 18) and healthy controls (n = 30) completed three challenging postural control tasks on the EquiTest® system (Neurocom). Infratentorial grey matter (GM) and white matter (WM) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I-IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI. © 2015 Wiley Periodicals, Inc.

A Control Scheme That Uses Dynamic Postural Synergies to Coordinate a Hybrid Walking Neuroprosthesis: Theory and Experiments.

PubMed

Alibeji, Naji A; Molazadeh, Vahidreza; Dicianno, Brad E; Sharma, Nitin

2018-01-01

A hybrid walking neuroprosthesis that combines functional electrical stimulation (FES) with a powered lower limb exoskeleton can be used to restore walking in persons with paraplegia. It provides therapeutic benefits of FES and torque reliability of the powered exoskeleton. Moreover, by harnessing metabolic power of muscles via FES, the hybrid combination has a potential to lower power consumption and reduce actuator size in the powered exoskeleton. Its control design, however, must overcome the challenges of actuator redundancy due to the combined use of FES and electric motor. Further, dynamic disturbances such as electromechanical delay (EMD) and muscle fatigue must be considered during the control design process. This ensures stability and control performance despite disparate dynamics of FES and electric motor. In this paper, a general framework to coordinate FES of multiple gait-governing muscles with electric motors is presented. A muscle synergy-inspired control framework is used to derive the controller and is motivated mainly to address the actuator redundancy issue. Dynamic postural synergies between FES of the muscles and the electric motors were artificially generated through optimizations and result in key dynamic postures when activated. These synergies were used in the feedforward path of the control system. A dynamic surface control technique, modified with a delay compensation term, is used as the feedback controller to address model uncertainty, the cascaded muscle activation dynamics, and EMD. To address muscle fatigue, the stimulation levels in the feedforward path were gradually increased based on a model-based fatigue estimate. A Lyapunov-based stability approach was used to derive the controller and guarantee its stability. The synergy-based controller was demonstrated experimentally on an able-bodied subject and person with an incomplete spinal cord injury.

Investigation on thermo-acoustic instability dynamic characteristics of hydrocarbon fuel flowing in scramjet cooling channel based on wavelet entropy method

NASA Astrophysics Data System (ADS)

Zan, Hao; Li, Haowei; Jiang, Yuguang; Wu, Meng; Zhou, Weixing; Bao, Wen

2018-06-01

As part of our efforts to find ways and means to further improve the regenerative cooling technology in scramjet, the experiments of thermo-acoustic instability dynamic characteristics of hydrocarbon fuel flowing have been conducted in horizontal circular tubes at different conditions. The experimental results indicate that there is a developing process from thermo-acoustic stability to instability. In order to have a deep understanding on the developing process of thermo-acoustic instability, the method of Multi-scale Shannon Wavelet Entropy (MSWE) based on Wavelet Transform Correlation Filter (WTCF) and Multi-Scale Shannon Entropy (MSE) is adopted in this paper. The results demonstrate that the developing process of thermo-acoustic instability from noise and weak signals is well detected by MSWE method and the differences among the stability, the developing process and the instability can be identified. These properties render the method particularly powerful for warning thermo-acoustic instability of hydrocarbon fuel flowing in scramjet cooling channels. The mass flow rate and the inlet pressure will make an influence on the developing process of the thermo-acoustic instability. The investigation on thermo-acoustic instability dynamic characteristics at supercritical pressure based on wavelet entropy method offers guidance on the control of scramjet fuel supply, which can secure stable fuel flowing in regenerative cooling system.

[The modern approaches to the restoration of postural balance in the patients suffering from the consequences of an acute cerebrovascular accident (CVA)].

PubMed

Volovets, S A; Sergeenko, E Y; Darinskaya, L Y; Polyaev, B A; Yashinina, Y A; Isaeva, M A; Zhitareva, I V; Lobov, A N; Panova, T I

2018-05-21

the most frequent and severe consequences of an acute cerebrovascular accident (CVA) are locomotor and coordination disorders which significantly increase the risk of falling in a static position and when walking. The methods used for the rehabilitation of the affected patients are designed in the first place to enable the patients to acquire the skills necessary for maintaining the static balance. The modern equipment allows to carry out coordination training in the static position and also during walking. The objective of the present study was to evaluate, based on the results of our original research, the feasibility and effectiveness of the application of the «Balance tutor» system developed for the restoration of static and dynamic balance in the framework of the combined rehabilitation treatment of the patients suffering from impaired postural balance as a consequence of acute cerebrovascular accident (CVA). A total of 56 patients presenting with impaired postural balance following CVA were available for the examination. All of them underwent functional testing to assess the static and dynamic balance, walking abilities, and the risk of falling down including the study with the use of computer-assisted stabilometry. The study has demonstrated that the inclusion of the «Balance tutor» system for the restoration of the static and dynamic balance in the combined rehabilitative treatment of the patients having postural balance disorders after the CVA reduces the risk of fall for a walking patient, improves his (her) static and dynamic balance, increases the patient's ability to move without exterior help. The patients comprising the main study group were found to experience a decrease of statokinesiogram space in the «eyes are open» position (p = 0.0576, the Mann-Whitney U test) as well as a reliable decrease of the statokinesiogram space in the «eyes are closed» position (p=0.0063, the Mann-Whitney U test). Similar changes occurred in speed of pressure center relocation. By the end of the rehabilitation course, the patients of the main group exhibited a reliable enhancement in the dynamic balance rates estimated with the use of the Berg Balance Scale (p=0.028, Tukey's criterion), an increase in stability based at the Tinneti scale, p=0.0291; Tukey's criterion), and a decrease of the risk of falling during walk assessed with the application of Dynamic Gait Index scale (p = 0.0001, Tukey's criterion). The results of the present study with the inclusion of the «Balance tutor» system in the program of combined rehabilitation of the patients suffering from the consequences of CVA in the form of the postural balance impairment give evidence of the feasibility and effectiveness of this approach. There is reason to believe that its application is likely to reduce the risk of falling down and to improve characteristics of static and dynamic balance. The inclusion of the «Balance tutor» system in the program of combined rehabilitation of the patients suffering from the consequences of CVA in the form of the postural balance impairment is both feasible and effective.

Dynamics and Instabilities of Vortex Pairs

NASA Astrophysics Data System (ADS)

Leweke, Thomas; Le Dizès, Stéphane; Williamson, Charles H. K.

2016-01-01

This article reviews the characteristics and behavior of counter-rotating and corotating vortex pairs, which are seemingly simple flow configurations yet immensely rich in phenomena. Since the reviews in this journal by Widnall (1975) and Spalart (1998) , who studied the fundamental structure and dynamics of vortices and airplane trailing vortices, respectively, there have been many analytical, computational, and experimental studies of vortex pair flows. We discuss two-dimensional dynamics, including the merging of same-sign vortices and the interaction with the mutually induced strain, as well as three-dimensional displacement and core instabilities resulting from this interaction. Flows subject to combined instabilities are also considered, in particular the impingement of opposite-sign vortices on a ground plane. We emphasize the physical mechanisms responsible for the flow phenomena and clearly present the key results that are useful to the reader for predicting the dynamics and instabilities of parallel vortices.

Effect of Surface Tension Anisotropy and Welding Parameters on Initial Instability Dynamics During Solidification: A Phase-Field Study

NASA Astrophysics Data System (ADS)

Yu, Fengyi; Wei, Yanhong

2018-05-01

The effects of surface tension anisotropy and welding parameters on initial instability dynamics during gas tungsten arc welding of an Al-alloy are investigated by a quantitative phase-field model. The results show that the surface tension anisotropy and welding parameters affect the initial instability dynamics in different ways during welding. The surface tension anisotropy does not influence the solute diffusion process but does affect the stability of the solid/liquid interface during solidification. The welding parameters affect the initial instability dynamics by varying the growth rate and thermal gradient. The incubation time decreases, and the initial wavelength remains stable as the welding speed increases. When welding power increases, the incubation time increases and the initial wavelength slightly increases. Experiments were performed for the same set of welding parameters used in modeling, and the results of the experiments and simulations were in good agreement.

Effects of fatiguing treadmill running on sensorimotor control in athletes with and without functional ankle instability.

PubMed

Steib, Simon; Hentschke, Christian; Welsch, Goetz; Pfeifer, Klaus; Zech, Astrid

2013-08-01

Sensorimotor control is permanently impaired following functional ankle instability and temporarily decreased following fatigue. Little is known on potential interactions between both conditions. The purpose was to investigate the effect of fatiguing exercise on sensorimotor control in athletes with and without (coper, controls) functional ankle instability. 19 individuals with functional ankle instability, 19 ankle sprain copers, and 19 non-injured controls participated in this cohort study. Maximum reach distance in the star excursion balance test, unilateral jump landing stabilization time, center of pressure sway velocity in single-leg-stance, and passive ankle joint position sense were assessed before and immediately after fatiguing treadmill running. A three factorial linear mixed model was specified for each outcome to evaluate the effects of group, exhausting exercise (fatigue) and their interactions (group by fatigue). Effect sizes were calculated as Cohen's d. Maximum reach distance in the star excursion balance test, jump stabilization time and sway velocity, but not joint position sense, were negatively affected by fatigue in all groups. Effect sizes were moderate, ranging from 0.27 to 0.68. No significant group by fatigue interactions were found except for one measure. Copers showed significantly larger prefatigue to postfatigue reductions in anterior reach direction (P≤0.001; d=-0.55) compared to the ankle instability (P=0.007) and control group (P=0.052). Fatiguing exercise negatively affected postural control but not proprioception. Ankle status did not appear to have an effect on fatigue-induced sensorimotor control impairments. © 2013.

Adaptive control reduces trip-induced forward gait instability among young adults.

PubMed

Wang, Ting-Yun; Bhatt, Tanvi; Yang, Feng; Pai, Yi-Chung

2012-04-30

A vital functional plasticity of humans is their ability to adapt to threats to posture stability. The purpose of this study was to investigate adaptation to repeated trips in walking. Sixteen young adults were recruited and exposed to the sudden (electronic-mechanical) release of an obstacle, 11-cm in height, in the path of over ground walking during the mid-to-late left swing phase. Although none of the subjects fell on the first of eight unannounced, consecutive trips, all of them had to rely on compensatory step with a step length significantly longer than their regular to reduce their instability. In the subsequent trials, they were able to rapidly make adaptive adjustments in the control of their center-of-mass (COM) stability both proactively and reactively (i.e., before and after hitting or crossing the obstacle), such that the need for taking compensatory step was substantially diminished. The proactive adaptations included a reduced forward COM velocity that lessened forward instability in mid-to-late stance and an elevated toe clearance that reduced the likelihood of obstacle contact. The reactive adjustments were characterized by improved trunk control (by reducing its forward rotation) and limb support (by increasing hip height), and reduced forward instability (by both the posterior COM shift and the reduction in its forward velocity). These findings suggest that young adults can adapt appropriately to repeated trip perturbations and to reduce trip-induced excessive instability in both proactive and reactive manners. Copyright © 2012 Elsevier Ltd. All rights reserved.

Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults.

PubMed

Furtado, Fabianne; Gonçalves, Bruno da Silva B; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia; Forner-Cordero, Arturo

2016-01-01

The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation.

Can we reduce the effort of maintaining a neutral sitting posture? A pilot study.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-12-01

Neutral sitting postures encouraging lumbar lordosis have been recommended in the management of sitting-related low back pain (LBP). However, prolonged lordotic sitting postures can be associated with increased fatigue and discomfort. This pilot study investigated whether changing the type of chair used in sitting can reduce the effort of maintaining a neutral sitting posture. The muscle activation of six trunk muscles was recorded using surface electromyography in 12 painfree participants. Participants were facilitated into a neutral sitting posture for 1 min on both a standard backless office chair and a dynamic, forward-inclined chair (Back App). Lumbar multifidus activity was significantly lower on the Back App chair (p=0.013). None of the other five trunk muscles measured demonstrated a significant difference in activity between the chairs. There was no significant difference (p=0.108) in the perceived effort of maintaining the neutral sitting posture on the two chairs. This study suggests that the lumbar multifidus activation required to maintain a neutral sitting posture can be reduced by considering the type of chair used. The mechanism through which the Back App chair reduces lumbar multifidus activation is unclear, but the greatest difference between chairs is the degree of hip flexion. The ability to maintain a neutral lumbar posture with less lumbar multifidus activation is potentially advantageous during prolonged sitting. Further investigations of the effects of chair design on longer duration sitting, and among LBP subjects, are warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults

PubMed Central

Gonçalves, Bruno da Silva B.; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia

2016-01-01

The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation. PMID:27732604

Simultaneous use of camera and probe diagnostics to unambiguously identify and study the dynamics of multiple underlying instabilities during the route to plasma turbulence.

PubMed

Thakur, S C; Brandt, C; Light, A; Cui, L; Gosselin, J J; Tynan, G R

2014-11-01

We use multiple-tip Langmuir probes and fast imaging to unambiguously identify and study the dynamics of underlying instabilities during the controlled route to fully-developed plasma turbulence in a linear magnetized helicon plasma device. Langmuir probes measure radial profiles of electron temperature, plasma density and potential; from which we compute linear growth rates of instabilities, cross-phase between density and potential fluctuations, Reynold's stress, particle flux, vorticity, time-delay estimated velocity, etc. Fast imaging complements the 1D probe measurements by providing temporally and spatially resolved 2D details of plasma structures associated with the instabilities. We find that three radially separated plasma instabilities exist simultaneously. Density gradient driven resistive drift waves propagating in the electron diamagnetic drift direction separate the plasma into an edge region dominated by strong, velocity shear driven Kelvin-Helmholtz instabilities and a central core region which shows coherent Rayleigh-Taylor modes propagating in the ion diamagnetic drift direction. The simultaneous, complementary use of both probes and camera was crucial to identify the instabilities and understand the details of the very rich plasma dynamics.

Effect of long-term bedrest on lower leg muscle activation patterns during quiet standing.

PubMed

Miyoshi, T; Sato, T; Sekiguchi, H; Yamanaka, K; Miyazaki, M; Igawa, S; Komeda, T; Nakazawa, K; Yano, H

2001-07-01

It has been well known that balance instabilities after long-term exposure to microgravity (e.g., Anderson et al. 1986) or bedrest (BR) can be related to alterations and/or adaptations to postural control strategies. Little is known, however, how the reduced muscular activity affects the activation pattern of the lower limb muscles during quiet standing (QS). The purpose of this study was to investigate whether or not any changes in the lower limb muscle activation patterns during QS would occur after BR.

Resistance versus Balance Training to Improve Postural Control in Parkinson's Disease: A Randomized Rater Blinded Controlled Study

PubMed Central

Schlenstedt, Christian; Paschen, Steffen; Kruse, Annika; Raethjen, Jan; Weisser, Burkhard; Deuschl, Günther

2015-01-01

Background Reduced muscle strength is an independent risk factor for falls and related to postural instability in individuals with Parkinson’s disease. The ability of resistance training to improve postural control still remains unclear. Objective To compare resistance training with balance training to improve postural control in people with Parkinson’s disease. Methods 40 patients with idiopathic Parkinson’s disease (Hoehn&Yahr: 2.5–3.0) were randomly assigned into resistance or balance training (2x/week for 7 weeks). Assessments were performed at baseline, 8- and 12-weeks follow-up: primary outcome: Fullerton Advanced Balance (FAB) scale; secondary outcomes: center of mass analysis during surface perturbations, Timed-up-and-go-test, Unified Parkinson’s Disease Rating Scale, Clinical Global Impression, gait analysis, maximal isometric leg strength, PDQ-39, Beck Depression Inventory. Clinical tests were videotaped and analysed by a second rater, blind to group allocation and assessment time. Results 32 participants (resistance training: n = 17, balance training: n = 15; 8 drop-outs) were analyzed at 8-weeks follow-up. No significant difference was found in the FAB scale when comparing the effects of the two training types (p = 0.14; effect size (Cohen’s d) = -0.59). Participants from the resistance training group, but not from the balance training group significantly improved on the FAB scale (resistance training: +2.4 points, Cohen’s d = -0.46; balance training: +0.3 points, Cohen’s d = -0.08). Within the resistance training group, improvements of the FAB scale were significantly correlated with improvements of rate of force development and stride time variability. No significant differences were found in the secondary outcome measures when comparing the training effects of both training types. Conclusions The difference between resistance and balance training to improve postural control in people with Parkinson’s disease was small and not significant with this sample size. There was weak evidence that freely coordinated resistance training might be more effective than balance training. Our results indicate a relationship between the enhancement of rate of force development and the improvement of postural control. Trial Registration ClinicalTrials.gov ID: NCT02253563 PMID:26501562

Active Combustion Control for Aircraft Gas-Turbine Engines-Experimental Results for an Advanced, Low-Emissions Combustor Prototype

NASA Technical Reports Server (NTRS)

DeLaat, John C.; Kopasakis, George; Saus, Joseph R.; Chang, Clarence T.; Wey, Changlie

2012-01-01

Lean combustion concepts for aircraft engine combustors are prone to combustion instabilities. Mitigation of instabilities is an enabling technology for these low-emissions combustors. NASA Glenn Research Center s prior activity has demonstrated active control to suppress a high-frequency combustion instability in a combustor rig designed to emulate an actual aircraft engine instability experience with a conventional, rich-front-end combustor. The current effort is developing further understanding of the problem specifically as applied to future lean-burning, very low-emissions combustors. A prototype advanced, low-emissions aircraft engine combustor with a combustion instability has been identified and previous work has characterized the dynamic behavior of that combustor prototype. The combustor exhibits thermoacoustic instabilities that are related to increasing fuel flow and that potentially prevent full-power operation. A simplified, non-linear oscillator model and a more physics-based sectored 1-D dynamic model have been developed to capture the combustor prototype s instability behavior. Utilizing these models, the NASA Adaptive Sliding Phasor Average Control (ASPAC) instability control method has been updated for the low-emissions combustor prototype. Active combustion instability suppression using the ASPAC control method has been demonstrated experimentally with this combustor prototype in a NASA combustion test cell operating at engine pressures, temperatures, and flows. A high-frequency fuel valve was utilized to perturb the combustor fuel flow. Successful instability suppression was shown using a dynamic pressure sensor in the combustor for controller feedback. Instability control was also shown with a pressure feedback sensor in the lower temperature region upstream of the combustor. It was also demonstrated that the controller can prevent the instability from occurring while combustor operation was transitioning from a stable, low-power condition to a normally unstable high-power condition, thus enabling the high-power condition.

Live Imaging to Study Microtubule Dynamic Instability in Taxane-resistant Breast Cancers.

PubMed

Wang, Richard; Wang, Harris; Wang, Zhixiang

2017-02-20

Taxanes such as docetaxel belong to a group of microtubule-targeting agents (MTAs) that are commonly relied upon to treat cancer. However, taxane resistance in cancerous cells drastically reduces the effectiveness of the drugs' long-term usage. Accumulated evidence suggests that the mechanisms underlying taxane resistance include both general mechanisms, such as the development of multidrug resistance due to the overexpression of drug-efflux proteins, and taxane-specific mechanisms, such as those that involve microtubule dynamics. Because taxanes target cell microtubules, measuring microtubule dynamic instability is an important step in determining the mechanisms of taxane resistance and provides insight into how to overcome this resistance. In the experiment, an in vivo method was used to measure microtubule dynamic instability. GFP-tagged α-tubulin was expressed and incorporated into microtubules in MCF-7 cells, allowing for the recording of the microtubule dynamics by time lapse using a sensitive camera. The results showed that, as opposed to the non-resistant parental MCF-7CC cells, the microtubule dynamics of docetaxel-resistant MCF-7TXT cells are insensitive to docetaxel treatment, which causes the resistance to docetaxel-induced mitotic arrest and apoptosis. This paper will outline this in vivo method of measuring microtubule dynamic instability.

Creative Dance Practice Improves Postural Control in a Child With Cerebral Palsy.

PubMed

Stribling, Kate; Christy, Jennifer

2017-10-01

To investigate the effect of creative dance instruction on postural control and balance in an 11-year-old with spastic triplegic cerebral palsy, Gross Motor Function Classification Scale level II. We conducted 1-hour dance interventions twice weekly for 8 weeks, with a focus on somatosensory awareness and movement in all planes of motion. Computerized dynamic posturography using the SMART Balance Master/EquiTest (NeuroCom) was used to assess postural control and balance reactions before the first class and following the final class. Gains in standing stability, balance recovery, directional control, and endpoint excursion of movement were found. Participation in creative dance lessons appears to improve somatosensory effectiveness and postural control in a child with cerebral palsy. Dance is a fun way to improve balance and coordination. These interventions could be easily implemented into programs for children with cerebral palsy.

DTN routing in body sensor networks with dynamic postural partitioning.

PubMed

Quwaider, Muhannad; Biswas, Subir

2010-11-01

This paper presents novel store-and-forward packet routing algorithms for Wireless Body Area Networks ( WBAN ) with frequent postural partitioning. A prototype WBAN has been constructed for experimentally characterizing on-body topology disconnections in the presence of ultra short range radio links, unpredictable RF attenuation, and human postural mobility. On-body DTN routing protocols are then developed using a stochastic link cost formulation, capturing multi-scale topological localities in human postural movements. Performance of the proposed protocols are evaluated experimentally and via simulation, and are compared with a number of existing single-copy DTN routing protocols and an on-body packet flooding mechanism that serves as a performance benchmark with delay lower-bound. It is shown that via multi-scale modeling of the spatio-temporal locality of on-body link disconnection patterns, the proposed algorithms can provide better routing performance compared to a number of existing probabilistic, opportunistic, and utility-based DTN routing protocols in the literature.

Effects of Levodopa on Postural Strategies in Parkinson’s disease

PubMed Central

Mancini, Martina; Rocchi, Laura; Horak, Fay

2017-01-01

Altered postural control and balance are major disabling issues of Parkinson’s disease (PD). Static and dynamic posturography have provided insight into PD’s postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. PMID:27131172

Effects of Levodopa on Postural Strategies in Parkinson's disease.

PubMed

Baston, Chiara; Mancini, Martina; Rocchi, Laura; Horak, Fay

2016-05-01

Altered postural control and balance are major disabling issues of Parkinson's disease (PD). Static and dynamic posturography have provided insight into PD's postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance. Copyright © 2016 Elsevier B.V. All rights reserved.

Body size and lower limb posture during walking in humans

PubMed Central

Hora, Martin; Soumar, Libor; Pontzer, Herman; Sládek, Vladimír

2017-01-01

We test whether locomotor posture is associated with body mass and lower limb length in humans and explore how body size and posture affect net joint moments during walking. We acquired gait data for 24 females and 25 males using a three-dimensional motion capture system and pressure-measuring insoles. We employed the general linear model and commonality analysis to assess the independent effect of body mass and lower limb length on flexion angles at the hip, knee, and ankle while controlling for sex and velocity. In addition, we used inverse dynamics to model the effect of size and posture on net joint moments. At early stance, body mass has a negative effect on knee flexion (p < 0.01), whereas lower limb length has a negative effect on hip flexion (p < 0.05). Body mass uniquely explains 15.8% of the variance in knee flexion, whereas lower limb length uniquely explains 5.4% of the variance in hip flexion. Both of the detected relationships between body size and posture are consistent with the moment moderating postural adjustments predicted by our model. At late stance, no significant relationship between body size and posture was detected. Humans of greater body size reduce the flexion of the hip and knee at early stance, which results in the moderation of net moments at these joints. PMID:28192522

Postural Stability of Patients with Schizophrenia during Challenging Sensory Conditions: Implication of Sensory Integration for Postural Control.

PubMed

Teng, Ya-Ling; Chen, Chiung-Ling; Lou, Shu-Zon; Wang, Wei-Tsan; Wu, Jui-Yen; Ma, Hui-Ing; Chen, Vincent Chin-Hung

2016-01-01

Postural dysfunctions are prevalent in patients with schizophrenia and affect their daily life and ability to work. In addition, sensory functions and sensory integration that are crucial for postural control are also compromised. This study intended to examine how patients with schizophrenia coordinate multiple sensory systems to maintain postural stability in dynamic sensory conditions. Twenty-nine patients with schizophrenia and 32 control subjects were recruited. Postural stability of the participants was examined in six sensory conditions of different level of congruency of multiple sensory information, which was based on combinations of correct, removed, or conflicting sensory inputs from visual, somatosensory, and vestibular systems. The excursion of the center of pressure was measured by posturography. Equilibrium scores were derived to indicate the range of anterior-posterior (AP) postural sway, and sensory ratios were calculated to explore ability to use sensory information to maintain balance. The overall AP postural sway was significantly larger for patients with schizophrenia compared to the controls [patients (69.62±8.99); controls (76.53±7.47); t1,59 = -3.28, p<0.001]. The results of mixed-model ANOVAs showed a significant interaction between the group and sensory conditions [F5,295 = 5.55, p<0.001]. Further analysis indicated that AP postural sway was significantly larger for patients compared to the controls in conditions containing unreliable somatosensory information either with visual deprivation or with conflicting visual information. Sensory ratios were not significantly different between groups, although small and non-significant difference in inefficiency to utilize vestibular information was also noted. No significant correlations were found between postural stability and clinical characteristics. To sum up, patients with schizophrenia showed increased postural sway and a higher rate of falls during challenging sensory conditions, which was independent of clinical characteristics. Patients further demonstrated similar pattern and level of utilizing sensory information to maintain balance compared to the controls.

Relationships between postural orientation and self reported function, hop performance and muscle power in subjects with anterior cruciate ligament injury.

PubMed

Trulsson, Anna; Roos, Ewa M; Ageberg, Eva; Garwicz, Martin

2010-07-01

Injury to the anterior cruciate ligament (ACL) is associated not only with knee instability and impaired neuromuscular control, but also with altered postural orientation manifested as observable "substitution patterns". However, tests currently used to evaluate knee function in subjects with ACL injury are not designed to assess postural orientation. Therefore, we are in the process of developing an observational test set that measures postural orientation in terms of the ability to stabilize body segments in relation to each other and to the environment. The aim of the present study was to characterise correlations between this novel test set, called the Test for Substitution Patterns (TSP) and commonly used tests of knee function. In a blinded set-up, 53 subjects (mean age 30 years, range 20-39, with 2-5 years since ACL injury) were assessed using the TSP, the Knee Injury and Osteoarthritis Outcome Score subscale sport/recreation (KOOS sport/rec), 3 hop tests and 3 muscle power tests. Correlations between the scores of the TSP and the other tests were determined. Moderate correlations were found between TSP scores and KOOS sport/rec (rs = -0.43; p = 0.001) and between TSP scores and hop test results (rs = -0.40 to -0.46; p < or = 0.003), indicating that altered postural orientation was associated with worse self-reported KOOS sport/rec function and worse hop performance. No significant correlations were found between TSP scores and muscle power results. Subjects had higher TSP scores on their injured side than on their uninjured side (median 4 and 1 points; interquartile range 2-6 and 0-1.5, respectively; p < 0.0001). We conclude that the Test for Substitution Patterns is of relevance to the patient and measures a specific aspect of neuromuscular control not quantified by the other tests investigated. We suggest that the TSP may be a valuable complement in the assessment of neuromuscular control in the rehabilitation of subjects with ACL injury.

Influence of base of support size on arm pointing performance and associated anticipatory postural adjustments.

PubMed

Yiou, Eric; Hamaoui, Alain; Le Bozec, Serge

2007-08-09

The current study was designed to test the effect of changing the base of support (BoS) size in the initial posture on the performance of a pointing task and the associated "anticipatory postural adjustments" (APAs). Subjects performed series of arm pointing tasks at maximal velocity, from five postures that differed by the antero-posterior (AP) distance between the heels. This distance was increased stepwise from 0 cm (P0 condition) to 40 cm (P40 condition). Kinetics data were collected with a large force-plate, and kinematics data of the pointing were collected with a bi-axial accelerometer (AP and vertical direction) fixed at the wrist. ANOVA showed that the amplitude and the efficiency of the APAs, as well as the performance of the pointing, all statistically increased from P0 to P40 (with 0.0001

Nutrient chemotaxis suppression of a diffusive instability in bacterial colony dynamics

NASA Astrophysics Data System (ADS)

Arouh, Scott; Levine, Herbert

2000-07-01

Bacteria grown on a semisolid agar surface have been observed to form branching patterns as the colony envelope propagates outward. The fundamental cause of this instability relates to the need for limited nutrient to diffuse towards the colony. Here, we investigate the effect on this instability of allowing the bacteria to move chemotactically in response to the nutrient gradient. Our results show that this additional effect has a tendency to suppress the instability. Our calculations are done within the context of a simple ``cutoff'' model of colony dynamics, but presumably remain valid for more complex and hence more realistic approaches.

Effect of midsole thickness of dance shoes on dynamic postural stability.

PubMed

Wyon, Matthew A; Cloak, Ross; Lucas, Josephine; Clarke, Frances

2013-12-01

Landing from jumps is one of the main causes of injury within dance. A number of studies have reported a negative effect of shoe midsole thickness on lower limb kinematics during running due to the reduction in afferent sensory outputs from the foot's epithelium. The purpose of this study was to examine the influence of varying midsole thicknesses in dance shoes on dynamic postural stability during a single-leg landing. Twenty-eight female undergraduate dance participants volunteered for the study. They carried out three trials under four conditions: barefoot and in ballet flats (2 mm midsole thickness), jazz shoes (7 mm), and dance sneakers (30 mm). The task consisted of a single-leg forward jump over a hurdle at 50% of their maximal vertical jump height, landing on a force platform, and balancing for 3 seconds. The stability indices for vertical stability (VSI), anterior-posterior stability (APSI), medial-lateral stability (MLSI), and dynamic postural stability (DPSI) were calculated using Wikstrom's revised method. Significant differences were reported between the midsole thicknesses for both DPSI and VSI (p<0.01). No statistical differences were noted for the indices SPSI or MLSI. The present data agree with the running studies in that increased midsole thickness has a negative influence on landing stability.

Dynamic stability control in forward falls: postural corrections after muscle fatigue in young and older adults.

PubMed

Mademli, Lida; Arampatzis, Adamantios; Karamanidis, Kiros

2008-06-01

Many studies report that muscle strength loss may alter the human system's capacity to generate rapid force for balance corrections after perturbations, leading to deficient recovery behaviours. Yet little is known regarding the effect of modifications in the neuromuscular system induced by fatigue on dynamic stability control during postural perturbations. This study investigates the effect of muscle strength decline induced by fatiguing contractions on the dynamic stability control of young and older adults during forward falls. Eleven young and eleven older male adults had to regain balance after sudden falls before and after submaximal fatiguing knee extension-flexion contractions. Young subjects had a higher margin of stability than older ones before and after the fatiguing task. This reflects their enhanced ability in using mechanisms for maintaining dynamic stability (i.e. a greater base of support). The margin of stability, the boundary of the base of support and the position of the extrapolated centre of mass, remained unaffected by the reduction in muscle strength induced by the fatiguing contractions, indicating an appropriate adjustment of the motor commands to compensate the deficit in muscle strength. Both young and older adults were able to counteract the decreased horizontal ground reaction forces after the fatiguing task by flexing their knee to a greater extent, leading to similar decreases in the horizontal velocity of centre of mass as in the pre fatigue condition. The results demonstrate the ability of the central nervous system to rapidly modify the execution of postural corrections including mechanisms for maintaining dynamic stability.

Absence of Rotation Perception during Warm Water Caloric Irrigation in Some Seniors with Postural Instability.

PubMed

Chiarovano, Elodie; Vidal, Pierre-Paul; Magnani, Christophe; Lamas, Georges; Curthoys, Ian S; de Waele, Catherine

2016-01-01

Falls in seniors are a major public health problem. Falls lead to fear of falling, reduced mobility, and decreased quality of life. Vestibular dysfunction is one of the fall risk factors. The relationship between objective measures of vestibular responses and age has been studied. However, the effects of age on vestibular perception during caloric stimulation have not been studied. Twenty senior subjects were included in the study, and separated in two groups: 10 seniors reporting postural instability (PI) and exhibiting absence of vestibular perception when they tested with caloric stimulation and 10 sex- and age-matched seniors with no such problems (controls). We assessed vestibular perception on a binary rating scale during the warm irrigation of the caloric test. The function of the various vestibular receptors was assessed using video head impulse test (vHIT), caloric tests, and cervical and ocular vestibular-evoked myogenic potentials. The Equitest was used to evaluate balance. No horizontal canal dysfunction assessed using both caloric test and vHIT was detected in either group. No significant difference was detected between PI and control groups for the peak SPV of caloric-induced ocular nystagmus or for the HVOR gain. All the controls perceived rotation when the maximal SPV during warm irrigation was equal to or ≥15°/s. None of the subjects in the PI group perceived rotation even while the peak SPV exceeded 15°/s, providing objective evidence of normal peripheral horizontal canal function. All the PI group had abnormal Equitest results, particularly in the two last conditions. These investigations show for the first time that vestibular perception can be absent during a caloric test despite normal horizontal canal function. We call this as dissociation vestibular neglect. Patients with poor vestibular perception may not be aware of postural perturbations and so will not correct for them. Thus, falls in the elderly may result, among other factors, from a vestibular neglect due to an inappropriate central processing of normal vestibular peripheral inputs. That is, failure to perceive rotation during caloric testing when the SPV is >15°/s, should prompt the clinician to envisage preventive actions to avoid future falls such as rehabilitation.

Electromiography comparison of distal and proximal lower limb muscle activity patterns during external perturbation in subjects with and without functional ankle instability.

PubMed

Kazemi, Khadijeh; Arab, Amir Massoud; Abdollahi, Iraj; López-López, Daniel; Calvo-Lobo, César

2017-10-01

Ankle sprain is one of the most common injuries among athletes and the general population. Most ankle injuries commonly affect the lateral ligament complex. Changes in postural sway and hip abductor muscle strength may be generated after inversion ankle sprain. Therefore, the consequences of ankle injury may affect proximal structures of the lower limb. The aim is to describe and compare the activity patterns of distal and proximal lower limb muscles following external perturbation in individuals with and without functional ankle instability. The sample consisted of 16 women with functional ankle instability and 18 healthy women were recruited to participate in this research. The external perturbation via body jacket using surface electromyography, amplitude and onset of muscle activity of gluteus maximums, gluteus medius, tibialis anterior, and peroneus longus was recorded and analyzed during external perturbation. There were differences between the onset of muscles activity due to perturbation direction in the two groups (healthy and functional ankle instability). In the healthy group, there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during front perturbation with eyes open and closed. In the functional ankle instability group; there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during perturbation of the front and back with eyes open. There were statistically significant differences in the onset of muscle activity and amplitude of muscle activity, with-in and between groups (P<0.05). Therefore, in the presence of functional ankle instability, activation patterns of the lower limb proximal muscles may be altered. Copyright © 2017 Elsevier B.V. All rights reserved.

Lending sociodynamics and economic instability

NASA Astrophysics Data System (ADS)

Hawkins, Raymond J.

2011-11-01

We show how the dynamics of economic instability and financial crises articulated by Keynes in the General Theory and developed by Minsky as the Financial Instability Hypothesis can be formalized using Weidlich’s sociodynamics of opinion formation. The model addresses both the lending sentiment of a lender in isolation as well as the impact on that lending sentiment of the behavior of other lenders. The risk associated with lending is incorporated through a stochastic treatment of loan dynamics that treats prepayment and default as competing risks. With this model we are able to generate endogenously the rapid changes in lending opinion that attend slow changes in lending profitability and find these dynamics to be consistent with the rise and collapse of the non-Agency mortgage-backed securities market in 2007/2008. As the parameters of this model correspond to well-known phenomena in cognitive and social psychology, we can both explain why economic instability has proved robust to advances in risk measurement and suggest how policy for reducing economic instability might be formulated in an experimentally sound manner.

Impact of Sex on the Nonmotor Symptoms and the Health-Related Quality of Life in Parkinson's Disease

PubMed Central

Kovács, Márton; Makkos, Attila; Aschermann, Zsuzsanna; Janszky, József; Komoly, Sámuel; Weintraut, Rita; Karádi, Kázmér; Kovács, Norbert

2016-01-01

Background. Female Parkinson's disease (PD) patients seem to experience not only more severe motor complications and postural instability but also more pronounced depression, anxiety, pain, and sleep disturbances. Objective. The aim of the present study was to evaluate the role of sex as a possible independent predictor of HRQoL in PD. Methods. In this cross-sectional study, 621 consecutive patients treated at the University of Pécs were enrolled. Severity of PD symptoms was assessed by MDS-UPDRS, UDysRS, Non-Motor Symptoms Scale, PDSS-2, Hamilton Anxiety Scale, Montgomery-Asberg Depression Rating Scale, Lille Apathy Rating Scale, and Addenbrooke Cognitive Examination. HRQoL was assessed by PDQ-39 and EQ-5D. Multiple regression analysis was performed to estimate the PDQ-39 and EQ-5D index values based on various clinical factors. Results. Although females received significantly lower dosage of levodopa, they had significantly more disabling dyskinesia and worse postural instability. Anxiety, pain, sleep disturbances, and orthostatic symptoms were more frequent among females while sexual dysfunction, apathy, and daytime sleepiness were more severe among males. Women had worse HRQoL than men (EQ-5D index value: 0.620 ± 0.240 versus 0.663 ± 0.229, p = 0.025, and PDQ-39 SI: 27.1 ± 17.0 versus 23.5 ± 15.9, p = 0.010). Based on multiple regression analysis, sex was an independent predictor for HRQoL in PD. Conclusions. Based on our results, female sex is an independent predictor for having worse HRQoL in PD. PMID:27293959

Vascular risk factors and the effect of white matter lesions on extrapyramidal signs in Alzheimer's disease.

PubMed

Park, Moon Ho; Min, Joo Young; Kwon, Do-Young; Lee, Seung Hwan; Na, Hae Ri; Cho, Sung Tae; Na, Duk L

2011-06-01

Extrapyramidal signs (EPSs), which are important characteristics of Parkinson's disease (PD), occur frequently in Alzheimer's disease (AD). Although AD and PD share common clinical features such as EPSs, these diseases vary with respect to vascular risk factors. The presence of vascular risk factors increases the risk of AD; however, these factors have been known to be inversely associated with PD. We aimed to assess the effect of vascular risk factors and white matter lesions (WMLs) on EPSs in AD. We recruited 1,187 AD patients and 333 controls with neither cognitive impairment nor EPSs. All participants underwent detailed clinical evaluations which included assessments of vascular risk factors, cognitive function, and EPSs, as well as WMLs on brain MRIs. EPS subtypes were classified into tremor-dominant, postural instability gait difficulty, or indeterminate; WMLs subtypes were classified into periventricular WML (pvWML) or deep WML (dWML). EPSs were present in 17.9% of subjects with AD and were significantly associated with vascular risk factors such as age, male gender, diabetes mellitus, and WMLs. Additionally, a multivariate logistic regression analysis showed that EPSs in AD were associated with pvWML (odds ratio (OR), 1.61-2.52), not with dWML. With respect to EPS subtypes, the majority (78.4%) of EPSs in AD were postural instability gait difficulty, which was also associated with WMLs (OR 1.84-2.41), pvWML (OR 2.09-3.14), and dWML (OR 1.83-3.42). EPSs in AD are associated with selected vascular risk factors as well as WMLs.

Deep Brain Stimulation of Pedunculopontine Nucleus for Postural Instability and Gait Disorder After Parkinson Disease: A Meta-Analysis of Individual Patient Data.

PubMed

Wang, Jia-Wei; Zhang, Yu-Qing; Zhang, Xiao-Hua; Wang, Yun-Peng; Li, Ji-Ping; Li, Yong-Jie

2017-06-01

Postural instability and gait disorder (PIGD) in Parkinson disease (PD) has been a great challenge in clinical practice because PIGD is closely linked to major morbidity and mortality in PD. Pedunculopontine nucleus (PPN) has been considered as a potential promising target for deep brain stimulation (DBS) in the treatment of PIGD. A meta-analysis of individual patient data was performed to assess the effects of PPN DBS on PIGD in patients with PD and explore the factors predicting good outcome. According to the study strategy, we searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, and other sources. After searching the literature, 2 investigators independently screened the literature, assessed the quality of the included trials, and extracted the data. The outcome measures included PIGD, freezing of gait, and falling in PD. Then, individual patient data were incorporated into SPSS software for statistical analyses across series. Six studies reporting individual patient data were included for final analysis. PPN DBS significantly improved PIGD as well as freezing of gait and falling after PD, which was depending on the duration of follow-up and types of outcome measures. In addition, patient age, disease duration, levodopa-equivalent dosage, and the choice of unilateral or bilateral stimulation were similar in groups of patients with PD with or without improvement in PIGD after PPN DBS. Our study provides evidence that PPN DBS may improve PIGD, which should be interpreted with caution and needs further verification before making generalization of our results. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of pelvic movement in the elderly during walking using a posture monitoring system equipped with a triaxial accelerometer and a gyroscope.

PubMed

Ishigaki, Norio; Kimura, Teiji; Usui, Yuki; Aoki, Kaoru; Narita, Nobuyo; Shimizu, Masayuki; Hara, Kazuo; Ogihara, Nobuhide; Nakamura, Koichi; Kato, Hiroyuki; Ohira, Masayoshi; Yokokawa, Yoshiharu; Miyoshi, Kei; Murakami, Narumichi; Okada, Shinpei; Nakamura, Tomokazu; Saito, Naoto

2011-06-03

The incidence of falls in the elderly is increasing with the aging of society and is becoming a major public health issue. From the viewpoint of prevention of falls, it is important to evaluate the stability of the gait in the elderly people. The pelvic movement, which is a critical factor for walking stability, was analyzed using a posture monitoring system equipped with a triaxial accelerometer and a gyroscope. The subjects were 95 elderly people over 60 years of age. The criteria for instability were open-eye standing on one leg for 15s or less, and 11s or more on 3m timed up and go test. Forty subjects who did not meet both of these criteria comprised the stable group, and the remaining 55 subjects comprised the unstable group. Pelvic movement during walking was compared between the two groups. The angle, angular velocity, and acceleration were analyzed based on the wave shape derived from the device worn around the second sacral. The results indicated that pelvic movement was lower in all three directions in the unstable group compared to the stable group, and the changes in the pelvic movement during walking in unstable elderly people were also reduced. This report is the first to evaluate pelvic movement by both a triaxial accelerometer and a triaxial gyroscope simultaneously. The characteristics of pelvic movement during walking can be applied in screening to identify elderly people with instability, which is the main risk factor associated with falls. Copyright © 2011 Elsevier Ltd. All rights reserved.

Improved postural control after dynamic balance training in older overweight women.

PubMed

Bellafiore, Marianna; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio; Farina, Felicia; Palma, Antonio

2011-01-01

Many studies have reported a greater frequency of falls among older women than men in conditions which stress balance. Previously, we found an improvement in static balance in older women with an increased support surface area and equal load redistribution on both feet, in response to a dynamic balance training protocol. The aim of the present study was to examine whether the same training program and body composition would have effects on the postural control of older overweight women. Ten healthy women (68.67 ± 5.50 yrs; 28.17 ± 3.35 BMI) participated in a five-week physical activity program. This included dynamic balance exercises, such as heel-to-toe walking in different directions, putting their hands on their hips, eyes open (EO) or closed (EC), with a tablet on their heads, going up and down one step, and walking on a mat. Postural stability was assessed before and after training with an optoelectronic platform and a uni-pedal balance performance test. Body composition of the trunk, upper limbs and lower limbs was measured by bio-impedance analysis. The mean speed (MS), medial-lateral MS (MS-x), anterior-posterior MS (MS-y), sway path (SP) and ellipse surface area (ESA) of the pressure center was reduced after training in older women. However, only MS, MS-x, MS-y and SP significantly decreased in bipodalic conditions with EO and MS-y also with EC (p<0.05). Instead, in monopodalic conditions, we found a significant reduction in the ESA of both feet with EO and EC. These data were associated with a significant increase in the lean mass of lower limbs and a higher number of participants who improved their ability to maintain unipedal static balance. Our dynamic balance training protocol appears to be feasible, safe and repeatable for older overweight women and to have positive effects in improving their lateral and anterior-posterior postural control, mainly acting on the visual and skeletal muscle components of the balance control system.

Effects of Kinesio taping and exercise on forward head posture.

PubMed

Shih, Hsu-Sheng; Chen, Shu-Shi; Cheng, Su-Chun; Chang, Hsun-Wen; Wu, Pei-Rong; Yang, Jin-Shiou; Lee, Yi-Shuang; Tsou, Jui-Yi

2017-01-01

Little is known about the effects of Kinesio taping and therapeutic exercise on correcting forward head posture. To compare Kinesio taping versus therapeutic exercise for forward head posture on static posture, dynamic mobility and functional outcomes. Sixty subjects (31 women, 29 men) with forward head postures participated in this study. They were randomly assigned to either one of the three groups: (1) exercise group (n = 20), (2) taping group (n = 20), and (3) control groups (n = 20). The horizontal forward displacement (HFD) between ear lobe and acromion process, upper cervical and lower cervical angle (UCA, LCA), active range of motion (AROM) of cervical spine, and neck disability index (NDI) were measured before and after a 5-week intervention, and a 2-week follow-up. Data were analyzed by means of a mixed design repeated-measures ANOVA. Both taping and exercise groups showed significant improvements in HFD compared with the control group at post-treatment and follow-up. Compared with the control group, the exercise group exhibited significant improvements in the LCA and the side bending AROM at post-treatment. Both Kinesio taping and therapeutic exercise improve forward head posture after intervention and a 2-week follow-up. The effectiveness of therapeutic exercise is better than taping.

Human body modeling method to simulate the biodynamic characteristics of spine in vivo with different sitting postures.

PubMed

Dong, Rui-Chun; Guo, Li-Xin

2017-11-01

The aim of this study is to model the computational model of seated whole human body including skeleton, muscle, viscera, ligament, intervertebral disc, and skin to predict effect of the factors (sitting postures, muscle and skin, buttocks, viscera, arms, gravity, and boundary conditions) on the biodynamic characteristics of spine. Two finite element models of seated whole body and a large number of finite element models of different ligamentous motion segments were developed and validated. Static, modal, and transient dynamic analyses were performed. The predicted vertical resonant frequency of seated body model was in the range of vertical natural frequency of 4 to 7 Hz. Muscle, buttocks, viscera, and the boundary conditions of buttocks have influence on the vertical resonant frequency of spine. Muscle played a very important role in biodynamic response of spine. Compared with the vertical posture, the posture of lean forward or backward led to an increase in stress on anterior or lateral posterior of lumbar intervertebral discs. This indicated that keeping correct posture could reduce the injury of vibration on lumbar intervertebral disc under whole-body vibration. The driving posture not only reduced the load of spine but also increased the resonant frequency of spine. Copyright © 2017 John Wiley & Sons, Ltd.

Electromyographic activity of the trunk extensor muscles: effect of varying hip position and lumbar posture during Roman chair exercise.

PubMed

Mayer, John M; Verna, Joe L; Manini, Todd M; Mooney, Vert; Graves, James E

2002-11-01

To evaluate the effect of hip position and lumbar posture on the surface electromyographic activity of the trunk extensors during Roman chair exercise. Descriptive, repeated measures. University-based musculoskeletal research laboratory. Twelve healthy volunteers (7 men, 5 women; age range, 18-35y) without a history of low back pain were recruited from a university setting. Not applicable. Surface electromyographic activity was recorded from the lumbar extensor, gluteal, and hamstring musculature during dynamic Roman chair exercise. For each muscle group, electromyographic activity (mV/rep) was compared among exercises with internal hip rotation and external hip rotation and among exercises by using a typical lumbar posture (nonbiphasic) and a posture that accentuated lumbar lordosis (biphasic). For the lumbar extensors, electromyographic activity during exercise was 18% greater with internal hip rotation than external hip rotation (P< or =.05) and was 25% greater with a biphasic posture than with a nonbiphasic posture (P< or =.05). For the gluteals and hamstrings, there was no difference in electromyographic activity between internal and external hip rotation or between biphasic and nonbiphasic postures (P >.05). The level of recruitment of the lumbar extensors can be modified during Roman chair exercise by altering hip position and lumbar posture. Clinicians can use these data to develop progressive exercise protocols for the lumbar extensors with a variety of resistance levels without the need for complex equipment. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Balance Training Enhances Vestibular Function and Reduces Overactive Proprioceptive Feedback in Elderly

PubMed Central

Wiesmeier, Isabella K.; Dalin, Daniela; Wehrle, Anja; Granacher, Urs; Muehlbauer, Thomas; Dietterle, Joerg; Weiller, Cornelius; Gollhofer, Albert; Maurer, Christoph

2017-01-01

Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits. PMID:28848430

Cervical vertebral realignment when voluntarily adopting a protective neck posture.

PubMed

Newell, Robyn S; Siegmund, Gunter P; Blouin, Jean-Sébastien; Street, John; Cripton, Peter A

2014-07-01

In vivo human volunteer study of the intervertebral postural changes and muscle activity levels while tensing the neck muscles. To determine if actively tensing the neck muscles changes the posture of the cervical spine and, because axial impact neck injury often occurs while inverted, whether these changes exist both upright and upside down. Rollover accidents are dynamic and complex events in which head contacts with the vehicle interior can cause catastrophic neck injuries. Computational modeling has suggested that active neck muscles may increase the risk of cervical spine fracture in a rollover crash. Cadaver testing has also demonstrated that overall neck alignment and curvature are key to understanding and preventing catastrophic neck injuries. Although muscle activity and neck posture affects the resulting injury, there are currently no in vivo data describing how tensing the neck muscles influences intervertebral posture. Eleven human subjects (6 females, 5 males) actively tensed their neck muscles while seated upright and inverted. Vertebral alignment was measured using fluoroscopy and muscle activity was recorded using surface and indwelling electrodes in 8 neck muscles. On average, tensed muscles increased cervical spine curvature and anterior motion of the cervical vertebrae relative to the torso. These changes, which were magnified by inversion, indicate that cervical intervertebral posture differs considerably between the relaxed and tensed states. Active muscle contraction can change the vertebral alignment in upright and inverted postures. This change in posture may alter the load path and injury mechanics during an axial head impact and may help explain the disparity between the neck injuries observed in real-world rollover accidents and ex vivo cadaver experiments. N/A.

Effect of textured foot orthotics on static and dynamic postural stability in middle-aged females.

PubMed

Wilson, Marjorie L; Rome, Keith; Hodgson, David; Ball, Peter

2008-01-01

Foot orthotics (FO) may be prescribed for a range of lower limb and foot conditions. Prior studies report use of FO in enhancing postural stability in healthy younger adults, and do not control for footwear type. Currently, interest in the effects of FO on postural stability in older adults has increased. Limited reports exist of the effects on postural stability of FO made of combinations of materials, thicknesses and surface textures. In this study 40 healthy females (51.1+/-5.8 years) recruited into a within subject test-retest randomised clinical trial were provided with identical footwear and randomised into four FO conditions (control, grid, dimple and plain, n=10 for each condition). Participants wore the footwear for 4 weeks, a minimum of 6h/day. A Kistler force plate was used to determine postural stability variables (anterior-posterior displacements and medial-lateral displacements) for each participant in a static position, with eyes open and eyes closed. Base of support was evaluated using the GAITRite system. Each outcome measure was measured at baseline and 4 weeks. Postural stability variables demonstrated no significant differences between the four FO conditions. No significant differences were observed with base of support between the four conditions. We have demonstrated no detrimental effects on postural stability in older females after 4 weeks. This is regardless of orthotic texture and is independent of footwear. Biomechanical or sensory effects of FO on postural stability are still to be determined. These may be dependent on the geometry and texture of the orthotic.

Ice skating promotes postural control in children.

PubMed

Keller, M; Röttger, K; Taube, W

2014-12-01

High fall rates causing injury and enormous financial costs are reported for children. However, only few studies investigated the effects of balance training in children and these studies did not find enhanced balance performance in postural (transfer) tests. Consequently, it was previously speculated that classical balance training might not be stimulating enough for children to adequately perform these exercises. Therefore, the aim of this study is to evaluate the influence of ice skating as an alternative form of balance training. Volunteers of an intervention (n = 17; INT: 13.1 ± 0.4 years) and a control group (n = 13; CON: 13.2 ± 0.3 years) were tested before and after training in static and dynamic postural transfer tests. INT participated in eight sessions of ice skating during education lessons, whereas CON participated in normal physical education. Enhanced balance performance was observed in INT but not in CON when tested on an unstable free-swinging platform (P < 0.05) or when performing a functional reach test (P < 0.001). This is the first study showing significantly enhanced balance performance after ice skating in children. More importantly, participating children improved static and dynamic balance control in postural tasks that were not part of the training. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson's Disease: A Systematic Review and Meta-Analysis.

PubMed

Harris, Dale M; Rantalainen, Timo; Muthalib, Makii; Johnson, Liam; Teo, Wei-Peng

2015-01-01

The use of virtual reality games (known as "exergaming") as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson's disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I (2) statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 -studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563-1.576), postural control (SMD 0.826, 95% CI 0.481-1.170), and dynamic balance (SMD -0.808, 95% CI -1.192 to -0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI -0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534-3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more -large-scale trials are needed to determine if the same is true for people with IPD.

The effects of muscle vibration on anticipatory postural adjustments.

PubMed

Slijper, Harm; Latash, Mark L

2004-07-23

The current study investigated the influence of changes in sensory information related to postural stability on anticipatory postural adjustments (APAs) in standing subjects. Subjects performed fast arm movements and a load release task while standing on a stable force platform or on an unstable board. We manipulated sensory information through vibration of the Achilles tendons and additional finger touch (contact forces under 1 N). Changes in the background activity of leg, trunk, and arm muscles and displacements of the center of pressure (COP) were quantified within time intervals typical for APAs. In the arm movement task, leg and trunk muscles showed a significant drop in the APAs with finger touch, while the vibration and standing on the unstable board each led to an increase in the APA magnitude. In the load release task, ventral muscles decreased their APA activity with touch, while dorsal muscles showed increased inhibition during APAs. During vibration, dorsal and ventral muscles showed increased excitation and inhibition during APAs, respectively. An additional analysis of APAs at a joint level, has shown that in both tasks, an index related to the co-activation of agonist-antagonist muscle pairs (C-index) was modulated with touch, vibration, and stability particularly in leg muscles. Small changes in the other index related to reciprocal activation (R-index) were found only in trunk muscles. Light touch and vibration induced opposing changes in the C-index, suggesting their opposite effects on the stabilization of a reference point or vertical. We conclude that the central nervous system deploys patterns of adjustments in which increased co-contraction of distal muscles and reciprocal adjustments in trunk muscles are modified to ensure equilibrium under postural instability.

The effect of six weeks endurance training on dynamic muscular control of the knee following fatiguing exercise.

PubMed

Hassanlouei, H; Falla, D; Arendt-Nielsen, L; Kersting, U G

2014-10-01

The aim of the study was to examine whether six weeks of endurance training minimizes the effects of fatigue on postural control during dynamic postural perturbations. Eighteen healthy volunteers were assigned to either a 6-week progressive endurance training program on a cycle ergometer or a control group. At week 0 and 7, dynamic exercise was performed on an ergometer until exhaustion and immediately after, the anterior-posterior centre of pressure (COP) sway was analyzed during full body perturbations. Maximal voluntary contractions (MVC) of the knee flexors and extensors, muscle fiber conduction velocity (MFCV) of the vastus lateralis and medialis during sustained isometric knee extension contractions, and power output were measured. Following the training protocol, maximum knee extensor and flexor force and power output increased significantly for the training group with no changes observed for the control group. Moreover, the reduction of MFCV due to fatigue changed for the training group only (from 8.6% to 3.4%). At baseline, the fatiguing exercise induced an increase in the centre of pressure sway during the perturbations in both groups (>10%). The fatiguing protocol also impaired postural control in the control group when measured at week 7. However, for the training group, sway was not altered after the fatiguing exercise when assessed at week 7. In summary, six weeks of endurance training delayed the onset of muscle fatigue and improved the ability to control balance in response to postural perturbations in the presence of muscle fatigue. Results implicate that endurance training should be included in any injury prevention program. Copyright © 2014 Elsevier Ltd. All rights reserved.

The timing of galvanic vestibular stimulation affects responses to platform translation

NASA Technical Reports Server (NTRS)

Hlavacka, F.; Shupert, C. L.; Horak, F. B.; Peterson, B. W. (Principal Investigator)

1999-01-01

We compared the effects of galvanic vestibular stimulation applied at 0, 0.5, 1.5 and 2.5 s prior to a backward platform translation on postural responses. The effect of the galvanic stimulation was largest on the final equilibrium position of the center of pressure (CoP). The largest effects occurred for the 0.5 and 0-s pre-period, when the dynamic CoP pressure changes in response to both the galvanic stimulus and the platform translation coincided. The shift in the final equilibrium position was also larger than the sum of the shifts for the galvanic stimulus and the platform translation alone for the 0.5 and 0-s pre-periods. The initial rate of change of the CoP response to the platform translation was not significantly affected in any condition. Changes in the peak CoP position could be accounted for by local interaction of CoP velocity changes induced by the galvanic and translation responses alone, but the changes in final equilibrium position could only be accounted for by a change in global body orientation. These findings suggest that the contribution of vestibulospinal information is greatest during the dynamic phase of the postural response, and that the vestibular system contributes most to the later components of the postural response, particularly to the final equilibrium position. These findings suggest that a nonlinear interaction between the vestibular signal induced by the galvanic current and the sensory stimuli produced by the platform translation occurs when the two stimuli are presented within 1 s, during the dynamic phase of the postural response to the galvanic stimulus. When presented at greater separations in time, the stimuli appear to be treated as independent events, such that no interaction occurs. Copyright 1999 Elsevier Science B.V.

The characterization of socio-political instability, development and sustainability with Fisher information

EPA Science Inventory

In an effort to evaluate socio-political instability, we studied the relationship between dynamic order, socio-political upheavals and sustainability in nation states. Estimating the degree of dynamic order inherent in the socio-political regime of various countries throughout th...

Resolving coiled shapes reveals new reorientation behaviors in C. elegans

PubMed Central

Broekmans, Onno D; Rodgers, Jarlath B; Ryu, William S; Stephens, Greg J

2016-01-01

We exploit the reduced space of C. elegans postures to develop a novel tracking algorithm which captures both simple shapes and also self-occluding coils, an important, yet unexplored, component of 2D worm behavior. We apply our algorithm to show that visually complex, coiled sequences are a superposition of two simpler patterns: the body wave dynamics and a head-curvature pulse. We demonstrate the precise Ω-turn dynamics of an escape response and uncover a surprising new dichotomy in spontaneous, large-amplitude coils; deep reorientations occur not only through classical Ω-shaped postures but also through larger postural excitations which we label here as δ-turns. We find that omega and delta turns occur independently, suggesting a distinct triggering mechanism, and are the serpentine analog of a random left-right step. Finally, we show that omega and delta turns occur with approximately equal rates and adapt to food-free conditions on a similar timescale, a simple strategy to avoid navigational bias. DOI: http://dx.doi.org/10.7554/eLife.17227.001 PMID:27644113

Instability and its relation to precipitation over the Eastern Iberian Peninsula

NASA Astrophysics Data System (ADS)

Iturrioz, I.; Hernández, E.; Ribera, P.; Queralt, S.

2007-04-01

Synoptic situations producing rainfall at four rawinsonde observatories at eastern Spain are classified as stratiform or convective depending on dynamic and thermodynamic instability indices. Two daily radiosonde and daily-accumulated precipitation data from four observatories in Eastern Spain are used: Madrid-Barajas (MB), Murcia (MU), Palma de Mallorca (PA) and Zaragoza (ZA). We calculated two thermodynamic instability indices from radiosonde data: CAPE and LI. Likewise, from ERA40 reanalysis data we have calculated the Q vector divergence over the Iberian Peninsula and Balearic Islands, as a parameter describing dynamical instability. Synoptic situations producing rainfall were classified as convective or stratiform, satisfying a criterion based on the values of dynamic and thermodynamic indices at each observatory. It is observed that the number of days with stratiform precipitation related to the total number of precipitation days follows a consistent annual pattern.

Dynamic multi-segmental postural control in patients with chronic non-specific low back pain compared to pain-free controls: A cross-sectional study.

PubMed

McCaskey, Michael A; Wirth, Brigitte; Schuster-Amft, Corina; de Bruin, Eling D

2018-01-01

Reduced postural control is thought to contribute to the development and persistence of chronic non-specific low back pain (CNLBP). It is therefore frequently assessed in affected patients and commonly reported as the average amount of postural sway while standing upright under a variety of sensory conditions. These averaged linear outcomes, such as mean centre of pressure (CP) displacement or mean CP surface areas, may not reflect the true postural status. Adding nonlinear outcomes and multi-segmental kinematic analysis has been reported to better reflect the complexity of postural control and may detect subtler postural differences. In this cross-sectional study, a combination of linear and nonlinear postural parameters were assessed in patients with CNLBP (n = 24, 24-75 years, 9 females) and compared to symptom-free controls (CG, n = 34, 22-67 years, 11 females). Primary outcome was postural control measured by variance of joint configurations (uncontrolled manifold index, UI), confidence ellipse surface areas (CEA) and approximate entropy (ApEn) of CP dispersion during the response phase of a perturbed postural control task on a swaying platform. Secondary outcomes were segment excursions and clinical outcome correlates for pain and function. Non-parametric tests for group comparison with P-adjustment for multiple comparisons were conducted. Principal component analysis was applied to identify patterns of segmental contribution in both groups. CNLBP and CG performed similarly with respect to the primary outcomes. Comparison of joint kinematics revealed significant differences of hip (P < .001) and neck (P < .025) angular excursion, representing medium to large group effects (r's = .36 - .51). Significant (P's < .05), but moderate correlations of ApEn (r = -.42) and UI (r = -.46) with the health-related outcomes were observed. These findings lend further support to the notion that averaged linear outcomes do not suffice to describe subtle postural differences in CNLBP patients with low to moderate pain status.

Dynamical instability of a charged gaseous cylinder

NASA Astrophysics Data System (ADS)

Sharif, M.; Mumtaz, Saadia

2017-10-01

In this paper, we discuss dynamical instability of a charged dissipative cylinder under radial oscillations. For this purpose, we follow the Eulerian and Lagrangian approaches to evaluate linearized perturbed equation of motion. We formulate perturbed pressure in terms of adiabatic index by applying the conservation of baryon numbers. A variational principle is established to determine characteristic frequencies of oscillation which define stability criteria for a gaseous cylinder. We compute the ranges of radii as well as adiabatic index for both charged and uncharged cases in Newtonian and post-Newtonian limits. We conclude that dynamical instability occurs in the presence of charge if the gaseous cylinder contracts to the radius R*.

Assessing Spontaneous Combustion Instability with Recurrence Quantification Analysis

NASA Technical Reports Server (NTRS)

Eberhart, Chad J.; Casiano, Matthew J.

2016-01-01

Spontaneous instabilities can pose a significant challenge to verification of combustion stability, and characterizing its onset is an important avenue of improvement for stability assessments of liquid propellant rocket engines. Recurrence Quantification Analysis (RQA) is used here to explore nonlinear combustion dynamics that might give insight into instability. Multiple types of patterns representative of different dynamical states are identified within fluctuating chamber pressure data, and markers for impending instability are found. A class of metrics which describe these patterns is also calculated. RQA metrics are compared with and interpreted against another metric from nonlinear time series analysis, the Hurst exponent, to help better distinguish between stable and unstable operation.

Balance control during gait initiation: State-of-the-art and research perspectives.

PubMed

Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis

2017-11-18

It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices.

Characterization and Early Detection of Balance Deficits in Fragile X Premutation Carriers With and Without Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS).

PubMed

O'Keefe, Joan A; Robertson-Dick, Erin; Dunn, Emily J; Li, Yan; Deng, Youping; Fiutko, Amber N; Berry-Kravis, Elizabeth; Hall, Deborah A

2015-12-01

Fragile X-associated tremor/ataxia syndrome (FXTAS) results from a "premutation" size 55-200 CGG repeat expansion in the fragile X mental retardation 1 (FMR1) gene. Core motor features include cerebellar gait ataxia and kinetic tremor, resulting in progressive mobility disability. There are no published studies characterizing balance deficits in FMR1 premutation carriers with and without FXTAS using a battery of quantitative measures to test the sensory integration underlying postural control, automatic postural reflexes, and dynamic postural stability limits. Computerized dynamic posturography (CDP) and two performance-based balance measures were administered in 44 premutation carriers, 21 with FXTAS and 23 without FXTAS, and 42 healthy controls to compare balance and functional mobility between these groups. Relationships between FMR1 molecular variables, age, and sex and CDP scores were explored. FXTAS subjects demonstrated significantly lower scores on the sensory organization test (with greatest reductions in the vestibular control of balance), longer response latencies to balance perturbations, and reduced stability limits compared to controls. Premutation carriers without FXTAS also demonstrated significantly delayed response latencies and disrupted sensory weighting for balance control. Advancing age, male sex, increased CGG repeat size, and reduced X activation of the normal allele in premutation carrier women predicted balance dysfunction. These postural control deficits in carriers with and without FXTAS implicate dysfunctional cerebellar neural networks and may provide valuable outcome markers for tailored rehabilitative interventions. Our findings suggest that CDP may provide sensitive measures for early detection of postural control impairments in at-risk carriers and better characterize balance dysfunction and progression in FXTAS.

Vestibular ataxia following shuttle flights: effects of microgravity on otolith-mediated sensorimotor control of posture.

PubMed

Paloski, W H; Black, F O; Reschke, M F; Calkins, D S; Shupert, C

1993-01-01

Orbital spaceflight exposes astronauts to an environment in which gravity is reduced to negligible magnitudes of 10(-3) to 10(-6) G. Upon insertion into earth orbit, the abrupt loss of the constant linear acceleration provided by gravity removes the otolith stimulus for vestibular sensation of vertical orientation constantly present on Earth. Since the central nervous system (CNS) assesses spatial orientation by simultaneously interpreting sensory inputs from the vestibular, visual, and proprioceptive systems, loss of the otolith-mediated vertical reference input results in an incorrect estimation of spatial orientation, which, in turn, causes a degradation in movement control. Over time, however, the CNS adapts to the loss of gravitational signals. Upon return to Earth, the vertical reference provided by gravitational stimulation of the otolith organ reappears. As a result, a period of CNS readaptation must occur upon return to terrestrial environment. Among the physiological changes observed during the postflight CNS readaptation period is a disruption of postural equilibrium control. Using a dynamic posturography system (modified NeuroCom EquiTest), 16 astronauts were tested at 60, 30, and 10 days preflight and retested at 1 to 5 hours, and 8 days postflight. All astronauts tested demonstrated decreased postural stability immediately upon return to Earth. The most dramatic increases in postural sway occurred during those sensory conditions in which both the visual and proprioceptive feedback information used for postural control were altered by the dynamic posturography system, requiring reliance primarily upon vestibular function for control of upright stance. Less marked but statistically significant increases in sway were observed under those conditions in which visual and foot support surface inputs alone were altered.(ABSTRACT TRUNCATED AT 250 WORDS)

Balance control during gait initiation: State-of-the-art and research perspectives

PubMed Central

Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis

2017-01-01

It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices. PMID:29184756

What can posturography tell us about vestibular function?

NASA Technical Reports Server (NTRS)

Black, F. O.

2001-01-01

Patients with balance disorders want answers to the following basic questions: (1) What is causing my problem? and (2) What can be done about my problem? Information to fully answer these questions must include status of both sensory and motor components of the balance control systems. Computerized dynamic posturography (CDP) provides quantitative assessment of both sensory and motor components of postural control along with how the sensory inputs to the brain interact. This paper reviews the scientific basis and clinical applications of CDP. Specifically, studies describing the integration of vestibular inputs with other sensory systems for postural control are briefly summarized. Clinical applications, including assessment, rehabilitation, and management are presented. Effects of aging on postural control along with prevention and management strategies are discussed.

Reaching while standing in microgravity: a new postural solution to oversimplify movement control.

PubMed

Casellato, Claudia; Tagliabue, Michele; Pedrocchi, Alessandra; Papaxanthis, Charalambos; Ferrigno, Giancarlo; Pozzo, Thierry

2012-01-01

Many studies showed that both arm movements and postural control are characterized by strong invariants. Besides, when a movement requires simultaneous control of the hand trajectory and balance maintenance, these two movement components are highly coordinated. It is well known that the focal and postural invariants are individually tightly linked to gravity, much less is known about the role of gravity in their coordination. It is not clear whether the effect of gravity on different movement components is such as to keep a strong movement-posture coordination even in different gravitational conditions or whether gravitational information is necessary for maintaining motor synergism. We thus set out to analyze the movements of eleven standing subjects reaching for a target in front of them beyond arm's length in normal conditions and in microgravity. The results showed that subjects quickly adapted to microgravity and were able to successfully accomplish the task. In contrast to the hand trajectory, the postural strategy was strongly affected by microgravity, so to become incompatible with normo-gravity balance constraints. The distinct effects of gravity on the focal and postural components determined a significant decrease in their reciprocal coordination. This finding suggests that movement-posture coupling is affected by gravity, and thus, it does not represent a unique hardwired and invariant mode of control. Additional kinematic and dynamic analyses suggest that the new motor strategy corresponds to a global oversimplification of movement control, fulfilling the mechanical and sensory constraints of the microgravity environment.

Towards incorporating affective computing to virtual rehabilitation; surrogating attributed attention from posture for boosting therapy adaptation

NASA Astrophysics Data System (ADS)

Rivas, Jesús J.; Heyer, Patrick; Orihuela-Espina, Felipe; Sucar, Luis Enrique

2015-01-01

Virtual rehabilitation (VR) is a novel motor rehabilitation therapy in which the rehabilitation exercises occurs through interaction with bespoken virtual environments. These virtual environments dynamically adapt their activity to match the therapy progress. Adaptation should be guided by the cognitive and emotional state of the patient, none of which are directly observable. Here, we present our first steps towards inferring non-observable attentional state from unobtrusively observable seated posture, so that this knowledge can later be exploited by a VR platform to modulate its behaviour. The space of seated postures was discretized and 648 pictures of acted representations were exposed to crowd-evaluation to determine attributed state of attention. A semi-supervised classifier based on Na¨ıve Bayes with structural improvement was learnt to unfold a predictive relation between posture and attributed attention. Internal validity was established following a 2×5 cross-fold strategy. Following 4959 votes from crowd, classification accuracy reached a promissory 96.29% (µ±σ = 87.59±6.59) and F-measure reached 82.35% (µ ± σ = 69.72 ± 10.50). With the afforded rate of classification, we believe it is safe to claim posture as a reliable proxy for attributed attentional state. It follows that unobtrusively monitoring posture can be exploited for guiding an intelligent adaptation in a virtual rehabilitation platform. This study further helps to identify critical aspects of posture permitting inference of attention.

IMMEDIATE AND FOLLOW-UP EFFECTS OF A POSTURE EDUCATION PROGRAM FOR ELEMENTARY SCHOOL STUDENTS

PubMed Central

dos Santos, Natália Brites; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Vieira, Adriane

2017-01-01

ABSTRACT Objective: To assess the short- and medium-term effects of the posture education program (PEP) for students of elementary school regarding theoretical knowledge and posture during activities of daily living (ADLs). Methods: The sample consisted of 38 students (aged 8-12 years) in the third grade of elementary school in Porto Alegre, Rio Grande do Sul (Southern Brazil). The children were evaluated in three moments: prior to attending the PEP (pretest); after attending the PEP (post-test); and five months after the conclusion of the PEP, immediately after a learning review of four lessons (five months follow-up). The posture during ADLs and the theoretical knowledge about spine and body posture were assessed, based on specific instruments (layout for assessing the dynamic posture - LADy; and questionnaire). The Friedman test, post hoc Wilcoxon test, and Bonferroni correction were applied to identify the differences among the evaluative moments, as they are statistically significant at α<0.05. Results: No statistically significant difference was found between the post-test and follow-up concerning the theoretical knowledge. In addition, no statistically significant difference was found between post-test and follow-up in relation to ADLs; however, the performance of students was higher in the post-test and follow-up, when compared with the pretest. Conclusions: Immediately after the PEP’s conclusion, the students improved their posture in ADLs. These positive effects and the theoretical knowledge were retained in the follow-up (after the review lessons). PMID:28977326

Rayleigh-Taylor instability-fascinating gateway to the study of fluid dynamics

NASA Astrophysics Data System (ADS)

Benjamin, Robert F.

1999-09-01

A series of low-cost simple, "kitchen-physics" experiments demonstrates Rayleigh-Taylor Instability (RTI), the growth of ripples at an interface between fluids when the higher-density fluid is on top. We also describe the importance of RTI in ocean dynamics and commercial products.

A novel dynamic sensing of wearable digital textile sensor with body motion analysis.

PubMed

Yang, Chang-Ming; Lin, Zhan-Sheng; Hu, Chang-Lin; Chen, Yu-Shih; Ke, Ling-Yi; Chen, Yin-Rui

2010-01-01

This work proposes an innovative textile sensor system to monitor dynamic body movement and human posture by attaching wearable digital sensors to analyze body motion. The proposed system can display and analyze signals when individuals are walking, running, veering around, walking up and down stairs, as well as falling down with a wearable monitoring system, which reacts to the coordination between the body and feet. Several digital sensor designs are embedded in clothing and wear apparel. Any pressure point can determine which activity is underway. Importantly, wearable digital sensors and a wearable monitoring system allow adaptive, real-time postures, real time velocity, acceleration, non-invasive, transmission healthcare, and point of care (POC) for home and non-clinical environments.

Predictors of chronic ankle instability: Analysis of peroneal reaction time, dynamic balance and isokinetic strength.

PubMed

Sierra-Guzmán, Rafael; Jiménez, Fernando; Abián-Vicén, Javier

2018-05-01

Previous studies have reported the factors contributing to chronic ankle instability, which could lead to more effective treatments. However, factors such as the reflex response and ankle muscle strength have not been taken into account in previous investigations. Fifty recreational athletes with chronic ankle instability and 55 healthy controls were recruited. Peroneal reaction time in response to sudden inversion, isokinetic evertor muscle strength and dynamic balance with the Star Excursion Balance Test and the Biodex Stability System were measured. The relationship between the Cumberland Ankle Instability Tool score and performance on each test was assessed and a backward multiple linear regression analysis was conducted. Participants with chronic ankle instability showed prolonged peroneal reaction time, poor performance in the Biodex Stability System and decreased reach distance in the Star Excursion Balance Test. No significant differences were found in eversion and inversion peak torque. Moderate correlations were found between the Cumberland Ankle Instability Tool score and the peroneal reaction time and performance on the Star Excursion Balance Test. Peroneus brevis reaction time and the posteromedial and lateral directions of the Star Excursion Balance Test accounted for 36% of the variance in the Cumberland Ankle Instability Tool. Dynamic balance deficits and delayed peroneal reaction time are present in participants with chronic ankle instability. Peroneus brevis reaction time and the posteromedial and lateral directions of the Star Excursion Balance Test were the main contributing factors to the Cumberland Ankle Instability Tool score. No clear strength impairments were reported in unstable ankles. Copyright © 2018 Elsevier Ltd. All rights reserved.