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.

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.

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 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

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

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.

(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…

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.

Recovery of postural equilibrium control following spaceflight

NASA Technical Reports Server (NTRS)

Paloski, W. H.; Reschke, M. F.; Black, F. O.; Doxey, D. D.; Harm, D. L.

1992-01-01

Decreased postural stability is observed in most astronauts immediately following spaceflight. Because ataxia may present postflight operational hazards, it is important to determine the incidence of postural instability immediately following landing and the dynamics of recovery of normal postural equilibrium control. It is postulated that postflight postural instability results from in-flight adaptive changes in central nervous system (CNS) processing of sensory information from the visual, vestibular, and proprioceptive systems. The purpose of the present investigation was to determine the magnitude and time course of postflight recovery of postural equilibrium control and, hence, readaptation of CNS processing of sensory information. Thirteen crew members from six spaceflight missions were studied pre- and postflight using a modified commercial posturography system. Postural equilibrium control was found to be seriously disrupted immediately following spaceflight in all subjects. Readaptation to the terrestrial environment began immediately upon landing, proceeded rapidly for the first 10-12 hours, and then proceeded much more slowly for the subsequent 2-4 days until preflight stability levels were reachieved. It is concluded that the overall postflight recovery of postural stability follows a predictable time course.

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.

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.

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.

Dynamic Imbalance Analysis and Stability Control of Galloping Gait for a Passive Quadruped Robot.

PubMed

Wang, Chunlei; Zhang, Ting; Wei, Xiaohui; Long, Yongjun; Wang, Shigang

2015-01-01

Some imbalance and balance postures of a passive quadruped robot with a simplified mathematical model are studied. Through analyzing the influence of the touchdown angle of the rear leg on the posture of the trunk during the flight phase, the stability criterion is concluded: the closer are the two moments which are the zero time of the pitching angle and the peak time of the center of mass, the better is the stability of the trunk posture during the flight phase. Additionally, the validity of the stability criterion is verified for the cat, greyhound, lion, racehorse, basset hound, and giraffe. Furthermore, the stability criterion is also applicable when the center of the mass of body is shifted. Based on the stability criterion, the necessary and sufficient condition of the galloping stability for the quadruped robot is proposed to attain a controlled thrust. The control strategy is designed by an optimization dichotomy algorithm for seeking the zero point of the balance condition. Through the control results, it is demonstrated that the imbalance posture of the trunk could be stabilized by adjusting the stiffness of four legs.

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.

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

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

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.

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.

Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis

PubMed Central

Ghai, Shashank; Ghai, Ishan; Effenberg, Alfred O

2017-01-01

The use of dual-task training paradigm to enhance postural stability in patients with balance impairments is an emerging area of interest. The differential effects of dual tasks and dual-task training on postural stability still remain unclear. A systematic review and meta-analysis were conducted to analyze the effects of dual task and training application on static and dynamic postural stability among various population groups. Systematic identification of published literature was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, from inception until June 2016, on the online databases Scopus, PEDro, MEDLINE, EMBASE, and SportDiscus. Experimental studies analyzing the effects of dual task and dual-task training on postural stability were extracted, critically appraised using PEDro scale, and then summarized according to modified PEDro level of evidence. Of 1,284 records, 42 studies involving 1,480 participants met the review’s inclusion criteria. Of the studies evaluating the effects of dual-task training on postural stability, 87.5% of the studies reported significant enhancements, whereas 30% of the studies evaluating acute effects of dual tasks on posture reported significant enhancements, 50% reported significant decrements, and 20% reported no effects. Meta-analysis of the pooled studies revealed moderate but significant enhancements of dual-task training in elderly participants (95% CI: 1.16–2.10) and in patients suffering from chronic stroke (−0.22 to 0.86). The adverse effects of complexity of dual tasks on postural stability were also revealed among patients with multiple sclerosis (−0.74 to 0.05). The review also discusses the significance of verbalization in a dual-task setting for increasing cognitive–motor interference. Clinical implications are discussed with respect to practical applications in rehabilitation settings. PMID:28356727

Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis.

PubMed

Ghai, Shashank; Ghai, Ishan; Effenberg, Alfred O

2017-01-01

The use of dual-task training paradigm to enhance postural stability in patients with balance impairments is an emerging area of interest. The differential effects of dual tasks and dual-task training on postural stability still remain unclear. A systematic review and meta-analysis were conducted to analyze the effects of dual task and training application on static and dynamic postural stability among various population groups. Systematic identification of published literature was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, from inception until June 2016, on the online databases Scopus, PEDro, MEDLINE, EMBASE, and SportDiscus. Experimental studies analyzing the effects of dual task and dual-task training on postural stability were extracted, critically appraised using PEDro scale, and then summarized according to modified PEDro level of evidence. Of 1,284 records, 42 studies involving 1,480 participants met the review's inclusion criteria. Of the studies evaluating the effects of dual-task training on postural stability, 87.5% of the studies reported significant enhancements, whereas 30% of the studies evaluating acute effects of dual tasks on posture reported significant enhancements, 50% reported significant decrements, and 20% reported no effects. Meta-analysis of the pooled studies revealed moderate but significant enhancements of dual-task training in elderly participants (95% CI: 1.16-2.10) and in patients suffering from chronic stroke (-0.22 to 0.86). The adverse effects of complexity of dual tasks on postural stability were also revealed among patients with multiple sclerosis (-0.74 to 0.05). The review also discusses the significance of verbalization in a dual-task setting for increasing cognitive-motor interference. Clinical implications are discussed with respect to practical applications in rehabilitation settings.

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

PubMed Central

2014-01-01

Background We investigated lateral dominance in the postural stability of single-leg stance with anteroposterior floor oscillations at various frequencies. Methods Thirty adults maintained a single-leg stance on a force platform for 20 seconds per trial. Trials were performed with no oscillation (static condition) and with anteroposterior floor oscillations (2.5-cm amplitude) at six frequencies: 0.25, 0.5, 0.75, 1.0, 1.25 and 1.5 Hz (dynamic condition). A set of three trials was performed on each leg in each oscillation frequency in random order. The mean speed of the center of pressure in the anteroposterior direction (CoPap) was calculated as an index of postural stability, and frequency analysis of CoPap sway was performed. Footedness for carrying out mobilizing activities was assessed with a questionnaire. Results CoPap speed exponentially increased as oscillation frequency increased in both legs. The frequency analysis of CoPap showed a peak <0.3 Hz at no oscillation. The frequency components at 0.25-Hz oscillation included common components with no oscillation and those at 1.5-Hz oscillation showed the maximum amplitude among all conditions. Postural stability showed no significant difference between left- and right-leg stance at no oscillation and oscillations ≤1.25 Hz, but at 1.5-Hz oscillation was significantly higher in the right-leg stance than in the left-leg stance. For the lateral dominance of postural stability at individual levels, the lateral difference in postural stability at no oscillation was positively correlated with that at 0.25-Hz oscillation (r = 0.51) and negatively correlated with that at 1.5-Hz oscillation (r = -0.53). For 70% of subjects, the dominant side of postural stability was different at no oscillation and 1.5-Hz oscillation. In the subjects with left- or right-side dominance at no oscillation, 94% or 38% changed their dominant side at 1.5-Hz oscillation, with a significant difference between these percentages. In the 1.5-Hz oscillation, 73% of subjects had concordance between the dominant side of postural stability and that of mobilizing footedness. Conclusion In static conditions, there was no lateral dominance of stability during single-leg stance. At 1.5-Hz oscillation, the highest frequency, right-side dominance of postural stability was recognized. Functional role in supporting leg may be divided between left and right legs according to the change of balance condition from static to dynamic. PMID:25127541

The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain.

PubMed

Lee, Szu-Ping; Souza, Richard B; Powers, Christopher M

2012-07-01

Hip abductors play an important role in maintaining trunk and pelvis stability during unipedal tasks. The purpose of the study was to compare postural stability between individuals with patellofemoral pain (PFP) and pain-free controls. A secondary purpose was to evaluate the effect of a hip stabilizing brace on postural stability. Twenty females with PFP (27.3±6.3 years) and 19 controls (26.1±4.5 years) participated. Each subject performed a unipedal step-down balance task with the stance leg on a force platform from which center of pressure (COP) excursion was recorded. Quantitative COP excursion patterns (mean and peak displacements) were used as measures of postural stability. For subjects with PFP, postural stability also was quantified following the application of a hip stabilizing brace. Hip abductor strength was significantly lower in PFP group compared to the control group (1.39±0.4 vs. 1.62±0.26 N/kg-BW, p=0.046). Peak and mean medial-lateral COP displacements during the balance task were greater in the PFP group (39.8±6.7 vs. 24.3±3.8 mm, p<0.001; 24.7±16.3 vs. 13.5±4.4 mm, p=0.005). Application of the hip stabilizing brace reduced the peak and mean COP displacement (39.8±6.7 vs. 24.7±4.7 mm, p<0.001; 24.7±16.3 vs. 16.8±15.1 mm, p=0.02). Our results demonstrate that females with PFP exhibit impaired medial-lateral postural stability when compared to control subjects. Application of a hip stabilizing brace significantly improved stability to a level comparable to the controls. Copyright © 2012 Elsevier B.V. All rights reserved.

Dynamic Imbalance Analysis and Stability Control of Galloping Gait for a Passive Quadruped Robot

PubMed Central

Wang, Chunlei; Zhang, Ting; Wei, Xiaohui; Long, Yongjun; Wang, Shigang

2015-01-01

Some imbalance and balance postures of a passive quadruped robot with a simplified mathematical model are studied. Through analyzing the influence of the touchdown angle of the rear leg on the posture of the trunk during the flight phase, the stability criterion is concluded: the closer are the two moments which are the zero time of the pitching angle and the peak time of the center of mass, the better is the stability of the trunk posture during the flight phase. Additionally, the validity of the stability criterion is verified for the cat, greyhound, lion, racehorse, basset hound, and giraffe. Furthermore, the stability criterion is also applicable when the center of the mass of body is shifted. Based on the stability criterion, the necessary and sufficient condition of the galloping stability for the quadruped robot is proposed to attain a controlled thrust. The control strategy is designed by an optimization dichotomy algorithm for seeking the zero point of the balance condition. Through the control results, it is demonstrated that the imbalance posture of the trunk could be stabilized by adjusting the stiffness of four legs. PMID:27110095

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 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.

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

Step-Down Test Assessment of Postural Stability in Patients With Chronic Ankle Instability.

PubMed

Bolt, Doris; Giger, René; Wirth, Stefan; Swanenburg, Jaap

2018-01-23

The underlying mechanism in 27% of ankle sprains is a fall while navigating stairs. Therefore, the step-down test (SDT) may be useful to investigate dynamic postural stability deficits in individuals with chronic ankle instability (CAI). To investigate the test-retest reliability and validity of the forward and lateral SDT protocol between individuals with CAI and uninjured controls. Test-retest study. University hospital. A total of 46  individuals, 23 with CAI and 23 uninjured controls. Time to stabilization of the forward and lateral SDT. The absolute reliability (SEM = 0.04-0.12 s; SDD = 0.11-0.33 s) of the SDT protocol was acceptable, whereas the relative reliability (ICC 3 , k = 0.12-0.63) and discriminant validity (P = .42-.99; AUC = 0.50-0.57) were not. The SDT appears to not be challenging enough to detect dynamic postural stability differences between individuals with and without CAI. However, the SDT may be capable of measuring change over time based on its good absolute reliability.

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.

Intrarater test-retest reliability of static and dynamic stability indexes measurement using the Biodex Stability System during unilateral stance.

PubMed

Arifin, Nooranida; Abu Osman, Noor Azuan; Wan Abas, Wan Abu Bakar

2014-04-01

The measurements of postural balance often involve measurement error, which affects the analysis and interpretation of the outcomes. In most of the existing clinical rehabilitation research, the ability to produce reliable measures is a prerequisite for an accurate assessment of an intervention after a period of time. Although clinical balance assessment has been performed in previous study, none has determined the intrarater test-retest reliability of static and dynamic stability indexes during dominant single stance. In this study, one rater examined 20 healthy university students (female=12, male=8) in two sessions separated by 7 day intervals. Three stability indexes--the overall stability index (OSI), anterior/posterior stability index (APSI), and medial/ lateral stability index (MLSI) in static and dynamic conditions--were measured during single dominant stance. Intraclass correlation coefficient (ICC), standard error measurement (SEM) and 95% confidence interval (95% CI) were calculated. Test-retest ICCs for OSI, APSI, and MLSI were 0.85, 0.78, and 0.84 during static condition and were 0.77, 0.77, and 0.65 during dynamic condition, respectively. We concluded that the postural stability assessment using Biodex stability system demonstrates good-to-excellent test-retest reliability over a 1 week time interval.

Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial.

PubMed

Ross, Scott E; Arnold, Brent L; Blackburn, J Troy; Brown, Cathleen N; Guskiewicz, Kevin M

2007-12-17

Ankle sprains are common injuries that often lead to functional ankle instability (FAI), which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR) stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1) conventional coordination training group (CCT); 2) SR stimulation coordination training group (SCT); or 3) control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P) and medial/lateral (M/L) center-of-pressure velocity (COPvel), M/L COP standard deviation (COPsd), M/L COP maximum excursion (COPmax), and COP area (COParea). Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 +/- 0.4 cm/s vs. 2.7 +/- 0.6 cm/s), M/L COPvel (2.6 +/- 0.5 cm/s vs. 2.9 +/- 0.5 cm/s), M/L COPsd (0.63 +/- 0.12 cm vs. 0.73 +/- 0.11 cm), M/L COPmax (1.76 +/- 0.25 cm vs. 1.98 +/- 0.25 cm), and COParea (0.13 +/- 0.03 cm2 vs. 0.16 +/- 0.04 cm2) than the pooled means of the CCT and control groups (P < 0.05). Reduced values in COP measures indicated postural stability improvements. Thus, six weeks of coordination training with SR stimulation enhanced postural stability. Future research should examine the use of SR stimulation for decreasing recurrent ankle sprain injury in physically active individuals with FAI.

Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial

PubMed Central

Ross, Scott E; Arnold, Brent L; Blackburn, J Troy; Brown, Cathleen N; Guskiewicz, Kevin M

2007-01-01

Background Ankle sprains are common injuries that often lead to functional ankle instability (FAI), which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR) stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. Methods This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1) conventional coordination training group (CCT); 2) SR stimulation coordination training group (SCT); or 3) control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P) and medial/lateral (M/L) center-of-pressure velocity (COPvel), M/L COP standard deviation (COPsd), M/L COP maximum excursion (COPmax), and COP area (COParea). Results Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 ± 0.4 cm/s vs. 2.7 ± 0.6 cm/s), M/L COPvel (2.6 ± 0.5 cm/s vs. 2.9 ± 0.5 cm/s), M/L COPsd (0.63 ± 0.12 cm vs. 0.73 ± 0.11 cm), M/L COPmax (1.76 ± 0.25 cm vs. 1.98 ± 0.25 cm), and COParea (0.13 ± 0.03 cm2 vs. 0.16 ± 0.04 cm2) than the pooled means of the CCT and control groups (P < 0.05). Conclusion Reduced values in COP measures indicated postural stability improvements. Thus, six weeks of coordination training with SR stimulation enhanced postural stability. Future research should examine the use of SR stimulation for decreasing recurrent ankle sprain injury in physically active individuals with FAI. PMID:18086314

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.

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.

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.

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.

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.

Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

PubMed Central

Paterno, Mark V.; Schmitt, Laura C.; Ford, Kevin R.; Rauh, Mitchell J.; Myer, Gregory D.; Huang, Bin; Hewett, Timothy E.

2016-01-01

Background Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non–anterior cruciate ligament–injured athletes. Hypotheses Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion Altered neuromuscular control of the hip and knee during a dynamic landing task and postural stability deficits after ACLR are predictors of a second anterior cruciate ligament injury after an athlete is released to return to sport. PMID:20702858

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.

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.;

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.

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.

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.

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

The effect of resistance level and stability demands on recruitment patterns and internal loading of spine in dynamic flexion and extension using a simple trunk model.

PubMed

Zeinali-Davarani, Shahrokh; Shirazi-Adl, Aboulfazl; Dariush, Behzad; Hemami, Hooshang; Parnianpour, Mohamad

2011-07-01

The effects of external resistance on the recruitment of trunk muscles in sagittal movements and the coactivation mechanism to maintain spinal stability were investigated using a simple computational model of iso-resistive spine sagittal movements. Neural excitation of muscles was attained based on inverse dynamics approach along with a stability-based optimisation. The trunk flexion and extension movements between 60° flexion and the upright posture against various resistance levels were simulated. Incorporation of the stability constraint in the optimisation algorithm required higher antagonistic activities for all resistance levels mostly close to the upright position. Extension movements showed higher coactivation with higher resistance, whereas flexion movements demonstrated lower coactivation indicating a greater stability demand in backward extension movements against higher resistance at the neighbourhood of the upright posture. Optimal extension profiles based on minimum jerk, work and power had distinct kinematics profiles which led to recruitment patterns with different timing and amplitude of activation.

Postural Stability of Special Warfare Combatant-Craft Crewmen With Tactical Gear.

PubMed

Morgan, Paul M; Williams, Valerie J; Sell, Timothy C

The US Naval Special Warfare's Special Warfare Combatant-Craft Crewmen (SWCC) operate on small, high-speed boats while wearing tactical gear (TG). The TG increases mission safety and success but may affect postural stability, potentially increasing risk for musculoskeletal injury. Therefore, the purpose of this study was to examine the effects of TG on postural stability during the Sensory Organization Test (SOT). Eight SWCC performed the SOT on NeuroCom's Balance Manager with TG and with no tactical gear (NTG). The status of gear was performed in randomized order. The SOT consisted of six different conditions that challenge sensory systems responsible for postural stability. Each condition was performed for three trials, resulting in a total of 18 trials. Overall performance, each individual condition, and sensory system analysis (somatosensory, visual, vestibular, preference) were scored. Data were not normally distributed therefore Wilcoxon signed-rank tests were used to compare each variable (ρ = .05). No significant differences were found between NTG and TG tests. No statistically significant differences were detected under the two TG conditions. This may be due to low statistical power, or potentially insensitivity of the assessment. Also, the amount and distribution of weight worn during the TG conditions, and the SWCC's unstable occupational platform, may have contributed to the findings. The data from this sample will be used in future research to better understand how TG affects SWCC. The data show that the addition of TG used in our study did not affect postural stability of SWCC during the SOT. Although no statistically significant differences were observed, there are clinical reasons for continued study of the effect of increased load on postural stability, using more challenging conditions, greater surface perturbations, dynamic tasks, and heavier loads. 2016.

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.

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.

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.

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.

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.

A Simple Postflight Measure of Postural Atania in Astronauts

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Harm, D. I.; Kofman, I. S.; Wood, S. J.; Bloomberg, J. J.

2011-01-01

Astronauts returning from space flight universally present with postural ataxia. Throughout the Space Shuttle Program, measurement of ataxia has concentrated on sway in the anterior-posterior (AP) plane. The current investigation, as a part of a larger functional study, concentrated on characterizing postural instability using dynamic stabilographic sway patterns in both the AP and medial-lateral (ML) planes. To accomplish this goal, six astronauts from short-duration (Shuttle) and three from long-duration (ISS) flights were required to recover from a simulated fall. Subjects with eyes open, wearing running shoes lay prone on the floor for 2 minutes and then quickly stood up, maintained a quiet stance for 3 minutes, arms relaxed along the side of the body, and feet comfortably placed on the force plate. Crewmembers were tested twice before flight, on landing day (Shuttle only), and 1, 6, and 30 days after flight. Anterior-posterior and ML center-of-pressure (COP) coordinates were calculated from the ground reaction forces collected at 500 Hz. The 3-minute quiet stance trial was broken into three 1-minute segments for stabilogram diffusion analysis. A mean sway speed (rate of change of COP displacement) was also calculated as an additional postural stability parameter. While there was considerable variation, most of crewmembers tested exhibited increased stochastic activity evidenced by larger short-term COP diffusion coefficients postflight in both the AP and ML planes, suggesting significant changes in postural control mechanisms, particularly control of lower limb muscle function. As expected, postural instability of ISS astronauts on the first day postflight was similar to that of Shuttle crewmembers on landing day. Recoveries of stochastic activity and mean sway speed to baseline levels were typically observed by the 30th day postflight for both long-duration and short-duration crewmembers. Dynamic postural stability characteristics obtained in this low-impact study complement the data measured with computerized dynamic posturography.

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).

[Effects of Surgically Treated Pelvic Ring and Acetabular Fractures on Postural Control].

PubMed

Lang, P; Schnegelberger, A; Riesner, H-J; Stuby, F; Friemert, B; Palm, H-G

2016-04-01

The aim of surgical treatment of pelvic ring and acetabular fractures is to allow rapid mobilisation of patients in order to restore stance and gait stability (postural control), as this significantly correlates with a positive outcome. The regulation of postural stability is mainly controlled by transmission of proprioceptive stimuli. In addition, the pelvis serves as a connection between the legs and the spine and thus is also of great importance for mechanical stabilisation. It remains unclear whether surgical treatment of pelvic ring and acetabular fractures affects the regulation of postural control. Therefore, the aim of this study was to examine the impact of surgically treated pelvic ring and acetabular fractures on postural stability by means of computerised dynamic posturography (CDP) after a mean of 35 months and to compare the results with a healthy control group. A retrospective case control study of 38 patients with surgically treated pelvic ring and acetabular fractures and 38 healthy volunteers was carried out using CDP. The average time of follow-up was 35 (12-78) months. The most important outcome parameter in this investigation was the overall stability index (OSI). Hip joint mobility, the health-related quality of life (SF-12) and pain were supplementary outcome parameters. It was found that surgically treated pelvic ring and acetabular fractures had no influence on postural stability. The OSI was 2.1 ° in the patient group and 1.9 ° in the control group. There was no significant difference between the groups in hip joint mobility. A total of 52 % of patients showed no or only mild pain. Mean health-related quality of life was the same as in the total population. Surgically treated pelvic ring and acetabular fractures do not lead to deterioration in postural control in the mid term. This is of high prognostic importance for rapid mobilisation of the patients. Therefore no increase in the risk of falling is expected after successfully treatment of fractures. Georg Thieme Verlag KG Stuttgart · New York.

Postural Stability in Healthy Child and Youth Athletes: The Effect of Age, Sex, and Concussion-Related Factors on Performance.

PubMed

Paniccia, Melissa; Wilson, Katherine E; Hunt, Anne; Keightley, Michelle; Zabjek, Karl; Taha, Tim; Gagnon, Isabelle; Reed, Nick

Postural stability plays a key role in sport performance, especially after concussion. Specific to healthy child and youth athletes, little is known about the influence development and sex may have on postural stability while considering other subjective clinical measures used in baseline/preinjury concussion assessment. This study aims to describe age- and sex-based trends in postural stability in uninjured child and youth athletes at baseline while accounting for concussion-related factors. (1) Postural stability performance will improve with age, (2) females will display better postural stability compared to males, and (3) concussion-like symptoms will affect postural stability performance in healthy children and youth. Cross-sectional study. Level 3. This study comprised 889 healthy/uninjured child and youth athletes (54% female, 46% male) between the ages of 9 and 18 years old. Participants completed preseason baseline testing, which included demographic information (age, sex, concussion history), self-report of concussion-like symptoms (Post-Concussion Symptom Inventory [PCSI]-Child and PCSI-Youth), and measures of postural stability (BioSway; Biodex Medical Systems). Two versions of the PCSI were used (PCSI-C, 9- to 12-year-olds; PCSI-Y, 13- to 18-year-olds). Postural stability was assessed via sway index under 4 sway conditions of increasing difficulty by removing visual and proprioceptive cues. In children aged 9 to 12 years old, there were significant age- ( P < 0.05) and sex-based effects ( P < 0.05) on postural stability. Performance improved with age, and girls performed better than boys. For youth ages 13 to 18 years old, postural stability also improved with age ( P < 0.05). In both child and youth subgroups, postural stability worsened with increasing concussion-like symptoms ( P < 0.05). There are developmental and baseline symptom trends regarding postural stability performance. These findings provide a preliminary foundation for postconcussion comparisons and highlight the need for a multimodal approach in assessing and understanding physical measures such as postural stability.

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.

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

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.

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

Components of Standing Postural Control Evaluated in Pediatric Balance Measures: A Scoping Review.

PubMed

Sibley, Kathryn M; Beauchamp, Marla K; Van Ooteghem, Karen; Paterson, Marie; Wittmeier, Kristy D

2017-10-01

To identify measures of standing balance validated in pediatric populations, and to determine the components of postural control captured in each tool. Electronic searches of MEDLINE, Embase, and CINAHL databases using key word combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests, and child/pediatrics; gray literature; and hand searches. Inclusion criteria were measures with a stated objective to assess balance, with pediatric (≤18y) populations, with at least 1 psychometric evaluation, with at least 1 standing task, with a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. There were 21 measures included. Two reviewers extracted descriptive characteristics, and 2 investigators independently coded components of balance in each measure using a systems perspective for postural control, an established framework for balance in pediatric populations. Components of balance evaluated in measures were underlying motor systems (100% of measures), anticipatory postural control (72%), static stability (62%), sensory integration (52%), dynamic stability (48%), functional stability limits (24%), cognitive influences (24%), verticality (9%), and reactive postural control (0%). Assessing children's balance with valid and comprehensive measures is important for ensuring development of safe mobility and independence with functional tasks. Balance measures validated in pediatric populations to date do not comprehensively assess standing postural control and omit some key components for safe mobility and independence. Existing balance measures, that have been validated in adult populations and address some of the existing gaps in pediatric measures, warrant consideration for validation in children. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. 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.

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.

The Relationship Between Postural and Movement Stability.

PubMed

Feldman, Anatol G

2016-01-01

Postural stabilization is provided by stretch reflexes, intermuscular reflexes, and intrinsic muscle properties. Taken together, these posture-stabilizing mechanisms resist deflections from the posture at which balance of muscle and external forces is maintained. Empirical findings suggest that for each muscle, these mechanisms become functional at a specific, spatial threshold-the muscle length or respective joint angle at which motor units begin to be recruited. Empirical data suggest that spinal and supraspinal centers can shift the spatial thresholds for a group of muscles that stabilized the initial posture. As a consequence, the same stabilizing mechanisms, instead of resisting motion from the initial posture, drive the body to another stable posture. In other words by shifting spatial thresholds, the nervous system converts movement resisting to movement-producing mechanisms. It is illustrated that, contrary to conventional view, this control strategy allows the system to transfer body balance to produce locomotion and other actions without loosing stability at any point of them. It also helps orient posture and movement with the direction of gravity. It is concluded that postural and movement stability is provided by a common mechanism.

Preliminary results of dancing exercise on postural stability in adolescent females.

PubMed

Cheng, Hsu-Sheng; Law, Cheung-Lun; Pan, Hui-Fang; Hsiao, Yueh-Ping; Hu, Jeng-Ho; Chuang, Fu-Kai; Huang, Mao-Hsiung

2011-12-01

Twenty-six female student dancers of Chung-hua school of Art (mean age 17.5 ± 0.5 years) and twenty-five healthy active female collegiate students (mean age 18.1 ± 1.0 years) participated in this study to investigate the effects of dancing exercise on postural stability of adolescent female through a comparison study of two cohorts. The groups were matched in height and weight. Participants were excluded for left-side dominance, sustained lower extremity injury, any known vestibular system dysfunction, uncorrected visual problems, and other neurological conditions. Static and dynamic standing balances were measured by means of Biodex Stability System in six conditions include bilateral, dominant, and nondominant single leg stances with eye-open and eye-closed conditions. To investigate the difference between static and dynamic stabilities, two protocols were performed: the first protocol consisted of four positions including static position, Level 8, Level 4, and Level 1, respectively. They were instructed to maintain a level platform as stably as possible for a period of 30 seconds for each test and given a 30-second rest between tests. The second protocol was descending stability level that was gradually changed from Level 12 to Level 1 for 60 seconds. Balance indices included overall stability index, anterior-posterior stability index (APSI), and medial-lateral stability index. The results of first protocol showed that there were significant differences in overall stability index score between study and control groups at Level 8 with dominant single leg standing in the eye-open condition and the APSI score at Level 8 and at Level 4 with dominant single-leg standing in the eye-closed condition. There was no significant difference in the second protocol. The possible explanation is loss of familiarization adaptation because of level change consequently in both the groups, not step-by-step as in the first protocol study. Furthermore, a positive correlation was found between the dancing experience and the APSI at Level 8 and Level 4 with dominant single-leg standing in the eye-closed condition. In conclusion the findings implied that dancing exercise results in better postural stability and less visual dependence on postural control in adolescent females. Copyright © 2011. Published by Elsevier B.V.

Effect of Footwear on Dynamic Stability during Single-leg Jump Landings.

PubMed

Bowser, Bradley J; Rose, William C; McGrath, Robert; Salerno, Jilian; Wallace, Joshua; Davis, Irene S

2017-06-01

Barefoot and minimal footwear running has led to greater interest in the biomechanical effects of different types of footwear. The effect of running footwear on dynamic stability is not well understood. The purpose of this study was to compare dynamic stability and impact loading across 3 footwear conditions; barefoot, minimal footwear and standard running shoes. 25 injury free runners (21 male, 4 female) completed 5 single-leg jump landings in each footwear condition. Dynamic stability was assessed using the dynamic postural stability index and its directional components (mediolateral, anteroposterior, vertical). Peak vertical ground reaction force and vertical loadrates were also compared across footwear conditions. Dynamic stability was dependent on footwear type for all stability indices (ANOVA, p<0.05). Post-hoc tests showed dynamic stability was greater when barefoot than in running shoes for each stability index (p<0.02) and greater than minimal footwear for the anteroposterior stability index (p<0.01). Peak vertical force and average loadrates were both dependent on footwear (p≤0.05). Dynamic stability, peak vertical force, and average loadrates during single-leg jump landings appear to be affected by footwear type. The results suggest greater dynamic stability and lower impact loading when landing barefoot or in minimal footwear. © Georg Thieme Verlag KG Stuttgart · New York.

Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review.

PubMed

Sibley, Kathryn M; Beauchamp, Marla K; Van Ooteghem, Karen; Straus, Sharon E; Jaglal, Susan B

2015-01-01

To identify components of postural control included in standardized balance measures for adult populations. Electronic searches of MEDLINE, EMBASE, and CINAHL databases using keyword combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests/validation studies, instrument construction/instrument validation, geriatric assessment/disability evaluation, gray literature, and hand searches. Inclusion criteria were measures with a stated objective to assess balance, adult populations (18y and older), at least 1 psychometric evaluation, 1 standing task, a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. Sixty-six measures were included. A research assistant extracted descriptive characteristics and 2 reviewers independently coded components of balance in each measure using the Systems Framework for Postural Control, a widely recognized model of balance. Components of balance evaluated in these measures were underlying motor systems (100% of measures), anticipatory postural control (71%), dynamic stability (67%), static stability (64%), sensory integration (48%), functional stability limits (27%), reactive postural control (23%), cognitive influences (17%), and verticality (8%). Thirty-four measures evaluated 3 or fewer components of balance, and 1 measure-the Balance Evaluation Systems Test-evaluated all components of balance. Several standardized balance measures provide only partial information on postural control and omit important components of balance related to avoiding falls. As such, the choice of measure(s) may limit the overall interpretation of an individual's balance ability. Continued work is necessary to increase the implementation of comprehensive balance assessment in research and practice. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of postural control and maturation of sensory systems in children of different ages a cross-sectional study.

PubMed

Sá, Cristina Dos Santos Cardoso de; Boffino, Catarina Costa; Ramos, Renato Teodoro; Tanaka, Clarice

To evaluate the stability, postural adjustments and contributions of sensory information for postural control in children. 40 boys and 40 girls were equally divided into groups of 5, 7, 9 and 12 years (G5, G7, G9 and G12). All children were submitted to dynamic posturography using a modified sensory organization test, using four sensory conditions: combining stable or sway referencing platform with eyes opened, or closed. The area and displacements of the center of pressure were used to determine stability, while the adjustments were used to measure the speed of the center of pressure displacements. These measurements were compared between groups and test conditions. Stability tends to increase with age and to decrease with sensory manipulation with significant differences between G5 and G7 in different measures. G7 differed from G12 under the conditions of stable and sway platform with eyes open. G9 did not differ from G12. Similar behavior was observed for adjustments, especially in anterior-posterior directions. Postural stability and adjustments were associated with age and were influenced by sensory manipulation. The ability to perform anterior-posterior adjustments was more evident and sensory maturation occurred firstly on the visual system, then proprioceptive system, and finally, the vestibular system, reaching functional maturity at nine years of age. Seven-year-olds seem to go through a period of differentiated singularity in postural control. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

A new methodology based on functional principal component analysis to study postural stability post-stroke.

PubMed

Sánchez-Sánchez, M Luz; Belda-Lois, Juan-Manuel; Mena-Del Horno, Silvia; Viosca-Herrero, Enrique; Igual-Camacho, Celedonia; Gisbert-Morant, Beatriz

2018-05-05

A major goal in stroke rehabilitation is the establishment of more effective physical therapy techniques to recover postural stability. Functional Principal Component Analysis provides greater insight into recovery trends. However, when missing values exist, obtaining functional data presents some difficulties. The purpose of this study was to reveal an alternative technique for obtaining the Functional Principal Components without requiring the conversion to functional data beforehand and to investigate this methodology to determine the effect of specific physical therapy techniques in balance recovery trends in elderly subjects with hemiplegia post-stroke. A randomized controlled pilot trial was developed. Thirty inpatients post-stroke were included. Control and target groups were treated with the same conventional physical therapy protocol based on functional criteria, but specific techniques were added to the target group depending on the subjects' functional level. Postural stability during standing was quantified by posturography. The assessments were performed once a month from the moment the participants were able to stand up to six months post-stroke. The target group showed a significant improvement in postural control recovery trend six months after stroke that was not present in the control group. Some of the assessed parameters revealed significant differences between treatment groups (P < 0.05). The proposed methodology allows Functional Principal Component Analysis to be performed when data is scarce. Moreover, it allowed the dynamics of recovery of two different treatment groups to be determined, showing that the techniques added in the target group increased postural stability compared to the base protocol. Copyright © 2018 Elsevier Ltd. 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.

Static and dynamic balance performance in patients with osteoporotic vertebral compression fracture.

PubMed

Wang, Ling-Yi; Liaw, Mei-Yun; Huang, Yu-Chi; Lau, Yiu-Chung; Leong, Chau-Peng; Pong, Ya-Ping; Chen, Chia-Lin

2013-01-01

Patients with osteoporotic vertebral compression fracture (OVCF) have postural changes and increased risk of falling. The aim of this study is to compare balance characteristics between patients with OVCF and healthy control subjects. Patients with severe OVCF and control subjects underwent computerised dynamic posturography (CDP) in this case-control study. Forty-seven OVCF patients and 45 controls were recruited. Compared with the control group, the OVCF group had significantly decreased average stability; maximal stability under the `eye open with swayed support surface' (CDP subtest 4) and 'eye closed with swayed support surface' conditions (subtest 5); and decreased ankle strategy during subtests 4 and 5 and under the `swayed vision with swayed support surface' condition (subtest 6). The OVCF group fell more frequently during subtests 5 and 6 and had longer overall reaction time and longer reaction time when moving backward during the directional control test. OVCF patients had poorer static and dynamic balance performance compared with normal control. They had decreased postural stability and ankle strategy with increased fall frequency on a swayed surface; they also had longer reaction times overall and in the backward direction. Therefore, we suggest balance rehabilitation for patients with OVCF to prevent fall.

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.

Designing a Self-Stabilizing Robot for Dynamic Mobile Manipulation

DTIC Science & Technology

2006-01-01

Designing a Self-Stabilizing Robot For Dynamic Mobile Manipulation Patrick Deegan Bryan J. Thibodeau Roderic Grupen Laboratory for Perceptual... Craig and the Modified D-H standard[14]. Fig. 9. Increase in forces that can be applied to the environment using whole body postural control, for an end...4. This work was supported by NASA grant NNJ05HB61A-5710001842 and ARO grant W911NF-05-1- 0396. REFERENCES [1] B. J. Thibodeau, P. Deegan , and R

Effects of interactive metronome training on postural stability and upper extremity function in Parkinson's disease: a case study.

PubMed

Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

2017-01-01

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson's disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson's disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient's static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson's disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson's disease.

Effects of interactive metronome training on postural stability and upper extremity function in Parkinson’s disease: a case study

PubMed Central

Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

2017-01-01

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson’s disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson’s disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient’s static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson’s disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson’s disease. PMID:28210066

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.

Running over rough terrain reveals limb control for intrinsic stability.

PubMed

Daley, Monica A; Biewener, Andrew A

2006-10-17

Legged animals routinely negotiate rough, unpredictable terrain with agility and stability that outmatches any human-built machine. Yet, we know surprisingly little about how animals accomplish this. Current knowledge is largely limited to studies of steady movement. These studies have revealed fundamental mechanisms used by terrestrial animals for steady locomotion. However, it is unclear whether these models provide an appropriate framework for the neuromuscular and mechanical strategies used to achieve dynamic stability over rough terrain. Perturbation experiments shed light on this issue, revealing the interplay between mechanics and neuromuscular control. We measured limb mechanics of helmeted guinea fowl (Numida meleagris) running over an unexpected drop in terrain, comparing their response to predictions of the mass-spring running model. Adjustment of limb contact angle explains 80% of the variation in stance-phase limb loading following the perturbation. Surprisingly, although limb stiffness varies dramatically, it does not influence the response. This result agrees with a mass-spring model, although it differs from previous findings on humans running over surfaces of varying compliance. However, guinea fowl sometimes deviate from mass-spring dynamics through posture-dependent work performance of the limb, leading to substantial energy absorption following the perturbation. This posture-dependent actuation allows the animal to absorb energy and maintain desired velocity on a sudden substrate drop. Thus, posture-dependent work performance of the limb provides inherent velocity control over rough terrain. These findings highlight how simple mechanical models extend to unsteady conditions, providing fundamental insights into neuromuscular control of movement and the design of dynamically stable legged robots and prosthetic devices.

Age-Related Differences in Motor Coordination during Simultaneous Leg Flexion and Finger Extension: Influence of Temporal Pressure

PubMed Central

Hussein, Tarek; Yiou, Eric; Larue, Jacques

2013-01-01

Although the effect of temporal pressure on spatio-temporal aspects of motor coordination and posture is well established in young adults, there is a clear lack of data on elderly subjects. This work examined the aging-related effects of temporal pressure on movement synchronization and dynamic stability. Sixteen young and eleven elderly subjects performed series of simultaneous rapid leg flexions in an erect posture paired with ipsilateral index-finger extensions, minimizing the difference between heel and finger movement onsets. This task was repeated ten times under two temporal conditions (self-initiated [SI] vs. reaction-time [RT]). Results showed that, first, temporal pressure modified movement synchronization; the finger extension preceded swing heel-off in RT, and inversely in SI. Synchronization error and associated standard deviation were significantly greater in elderly than in young adults in SI only, i.e. in the condition where proprioception is thought to be crucial for temporal coordination. Secondly, both groups developed a significantly shorter mediolateral (ML) anticipatory postural adjustment duration in RT (high temporal pressure) than in SI. In both groups, this shortening was compensated by an increase in the anticipatory peak of centre-of-gravity (CoG) acceleration towards the stance-leg so that ML dynamic stability at foot-off, quantified with the “extrapolated centre-of-mass”, remained unchanged across temporal conditions. This increased CoG acceleration was associated with an increased anticipatory peak of ML centre-of-pressure shift towards the swing-leg in young adults only. This suggested that the ability to accelerate the CoG with the centre-of-pressure shift was degraded in elderly, probably due to weakness in the lower limb muscles. Dynamic stability at foot-off was also degraded in elderly, with a consequent increased risk of ML imbalance and falling. The present study provides new insights into the ability of elderly adults to deal with temporal pressure constraints in adapting whole-body coordination of postural and focal components of paired movement. PMID:24340080

Age-related differences in motor coordination during simultaneous leg flexion and finger extension: influence of temporal pressure.

PubMed

Hussein, Tarek; Yiou, Eric; Larue, Jacques

2013-01-01

Although the effect of temporal pressure on spatio-temporal aspects of motor coordination and posture is well established in young adults, there is a clear lack of data on elderly subjects. This work examined the aging-related effects of temporal pressure on movement synchronization and dynamic stability. Sixteen young and eleven elderly subjects performed series of simultaneous rapid leg flexions in an erect posture paired with ipsilateral index-finger extensions, minimizing the difference between heel and finger movement onsets. This task was repeated ten times under two temporal conditions (self-initiated [SI] vs. reaction-time [RT]). Results showed that, first, temporal pressure modified movement synchronization; the finger extension preceded swing heel-off in RT, and inversely in SI. Synchronization error and associated standard deviation were significantly greater in elderly than in young adults in SI only, i.e. in the condition where proprioception is thought to be crucial for temporal coordination. Secondly, both groups developed a significantly shorter mediolateral (ML) anticipatory postural adjustment duration in RT (high temporal pressure) than in SI. In both groups, this shortening was compensated by an increase in the anticipatory peak of centre-of-gravity (CoG) acceleration towards the stance-leg so that ML dynamic stability at foot-off, quantified with the "extrapolated centre-of-mass", remained unchanged across temporal conditions. This increased CoG acceleration was associated with an increased anticipatory peak of ML centre-of-pressure shift towards the swing-leg in young adults only. This suggested that the ability to accelerate the CoG with the centre-of-pressure shift was degraded in elderly, probably due to weakness in the lower limb muscles. Dynamic stability at foot-off was also degraded in elderly, with a consequent increased risk of ML imbalance and falling. The present study provides new insights into the ability of elderly adults to deal with temporal pressure constraints in adapting whole-body coordination of postural and focal components of paired movement.

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

Head Stability and Head-Trunk Coordination in Horseback Riders: The Contribution of Visual Information According to Expertise

PubMed Central

Olivier, Agnès; Faugloire, Elise; Lejeune, Laure; Biau, Sophie; Isableu, Brice

2017-01-01

Maintaining equilibrium while riding a horse is a challenging task that involves complex sensorimotor processes. We evaluated the relative contribution of visual information (static or dynamic) to horseback riders' postural stability (measured from the variability of segment position in space) and the coordination modes they adopted to regulate balance according to their level of expertise. Riders' perceptual typologies and their possible relation to postural stability were also assessed. Our main assumption was that the contribution of visual information to postural control would be reduced among expert riders in favor of vestibular and somesthetic reliance. Twelve Professional riders and 13 Club riders rode an equestrian simulator at a gallop under four visual conditions: (1) with the projection of a simulated scene reproducing what a rider sees in the real context of a ride in an outdoor arena, (2) under stroboscopic illumination, preventing access to dynamic visual cues, (3) in normal lighting but without the projected scene (i.e., without the visual consequences of displacement) and (4) with no visual cues. The variability of the position of the head, upper trunk and lower trunk was measured along the anteroposterior (AP), mediolateral (ML), and vertical (V) axes. We computed discrete relative phase to assess the coordination between pairs of segments in the anteroposterior axis. Visual field dependence-independence was evaluated using the Rod and Frame Test (RFT). The results showed that the Professional riders exhibited greater overall postural stability than the Club riders, revealed mainly in the AP axis. In particular, head variability was lower in the Professional riders than in the Club riders in visually altered conditions, suggesting a greater ability to use vestibular and somesthetic information according to task constraints with expertise. In accordance with this result, RFT perceptual scores revealed that the Professional riders were less dependent on the visual field than were the Club riders. Finally, the Professional riders exhibited specific coordination modes that, unlike the Club riders, departed from pure in-phase and anti-phase patterns and depended on visual conditions. The present findings provide evidence of major differences in the sensorimotor processes contributing to postural control with expertise in horseback riding. PMID:28194100

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

Postural stability and ankle sprain history in athletes compared to uninjured controls.

PubMed

Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; Verhagen, Evert A L M; van Dieën, Jaap H

2014-02-01

Diminished postural stability is a risk factor for ankle sprain occurrence and ankle sprains result in impaired postural stability. To date, ankle sprain history has not been taken into account as a determinant of postural stability, while it could possibly specify subgroups of interest. Postural stability was compared between 18 field hockey athletes who had recovered from an ankle sprain (mean (SD); 3.6 (1.5) months post-injury), and 16 uninjured controls. Force plate and kinematics parameters were calculated during single-leg standing: mean center of pressure speed, mean absolute horizontal ground reaction force, mean absolute ankle angular velocity, and mean absolute hip angular velocity. Additionally, cluster analysis was applied to the 'injured' participants, and the cluster with diminished postural stability was compared to the other participants with respect to ankle sprain history. MANCOVA showed no significant difference between groups in postural stability (P = 0.68). A self-reported history of an (partial) ankle ligament rupture was typically present in the cluster with diminished postural stability. Subsequently, a 'preceding rupture' was added as a factor in the MANCOVA, which showed a significant association between diminished postural stability and a 'preceding rupture' (P = 0.01), for all four individual parameters (P: 0.001-0.029; Cohen's d: 0.96-2.23). Diminished postural stability is not apparent in all previously injured athletes. However, our analysis suggests that an (mild) ankle sprain with a preceding severe ankle sprain is associated with impaired balance ability. Therefore, sensorimotor training may be emphasized in this particular group and caution is warranted in return to play decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

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.

Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

PubMed

Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

2013-02-01

To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=.38, P=.001), physical domain and function (r=.34-.48, P=.001 to P<.004), activities of daily living (r=.51, P<.001), and sports and recreation (r=.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=.52, P<.001) and quality of life (r=0.4, P=.001). Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality-of-life measures than did controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Recovery of Posture Stability at Different Foot Placements in Patients Who Underwent Minimally Invasive Total Hip Arthroplasty: A One-Year Follow-Up Study.

PubMed

Chang, Chun-Ju; Lin, Na-Ling; Lee, Mel S; Chern, Jen-Suh

2015-01-01

To understand the progression of recovery in postural stability and physical functioning after patients received the minimally invasive total hip arthroplasty (MTHA), we monitor the pain level, functional capacity, and postural stability before and after operation within one year. In total of 23 subjects in our study, we found out that MTHA was effective in relieving pain in first 2 weeks and restoring the hip joint integrity, but the postural stability was influenced especially in tandem stand in both anterior-posterior and medial-lateral directions. The recovery of postural stability and functional capacity in one year duration fluctuated and no consistent improvement tendency was found. We suggested clinicians designing postsurgery rehabilitation program for consistent and progressive long-term recovery of postural stability and fall prevention to optimize surgical results and prevent undesired postoperative consequences.

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.

Effects of different foot progression angles and platform settings on postural stability and fall risk in healthy and medial knee osteoarthritic adults.

PubMed

Khan, Saad Jawaid; Khan, Soobia Saad; Usman, Juliana; Mokhtar, Abdul Halim; Abu Osman, Noor Azuan

2018-02-01

This study aims to investigate the effects of varying toe angles at different platform settings on Overall Stability Index of postural stability and fall risk using Biodex Balance System in healthy participants and medial knee osteoarthritis patients. Biodex Balance System was employed to measure postural stability and fall risk at different foot progression angles (ranging from -20° to 40°, with 10° increments) on 20 healthy (control group) and 20 knee osteoarthritis patients (osteoarthritis group) randomly (age: 59.50 ± 7.33 years and 61.50 ± 8.63 years; body mass: 69.95 ± 9.86 kg and 70.45 ± 8.80 kg). Platform settings used were (1) static, (2) postural stability dynamic level 8 (PS8), (3) fall risk levels 12 to 8 (FR12) and (4) fall risk levels 8 to 2 (FR8). Data from the tests were analysed using three-way mixed repeated measures analysis of variance. The participant group, platform settings and toe angles all had a significant main effect on balance ( p ≤ 0.02). Platform settings had a significant interaction effect with participant group F(3, 144) = 6.97, p < 0.01 and toe angles F(21, 798) = 2.83, p < 0.01. Non-significant interactions were found for group × toe angles, F(7, 266) = 0.89, p = 0.50, and for group × toe angles × settings, F(21, 798) = 1.07, p = 0.36. The medial knee osteoarthritis group has a poorer postural stability and increased fall risk as compared to the healthy group. Changing platform settings has a more pronounced effect on balance in knee osteoarthritis group than in healthy participants. Changing toe angles produced similar effects in both the participant groups, with decreased stability and increased fall risk at extreme toe-in and toe-out angles.

The effects of dance training program on the postural stability of middle aged women.

PubMed

Kostić, Radmila; Uzunović, Slavoljub; Purenović-Ivanović, Tijana; Miletić, Đurđica; Katsora, Georgija; Pantelić, Saša; Milanović, Zoran

2015-11-01

The aim of the study was to determine the effects of Greek folk dancing on postural stability in middle age women. Sixty-three women aged from 47-53 participated in this study. All participants were randomly divided into the experimental group - 33 participants (mean ± SD; body height=160.13 ± 12.07 cm, body mass=63.81 ± 10.56 kg), and the control group - 30 participants (mean ± SD; body height=160.63 ± 6.22 cm, body mass=64.79 ± 8.19 kg). The following tests were used to evaluate the motor balance and posture stability of participants; the double-leg stance along the length of a balance beam (eyes open), the double-leg stance along the width of a balance beam (eyes open), the single-leg stance (eyes open) and the double-leg stance on one's toes (eyes closed). The Functional Reach Test for balance and the Star Excursion Balance Test were used to evaluate dynamic balance. The multivariate analysis of covariance of static and dynamic balance between participants of the experimental and control group at the final measuring, with neutralized differences at the initial measuring (Wilks' λ=0.45), revealed a significant difference (p<0.05). The intergroup difference at the final measuring was also found to be significant (p<0.05) for the following variables; the double-leg stance on one's toes, the Functional Reach Test, balance of the right anterolateral, balance of the right posterolateral and balance of the left posteromedial. An organized dance activity programme does lead to the improvement of static and dynamic balance in middle aged women. Copyright© by the National Institute of Public Health, Prague 2015.

Balance ability and postural stability among patients with painful shoulder disorders and healthy controls

PubMed Central

2013-01-01

Background In therapeutic settings, patients with shoulder pain often exhibit deficient coordinative abilities in their trunk and lower extremities. The aim of the study was to investigate 1) if there is a connection between shoulder pain and deficits in balance ability and postural stability, 2) if pain intensity is related to balance ability and postural stability, and 3) if there is a connection between body mass index (BMI) and balance ability and postural stability. Methods In this case–control study, patients (n = 40) with pathological shoulder pain (> 4 months) were matched with a healthy controls (n = 40) and were compared with regard to their balance ability and postural stability. Outcome parameters were postural stability, balance ability and symmetry index which were measured using the S3-Check system. In addition, the influence of shoulder pain intensity and BMI on the outcome parameters was analysed. Results Patients with shoulder pain showed significantly worse results in measurements of postural stability right/left (p < 0.01) and front/back (p < 0.01) as well as balance ability right/left (p = 0.01) and front/back (p < 0.01) compared to healthy controls. There were no significant group differences with regard to symmetry index. However, there was a significant (p < 0.01) symmetry shift towards the affected side within the shoulder pain group. There was no correlation between pain intensity and measurements of balance ability or postural stability. Likewise, no correlation between BMI and deficiencies in balance ability and postural stability was established. Conclusions Patients with pathological shoulder pain (> 4 months) have deficiencies in balance ability and postural stability; however the underlying mechanisms for this remain unclear. Neither pain intensity nor BMI influenced the outcome parameters. Patients with shoulder pain shift their weight to the affected side. Further research is needed to determine if balance training can improve rehabilitation results in patients with shoulder pathologies. PMID:24088342

The effect of leg preference on postural stability in healthy athletes.

PubMed

Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; Hupperets, Maarten D W; van Dieën, Jaap H

2014-01-03

In research regarding postural stability, leg preference is often tested and controlled for. However, leg preference may vary between tasks. As athletes are a group of interest for postural stability testing, we evaluated the effect of five leg preference tasks categorization (step up, hop, ball kick, balance, pick up) on single-leg postural stability of 16 field hockey athletes. The 'center of pressure speed' was calculated as the primary outcome variable of single-leg postural stability. Secondary variables were 'mean length of the GRF vector in the horizontal plane', 'mean length of the ankle angular velocity vector', and 'mean length of the hip angular velocity vector', as well as the separate outcomes per degree of freedom. Results showed that leg preference was inconsistent between leg preference tasks. Moreover, the primary and secondary variables yielded no significant difference between the preferred and non-preferred legs, regardless of the applied leg preference task categorization (p>0.05). The present findings do not support the usability of leg preference tasks in controlling for bias of postural stability. In conclusion, none of the applied leg preference tasks revealed a significant effect on postural stability in healthy field hockey athletes. © 2013 Published by Elsevier Ltd.

The influence of an immersive virtual environment on the segmental organization of postural stabilizing responses.

PubMed

Keshner, E A; Kenyon, R V

2000-01-01

We examined the effect of a 3-dimensional stereoscopic scene on segmental stabilization. Eight subjects participated in static sway and locomotion experiments with a visual scene that moved sinusoidally or at constant velocity about the pitch or roll axes. Segmental displacements, Fast Fourier Transforms, and Root Mean Square values were calculated. In both pitch and roll, subjects exhibited greater magnitudes of motion in head and trunk than ankle. Smaller amplitudes and frequent phase reversals suggested control of the ankle by segmental proprioceptive inputs and ground reaction forces rather than by the visual-vestibular signals. Postural controllers may set limits of motion at each body segment rather than be governed solely by a perception of the visual vertical. Two locomotor strategies were also exhibited, implying that some subjects could override the effect of the roll axis optic flow field. Our results demonstrate task dependent differences that argue against using static postural responses to moving visual fields when assessing more dynamic tasks.

The effect of sensorimotor training on the postural stability of visually impaired women over 50 years of age.

PubMed

Maćkowiak, Zuzanna; Osiński, Wieslaw; Salamon, Artur

2015-01-01

Previous studies indicated that blind and visually impaired people are a group with greater risk of falls. Postmenopausal changes significantly decrease physical efficiency and impair the body's mechanisms for maintaining postural stability. In addition, the frequency of falls among women is much higher than in men. The aim of this study was to analyze the effect of sensorimotor exercise on changes in postural stability of visually impaired women over 50 years of age. Visually impaired women from group E showed a lower level of postural stability measured with EO compared to the healthy women. After completing the exercise, a more pronounced improvement in the level of postural stability was observed in group E.

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.

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.

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.

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.

A Wireless Accelerometer-Based Body Posture Stability Detection System and Its Application for Meditation Practitioners

PubMed Central

Chang, Kang-Ming; Chen, Sih-Huei; Lee, Hsin-Yi; Ching, Congo Tak-Shing; Huang, Chun-Lung

2012-01-01

The practice of meditation has become an interesting research issue in recent decades. Meditation is known to be beneficial for health improvement and illness reduction and many studies on meditation have been made, from both the physiological and psychological points of view. It is a fundamental requirement of meditation practice to be able to sit without body motion. In this study, a novel body motion monitoring and estimation system has been developed. A wireless tri-axis accelerometer is used to measure body motion. Both a mean and maximum motion index is derived from the square summation of three axes. Two experiments were conducted in this study. The first experiment was to investigate the motion index baseline among three leg-crossing postures. The second experiment was to observe posture dynamics for thirty minute’s meditation. Twenty-six subjects participated in the experiments. In one experiment, thirteen subjects were recruited from an experienced meditation group (meditation experience > 3 years); and the other thirteen subjects were beginners (meditation experience < 1 years). There was a significant posture stability difference between both groups in terms of either mean or maximum parameters (p < 0.05), according to the results of the experiment. Results from another experiment showed that the motion index is different for various postures, such as full-lotus < half-lotus < non-lotus. PMID:23250281

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.

Determining postural stability

NASA Technical Reports Server (NTRS)

Forth, Katharine E. (Inventor); Paloski, William H. (Inventor); Lieberman, Erez (Inventor)

2011-01-01

A method for determining postural stability of a person can include acquiring a plurality of pressure data points over a period of time from at least one pressure sensor. The method can also include the step of identifying a postural state for each pressure data point to generate a plurality of postural states. The method can include the step of determining a postural state of the person at a point in time based on at least the plurality of postural states.

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.

Postural stability and vehicle kinematics during an evasive lane change manoeuvre: a driver training study.

PubMed

Petersen, Andrew; Barrett, Rod

2009-05-01

The purpose of this study was to investigate the effect of a 2-day driver-training course that emphasised postural stability maintenance during critical driving situations on postural stability and vehicle kinematics during an evasive lane change manoeuvre. Following training, the trainee group experienced enhanced postural stability during specific phases of the task. In terms of vehicle kinematics, the main adaptation to training was that trained drivers reduced the extent to which they experienced vehicle decelerations during rapid turning compared to controls. Such a strategy may confer a safety benefit due to the increased risks associated with simultaneous braking while turning during an evasive manoeuvre. The newly learned strategy was consistent with the strategy used by a group of highly skilled drivers (driving instructors). Taken together, the results of the study suggest postural stability may be a useful variable to consider in relation to the skill-based component of hierarchical driver training programmes. The findings of this study provide some preliminary evidence to suggest that postural stability may be an important consideration when instructing individuals on how to safely negotiate obstacles during driving.

NASA's Functional Task Test: Effects of Spaceflight and Six Degree Head-Down Bedrest on Dynamic Postural Stability

NASA Technical Reports Server (NTRS)

Taylor, L. C.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

Predictors of vertigo in patients with untreated vestibular schwannoma.

PubMed

Andersen, Jan Fredrik; Nilsen, Kathrin Skorpa; Vassbotn, Flemming Slinning; Møller, Per; Myrseth, Erling; Lund-Johansen, Morten; Goplen, Frederik Kragerud

2015-04-01

Previous studies have shown that vertigo is the most powerful negative predictor of quality of life in patients with vestibular schwannomas, but the variability in vertigo symptom severity is still poorly understood. We wanted to find out whether vertigo could be related to objective parameters such as tumor size, location, vestibular nerve function, hearing, and postural stability in patients with untreated vestibular schwannomas. Baseline data from prospective cohort study. Tertiary referral center. Four hundred thirty-four consecutive patients with unilateral VS diagnosed on MRI. Mean age 56 years (range 16-84 yr). Fifty-three percent women. Diagnostic, with a medical history, otolaryngological examination, pure-tone and speech audiometry, MRI, posturography, and videonystagmography with bithermal caloric tests. Dizziness measured on a 100-mm visual analog scale (VAS). Secondary outcome measures were canal paresis and postural imbalance (static and dynamic posturography). Three hundred three patients (70%) completed the VAS. Severe dizziness, defined as VAS 75 or greater, was reported by 9% of the patients. Larger tumors were associated with higher risk of postural instability and canal paresis. Moderate to severe dizziness was associated with postural imbalance and canal paresis, and possibly with small to medium-sized tumors. Postural instability was related to tumor size and canal paresis when measured by dynamic, but not with static, posturography. A minority of VS patients experience severe vestibular symptoms related to canal paresis and postural instability. A curvilinear relationship is hypothesized between tumor size and dizziness.

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.

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.

Motor Difficulties in Autism Spectrum Disorder: Linking Symptom Severity and Postural Stability

ERIC Educational Resources Information Center

Travers, Brittany G.; Powell, Patrick S.; Klinger, Laura G.; Klinger, Mark R.

2013-01-01

Postural stability is a fundamental aspect of motor ability that allows individuals to sustain and maintain the desired physical position of one's body. The present study examined postural stability in average-IQ adolescents and adults with Autism Spectrum Disorder (ASD). Twenty-six individuals with ASD and 26 age-and-IQ-matched individuals…

The Role of Postural Support in Young Adults' Control of Stationary Kicking

ERIC Educational Resources Information Center

Sidaway, Ben; Bouchard, Matthew; Chasse, Julie; Dunn, Jonathan; Govoni, Andrea; McPherson, Breanne; Roy, Katherine; Anderson, David I.

2017-01-01

Purpose: The requirement for postural stability during the performance of motor skills has been clearly demonstrated in infants, but the necessity for such a postural substrate is not well documented in adults. The present study investigated the role of postural stability during a ballistic ball-kicking task in adults by providing varying degrees…

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.

Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters.

PubMed

Horák, Stanislav; Sovová, Eliška; Pastucha, Dalibor; Konečný, Petr; Radová, Lenka; Calabová, Naděžda; Janoutová, Jana; Janout, Vladimír

2017-12-01

Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions). Copyright© by the National Institute of Public Health, Prague 2017

A Methodology for Investigating Adaptive Postural Control

NASA Technical Reports Server (NTRS)

McDonald, P. V.; Riccio, G. E.

1999-01-01

Our research on postural control and human-environment interactions provides an appropriate scientific foundation for understanding the skill of mass handling by astronauts in weightless conditions (e.g., extravehicular activity or EVA). We conducted an investigation of such skills in NASA's principal mass-handling simulator, the Precision Air-Bearing Floor, at the Johnson Space Center. We have studied skilled movement-body within a multidisciplinary context that draws on concepts and methods from biological and behavioral sciences (e.g., psychology, kinesiology and neurophysiology) as well as bioengineering. Our multidisciplinary research has led to the development of measures, for manual interactions between individuals and the substantial environment, that plausibly are observable by human sensory systems. We consider these methods to be the most important general contribution of our EVA investigation. We describe our perspective as control theoretic because it draws more on fundamental concepts about control systems in engineering than it does on working constructs from the subdisciplines of biomechanics and motor control in the bio-behavioral sciences. At the same time, we have attempted to identify the theoretical underpinnings of control-systems engineering that are most relevant to control by human beings. We believe that these underpinnings are implicit in the assumptions that cut across diverse methods in control-systems engineering, especially the various methods associated with "nonlinear control", "fuzzy control," and "adaptive control" in engineering. Our methods are based on these theoretical foundations rather than on the mathematical formalisms that are associated with particular methods in control-systems engineering. The most important aspects of the human-environment interaction in our investigation of mass handling are the functional consequences that body configuration and stability have for the pick up of information or the achievement of overt goals. It follows that an essential characteristic of postural behavior is the effective maintenance of the orientation and stability of the sensory and motor "platforms" (e.g., head or shoulders) over variations in the human, the environment and the task. This general skill suggests that individuals should be sensitive to the functional consequences of body configuration and stability. In other words, individuals should perceive the relation between configuration, stability, and performance so that they can adaptively control their interaction with the surroundings. Human-environment interactions constitute robust systems in that individuals can maintain the stability of such interactions over uncertainty about and variations in the dynamics of the interaction. Robust interactions allow individuals to adopt orientations and configurations that are not optimal with respect to purely energetic criteria. Individuals can tolerate variation in postural states, and such variation can serve an important function in adaptive systems. Postural variability generates stimulation which is "textured" by the dynamics of the human-environment system. The texture or structure in stimulation provides information about variation in dynamics, and such information can be sufficient to guide adaption in control strategies. Our method were designed to measure informative patterns of movement variability.

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

Treadmill Exercise with Increased Body Loading Enhances Post Flight Functional Performance

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

Postural Stability is Altered by Blood Shift

NASA Astrophysics Data System (ADS)

Marais, M.; Denise, P.; Guincetre, J. Y.; Normand, H.

2008-06-01

Non-vestibular influences as shift in blood volume changed perception of body posture. Then, factors affecting blood shift may alter postural control. The purpose of our study was to investigate the effects of leg venous contention on postural stability. Twelve subjects were studied on a balance plate for 5 minutes with the eyes closed, in 3 conditions: with no leg venous contention or grade 1 and 3 support stockings. Standard deviation of x and y position was calculated before and after the closure of the eyes. Strong venous contention altered postural stability, after the eyes were closed, during the first 10 s of standing. As support stockings prevent blood shift induced by upright posture, this result is in line with the hypothesis that blood shifts influence the perception of body orientation and postural control among others factors as vision, vestibular inputs... This strong venous contention could induce an increase of fall.

The effects of safety handrails and the heights of scaffolds on the subjective and objective evaluation of postural stability and cardiovascular stress in novice and expert construction workers.

PubMed

Min, Seung-Nam; Kim, Jung-Yong; Parnianpour, Mohamad

2012-05-01

Work performed on scaffolds carries the risk of falling that disproportionately threatens the safety and health of novice construction workers. Hence, objective measures of the postural stability, cardiovascular stress, and subjective difficulty in maintaining postural balance were evaluated for four expert and four novice construction workers performing a manual task in a standing posture on a scaffold with and without safety handrails at two different elevation heights. Based on a multivariate analysis of variance, the experience, scaffold height, and presence of a handrail were found to significantly affect measures of the postural stability and cardiovascular stress. At a lower level of worker experience, a higher scaffold height, and in the absence of a handrail (which may correspond to higher risk of a fall), postural stability was significantly reduced, while cardiovascular stress and subjective difficulties in maintaining postural balance increased. We emphasize the importance of training and handrails for fall prevention at construction sites. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Impaired perception of surface tilt in progressive supranuclear palsy

PubMed Central

Dale, Marian L.; Horak, Fay B.; Wright, W. Geoffrey; Schoneburg, Bernadette M.; Nutt, John G.; Mancini, Martina

2017-01-01

Introduction Progressive supranuclear palsy (PSP) is characterized by early postural instability and backward falls. The mechanisms underlying backward postural instability in PSP are not understood. The aim of this study was to test the hypothesis that postural instability in PSP is a result of dysfunction in the perception of postural verticality. Methods We gathered posturography data on 12 subjects with PSP to compare with 12 subjects with idiopathic Parkinson’s Disease (PD) and 12 healthy subjects. Objective tests of postural impairment included: dynamic sensory perception tests of gravity and of surface oscillations, postural responses to surface perturbations, the sensory organization test of postural sway under altered sensory conditions and limits of stability in stance. Results Perception of toes up (but not toes down) surface tilt was reduced in subjects with PSP compared to both control subjects (p≤0.001 standing, p≤0.007 seated) and subjects with PD (p≤0.03 standing, p≤0.04 seated). Subjects with PSP, PD and normal controls accurately perceived the direction of gravity when standing on a tilting surface. Unlike PD and control subjects, subjects with PSP exerted less postural corrective torque in response to toes up surface tilts. Discussion Difficulty perceiving backward tilt of the surface or body may account for backward falls and postural impairments in patients with PSP. These observations suggest that abnormal central integration of sensory inputs for perception of body and surface orientation contributes to the pathophysiology of postural instability in PSP. PMID:28267762

Virtual Reality Telerehabilitation for Postural Instability in Parkinson's Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial

PubMed Central

Geroin, Christian; Dimitrova, Eleonora; Boldrini, Paolo; Waldner, Andreas; Bonadiman, Silvia; Regazzo, Sara; Stirbu, Elena; Primon, Daniela; Bosello, Christian; Gravina, Aristide Roberto; Peron, Luca; Trevisan, Monica; Garcia, Alberto Carreño; Menel, Alessia; Bloccari, Laura; Valè, Nicola; Saltuari, Leopold; Tinazzi, Michele

2017-01-01

Introduction Telerehabilitation enables patients to access remote rehabilitation services for patient-physiotherapist videoconferencing in their own homes. Home-based virtual reality (VR) balance training has been shown to reduce postural instability in patients with Parkinson's disease (PD). The primary aim was to compare improvements in postural stability after remotely supervised in-home VR balance training and in-clinic sensory integration balance training (SIBT). Methods In this multicenter study, 76 PD patients (modified Hoehn and Yahr stages 2.5–3) were randomly assigned to receive either in-home VR telerehabilitation (n = 38) or in-clinic SIBT (n = 38) in 21 sessions of 50 minutes each, 3 days/week for 7 consecutive weeks. VR telerehabilitation consisted of graded exergames using the Nintendo Wii Fit system; SIBT included exercises to improve postural stability. Patients were evaluated before treatment, after treatment, and at 1-month follow-up. Results Analysis revealed significant between-group differences in improvement on the Berg Balance Scale for the VR telerehabilitation group (p = 0.04) and significant Time × Group interactions in the Dynamic Gait Index (p = 0.04) for the in-clinic group. Both groups showed differences in all outcome measures over time, except for fall frequency. Cost comparison yielded between-group differences in treatment and equipment costs. Conclusions VR is a feasible alternative to in-clinic SIBT for reducing postural instability in PD patients having a caregiver. PMID:29333454

Learning and Control Model of the Arm for Loading

NASA Astrophysics Data System (ADS)

Kim, Kyoungsik; Kambara, Hiroyuki; Shin, Duk; Koike, Yasuharu

We propose a learning and control model of the arm for a loading task in which an object is loaded onto one hand with the other hand, in the sagittal plane. Postural control during object interactions provides important points to motor control theories in terms of how humans handle dynamics changes and use the information of prediction and sensory feedback. For the learning and control model, we coupled a feedback-error-learning scheme with an Actor-Critic method used as a feedback controller. To overcome sensory delays, a feedforward dynamics model (FDM) was used in the sensory feedback path. We tested the proposed model in simulation using a two-joint arm with six muscles, each with time delays in muscle force generation. By applying the proposed model to the loading task, we showed that motor commands started increasing, before an object was loaded on, to stabilize arm posture. We also found that the FDM contributes to the stabilization by predicting how the hand changes based on contexts of the object and efferent signals. For comparison with other computational models, we present the simulation results of a minimum-variance model.

Elderly Fallers Enhance Dynamic Stability Through Anticipatory Postural Adjustments during a Choice Stepping Reaction Time

PubMed Central

Tisserand, Romain; Robert, Thomas; Chabaud, Pascal; Bonnefoy, Marc; Chèze, Laurence

2016-01-01

In the case of disequilibrium, the capacity to step quickly is critical to avoid falling in elderly. This capacity can be simply assessed through the choice stepping reaction time test (CSRT), where elderly fallers (F) take longer to step than elderly non-fallers (NF). However, the reasons why elderly F elongate their stepping time remain unclear. The purpose of this study is to assess the characteristics of anticipated postural adjustments (APA) that elderly F develop in a stepping context and their consequences on the dynamic stability. Forty-four community-dwelling elderly subjects (20 F and 24 NF) performed a CSRT where kinematics and ground reaction forces were collected. Variables were analyzed using two-way repeated measures ANOVAs. Results for F compared to NF showed that stepping time is elongated, due to a longer APA phase. During APA, they seem to use two distinct balance strategies, depending on the axis: in the anteroposterior direction, we measured a smaller backward movement and slower peak velocity of the center of pressure (CoP); in the mediolateral direction, the CoP movement was similar in amplitude and peak velocity between groups but lasted longer. The biomechanical consequence of both strategies was an increased margin of stability (MoS) at foot-off, in the respective direction. By elongating their APA, elderly F use a safer balance strategy that prioritizes dynamic stability conditions instead of the objective of the task. Such a choice in balance strategy probably comes from muscular limitations and/or a higher fear of falling and paradoxically indicates an increased risk of fall. PMID:27965561

Influence of the visual environment on the postural stability in healthy older women.

PubMed

Brooke-Wavell, K; Perrett, L K; Howarth, P A; Haslam, R A

2002-01-01

A poor postural stability in older people is associated with an increased risk of falling. It is recognized that visual environment factors (such as poor lighting and repeating patterns on escalators) may contribute to falls, but little is known about the effects of the visual environment on postural stability in the elderly. To determine whether the postural stability of older women (using body sway as a measure) differed under five different visual environment conditions. Subjects were 33 healthy women aged 65-76 years. Body sway was measured using an electronic force platform which identified the location of their centre of gravity every 0.05 s. Maximal lateral sway and anteroposterior sway were determined and the sway velocity calculated over 1-min trial periods. Body sway was measured under each of the following conditions: (1) normal laboratory lighting (186 lx); (2) moderate lighting (10 lx); (3) dim lighting (1 lx); (4) eyes closed, and (5) repeating pattern projected onto a wall. Each measure of the postural stability was significantly poorer in condition 4 (eyes closed) than in all other conditions. Anteroposterior sway was greater in condition 3 than in conditions 1 and 2, whilst the sway velocity was greater in condition 3 than in condition 2. Lateral sway did not differ significantly between different lighting levels (conditions 1-3). A projected repeating pattern (condition 5) did not significantly influence the postural stability relative to condition 1. The substantially greater body sway with eyes closed than with eyes open confirms the importance of vision in maintaining the postural stability. At the lowest light level, the body sway was significantly increased as compared with the other light levels, but was still substantially smaller than on closing the eyes. A projected repeating pattern did not influence the postural stability. Dim lighting levels and removing visual input appear to be associated with a poorer postural stability in older people and hence might be associated with an increased risk of falls. Copyright 2002 S. Karger AG, Basel

A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain.

PubMed

Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

2017-01-01

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical therapy and LSO significantly improved clinical and postural stability outcomes immediately after 4 weeks of intervention. The orthosis group did not display superior outcomes, except for functional disability.

A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain

PubMed Central

Azadinia, Fatemeh; Ebrahimi-Takamjani, Ismail; Kamyab, Mojtaba; Parnianpour, Mohamad; Asgari, Morteza

2017-01-01

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical therapy and LSO significantly improved clinical and postural stability outcomes immediately after 4 weeks of intervention. The orthosis group did not display superior outcomes, except for functional disability. PMID:29445655

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

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.

Effects of Changing Body Weight Distribution on Mediolateral Stability Control during Gait Initiation

PubMed Central

Caderby, Teddy; Yiou, Eric; Peyrot, Nicolas; de Viviés, Xavier; Bonazzi, Bruno; Dalleau, Georges

2017-01-01

During gait initiation, anticipatory postural adjustments (APA) precede the execution of the first step. It is generally acknowledged that these APA contribute to forward progression but also serve to stabilize the whole body in the mediolateral direction during step execution. Although previous studies have shown that changes in the distribution of body weight between both legs influence motor performance during gait initiation, it is not known whether and how such changes affect a person’s postural stability during this task. The aim of this study was to investigate the effects of changing initial body weight distribution between legs on mediolateral postural stability during gait initiation. Changes in body weight distribution were induced under experimental conditions by modifying the frontal plane distribution of an external load located at the participants’ waists. Fifteen healthy adults performed a gait initiation series at a similar speed under three conditions: with the overload evenly distributed over both legs; with the overload strictly distributed over the swing-limb side; and with the overload strictly distributed over the stance-leg side. Our results showed that the mediolateral location of center-of-mass (CoM) during the initial upright posture differed between the experimental conditions, indicating modifications in the initial distribution of body weight between the legs according to the load distribution. While the parameters related to the forward progression remained unchanged, the alterations in body weight distribution elicited adaptive changes in the amplitude of APA in the mediolateral direction (i.e., maximal mediolateral shift of the center of pressure (CoP)), without variation in their duration. Specifically, it was observed that the amplitude of APA was modulated in such a way that mediolateral dynamic stability at swing foot-contact, quantified by the margin of stability (i.e., the distance between the base of support boundary and the extrapolated CoM position), did not vary between the conditions. These findings suggest that APA seem to be scaled as a function of the initial body weight distribution between both legs so as to maintain optimal conditions of stability during gait initiation. PMID:28396629

The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder - a double blind randomized control trial.

PubMed

Jacobi-Polishook, Talia; Shorer, Zamir; Melzer, Itshak

2009-05-15

To investigate the effects of Methylphenidate (MPH) on postural stability in attention deficit hyperactivity disorder (ADHD) children in single and dual task conditions. A randomized controlled double-blind study analyzing postural stability in 24 ADHD children before and after MPH vs. placebo treatments, in three task conditions: (1) Single task, standing still; (2) dual task, standing still performing a memory-attention demanding task; (3) standing still listening to music. MPH resulted in a significant improvement in postural stability during the dual task condition and while listening to music, with no equivalent improvement in placebo controls. MPH improves postural stability in ADHD, especially when an additional task is performed. This is probably due to enhanced attention abilities, thus contributing to improved balance control during performance of tasks that require attention. MPH remains to be studied as a potential drug treatment to improve balance control and physical functioning in other clinical populations.

Immediate Beneficial Effects of Mental Rotation Using Foot Stimuli on Upright Postural Stability in Healthy Participants

PubMed Central

Kawasaki, Tsubasa

2013-01-01

The present study was designed to investigate whether an intervention during which participants were involved in mental rotation (MR) of a foot stimulus would have immediate beneficial effects on postural stability (Experiment 1) and to confirm whether it was the involvement of MR of the foot, rather than simply viewing foot stimuli, that could improve postural stability (Experiment 2). Two different groups of participants (n = 16 in each group) performed MR intervention of foot stimuli in each of the two experiments. Pre- and postmeasurements of postural stability during unipedal and bipedal standing were made using a force plate for the intervention. Consistently, postural sway values for unipedal standing, but not for bipedal standing, were decreased immediately after the MR intervention using the foot stimuli. Such beneficial effects were not observed after the MR intervention using car stimuli (Experiment 1) or when participants observed the same foot stimuli during a simple reaction task (Experiment 2). These findings suggest that the MR intervention using the foot stimuli could contribute to improving postural stability, at least when it was measured immediately after the intervention, under a challenging standing condition (i.e., unipedal standing). PMID:24459588

Spatial Cues Provided by Sound Improve Postural Stabilization: Evidence of a Spatial Auditory Map?

PubMed Central

Gandemer, Lennie; Parseihian, Gaetan; Kronland-Martinet, Richard; Bourdin, Christophe

2017-01-01

It has long been suggested that sound plays a role in the postural control process. Few studies however have explored sound and posture interactions. The present paper focuses on the specific impact of audition on posture, seeking to determine the attributes of sound that may be useful for postural purposes. We investigated the postural sway of young, healthy blindfolded subjects in two experiments involving different static auditory environments. In the first experiment, we compared effect on sway in a simple environment built from three static sound sources in two different rooms: a normal vs. an anechoic room. In the second experiment, the same auditory environment was enriched in various ways, including the ambisonics synthesis of a immersive environment, and subjects stood on two different surfaces: a foam vs. a normal surface. The results of both experiments suggest that the spatial cues provided by sound can be used to improve postural stability. The richer the auditory environment, the better this stabilization. We interpret these results by invoking the “spatial hearing map” theory: listeners build their own mental representation of their surrounding environment, which provides them with spatial landmarks that help them to better stabilize. PMID:28694770

Letter to the Editor: On "Advantages and disadvantages of stiffness instructions when studying postural control" by C.T. Bonnet: You just can't win: Advantages and disadvantages of the postural stability requirement.

PubMed

Lajoie, Y; Richer, N; Jehu, D A; Polskaia, N; Saunders, D

2016-05-01

In the examination of postural control, instructions to stand as still as possible are common and promote a relatively unnatural sway pattern. The validity of the stability requirement is discussed in the present commentary in response to the discussion initiated by Cedrick T. Bonnet. The advantages of using the stability requirement include: evaluating unbiased postural control, reducing variability in postural sway, manipulating focus of attention, examining the ability to maintain an upright stance, and ecological validity of testing. The disadvantages include: constraining natural postural sway, increasing the complexity of the control condition, promoting an internal focus of attention, and reducing the ability to detect exploratory behaviour. After evaluating the aforementioned advantages and disadvantages, the present commentary suggests that researchers should strive to provide specific instructions to maintain feet, arm and eye position without specifically requiring participants to reduce their postural sway. Copyright © 2015 Elsevier B.V. All rights reserved.

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.

Design and Validation of a Low-Cost Portable Device to Quantify Postural Stability.

PubMed

Zhu, Yong

2017-03-18

Measurement of the displacement of the center-of-pressure (COP) is an important tool used in biomechanics to assess postural stability and human balance. The goal of this research was to design and validate a low-cost portable device that can offer a quick indication of the state of postural stability and human balance related conditions. Approximate entropy (ApEn) values reflecting the amount of irregularity hiding in COP oscillations were used to calculate the index. The prototype adopted a portable design using the measurements of the load cells located at the four corners of a low-cost force platform. The test subject was asked to stand on the device in a quiet, normal, upright stance for 30 s with eyes open and subsequently for 30 s with eyes closed. Based on the COP displacement signals, the ApEn values were calculated. The results indicated that the prototype device was capable of capturing the increase in regularity of postural control in the visual-deprivation conditions. It was also able to decipher the subtle postural control differences along anterior-posterior and medial-lateral directions. The data analysis demonstrated that the prototype would enable the quantification of postural stability and thus provide a low-cost portable device to assess many conditions related to postural stability and human balance such as aging and pathologies.

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

Dynamic stability of the trunk during unstable sitting in people with low back pain.

PubMed

Freddolini, Marco; Strike, Siobhan; Lee, Raymond

2014-05-01

Cross-sectional study. To evaluate the dynamic stability and kinematics of the trunk during unstable sitting, and to determine the differences in these biomechanical parameters between healthy participants and participants with low back pain (LBP). Patients with LBP exhibited alterations in trunk kinematics while performing different dynamic tasks and in static posture as a result of pain. It is not clear if changing in trunk motion may reduce postural control and the ability to perform a balancing task. Twenty-three participants with LBP and 31 healthy participants were requested to sit on a custom-made swinging chair and to regain the balance after tilting the chair backward for 10° and 20°. Lumbar spine, pelvis, and chair motions were recorded using FASTRAK sensors. The thoracolumbar curvature of all participants was also evaluated in the standing position. The angular displacement of the chair was fitted in an equation describing the underdamped second-order response to a step input. Kinematic analysis showed that the hip range of motion increased whereas spine range of motion angle decreased in participants with LBP for both tilt angles (P < 0.05). There were no significant differences between the 2 subject groups in the time required to regain balance, and the natural frequency and damping ratio of the kinematic equation. Lumbar lordosis significantly decreased in LBP group. Participants with LBP showed trunk postural and movement adaptations that seems to be compensatory strategies to decrease the risk of further injuries and aggravation of the symptoms, but their ability to regain the balance was not affected by LBP. Clinicians should encourage patients with LBP to remain active while they are experiencing pain.

Predictors of Postural Stability in Children with ADHD

ERIC Educational Resources Information Center

Ghanizadeh, Ahmad

2011-01-01

Objective: As children with ADHD who have more inattention problems are more frequently with fine motor problems, it is not clear whether postural balance problems are associated with different subtypes of ADHD. This study investigates the predictors of postural stability in children with ADHD considering the covariant factors of age, gender, and…

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

Independent walking as a major skill for the development of anticipatory postural control: evidence from adjustments to predictable perturbations.

PubMed

Cignetti, Fabien; Zedka, Milan; Vaugoyeau, Marianne; Assaiante, Christine

2013-01-01

Although there is suggestive evidence that a link exists between independent walking and the ability to establish anticipatory strategy to stabilize posture, the extent to which this skill facilitates the development of anticipatory postural control remains largely unknown. Here, we examined the role of independent walking on the infants' ability to anticipate predictable external perturbations. Non-walking infants, walking infants and adults were sitting on a platform that produced continuous rotation in the frontal plane. Surface electromyography (EMG) of neck and lower back muscles and the positions of markers located on the platform, the upper body and the head were recorded. Results from cross-correlation analysis between rectified and filtered EMGs and platform movement indicated that although muscle activation already occurred before platform movement in non-walking infants, only walking infants demonstrated an adult-like ability for anticipation. Moreover, results from further cross-correlation analysis between segmental angular displacement and platform movement together with measures of balance control at the end-points of rotation of the platform evidenced two sorts of behaviour. The adults behaved as a non-rigid non-inverted pendulum, rather stabilizing head in space, while both the walking and non-walking infants followed the platform, behaving as a rigid inverted pendulum. These results suggest that the acquisition of independent walking plays a role in the development of anticipatory postural control, likely improving the internal model for the sensorimotor control of posture. However, despite such improvement, integrating the dynamics of an external object, here the platform, within the model to maintain balance still remains challenging in infants.

Tests of Dorsolateral Frontal Function Correlate with Objective Tests of Postural Stability in Early to Moderate Stage Parkinson’s Disease

PubMed Central

Nocera, Joe R.; Price, Catherine; Fernandez, Hubert H.; Amano, Shinichi; Vallabhajosula, Srikant; Okun, Michael S.; Hwynn, Nelson; Hass, Chris J.

2010-01-01

A substantial number of individuals with Parkinson’s disease who display impaired postural stability experience accelerated cognitive decline and an increased prevalence of dementia. To date, studies suggest that this relationship, believed to be due to involvement of nondopaminergic circuitry, occurs later in the disease process. Research has yet to adequately investigate this cognitive-posturomotor relationship especially when examining earlier disease states. To gain greater understanding of the relationship between postural stability and cognitive function/dysfunction we evaluated a more stringent, objective measure of postural stability (center of pressure displacement), and also more specific measures of cognition in twenty-two patients with early to moderate stage Parkinson’s disease. The magnitude of the center of pressure displacement in this cohort was negatively correlated with performance on tests known to activate dorsolateral frontal regions. Additionally, the postural stability item of the UPDRS exhibited poor correlation with the more objective measure of center of pressure displacement and all specific measures of cognition. These results may serve as rationale for a more thorough evaluation of postural stability and cognition especially in individuals with mild Parkinson’s disease. Greater understanding of the relationship between motor and cognitive processes in Parkinson’s disease will be critical for understanding the disease process and its potential therapeutic possibilities. PMID:20829093

The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis.

PubMed

Kenis-Coskun, Ozge; Karadag-Saygi, Evrim; Bahar-Ozdemir, Yeliz; Gokdemir, Yasemin; Karadag, Bulent; Kayhan, Onder

2017-11-21

Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF. Patients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability. Fifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p = 0.006 and p = 0.01) and spine appearance and movement (p = 0.001 and p = 0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45 ± 7.79 while it was 20.47 ± 6.95 in the CF group (p = 0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters. In patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.

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.

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.

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.

Role of different sensory inputs for maintenance of body posture in sitting rat and rabbit.

PubMed

Deliagina, T; Beloozerova, I N; Popova, L B; Sirota, M G; Swadlow, H A; Grant, G; Orlovsky, G N

2000-10-01

In this paper, we describe the postural activity in sitting rats and rabbits. An animal was positioned on the platform that could be tilted in the frontal plane for up to +/-20-30 degrees, and postural corrections were video recorded. We found that in both rat and rabbit, the postural reactions led to stabilization of the dorsal-side-up trunk orientation. The result of this was that the trunk tilt constituted only approximately 50% (rat) and 25% (rabbit) of the platform tilt. In addition, in the rabbit the head orientation was also stabilized. Trunk stabilization persisted in the animals subjected to the bilateral labyrinthectomy and blindfolding, suggesting that the somatosensory input is primarily responsible for trunk stabilization. Trunk stabilization was due to extension of the limbs on the side moving down, and flexion of the opposite limbs. EMG recordings showed that the limb extension was caused by the active contraction of extensor muscles. We argue that signals from the Golgi tendon organs of the extensor muscles may considerably contribute to elicitation of postural corrective responses to the lateral tilt.

Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?

PubMed

Rusaw, David; Hagberg, Kerstin; Nolan, Lee; Ramstrand, Nerrolyn

2012-01-01

The use of vibration as a feedback modality to convey motion of the body has been shown to improve measures of postural stability in some groups of patients. Because individuals using transtibial prostheses lack sensation distal to the amputation, vibratory feedback could possibly be used to improve their postural stability. The current investigation provided transtibial prosthesis users (n = 24, mean age 48 yr) with vibratory feedback proportional to the signal received from force transducers located under the prosthetic foot. Postural stability was evaluated by measuring center of pressure (CoP) movement, limits of stability, and rhythmic weight shift while participants stood on a force platform capable of rotations in the pitch plane (toes up/toes down). The results showed that the vibratory feedback increased the mediolateral displacement amplitude of CoP in standing balance and reduced the response time to rapid voluntary movements of the center of gravity. The results suggest that the use of vibratory feedback in an experimental setting leads to improvements in fast open-loop mechanisms of postural control in transtibial prosthesis users.

Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain.

PubMed

Birn-Jeffery, Aleksandra V; Hubicki, Christian M; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W; Daley, Monica A

2014-11-01

Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force-length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force-length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. © 2014. Published by The Company of Biologists Ltd.

Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain

PubMed Central

Birn-Jeffery, Aleksandra V.; Hubicki, Christian M.; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W.; Daley, Monica A.

2014-01-01

Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force–length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force–length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. PMID:25355848

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

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.

Outcomes of total hip arthroplasty: a study of patients one year postsurgery.

PubMed

Trudelle-Jackson, Elaine; Emerson, Roger; Smith, Sue

2002-06-01

Ex post facto research using prospective analysis of differences between the involved hip and uninvolved hip. To assess outcomes of total hip arthroplasty (THA) by comparing range of motion (ROM), muscle strength, and postural stability in the surgical hip to those of the uninvolved hip 1 year postsurgery. An additional objective was to assess degree of relationship among ROM, strength, and postural stability impairments to a measure of self-assessed function. Most patients who have THA receive physical therapy that consists mainly of self-care instructions and an exercise protocol that emphasizes mobility during the acute phase of recovery. But, outcomes of THA 1 year postsurgery indicate that current physical therapy programs used during the acute phase of recovery do not effectively restore physical and functional performance. Subjects consisted of 11 women and 4 men (mean age +/- standard deviation = 62 +/- 8 years) with unilateral THA performed 1 year prior to data collection. Assessment variables consisted of self-assessment of function and measures of postural stability, muscle strength, and hip ROM. The 12-Item Hip Questionnaire was used for self-assessment of function. Three separate repeated measures MANOVA were used to compare the involved side to the uninvolved side in measures of postural stability, strength, and ROM. The Spearman's rho was used to assess degree of association between the subjects' score of self-assessed function and impairments in strength and postural stability. Measures of postural stability were significantly lower (P < or = 0.01) on the side of the replaced hip. Differences in strength values between the involved and uninvolved sides were not statistically significant. Correlations between scores of self-assessed function and hip abductor and knee extensor strength were statistically significant (r = 0.56, P < or = 0.03). Self-assessed function was not significantly correlated to postural stability impairments. The brief postsurgical rehabilitation program received by patients with THA may not be sufficient. A second phase of rehabilitation implemented 4 months or more after surgery that emphasizes weight bearing and postural stability may be advisable.

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.

Voluntarily controlled but not merely observed visual feedback affects postural sway

PubMed Central

Asai, Tomohisa; Hiromitsu, Kentaro; Imamizu, Hiroshi

2018-01-01

Online stabilization of human standing posture utilizes multisensory afferences (e.g., vision). Whereas visual feedback of spontaneous postural sway can stabilize postural control especially when observers concentrate on their body and intend to minimize postural sway, the effect of intentional control of visual feedback on postural sway itself remains unclear. This study assessed quiet standing posture in healthy adults voluntarily controlling or merely observing visual feedback. The visual feedback (moving square) had either low or high gain and was either horizontally flipped or not. Participants in the voluntary-control group were instructed to minimize their postural sway while voluntarily controlling visual feedback, whereas those in the observation group were instructed to minimize their postural sway while merely observing visual feedback. As a result, magnified and flipped visual feedback increased postural sway only in the voluntary-control group. Furthermore, regardless of the instructions and feedback manipulations, the experienced sense of control over visual feedback positively correlated with the magnitude of postural sway. We suggest that voluntarily controlled, but not merely observed, visual feedback is incorporated into the feedback control system for posture and begins to affect postural sway. PMID:29682421

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.

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.

Postural stability of sitting women.

PubMed

Nag, Pranab K; Vyas, Heer; Nag, Anjali; Pal, Swati

2013-01-01

The study examined the utility of stabilometric dimensions and explored whether the changes in sitting postures were manifested in functional measures of postural control. Eleven women participated in the study, which used 11 chair sitting postures: arms on laps or arms right angled; armrest at a height of 17, 20 and 23 cm; with or without backrest; slouch or straight back; legs right angled at knees or crossed legs. The backrest and armrest shifted 16.3% of body weight from a seat pan. The characteristics of stabilometric dimensions evaluated the influence of seat components and sitting behaviour on postural balance. The study attempted to evaluate stability and its application in human-seat interface design.

Role of brain hemispheric dominance in anticipatory postural control strategies.

PubMed

Cioncoloni, David; Rosignoli, Deborah; Feurra, Matteo; Rossi, Simone; Bonifazi, Marco; Rossi, Alessandro; Mazzocchio, Riccardo

2016-07-01

Most of the cerebral functions are asymmetrically represented in the two hemispheres. Moreover, dexterity and coordination of the distal segment of the dominant limbs depend on cortico-motor lateralization. In this study, we investigated whether postural control may be also considered a lateralized hemispheric brain function. To this aim, 15 young subjects were tested in standing position by measuring center of pressure (COP) shifts along the anteroposterior axis (COP-Y) during dynamic posturography before and after continuous Theta Burst Stimulation (cTBS) intervention applied to the dominant or non-dominant M1 hand area as well as to the vertex. We show that when subjects were expecting a forward platform translation, the COP-Y was positioned significantly backward or forward after dominant or non-dominant M1 stimulation, respectively. We postulate that cTBS applied on M1 may have disrupted the functional connectivity between intra- and interhemispheric areas implicated in the anticipatory control of postural stability. This study suggests a functional asymmetry between the two homologous primary motor areas, with the dominant hemisphere playing a critical role in the selection of the appropriate postural control strategy.

Does a crouched leg posture enhance running stability and robustness?

PubMed

Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

2011-07-21

Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

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

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.

Y balance test has no correlation with the Stability Index of the Biodex Balance System.

PubMed

Almeida, Gabriel Peixoto Leão; Monteiro, Isabel Oliveira; Marizeiro, Débora Fortes; Maia, Laísa Braga; de Paula Lima, Pedro Olavo

2017-02-01

A cross-sectional study design. The Stability Index of the Biodex Balance System (SI-BBS) and Y Balance Test (YBT) has been used in studies assessing postural stability but no studies have verified the association of the YBT with the SI-BBS. To analyze the association of the Y Balance Test (YBT) with the Stability Index of the Biodex Balance System (SI-BBS) to evaluate postural stability. Forty participants who engaged in recreational physical activities, 12 of whom had a history of injury to the lower limbs. Was used the SI-BBS and the anterior, posterolateral, posteromedial, and composite measures of the YBT. The order of execution of the tests and of the lower limbs evaluated was randomized and blind tested by two evaluators. Pearson's correlation coefficient was used to check the strength of the relationship between the distances achieved on the YBT and the SI-BBS. The YBT showed excellent reliability in the anterior, posteromedial, and posterolateral directions. However, the YBT showed no statistically significant correlation with any variables in the SI-BBS, indicating poor validity between YBT and SI-BBS assessments of postural stability in people with and without history of lower limb injuries. The results of this study showed the YBT is not correlated with the SI-BBS as an assessment of postural stability. This finding has implications for researchers and clinicians using YBT results as the only measure of postural stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Surface effects on dynamic stability and loading during outdoor running using wireless trunk accelerometry.

PubMed

Schütte, Kurt H; Aeles, Jeroen; De Beéck, Tim Op; van der Zwaard, Babette C; Venter, Rachel; Vanwanseele, Benedicte

2016-07-01

Despite frequently declared benefits of using wireless accelerometers to assess running gait in real-world settings, available research is limited. The purpose of this study was to investigate outdoor surface effects on dynamic stability and dynamic loading during running using tri-axial trunk accelerometry. Twenty eight runners (11 highly-trained, 17 recreational) performed outdoor running on three outdoor training surfaces (concrete road, synthetic track and woodchip trail) at self-selected comfortable running speeds. Dynamic postural stability (tri-axial acceleration root mean square (RMS) ratio, step and stride regularity, sample entropy), dynamic loading (impact and breaking peak amplitudes and median frequencies), as well as spatio-temporal running gait measures (step frequency, stance time) were derived from trunk accelerations sampled at 1024Hz. Results from generalized estimating equations (GEE) analysis showed that compared to concrete road, woodchip trail had several significant effects on dynamic stability (higher AP ratio of acceleration RMS, lower ML inter-step and inter-stride regularity), on dynamic loading (downward shift in vertical and AP median frequency), and reduced step frequency (p<0.05). Surface effects were unaffected when both running level and running speed were added as potential confounders. Results suggest that woodchip trails disrupt aspects of dynamic stability and loading that are detectable using a single trunk accelerometer. These results provide further insight into how runners adapt their locomotor biomechanics on outdoor surfaces in situ. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

Balance Training Reduces Brain Activity during Motor Simulation of a Challenging Balance Task in Older Adults: An fMRI Study

PubMed Central

Ruffieux, Jan; Mouthon, Audrey; Keller, Martin; Mouthon, Michaël; Annoni, Jean-Marie; Taube, Wolfgang

2018-01-01

Aging is associated with a shift from an automatic to a more cortical postural control strategy, which goes along with deteriorations in postural stability. Although balance training has been shown to effectively counteract these behavioral deteriorations, little is known about the effect of balance training on brain activity during postural tasks in older adults. We, therefore, assessed postural stability and brain activity using fMRI during motor imagery alone (MI) and in combination with action observation (AO; i.e., AO+MI) of a challenging balance task in older adults before and after 5 weeks of balance training. Results showed a nonsignificant trend toward improvements in postural stability after balance training, accompanied by reductions in brain activity during AO+MI of the balance task in areas relevant for postural control, which have been shown to be over-activated in older adults during (simulation of) motor performance, including motor, premotor, and multisensory vestibular areas. This suggests that balance training may reverse the age-related cortical over-activations and lead to changes in the control of upright posture toward the one observed in young adults. PMID:29472847

Balance Training Reduces Brain Activity during Motor Simulation of a Challenging Balance Task in Older Adults: An fMRI Study.

PubMed

Ruffieux, Jan; Mouthon, Audrey; Keller, Martin; Mouthon, Michaël; Annoni, Jean-Marie; Taube, Wolfgang

2018-01-01

Aging is associated with a shift from an automatic to a more cortical postural control strategy, which goes along with deteriorations in postural stability. Although balance training has been shown to effectively counteract these behavioral deteriorations, little is known about the effect of balance training on brain activity during postural tasks in older adults. We, therefore, assessed postural stability and brain activity using fMRI during motor imagery alone (MI) and in combination with action observation (AO; i.e., AO+MI) of a challenging balance task in older adults before and after 5 weeks of balance training. Results showed a nonsignificant trend toward improvements in postural stability after balance training, accompanied by reductions in brain activity during AO+MI of the balance task in areas relevant for postural control, which have been shown to be over-activated in older adults during (simulation of) motor performance, including motor, premotor, and multisensory vestibular areas. This suggests that balance training may reverse the age-related cortical over-activations and lead to changes in the control of upright posture toward the one observed in young adults.

Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy.

PubMed

Rasooli, A H; Birgani, P M; Azizi, Sh; Shahrokhi, A; Mirbagheri, M M

2017-07-01

We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability.

PubMed

Hadadi, Mohammad; Ebrahimi, Ismaeil; Mousavi, Mohammad Ebrahim; Aminian, Gholamreza; Esteki, Ali; Rahgozar, Mehdi

2017-02-01

Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients. The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients. Cross-sectional study. An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform. The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support. The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals. Clinical relevance Application of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.

Time to Stabilization of Anterior Cruciate Ligament–Reconstructed Versus Healthy Knees in National Collegiate Athletic Association Division I Female Athletes

PubMed Central

Webster, Kathryn A.; Gribble, Phillip A.

2010-01-01

Abstract Context: Jump landing is a common activity in collegiate activities, such as women's basketball, volleyball, and soccer, and is a common mechanism for anterior cruciate ligament (ACL) injury. It is important to better understand how athletes returning to competition after ACL reconstruction are able to maintain dynamic postural control during a jump landing. Objective: To use time to stabilization (TTS) to measure differences in dynamic postural control during jump landing in ACL-reconstructed (ACLR) knees compared with healthy knees among National Collegiate Athletic Association Division I female athletes. Design: Case-control study. Setting: University athletic training research laboratory. Patients or Other Participants: Twenty-four Division I female basketball, volleyball, and soccer players volunteered and were assigned to the healthy control group (n  =  12) or the ACLR knee group (n  =  12). Participants with ACLR knees were matched to participants with healthy knees by sport and by similar age, height, and mass. Intervention(s): At 1 session, participants performed a single-leg landing task for both limbs. They were instructed to stabilize as quickly as possible in a single-limb stance and remain as motionless as possible for 10 seconds. Main Outcome Measure(s): The anterior-posterior TTS and medial-lateral TTS ground reaction force data were used to calculate resultant vector of the TTS (RVTTS) during a jump landing. A 1-way analysis of variance was used to determine group differences on RVTTS. The means and SDs from the participants' 10 trials in each leg were used for the analyses. Results: The ACLR group (2.01 ± 0.15 seconds, 95% confidence interval [CI]  =  1.91, 2.10) took longer to stabilize than the control group (1.90 ± 0.07 seconds, 95% CI  =  1.86, 1.95) (F1,22  =  4.28, P  =  .05). This result was associated with a large effect size and a 95% CI that did not cross zero (Cohen d  =  1.0, 95% CI  =  0.91, 1.09). Conclusions: Although they were Division I female athletes at an average of 2.5 years after ACL reconstruction, participants with ACLR knees demonstrated dynamic postural-control deficits as evidenced by their difficulty in controlling ground reaction forces. This increased TTS measurement might contribute to the established literature reflecting differences in single-limb dynamic control. Clinicians might need to focus rehabilitation efforts on stabilization after jump landing. Further research is needed to determine if TTS is a contributing factor in future injury. PMID:21062181

Standing postural instability in patients with schizophrenia: Relationships with psychiatric symptoms, anxiety, and the use of neuroleptic medications.

PubMed

Matsuura, Yukako; Fujino, Haruo; Hashimoto, Ryota; Yasuda, Yuka; Yamamori, Hidenaga; Ohi, Kazutaka; Takeda, Masatoshi; Imura, Osamu

2015-03-01

The purpose of this study was to assess postural instability in patients with schizophrenia using a pressure-sensitive platform and to examine the effects of anxiety, psychiatric symptoms, and the use of neuroleptic medications on postural sway. Participants were 23 patients with schizophrenia and 23 healthy controls. We found that the patients showed greater overall postural instability than the controls. Furthermore, they demonstrated greater instability when the test was performed with the eyes closed than with the eyes open. However, removal of visual input had less impact on the indices of postural instability in the patients than in the controls, suggesting that schizophrenia is associated with difficulties in integrating visual information and proprioceptive signals. Furthermore, in contrast to the controls, anxiety exacerbated postural instability in the patients. There were significant associations between postural stability and psychiatric symptoms in the patients without extrapyramidal symptoms, whereas medication dose did not significantly correlate with postural stability. Copyright © 2015 Elsevier B.V. All rights reserved.

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 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.

Obesity Impact on the Attentional Cost for Controlling Posture

PubMed Central

Mignardot, Jean-Baptiste; Olivier, Isabelle; Promayon, Emmanuel; Nougier, Vincent

2010-01-01

Background This study investigated the effects of obesity on attentional resources allocated to postural control in seating and unipedal standing. Methods Ten non obese adults (BMI = 22.4±1.3, age = 42.4±15.1) and 10 obese adult patients (BMI = 35.2±2.8, age = 46.2±19.6) maintained postural stability on a force platform in two postural tasks (seated and unipedal). The two postural tasks were performed (1) alone and (2) in a dual-task paradigm in combination with an auditory reaction time task (RT). Performing the RT task together with the postural one was supposed to require some attentional resources that allowed estimating the attentional cost of postural control. 4 trials were performed in each condition for a total of 16 trials. Findings (1) Whereas seated non obese and obese patients exhibited similar centre of foot pressure oscillations (CoP), in the unipedal stance only obese patients strongly increased their CoP sway in comparison to controls. (2) Whatever the postural task, the additional RT task did not affect postural stability. (3) Seated, RT did not differ between the two groups. (4) RT strongly increased between the two postural conditions in the obese patients only, suggesting that body schema and the use of internal models was altered with obesity. Interpretation Obese patients needed more attentional resources to control postural stability during unipedal stance than non obese participants. This was not the case in a more simple posture such as seating. To reduce the risk of fall as indicated by the critical values of CoP displacement, obese patients must dedicate a strong large part of their attentional resources to postural control, to the detriment of non-postural events. Obese patients were not able to easily perform multitasking as healthy adults do, reflecting weakened psycho-motor abilities. PMID:21187914

Influence of both cutaneous input from the foot soles and visual information on the control of postural stability in dyslexic children.

PubMed

Goulème, Nathalie; Villeneuve, Philippe; Gérard, Christophe-Loïc; Bucci, Maria Pia

2017-07-01

Dyslexic children show impaired in postural stability. The aim of our study was to test the influence of foot soles and visual information on the postural control of dyslexic children, compared to non-dyslexic children. Postural stability was evaluated with TechnoConcept ® platform in twenty-four dyslexic children (mean age: 9.3±0.29years) and in twenty-four non-dyslexic children, gender- and age-matched, in two postural conditions (with and without foam: a 4-mm foam was put under their feet or not) and in two visual conditions (eyes open and eyes closed). We measured the surface area, the length and the mean velocity of the center of pressure (CoP). Moreover, we calculated the Romberg Quotient (RQ). Our results showed that the surface area, length and mean velocity of the CoP were significantly greater in the dyslexic children compared to the non-dyslexic children, particularly with foam and eyes closed. Furthermore, the RQ was significantly smaller in the dyslexic children and significantly greater without foam than with foam. All these findings suggest that dyslexic children are not able to compensate with other available inputs when sensorial inputs are less informative (with foam, or eyes closed), which results in poor postural stability. We suggest that the impairment of the cerebellar integration of all the sensorial inputs is responsible for the postural deficits observed in dyslexic children. Copyright © 2017 Elsevier B.V. All rights reserved.

Postural stability changes during large vertical diplopia induced by prism wear in normal subjects.

PubMed

Matsuo, Toshihiko; Yamasaki, Hanako; Yasuhara, Hirotaka; Hasebe, Kayoko

2013-01-01

To test the effect of double vision on postural stability, we measured postural stability by electric stabilometry before prism-wearing and immediately, 15, 30, and 60min after continuous prism-wearing with 6 prism diopters in total (a 3-prism-diopter prism placed with the base up in front of one eye and with the base down in front of the other eye) in 20 normal adult individuals with their eyes open or closed. Changes in stabilometric parameters in the time course of 60min were analyzed statistically by repeated-measure analysis of variance. When subjectsｾ eyes were closed, the total linear length (cm) and the unit-time length (cm/sec) of the sway path were significantly shortened during the 60-minute prism-wearing (p＜0.05). No significant change was noted in any stabilometric parameters obtained with the eyes open during the time course. In conclusion, postural stability did not change with the eyes open in the condition of large vertical diplopia, induced by prism-wearing for 60min, while the stability became better when measured with the eyes closed. A postural control mechanism other than that derived from visual input might be reinforced under abnormal visual input such as non-fusionable diplopia.

Comparison of the Wii Balance Board and the BESS tool measuring postural stability in collegiate athletes.

PubMed

Guzman, Jill; Aktan, Nadine

2016-02-01

Concussions are a major health concern for athletes given the potential for these injuries in a wide range of sport activities. The leading concern for clinicians is that athletes are at risk for devastating consequences if they are not evaluated properly and cleared too early to return to play or competition. The evaluation of postural stability has been identified as an important aspect to the comprehensive management of such injuries. Clinicians are in need of a portable tool they can use in various settings to aid in decision making and health care delivery for concussed athletes. The Nintendo Wii Balance Board (Nintendo of America Inc., Redmond, Washington) is a portable, cost-effective tool that has the potential to aid in the evaluation of postural stability in concussed individuals. The purpose of this study was to evaluate the Wii Balance Board as an objective, user-friendly, cost effective, valid alternative tool for the measurement of postural stability in college athletes. This study questioned whether the Wii Balance Board, when compared to the Balance Error Scoring System (BESS), is an objective tool that can be used as an acceptable measurement of postural stability in college athletes. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Adaptive changes in anticipatory postural adjustments with novel and familiar postural supports.

PubMed

Hall, Leanne M; Brauer, Sandra; Horak, Fay; Hodges, Paul W

2010-02-01

Anticipatory postural adjustments (APAs) serve to stabilize posture prior to initiation of voluntary movement. This study examined the effects of changes in postural support on APAs using novel and familiar support paradigms. We also investigated whether postural strategies were refined with practice and how the CNS responded when multiple supports were available. Twelve healthy subjects stood on dual force platforms and performed 20 randomized left and right rapid leg-lift tasks in response to a visual cue under four conditions: unsupported, bilateral handgrip, bite plate, and a combined handgrip and bite plate condition. Vertical ground reaction forces, electromyography of limb, trunk and jaw muscles, and forces exerted on the support apparatus were recorded. Shift in center-of-pressure amplitude and duration were reduced with increased support. Muscles were recruited in advance of the focal movement when able to contribute to stability, and activity was modulated based on the amount of support available. The CNS adapted anticipatory postural strategies immediately with changes in condition regardless of familiarity with the support; however, adaptation was only complete at the first repetition in conditions that involved familiar support strategies. Tasks that involved a novel bite strategy continued to adapt with practice. In the multiple support condition, both hand and bite strategies were immediately incorporated; however, the contribution of each was not identical to conditions where supports were provided individually. This study emphasizes the flexibility of the CNS to organize postural strategies to meet the demands of postural stability in both familiar and novel situations.

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)

Comparison of postural stability between injured and uninjured ballet dancers.

PubMed

Lin, Cheng-Feng; Lee, I-Jung; Liao, Jung-Hsien; Wu, Hong-Wen; Su, Fong-Chin

2011-06-01

Ballet movements require a limited base of support; thus, ballet dancers require a high level of postural control. However, postural stability in ballet dancers is still unclear and needs to be understood. To evaluate ballet dancers' postural stability in performing single-leg standing, the en pointe task, and the first and fifth positions and to determine differences in task performance among healthy nondancers, healthy dancers, and dancers with ankle sprains. Controlled laboratory study. Injured dancers, uninjured dancers, and nondancers were recruited for this study (N = 33 age-matched participants; n= 11 per group). The tasks tested were single-leg standing with eyes open and closed, first position, fifth position, and en pointe. Center of pressure parameters were calculated from the ground-reaction force collected with 1 force plate. Analysis of variance was used to assess the differences of center of pressure parameters among 3 groups in single-leg standing; independent t test was used to examine the differences of center of pressure parameters between injured and uninjured dancers. During single-leg standing, injured dancers had significantly greater maximum displacement in the medial-lateral direction and total trajectory of center of pressure, compared with the uninjured dancers and nondancers. During the first and fifth positions, the injured dancers demonstrated significantly greater standard deviation of center of pressure position in the medial-lateral and anterior-posterior directions, compared with the uninjured dancers. During en pointe, the injured dancers had significantly greater maximum displacement in the medial-lateral direction and the anterior-posterior direction, compared with the uninjured dancers. The injured and uninjured dancers demonstrated differences in postural stability in the medial-lateral direction during single-leg standing and the ballet postures. Although the injured dancers received ballet training, their postural stability may still be inferior to that of the nondancers. This study is a first step in understanding that injured ballet dancers do not have the same postural stability as uninjured dancers and that it is even inferior to that of nondancers, which is important to understand for further study on rehabilitation. The future development of effective balance training programs for ballet dancers with ankle injuries should emphasize improvements in medial-lateral directional balance.

Star Excursion Balance Test performance and application in elite junior rugby union players.

PubMed

Coughlan, Garrett F; Delahunt, Eamonn; O'Sullivan, Eoghan; Fullam, Karl; Green, Brian S; Caulfield, Brian M

2014-11-01

To evaluate performance on selected reach directions of the Start Excursion Balance Test (SEBT) in an elite underage rugby union population, and determine if differences exist between the forward and back position units. This information may have implications for the application of this test in player injury prevention and management. Descriptive study. Gymnasium at an elite junior rugby union screening camp. 102 healthy male elite rugby union players (age = 17.9 ± 1.1 years, height = 1.83 ± 0.07 m, body mass = 90.5 ± 11.3 kg). Participants were assessed on the Anterior (A), Posterior-medial (PM), and Posterior-lateral (PL) reach directions of the SEBT. Normative data for SEBT performance in the A, PM and PL reach directions were established for an elite junior rugby union population. No significant differences in dynamic postural stability were observed between the forward and back position units. This study provides normative SEBT data on an elite junior rugby union population, which enables clinicians to compare player dynamic postural stability and has implications for use in the prevention and management of player injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Yasuda, Kazuhiro; Kaibuki, Naomi; Harashima, Hiroaki; Iwata, Hiroyasu

2017-06-01

Impaired balance in patients with hemiparesis caused by stroke is frequently related to deficits in the central integration of afferent inputs, and traditional rehabilitation reinforces excessive visual reliance by focusing on visual compensation. The present study investigated whether a balance task involving a haptic biofeedback (BF) system, which provided supplementary vibrotactile sensory cues associated with center-of-foot-pressure displacement, improved postural control in patients with stroke. Seventeen stroke patients were assigned to two groups: the Vibrotactile BF and Control groups. During the balance task (i.e., standing on a foam mat), participants in the Vibrotactile BF group tried to stabilize their postural sway while wearing the BF system around the pelvic girdle. In the Control group, participants performed an identical postural task without the BF system. Pre- and post-test measurements of postural control using a force plate revealed that the stability of bipedal posture in the Vibrotactile BF group was markedly improved compared with that in the Control group. A balance task involving a vibrotactile BF system improved postural stability in patients with stroke immediately. This confirms the potential of a haptic-based BF system for balance training, both in routine clinical practice and in everyday life.

Effects of Indoor Horseback Riding and Virtual Reality Exercises on the Dynamic Balance Ability of Normal Healthy Adults

PubMed Central

Lee, Daehee; Lee, Sangyong; Park, Jungseo

2014-01-01

[Purpose] The objective of this study was to determine the effect of indoor horseback riding and virtual reality exercises on the dynamic balance ability of normal adults. [Subjects] This study enrolled 24 normal adults and divided them into two groups: an indoor horseback riding exercise group (IHREG, n = 12) and a virtual reality exercise group (VREG, n = 12). [Methods] IHREG exercised on indoor horseback riding equipment and VREG exercised using the Nintendo Wii Fit three times a week for six weeks. The Biodex Balance System was used to analyze dynamic balance as measured by the overall stability index (OSI), anteroposterior stability index (APSI), and mediolateral stability index (MLSI). [Results] In the within-group comparison, IHREG and VERG both showed significant decreases in the dynamic balance indexes of OSI, APSI, and MLSI after the intervention, but no significant difference was found between the groups. [Conclusion] Both indoor horseback riding and virtual reality exercises were effective at improving the subjects’ dynamic balance ability as measured by OSI, APSI, and MLSI, and can be used as additional exercises for patients with conditions affecting postural control. PMID:25540494

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.

Validity of the Nintendo Wii® balance board for the assessment of standing balance in Parkinson's disease.

PubMed

Holmes, Jeffrey D; Jenkins, Mary E; Johnson, Andrew M; Hunt, Michael A; Clark, Ross A

2013-04-01

Impaired postural stability places individuals with Parkinson's at an increased risk for falls. Given the high incidence of fall-related injuries within this population, ongoing assessment of postural stability is important. To evaluate the validity of the Nintendo Wii(®) balance board as a measurement tool for the assessment of postural stability in individuals with Parkinson's. Twenty individuals with Parkinson's participated. Subjects completed testing on two balance tasks with eyes open and closed on a Wii(®) balance board and biomechanical force platform. Bland-Altman plots and a two-way, random-effects, single measure intraclass correlation coefficient model were used to assess concurrent validity of centre-of-pressure data. Concurrent validity was demonstrated to be excellent across balance tasks (intraclass correlation coefficients = 0.96, 0.98, 0.92, 0.94). This study suggests that the Wii(®) balance board is a valid tool for the quantification of postural stability among individuals with Parkinson's.

A flexed posture in elderly patients is associated with impairments in postural control during walking.

PubMed

de Groot, Maartje H; van der Jagt-Willems, Hanna C; van Campen, Jos P C M; Lems, Willem F; Beijnen, Jos H; Lamoth, Claudine J C

2014-02-01

A flexed posture (FP) is characterized by protrusion of the head and an increased thoracic kyphosis (TK), which may be caused by osteoporotic vertebral fractures (VFs). These impairments may affect motor function, and consequently increase the risk of falling and fractures. The aim of the current study was therefore to examine postural control during walking in elderly patients with FP, and to investigate the relationship with geriatric phenomena that may cause FP, such as increased TK, VFs, frailty, polypharmacy and cognitive impairments. Fifty-six elderly patients (aged 80 ± 5.2 years; 70% female) walked 160 m at self-selected speed while trunk accelerations were recorded. Walking speed, mean stride time and coefficient of variation (CV) of stride time were recorded. In addition, postural control during walking was quantified by time-dependent variability measures derived from the theory of stochastic dynamics, indicating smoothness, degree of predictability, and local stability of trunk acceleration patterns. Twenty-five patients (45%) had FP and demonstrated a more variable and less structured gait pattern, and a more irregular trunk acceleration pattern than patients with normal posture. FP was significantly associated with an increased TK, but not with other geriatric phenomena. An increased TK may bring the body's centre of mass forward, which requires correcting responses, and reduces the ability to respond on perturbation, which was reflected by higher variation in the gait pattern in FP-patients. Impairments in postural control during walking are a major risk factor for falling: the results indicate that patients with FP have impaired postural control during walking and might therefore be at increased risk of falling. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparative study of computerized dynamic posturography and the SwayStar system in healthy subjects.

PubMed

Faraldo-García, Ana; Santos-Pérez, Sofía; Crujeiras, Rosa; Labella-Caballero, Torcuato; Soto-Varela, Andrés

2012-03-01

For healthy subjects, posturography and SwayStar™ results are basically comparable, when they are obtained under the same sensory stimulation conditions. However, the management of the information and the mathematical analyses in the two systems are not comparable. Postural control represents man's ability to maintain the center of pressures inside the limits of stability. Posturography is a set of techniques that objectively studies and quantifies the postural control. The present study analyzed the different parameters of the dynamic computerized posturography and SwayStar systems related to balance, to determine whether the results of the two systems in the same healthy subject are equivalent. Seventy healthy individuals, with a mean age of 44.9 years, were homogeneously divided into seven age groups. Postural studies with a Neurocom(®) Smart Balance Master posturography platform (sensorial organization test), with the SwayStar(®) system (14 tests), and another sensorial organization test were recorded simultaneously with the two posturographs. The Pearson correlation test was used for the statistical study (p < 0.05). Comparison of the independent records showed correlation only in the Romberg position with eyes closed on a normal surface and in the Romberg position with open eyes on moving/foam surface. We found correlation for all conditions when simultaneously recorded.

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.

Assessment of postural stability using inertial measurement unit on inclined surfaces in healthy adults - biomed 2013.

PubMed

Frames, Chris; Soangra, Rahul; Lockhart, Thurmon E

2013-01-01

Fatal and nonfatal falls in the construction domain remain a significant issue in today’s workforce. The roofing industry in particular, annually ranks amongst the highest in all industries. Exposure to an inclined surface, such as an inclined roof surface, has been reported to have adverse effects on postural stability. The purpose of this preliminary study was to investigate the intra-individual differences in stability parameters on both inclined and level surfaces. Postural Stability (PS) and Limit of Stability (LOS) were assessed in seven healthy subjects (aged 25-35 years) on inclined and level surfaces using embedded force plates and an Inertial Measurement Unit (IMU). Four 90-second trials were collected on the inclined surface in distinctive positions: (1) Toes raised 20o above heel; (2) Heels raised 20o above toes (3); Transverse direction with dominant foot inverted at a lower height; (4) Transverse direction with non-dominant foot inverted at a lower height. Limit of Stability was evaluated by the two measurement devices in all four directions and margin of safety was quantified for each individual on both surfaces. The results reveal significant differences in postural stability between the flat surface condition and the inclined surface condition when subject was positioned perpendicular to the surface slope with one foot descended below the other; specifically, a significant increase was identified when visual support was interrupted. The findings lend support to the literature and will assist in future research regarding early detection of postural imbalance and preventative measures to reduce fall risks in professions where workers are consistently exposed to inclined surfaces.

Assessment of Postural Stability using Inertial Measurement Unit on Inclined Surfaces in Healthy Adults

PubMed Central

Frames, Chris; Soangra, Rahul; Lockhart, Thurmon E.

2013-01-01

Fatal and nonfatal falls in the construction domain remain a significant issue in today’s workforce. The roofing industry in particular, annually ranks amongst the highest in all industries. Exposure to an inclined surface, such as an inclined roof surface, has been reported to have adverse effects on postural stability. The purpose of this preliminary study was to investigate the intra-individual differences in stability parameters on both inclined and level surfaces. Postural Stability (PS) and Limit of Stability (LOS) were assessed in seven healthy subjects (aged 25-35 years) on inclined and level surfaces using embedded force plates and an Inertial Measurement Unit (IMU). Four 90-second trials were collected on the inclined surface in distinctive positions: (1) Toes raised 20° above heel; (2) Heels raised 20° above toes (3); Transverse direction with dominant foot inverted at a lower height; (4) Transverse direction with non-dominant foot inverted at a lower height. Limit of Stability was evaluated by the two measurement devices in all four directions and margin of safety was quantified for each individual on both surfaces. The results reveal significant differences in postural stability between the flat surface condition and the inclined surface condition when subject was positioned perpendicular to the surface slope with one foot descended below the other; specifically, a significant increase was identified when visual support was interrupted. The findings lend support to the literature and will assist in future research regarding early detection of postural imbalance and preventative measures to reduce fall risks in professions where workers are consistently exposed to inclined surfaces. PMID:23686205

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.

Experimental muscle pain challenges the postural stability during quiet stance and unexpected posture perturbation.

PubMed

Hirata, Rogério Pessoto; Ervilha, Ulysses Fernandes; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

2011-08-01

Musculoskeletal pain impairs postural control and stability. Nine subjects stood as quietly as possible on a moveable force platform before, during, and after experimental pain in the right leg muscles. A moveable force platform was used to measure the center of pressure and provided unexpected perturbations. Lower limb muscle activity, joint angles, and foot pressure distributions were measured. Hypertonic saline was used to induce pain in the vastus lateralis, vastus medialis, or biceps femoris muscle of the right leg. Compared to baseline and control sessions, pain in the knee extensor muscles during quiet standing evoked: 1) larger sway area, greater medial-lateral center of pressure displacement and higher speed (P < .05); 2) increased sway displacement in the anterior-posterior direction (P < .05); and 3) increased electromyography (EMG) activity for left tibialis anterior and left erector spinae muscles (P < .05). Pain provoked longer time to return to an equilibrium posture after forward EMG activity for, and pain in vastus medialis muscle decreased the time for the maximum hip flexion during this perturbation (P < .05). These results show that muscle pain impairs postural stability during quiet standing and after unexpected perturbation, which suggest that people suffering from leg muscle pain are more vulnerable to falls. This article presents the acute responses to leg muscle pain on the postural control. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient's postural control and stability during quiet standing and after recovering from unexpected perturbations. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

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

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.

Impaired jump landing after exercise in recreational and in high-performance athletes.

PubMed

Kuni, Benita; Cárdenas-Montemayor, Eloy; Bangert, Yannic; Rupp, Rüdiger; Ales, Janez; Friedmann-Bette, Birgit; Schmitt, Holger

2014-08-01

The risk of sustaining injuries increases with fatigue. The aim of this study was to analyze the influence of fatigue on dynamic postural control in jump landing and stabilization (ST) in athletes of different levels. In all, 18 high-performance ball sports athletes and 24 recreationally active subjects performed a jump test (JT) before and at 1, 5, 10, 15, and 20 minutes after a 30-minute treadmill run at the individual anaerobic threshold. An overhead ball switch hit during a forward jump triggered indicator lamps on either side of a force plate. After landing on the plate, ST on 1 leg (no light cue) or a second jump sideways (toward a light cue) was required. The ST force integral index was calculated for the ST trials. Dynamic postural control was significantly impaired in jump landing and ST in the first minute after the run: mean difference ± SD: 0.25 ± 0.48 m·s-1 (95% confidence interval: 0.10-0.40 m·s-1, p = 0.043; analysis of variance). No significant group differences were found. Under fatigued conditions, dynamic postural control in jump landing was impaired in an unexpected ST task. Not only recreational but also high-performance athletes were affected. Ball sports athletes could add a training exercise to their workout, which alternates between periods of high effort and neuromuscular training. Resistance to fatigue effects should be checked on a regular basis using JTs.

Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial.

PubMed

Martínez-Amat, Antonio; Hita-Contreras, Fidel; Lomas-Vega, Rafael; Caballero-Martínez, Isabel; Alvarez, Pablo J; Martínez-López, Emilio

2013-08-01

The purpose of this study was to evaluate the effect of a 12-week-specific proprioceptive training program on postural stability, gait, balance, and fall prevention in adults older than 65 years. The present study was a controlled clinical trial. Forty-four community dwelling elderly subjects (61-90 years; mean age, 78.07 ± 5.7 years) divided into experimental (n = 20) and control (n = 24) groups. The participants performed the Berg balance test before and after the training program, and we assessed participants' gait, balance, and the risk of falling, using the Tinetti scale. Medial-lateral plane and anterior-posterior plane displacements of the center of pressure, Sway area, length and speed, and the Romberg quotient about surface, speed, and distance were calculated in static posturography analysis (EPS pressure platform) under 2 conditions: eyes open and eyes closed. After a first clinical evaluation, patients were submitted to 12 weeks proprioception training program, 2 sessions of 50 minutes every week. This program includes 6 exercises with the BOSU and Swiss ball as unstable training tools that were designed to program proprioceptive training. The training program improved postural balance of older adults in mediolateral plane with eyes open (p < 0.05) and anterior-posterior plane with eyes closed (p < 0.01). Significant improvements were observed in Romberg quotient about surface (p < 0.05) and speed (p < 0.01) but not about distance (p > 0.05). After proprioception training, gait (Tinetti), and balance (Berg) test scores improved 14.66% and 11.47% respectively. These results show that 12 weeks proprioception training program in older adults is effective in postural stability, static, and dynamic balance and could lead to an improvement in gait and balance capacity, and to a decrease in the risk of falling in adults aged 65 years and older.

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.

Influences of arm proprioception and degrees of freedom on postural control with light touch feedback.

PubMed

Rabin, Ely; DiZio, Paul; Ventura, Joel; Lackner, James R

2008-02-01

Lightly touching a stable surface with one fingertip strongly stabilizes standing posture. The three main features of this phenomenon are fingertip contact forces maintained at levels too low to provide mechanical support, attenuation of postural sway relative to conditions without fingertip touch, and center of pressure (CP) lags changes in fingertip shear forces by approximately 250 ms. In the experiments presented here, we tested whether accurate arm proprioception and also whether the precision fingertip contact afforded by the arm's many degrees of freedom are necessary for postural stabilization by finger contact. In our first experiment, we perturbed arm proprioception and control with biceps brachii vibration (120-Hz, 2-mm amplitude). This degraded postural control, resulting in greater postural sway amplitudes. In a second study, we immobilized the touching arm with a splint. This prevented precision fingertip contact but had no effect on postural sway amplitude. In both experiments, the correlation and latency of fingertip contact forces to postural sway were unaffected. We conclude that postural control is executed based on information about arm orientation as well as tactile feedback from light touch, although precision fingertip contact is not essential. The consistent correlation and timing of CP movement and fingertip forces across conditions in which postural sway amplitude and fingertip contact are differentially disrupted suggests posture and the fingertip are controlled in parallel with feedback from the fingertip in this task.

Continuous cognitive task promotes greater postural stability than an internal or external focus of attention.

PubMed

Polskaia, Nadia; Richer, Natalie; Dionne, Eliane; Lajoie, Yves

2015-02-01

Research has demonstrated clear advantages of using an external focus of attention in postural control tasks, presumably since it allows a more automatic control of posture to emerge. However, the influence of cognitive tasks on postural stability has produced discordant results. This study aimed to compare the effects of an internal focus of attention, an external focus of attention and a continuous cognitive task on postural control. Twenty healthy participants (21.4±2.6 years) were recruited for this study. They were asked to stand quietly on a force platform with their feet together in three different attentional focus conditions: an internal focus condition (minimizing movements of the hips), an external focus condition (minimizing movements of markers placed on the hips) and a cognitive task condition (silently counting the total number of times a single digit was verbalized in a 3-digit sequence comprised of 30 numbers). Results demonstrated improved stability while performing the cognitive task as opposed to the internal and external focus conditions, as evidenced by a reduction in sway area, sway variability in the anterior-posterior (AP) and medial-lateral (ML) directions, and mean velocity (ML only). Results suggest that the use of a continuous cognitive task permits attention to be withdrawn from the postural task, thereby facilitating a more automatic control of posture. Copyright © 2014 Elsevier B.V. All rights reserved.

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.

Control of mediolateral stability during rapid step initiation with preferred and non-preferred leg: is it symmetrical?

PubMed

Yiou, E; Do, M C

2010-05-01

During voluntary stepping initiation, postural stability along the mediolateral direction is controlled via "anticipatory postural adjustment" (APA). This study tested the hypothesis that, in young healthy subjects, the biomechanical features of mediolateral APA depend on the leg that initiates stepping. Subjects (N=10) initiated a rapid single step with the preferred (P condition) and the non-preferred leg (NP condition) on a force-plate. Results showed that mediolateral APA duration (P=0.020) and amplitude were higher (as attested by the increase in maximal center-of-gravity velocity (P=0.003) and displacement (P<0.001) during APA), and that mediolateral stability was better (as attested by the attenuation in center-of-gravity velocity at time of swing-foot contact (P=0.007)) in P than in NP. These results support the view that stepping initiation in healthy subjects involves postural asymmetry. This statement may have relevant implications in clinical evaluation where postural asymmetry is generally considered as reflecting postural impairment. Copyright 2010 Elsevier B.V. All rights reserved.

Salivary α-amylase reflects change in attentional demands during postural control: comparison with probe reaction time.

PubMed

Akizuki, Kazunori; Ohashi, Yukari

2014-12-01

The influence of attention on postural control and the relationship between attention and falling has been reported in previous studies. Although a dual-task procedure is commonly used to measure attentional demand, such procedures are affected by allocation policy, which is a mental strategy to divide attention between simultaneous tasks. Therefore, we examined the effectiveness of salivary α-amylase, which is a physiological method for measuring attentional demand during postural control. Sixteen healthy participants performed a postural-control task using the Balance System, which is a device that can be calibrated to a specific stability level ("Level 1 = least stable" to "Level 8 = most stable"). Levels 1, 2, and 3 were used for this study. Dependent variables measured were overall stability index, which represents the variance of platform displacement in degrees from a horizontal plane; probe reaction time, which was measured using a sound stimulator and recorder; and salivary α-amylase, which was measured using a portable salivary amylase analyzer. As stability level of the test task decreased, both stability index and probe reaction time significantly increased. In addition, we identified a positive moderate correlation between probe reaction time and salivary α-amylase. Our results suggest that salivary α-amylase and probe reaction time reflect the change in attentional demands during a postural-control task and that salivary α-amylase may be an effective tool for evaluating attentional demands during postural control because it is noninvasive and simple to perform.

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

Assessment of postural control in patients with Parkinson's disease: sway ratio analysis.

PubMed

Błaszczyk, Janusz W; Orawiec, Renata

2011-04-01

Analysis of the postural stability impairments in neurodegenerative diseases is a very demanding task. Age-related declines in posturographic indices are usually superimposed on effects associated with the pathology and its treatment. We present the results of a novel postural sway ratio (SR) analysis in patients with Parkinson's disease (PD) and age-matched healthy subjects. The sway ratios have been assessed based upon center of foot-pressure (CP) signals recorded in 55 parkinsonians (Hoehn and Yahr: 1-3) and 55 age-matched healthy volunteers while standing quiet with eyes open (EO) and then with eyes closed (EC). Complementing classical sway measure abnormalities, the SR exhibited a high discriminative power for all controlled factors: pathology, vision, and direction of sway. Both the anteroposterior (AP) and mediolateral (ML) sway ratios were significantly increased in PD patients when compared to the control group. An additional SR increase was observed in the response to eyes closure. The sway ratio changes documented here can be attributed to a progressive decline of a postural stability control due to pathology. In fact, a significant correlation between the mediolateral SR under EO conditions and Motor Exam (section III) score of the UPDRS was found. The mediolateral sway ratios computed for EO and EC conditions significantly correlated with the CP path length (r = .87) and the mean anteroposterior CP position within the base of support (r = .38). Both indices reflect postural stability decline and fall tendency # in parkinsonians. The tremor-type PD patients (N=34) showed more pronounced relationships between the mediolateral SR and selected items from the UPDRS scale, including: falls (Kendall Tau=.47, p < .05), rigidity (.45, p < .05), postural stability (retropulsion) (.52), and the Motor Exam score (.73). The anteroposterior SR correlated only with tremor (Kendal Tau = .77, p < .05). It seems that in force plate posturography the SR can be recommended as a single reliable measure that allows for a better quantitative assessment of postural stability impairments. Copyright © 2010 Elsevier B.V. All rights reserved.

The effect of boundary shape and minima selection on single limb stance postural stability.

PubMed

Cobb, Stephen C; Joshi, Mukta N; Bazett-Jones, David M; Earl-Boehm, Jennifer E

2012-11-01

The effect of time-to-boundary minima selection and stability limit definition was investigated during eyes open and eyes closed condition single-limb stance postural stability. Anteroposterior and mediolateral time-to-boundary were computed using the mean and standard deviation (SD) of all time-to-boundary minima during a trial, and the mean and SD of only the 10 absolute time-to-boundary minima. Time-to-boundary with rectangular, trapezoidal, and multisegmented polygon defined stability limits were also calculated. Spearman's rank correlation coefficient test results revealed significant medium-large correlations between anteroposterior and mediolateral time-to-boundary scores calculated using both the mean and SD of the 10 absolute time-to-boundary minima and of all the time-to-boundary minima. Friedman test results revealed significant mediolateral time-to-boundary differences between boundary shape definitions. Follow-up Wilcoxon signed rank test results revealed significant differences between the rectangular boundary shape and both the trapezoidal and multisegmented polygon shapes during the eyes open and eyes closed conditions when both the mean and the SD of the time-to-boundary minima were used to represent postural stability. Significant differences were also revealed between the trapezoidal and multisegmented polygon definitions during the eyes open condition when the SD of the time-to-boundary minima was used to represent postural stability. Based on these findings, the overall results (i.e., stable versus unstable participants or groups) of studies computing postural stability using different minima selection can be compared. With respect to boundary shape, the trapezoid or multisegmented polygon shapes may be more appropriate than the rectangular shape as they more closely represent the anatomical shape of the stance foot.

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.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting.

PubMed

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting.

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.

Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder.

PubMed

Ries, Lilian Gerdi Kittel; Bérzin, Fausto

2008-01-01

The objective of this study was to evaluate the stability and the distribution of weight of individuals with TMD (Temporomandibular Disorder) when placed in an orthostatic position. Forty female volunteers, participating in this study, were distributed into a control and a TMD group. Clinical examinations of the craniomandibular system and of the neck were performed. Postural stability was evaluated using a stabilographic platform. Through this system, the sway index (SI), the maximum medial-lateral distance (MMLD), the maximum anterior-posterior distance (MAPD) and the medial-lateral symmetry (MLS) could be determined. Tests were performed in the mandibular rest position and during isometric and isotonic contraction. The variables were analyzed through repeated measures ANOVA. The level of significance was p < 0.05. The results of this study indicate that individuals with TMD present more pain in the cervical region (p < 0.05). The group with TMD showed a significant reduction in SI (p < 0.05), MMLD (p < 0.05) and MLS (p < 0.01). Individuals with TMD presented greater postural asymmetry, and cervical pain demonstrated a potential link with an increase in postural stability.

Sensorimotor enhancement with a mixed reality system for balance and mobility rehabilitation.

PubMed

Fung, Joyce; Perez, Claire F

2011-01-01

We have developed a mixed reality system incorporating virtual reality (VR), surface perturbations and light touch for gait rehabilitation. Haptic touch has emerged as a novel and efficient technique to improve postural control and dynamic stability. Our system combines visual display with the manipulation of physical environments and addition of haptic feedback to enhance balance and mobility post stroke. A research study involving 9 participants with stroke and 9 age-matched healthy individuals show that the haptic cue provided while walking is an effective means of improving gait stability in people post stroke, especially during challenging environmental conditions such as downslope walking.

The influence of foot posture on dorsiflexion range of motion and postural control in those with chronic ankle instability.

PubMed

Hogan, Kathleen K; Powden, Cameron J; Hoch, Matthew C

2016-10-01

To investigate the effect of foot posture on postural control and dorsiflexion range of motion in individuals with chronic ankle instability. The study employed a cross-sectional, single-blinded design. Twenty-one individuals with self-reported chronic ankle instability (male=5; age=23.76(4.18)years; height=169.27(11.46)cm; weight=73.65(13.37)kg; number of past ankle sprains=4.71(4.10); episode of giving way=17.00(18.20); Cumberland Ankle Instability Score=18.24(4.52); Ankle Instability Index=5.86(1.39)) participated. The foot posture index was used to categorize subjects into pronated (n=8; Foot Posture Index=7.50(0.93)) and neutral (n=13; Foot Posture Index=3.08(1.93)) groups. The dependent variables of dorsiflexion ROM and dynamic and static postural control were collected for both groups at a single session. There were no significant differences in dorsiflexion range of motion between groups (p=0.22) or any of the eyes open time-to-boundary variables (p>0.13). The pronated group had significantly less dynamic postural control than the neutral group as assessed by the anterior direction of the Star Excursion Balance Test (p<0.04). However, the pronated group had significantly higher time-to-boundary values than the neutral group for all eyes closed time-to-boundary variables (p≤0.05), which indicates better eyes closed static postural control. Foot posture had a significant effect on dynamic postural control and eyes closed static postural control in individuals with chronic ankle instability. These findings suggest that foot posture may influence postural control in those with chronic ankle instability. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control.

PubMed

Daley, M A; Felix, G; Biewener, A A

2007-02-01

We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle-tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain.

Running stability is enhanced by a proximo-distal gradient in joint neuromechanical control

PubMed Central

Daley, M. A.; Felix, G.; Biewener, A. A.

2008-01-01

Summary We currently know little about how animals achieve dynamic stability when running over uneven and unpredictable terrain, often characteristic of their natural environment. Here we investigate how limb and joint mechanics of an avian biped, the helmeted guinea fowl Numida meleagris, respond to an unexpected drop in terrain during running. In particular, we address how joint mechanics are coordinated to achieve whole limb dynamics. Based on muscle–tendon architecture and previous studies of steady and incline locomotion, we hypothesize a proximo-distal gradient in joint neuromechanical control. In this motor control strategy, (1) proximal muscles at the hip and knee joints are controlled primarily in a feedforward manner and exhibit load-insensitive mechanical performance, and (2) distal muscles at the ankle and tarsometatarso-phalangeal (TMP) joints are highly load-sensitive, due to intrinsic mechanical effects and rapid, higher gain proprioceptive feedback. Limb kinematics and kinetics during the unexpected perturbation reveal that limb retraction, controlled largely by the hip, remains similar to level running throughout the perturbed step, despite altered limb loading. Individual joints produce or absorb energy during both level and perturbed running steps, such that the net limb work depends on the balance of energy among the joints. The hip maintains the same mechanical role regardless of limb loading, whereas the ankle and TMP switch between spring-like or damping function depending on limb posture at ground contact. Initial knee angle sets limb posture and alters the balance of work among the joints, although the knee contributes little work itself. This distribution of joint function results in posture-dependent changes in work performance of the limb, which allow guinea fowl to rapidly produce or absorb energy in response to the perturbation. The results support the hypothesis that a proximo-distal gradient exists in limb neuromuscular performance and motor control. This control strategy allows limb cycling to remain constant, whereas limb posture, loading and energy performance are interdependent. We propose that this control strategy provides simple, rapid mechanisms for managing energy and controlling velocity when running over rough terrain. PMID:17234607

Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis.

PubMed

Chang, Yi-Tzu; Meng, Ling-Fu; Chang, Chun-Ju; Lai, Po-Liang; Lung, Chi-Wen; Chern, Jen-Suh

2017-01-01

Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12-18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm.

Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis

PubMed Central

Chang, Yi-Tzu; Meng, Ling-Fu; Chang, Chun-Ju; Lai, Po-Liang; Lung, Chi-Wen; Chern, Jen-Suh

2017-01-01

Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12–18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm. PMID:28713252

Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke.

PubMed

Lee, Nam G; You, Joshua Sung H; Yi, Chung H; Jeon, Hye S; Choi, Bong S; Lee, Dong R; Park, Jae M; Lee, Tae H; Ryu, In T; Yoon, Hyun S

2018-02-21

To compare the effects of conventional core stabilization and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke. Two-group randomized controlled trial with pretest-posttest design. Hospital rehabilitation center. Adults with chronic hemiparetic stroke (N=28). Participants were randomly divided into either conventional core stabilization (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of conventional core stabilization or DNS training for 30 minutes per session 5 times a week during the 4-week period. Electromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis (TrA)/internal oblique (IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling. Baseline APA times were delayed and fear of falling was moderately high in both the conventional core stabilization and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the conventional core stabilization group (P<.008). The BBS and TIS scores (P<.008) and the FES score (P<.003) were improved compared with baseline in both groups, but FES remained stable through the 2-year follow-up period only in the DNS group (P<.003). This is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Biomechanical and Physiological Validation of the Omni-Directional Treadmill Upgrade as a Mobility Platform for Immersive Environments

DTIC Science & Technology

2011-04-01

a potentially unstable single limb ( Marigold and Patla, 2002; Murray et al., 1985). In theory, adopting a more flexed posture should also lower the...when knowingly traversing slippery terrain ( Marigold and Patla). Despite minimal differences in temporal-spatial values and kinematics for the two...Walking in Healthy Individuals. J. Appl. Physiol. 2008, 104, 747–755. 22 Marigold , D. S.; Patla, A. E. Strategies for Dynamic Stability During

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.

Effect of sitting pause times on postural stability after supine-to-standing transfer in dimly lit environments.

PubMed

Johnson, Eric G; Meltzer, Jonathan D

2012-01-01

Falls are common and often take place in the home. Risk of fall increases if the environment is dimly lit. Longer sitting pause times, before standing, might improve postural stability after standing from a supine position. The purpose of this investigation was to measure the effects of sitting pause times on postural sway velocity immediately following a supine-to-standing transfer in a dimly lit room in older and younger adult women. Five women aged 65 to 70 years and 5 aged 23 to 30 years participated in the study. On each of 2 consecutive days, study participants lay on a mat table with their eyes closed for 45 minutes before performing a supine-to-standing transfer in a dimly lit room. Sitting pause times of 2 seconds and 30 seconds preceded the transfers. Mean postural sway velocity for the whole sample and for younger and older groups was less after a 30-second pause time than that after a 2-second pause time (sample, P = .001; young, P = .019; old, P = .021). No significant difference in mean postural sway velocity was observed between the 2 groups (P > .05). Total mean postural sway velocity was less when study participants performed a sitting pause of 30 seconds before standing in a dimly lit room. These results suggest that longer sitting pause times may provide improved adaptability to dimly lit environments contributing to improved postural stability.

Vibratory noise to the fingertip enhances balance improvement associated with light touch.

PubMed

Magalhães, Fernando Henrique; Kohn, André Fabio

2011-03-01

Light touch of a fingertip on an external stable surface greatly improves the postural stability of standing subjects. The hypothesis of the present work was that a vibrating surface could increase the effectiveness of fingertip signaling to the central nervous system (e.g., by a stochastic resonance mechanism) and hence improve postural stability beyond that achieved by light touch. Subjects stood quietly over a force plate while touching with their right index fingertip a surface that could be either quiescent or randomly vibrated at two low-level noise intensities. The vibratory noise of the contact surface caused a significant decrease in postural sway, as assessed by center of pressure measures in both time and frequency domains. Complementary experiments were designed to test whether postural control improvements were associated with a stochastic resonance mechanism or whether attentional mechanisms could be contributing. A full curve relating body sway parameters and different levels of vibratory noise resulted in a U-like function, suggesting that the improvement in sway relied on a stochastic resonance mechanism. Additionally, no decrease in postural sway was observed when the vibrating contact surface was attached to the subject's body, suggesting that no attentional mechanisms were involved. These results indicate that sensory cues obtained from the fingertip need not necessarily be associated with static contact surfaces to cause improvement in postural stability. A low-level noisy vibration applied to the contact surface could lead to a better performance of the postural control system.

Influence of fear of falling on anticipatory postural control of medio-lateral stability during rapid leg flexion.

PubMed

Yiou, E; Deroche, T; Do, M C; Woodman, T

2011-04-01

During leg flexion from erect posture, postural stability is organized in advance during "anticipatory postural adjustments" (APA). During these APA, inertial forces are generated that propel the centre of gravity (CoG) laterally towards stance leg side. This study examined how fear of falling (FoF) may influence this anticipatory postural control of medio-lateral (ML) stability. Ten young healthy participants performed a series of leg flexions at maximal velocity from low and high surface heights (6 and 66 cm above ground, respectively). In this latter condition with increased FoF, stance foot was placed at the lateral edge of the support surface to induce maximal postural threat. Results showed that the amplitude of ML inertial forces generated during APA decreased with FoF; this decrease was compensated by an increase in APA duration so that the CoG position at time of swing foot-off was located further towards stance leg side. With these changes in ML APA, the CoG was propelled in the same final (unipodal) position above stance foot as in condition with low FoF. These results contrast with those obtained in the literature during quiet standing which showed that FoF did not have any influence on the ML component of postural control. It is proposed that ML APA are modified with increased FoF, in such a way that the risk of a sideway fall induced by the large CoG motion is attenuated.

Postural changes following sensory reinterpretation as an analog to spaceflight

NASA Technical Reports Server (NTRS)

Paloski, William H.; Harm, D. L.; Reschke, M. F.; Doxey, D. D.; Skinner, N. C.; Michaud, L. J.; Parker, D. E.

1990-01-01

Postural control changes noted in astronauts immediately following spaceflight are thought to be caused by inflight adaptative changes in Central Nervous System (CNS) processing of sensory information from the visual, vestibular, and proprioceptive systems. In order to elicit these adaptative changes in ground based studies, a Tilt Translation Device (TTD) which causes the CNS of exposed subjects to reinterpret tilt generated sensory inputs from the otolith organs as linear translation of the subject was developed. This device was designed to simulate partially the stimulus rearrangement experienced by astronauts during microgravity. Postural stability is assessed in ten subjects before and after 30 minutes of exposure to TTD. The resulting data suggests that exposure to TTD causes decreases in postural stability and shifts in postflight studies of astronauts. It is concluded that the TTD may be an effective weightlessness simulator, and that the postural changes following TTD exposure may provide a useful dependent measure for evaluation of this apparatus.

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.

Time-interval for integration of stabilizing haptic and visual information in subjects balancing under static and dynamic conditions

PubMed Central

Honeine, Jean-Louis; Schieppati, Marco

2014-01-01

Maintaining equilibrium is basically a sensorimotor integration task. The central nervous system (CNS) continually and selectively weights and rapidly integrates sensory inputs from multiple sources, and coordinates multiple outputs. The weighting process is based on the availability and accuracy of afferent signals at a given instant, on the time-period required to process each input, and possibly on the plasticity of the relevant pathways. The likelihood that sensory inflow changes while balancing under static or dynamic conditions is high, because subjects can pass from a dark to a well-lit environment or from a tactile-guided stabilization to loss of haptic inflow. This review article presents recent data on the temporal events accompanying sensory transition, on which basic information is fragmentary. The processing time from sensory shift to reaching a new steady state includes the time to (a) subtract or integrate sensory inputs; (b) move from allocentric to egocentric reference or vice versa; and (c) adjust the calibration of motor activity in time and amplitude to the new sensory set. We present examples of processes of integration of posture-stabilizing information, and of the respective sensorimotor time-intervals while allowing or occluding vision or adding or subtracting tactile information. These intervals are short, in the order of 1–2 s for different postural conditions, modalities and deliberate or passive shift. They are just longer for haptic than visual shift, just shorter on withdrawal than on addition of stabilizing input, and on deliberate than unexpected mode. The delays are the shortest (for haptic shift) in blind subjects. Since automatic balance stabilization may be vulnerable to sensory-integration delays and to interference from concurrent cognitive tasks in patients with sensorimotor problems, insight into the processing time for balance control represents a critical step in the design of new balance- and locomotion training devices. PMID:25339872

Neural control and precision of flight muscle activation in Drosophila.

PubMed

Lehmann, Fritz-Olaf; Bartussek, Jan

2017-01-01

Precision of motor commands is highly relevant in a large context of various locomotor behaviors, including stabilization of body posture, heading control and directed escape responses. While posture stability and heading control in walking and swimming animals benefit from high friction via ground reaction forces and elevated viscosity of water, respectively, flying animals have to cope with comparatively little aerodynamic friction on body and wings. Although low frictional damping in flight is the key to the extraordinary aerial performance and agility of flying birds, bats and insects, it challenges these animals with extraordinary demands on sensory integration and motor precision. Our review focuses on the dynamic precision with which Drosophila activates its flight muscular system during maneuvering flight, considering relevant studies on neural and muscular mechanisms of thoracic propulsion. In particular, we tackle the precision with which flies adjust power output of asynchronous power muscles and synchronous flight control muscles by monitoring muscle calcium and spike timing within the stroke cycle. A substantial proportion of the review is engaged in the significance of visual and proprioceptive feedback loops for wing motion control including sensory integration at the cellular level. We highlight that sensory feedback is the basis for precise heading control and body stability in flies.

Sex Differences in Landing Biomechanics and Postural Stability During Adolescence: A Systematic Review with Meta-Analyses.

PubMed

Holden, Sinéad; Boreham, Colin; Delahunt, Eamonn

2016-02-01

The adolescent 'growth spurt' results in rapid growth of the skeletal system. It has been theorised that absence of a concomitant increase in muscular adaptations in female athletes may predispose them to an increased risk of anterior cruciate ligament injuries. To determine if sex differences exist in landing biomechanics and postural stability of adolescent athletes; with a further objective of determining if such differences are propagated during adolescence. The following databases were searched: MEDLINE, EMBASE, CINAHL, PEDro, PubMed, SPORTDiscus and Web of Science. Research papers were identified by including search terms for neuromuscular control, lower limb and pubertal development. Studies were required to be written in English; report on biomechanical analyses; include landing or postural control tasks; be cross-sectional or longitudinal; and include healthy adolescent/pubertal subjects. A modified version of the Strengthening the Reporting of Observational studies in Epidemiology checklist was used to rate methodological quality. Meta-analyses were performed when more than one study reported on an outcome measure. Sixteen articles were included. The overall methodological quality of evaluated studies was low (mean score = 5.75/10 points). Adolescent females exhibited increased knee valgus with increasing maturity. There was no consensus on sex differences in postural stability. With increasing maturation, females are characterized by increased knee valgus during landing tasks. To date, no research has longitudinally investigated postural stability development during adolescence in females, despite the importance of postural control training in injury prevention programmes. Therefore, further research on this topic is warranted.

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.

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

PubMed

Malakhov, M V; Makarenkova, E A; Mel'nikov, A A; Vikulov, A D

2014-01-01

The influence of breath holding and voluntary hyperventilation on the classic stabilometric parameters and the frequency characteristic of stabilographic signal were studied. We measured the stabilometric parameters on the force platform ("Ritm", Russia) on the healthy volunteers (n = 107) during quiet breath, voluntary hyperventilation (20 seconds) and maximal inspiratory breath holding (20 seconds). Respiratory frequency, respiratory amplitude and ventilation were estimated with strain gauge. We found that antero-posterior and medio-lateral sway amplitude and velocity as well as sway surface at breath-holding and at quiet breathing were the same, so breath holding didn't influence the postural stability. However the spectral parameters shifted to the high frequency range due to alteration of the respiratory muscles contractions during breath-holding versus quiet breath. Voluntary hyperventilation caused significant increase of all stabilographic indices that implied an impairment of postural stability, which was due to the increase of respiration frequency and amplitude. We also found that the spectral indices moved toward the high-frequency range with more pronounced degree of this shift versus breath holding. Besides, amplitudes of spectral peaks also increased. Perhaps such change of spectral indices was due to distortion of proprioceptive information because of increased excitability of nerve fibers during hyperventilation. Maximal inspiration breath holding causes strain of the postural control mechanisms that is reflected as elevation of postural sway frequency with no postural stability changes. Hyperventilation leads to the most prominent strain of balance function and decrease of steadiness that is manifested as increase of center of pressure oscillations amplitude and frequency.

Locomotion by Abdopus aculeatus (Cephalopoda: Octopodidae): walking the line between primary and secondary defenses.

PubMed

Huffard, Christine L

2006-10-01

Speeds and variation in body form during crawling, bipedal walking, swimming and jetting by the shallow-water octopus Abdopus aculeatus were compared to explore possible interactions between defense behaviors and biomechanics of these multi-limbed organisms. General body postures and patterns were more complex and varied during the slow mode of crawling than during fast escape maneuvers such as swimming and jetting. These results may reflect a trade-off between predator deception and speed, or simply a need to reduce drag during jet-propelled locomotion. Octopuses swam faster when dorsoventrally compressed, a form that may generate lift, than when swimming in the head-raised posture. Bipedal locomotion proceeded as fast as swimming and can be considered a form of fast escape (secondary defense) that also incorporates elements of crypsis and polyphenism (primary defenses). Body postures during walking suggested the use of both static and dynamic stability. Absolute speed was not correlated with body mass in any mode. Based on these findings the implications for defense behaviors such as escape from predation, aggression, and 'flatfish mimicry' performed by A. aculeatus and other octopuses are discussed.

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.

Birds achieve high robustness in uneven terrain through active control of landing conditions.

PubMed

Birn-Jeffery, Aleksandra V; Daley, Monica A

2012-06-15

We understand little about how animals adjust locomotor behaviour to negotiate uneven terrain. The mechanical demands and constraints of such behaviours likely differ from uniform terrain locomotion. Here we investigated how common pheasants negotiate visible obstacles with heights from 10 to 50% of leg length. Our goal was to determine the neuro-mechanical strategies used to achieve robust stability, and address whether strategies vary with obstacle height. We found that control of landing conditions was crucial for minimising fluctuations in stance leg loading and work in uneven terrain. Variation in touchdown leg angle (θ(TD)) was correlated with the orientation of ground force during stance, and the angle between the leg and body velocity vector at touchdown (β(TD)) was correlated with net limb work. Pheasants actively targeted obstacles to control body velocity and leg posture at touchdown to achieve nearly steady dynamics on the obstacle step. In the approach step to an obstacle, the birds produced net positive limb work to launch themselves upward. On the obstacle, body dynamics were similar to uniform terrain. Pheasants also increased swing leg retraction velocity during obstacle negotiation, which we suggest is an active strategy to minimise fluctuations in peak force and leg posture in uneven terrain. Thus, pheasants appear to achieve robustly stable locomotion through a combination of path planning using visual feedback and active adjustment of leg swing dynamics to control landing conditions. We suggest that strategies for robust stability are context specific, depending on the quality of sensory feedback available, especially visual input.

Smartphone virtual reality to increase clinical balance assessment responsiveness.

PubMed

Rausch, Matthew; Simon, Janet E; Starkey, Chad; Grooms, Dustin R

2018-05-22

To determine if a low cost smartphone based, clinically applicable virtual reality (VR) modification to the standard Balance Error Scoring System (BESS) can challenge postural stability beyond the traditional BESS. Cross-sectional study. University research laboratory. 28 adults (mean age 23.36 ± 2.38 years, mean height 1.74 m ± 0.13, mean weight 77.95 kg ± 16.63). BESS postural control errors and center of pressure (CoP) velocity were recorded during the BESS test and a VR modified BESS (VR-BESS). The VR-BESS used a headset and phone to display a rollercoaster ride to induce a visual and vestibular challenge to postural stability. The VR-BESS significantly increased total errors (20.93 vs. 11.42, p < 0.05) and CoP velocity summed across all stances and surfaces (52.96 cm/s vs. 37.73 cm/s, p < 0.05) beyond the traditional BESS. The VR-BESS provides a standardized, and effective way to increase postural stability challenge in the clinical setting. The VR-BESS can use any smartphone technology to induce postural stability deficits that may otherwise normalize with traditional testing. Thus, providing a unique relatively inexpensive and simple to operate clinical assessment tool and∖or training stimulus. Copyright © 2018 Elsevier Ltd. All rights reserved.

Influence of Passive Stiffness of Hamstrings on Postural Stability

PubMed Central

Kuszewski, Michał; Gnat, Rafał; Sobota, Grzegorz; Myśliwiec, Andrzej

2015-01-01

The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability. PMID:25964809

Influence of passive stiffness of hamstrings on postural stability.

PubMed

Kuszewski, Michał; Gnat, Rafał; Sobota, Grzegorz; Myśliwiec, Andrzej

2015-03-29

The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability.

The influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus.

PubMed

Herrera-Rangel, Aline; Aranda-Moreno, Catalina; Mantilla-Ochoa, Teresa; Zainos-Saucedo, Lylia; Jáuregui-Renaud, Kathrine

2014-01-01

To assess the influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus. 151 patients with no history of otology, neurology, or orthopaedic or balance disorders accepted to participate in the study. After a clinical interview and neuropathy assessment, postural stability was evaluated by static posturography (eyes open/closed on hard/soft surface) and the "Up & Go" test. During static posturography, on hard surface, the length of sway was related to peripheral neuropathy, gender, age, and obesity; on soft surface, the length of sway was related to peripheral neuropathy, gender, and age, the influence of neuropathy was larger in males than in females, and closing the eyes increased further the difference between genders. The mean time to perform the "Up & Go" test was 11.6 ± 2.2 sec, with influence of peripheral neuropathy, gender, and age. In order to preserve the control of static upright posture during conditions with deficient sensory input, male patients with type 2 diabetes mellitus with no history of balance disorders may be more vulnerable than females, and obesity may decrease the static postural control in both males and females.

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.

Increased alertness, better than posture prioritization, explains dual-task performance in prosthesis users and controls under increasing postural and cognitive challenge.

PubMed

Howard, Charla L; Perry, Bonnie; Chow, John W; Wallace, Chris; Stokic, Dobrivoje S

2017-11-01

Sensorimotor impairments after limb amputation impose a threat to stability. Commonly described strategies for maintaining stability are the posture first strategy (prioritization of balance) and posture second strategy (prioritization of concurrent tasks). The existence of these strategies was examined in 13 below-knee prosthesis users and 15 controls during dual-task standing under increasing postural and cognitive challenge by evaluating path length, 95% sway area, and anterior-posterior and medial-lateral amplitudes of the center of pressure. The subjects stood on two force platforms under usual (hard surface/eyes open) and difficult (soft surface/eyes closed) conditions, first alone and while performing a cognitive task without and then with instruction on cognitive prioritization. During standing alone, sway was not significantly different between groups. After adding the cognitive task without prioritization instruction, prosthesis users increased sway more under the dual-task than single-task standing (p ≤ 0.028) during both usual and difficult conditions, favoring the posture second strategy. Controls, however, reduced dual-task sway under a greater postural challenge (p ≤ 0.017), suggesting the posture first strategy. With prioritization of the cognitive task, sway was unchanged or reduced in prosthesis users, suggesting departure from the posture second strategy, whereas controls maintained the posture first strategy. Individual analysis of dual tasking revealed that greater postural demand in controls and greater cognitive challenge in prosthesis users led to both reduced sway and improved cognitive performance, suggesting cognitive-motor facilitation. Thus, activation of additional resources through increased alertness, rather than posture prioritization, may explain dual-task performance in both prosthesis users and controls under increasing postural and cognitive challenge.

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

Comparative impacts of Tai Chi, balance training, and a specially-designed yoga program on balance in older fallers.

PubMed

Ni, Meng; Mooney, Kiersten; Richards, Luca; Balachandran, Anoop; Sun, Mingwei; Harriell, Kysha; Potiaumpai, Melanie; Signorile, Joseph F

2014-09-01

To compare the effect of a custom-designed yoga program with 2 other balance training programs. Randomized controlled trial. Research laboratory. A group of older adults (N=39; mean age, 74.15 ± 6.99 y) with a history of falling. Three different exercise interventions (Tai Chi, standard balance training, yoga) were given for 12 weeks. Balance performance was examined during pre- and posttest using field tests, including the 8-foot up-and-go test, 1-leg stance, functional reach, and usual and maximal walking speed. The static and dynamic balances were also assessed by postural sway and dynamic posturography, respectively. Training produced significant improvements in all field tests (P<.005), but group difference and time × group interaction were not detected. For postural sway, significant decreases in the area of the center of pressure with eyes open (P=.001) and eyes closed (P=.002) were detected after training. For eyes open, maximum medial-lateral velocity significantly decreased for the sample (P=.013). For eyes closed, medial-lateral displacement decreased for Tai Chi (P<.01). For dynamic posturography, significant improvements in overall score (P=.001), time on the test (P=.006), and 2 linear measures in lateral (P=.001) and anterior-posterior (P<.001) directions were seen for the sample. Yoga was as effective as Tai Chi and standard balance training for improving postural stability and may offer an alternative to more traditional programs. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

More symmetrical gait after split-belt treadmill walking does not modify dynamic and postural balance in individuals post-stroke.

PubMed

Miéville, Carole; Lauzière, Séléna; Betschart, Martina; Nadeau, Sylvie; Duclos, Cyril

2018-04-24

Spontaneous gait is often asymmetrical in individuals post-stroke, despite their ability to walk more symmetrically on demand. Given the sensorimotor deficits in the paretic limb, this asymmetrical gait may facilitate balance maintenance. We used a split-belt walking protocol to alter gait asymmetry and determine the effects on dynamic and postural balance. Twenty individuals post-stroke walked on a split-belt treadmill. In two separate periods, the effects of walking with the non-paretic leg, and then the paretic one, on the faster belt on spatio-temporal symmetry and balance were compared before and after these perturbation periods. Kinematic and kinetic data were collected using a motion analysis system and an instrumented treadmill to determine symmetry ratios of spatiotemporal parameters and dynamic and postural balance. Balance, quantified by the concepts of stabilizing and destabilizing forces, was compared before and after split-belt walking for subgroups of participants who improved and worsened their symmetry. The side on the slow belt during split-belt walking, but not the changes in asymmetry, affected balance. Difficulty in maintaining balance was higher during stance phase of the leg that was on the slow belt and lower on the contralateral side after split-belt walking, mostly because the center of pressure was closer (higher difficulty) or further (lower difficulty) from the limit of the base of support, respectively. Changes in spatiotemporal parameters may be sought without additional alteration of balance during gait post-stroke. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spatial and temporal analysis of postural control in dyslexic children.

PubMed

Gouleme, Nathalie; Gerard, Christophe Loic; Bui-Quoc, Emmanuel; Bucci, Maria Pia

2015-07-01

The aim of this study is to examine postural control of dyslexic children using both spatial and temporal analysis. Thirty dyslexic (mean age 9.7±0.3years) and thirty non-dyslexic age-matched children participated in the study. Postural stability was evaluated using Multitest Equilibre from Framiral®. Posture was recorded in the following conditions: eyes open fixating a target (EO) and eyes closed (EC) on stable (-S-) and unstable (-U-) platforms. The findings of this study showed poor postural stability in dyslexic children with respect to the non-dyslexic children group, as demonstrated by both spatial and temporal analysis. In both groups of children postural control depends on the condition, and improves when the eyes are open on a stable platform. Dyslexic children have spectral power indices that are higher than in non-dyslexic children and they showed a shorter cancelling time. Poor postural control in dyslexic children could be due to a deficit in using sensory information most likely caused by impairment in cerebellar activity. The reliability of brain activation patterns, namely in using sensory input and cerebellar activity may explain the deficit in postural control in dyslexic children. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

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.

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

Adaptability of anticipatory postural adjustments associated with voluntary movement

PubMed Central

Yiou, Eric; Caderby, Teddy; Hussein, Tarek

2012-01-01

The control of balance is crucial for efficiently performing most of our daily motor tasks, such as those involving goal-directed arm movements or whole body displacement. The purpose of this article is twofold. Firstly, it is to recall how balance can be maintained despite the different sources of postural perturbation arising during voluntary movement. The importance of the so-called “anticipatory postural adjustments” (APA), taken as a “line of defence” against the destabilizing effect induced by a predicted perturbation, is emphasized. Secondly, it is to report the results of recent studies that questioned the adaptability of APA to various constraints imposed on the postural system. The postural constraints envisaged here are classified into biomechanical (postural stability, superimposition of motor tasks), (neuro) physiological (fatigue), temporal (time pressure) and psychological (fear of falling, emotion). Overall, the results of these studies point out the capacity of the central nervous system (CNS) to adapt the spatio-temporal features of APA to each of these constraints. However, it seems that, depending on the constraint, the “priority” of the CNS was focused on postural stability maintenance, on body protection and/or on maintenance of focal movement performance. PMID:22720267

Effects of Combining Running and Practical Duration Stretching on Proprioceptive Skills of National Sprinters.

PubMed

Romero-Franco, Natalia; Párraga-Montilla, Juan Antonio; Molina-Flores, Enrique M; Jiménez-Reyes, Pedro

2018-06-01

Romero-Franco, N, Párraga-Montilla, JA, Molina-Flores, EM, and Jiménez-Reyes, P. Effects of combining running and practical duration stretching on proprioceptive skills of national sprinters. J Strength Cond Res XX(X): 000-000, 2018-Practical duration stretching after aerobic activities is a recommended component of the first part of warm-up because of its effects on performance. However, its effects on proprioceptive skills are unknown. This study aimed to analyze the effects of running and practical duration static stretching (SS) and dynamic stretching (DS) on postural balance and the joint position sense (JPS) of national sprinters. Thirty-two national sprinters were randomly classified into a SS group (n = 11), DS group (n = 11), or control group (n = 10). Static stretching performed 5 minutes of running and short-duration (20 seconds) static stretches; DS performed 5 minutes of running and short-duration dynamic (20 seconds) stretches; and the control group performed 5 minutes of running. Before and after the intervention, unipedal static postural balance and knee JPS were evaluated. Static stretching exhibited a more centralized center of pressure in the medial-lateral plane for unipedal static postural balance in right-leg support after stretching (p = 0.005, d = 1.24), whereas DS showed values further from the center after stretching for the same unipedal support compared with baseline (p = 0.042, d = 0.49), and the control group remained stable (p > 0.05). Joint position sense did not show significant differences in any group (p > 0.05). In conclusion, combining running and practical duration SS may be beneficial for right-leg postural stabilization, whereas DS may be partly and slightly deleterious. Both SS and DS combined with running and running alone have neutral effects on knee JPS. Sports professionals should consider running and practical duration SS as part of the warm-up of sprinters to partly improve unipedal static postural balance.

Eye Movements Affect Postural Control in Young and Older Females

PubMed Central

Thomas, Neil M.; Bampouras, Theodoros M.; Donovan, Tim; Dewhurst, Susan

2016-01-01

Visual information is used for postural stabilization in humans. However, little is known about how eye movements prevalent in everyday life interact with the postural control system in older individuals. Therefore, the present study assessed the effects of stationary gaze fixations, smooth pursuits, and saccadic eye movements, with combinations of absent, fixed and oscillating large-field visual backgrounds to generate different forms of retinal flow, on postural control in healthy young and older females. Participants were presented with computer generated visual stimuli, whilst postural sway and gaze fixations were simultaneously assessed with a force platform and eye tracking equipment, respectively. The results showed that fixed backgrounds and stationary gaze fixations attenuated postural sway. In contrast, oscillating backgrounds and smooth pursuits increased postural sway. There were no differences regarding saccades. There were also no differences in postural sway or gaze errors between age groups in any visual condition. The stabilizing effect of the fixed visual stimuli show how retinal flow and extraocular factors guide postural adjustments. The destabilizing effect of oscillating visual backgrounds and smooth pursuits may be related to more challenging conditions for determining body shifts from retinal flow, and more complex extraocular signals, respectively. Because the older participants matched the young group's performance in all conditions, decreases of posture and gaze control during stance may not be a direct consequence of healthy aging. Further research examining extraocular and retinal mechanisms of balance control and the effects of eye movements, during locomotion, is needed to better inform fall prevention interventions. PMID:27695412

Eye Movements Affect Postural Control in Young and Older Females.

PubMed

Thomas, Neil M; Bampouras, Theodoros M; Donovan, Tim; Dewhurst, Susan

2016-01-01

Visual information is used for postural stabilization in humans. However, little is known about how eye movements prevalent in everyday life interact with the postural control system in older individuals. Therefore, the present study assessed the effects of stationary gaze fixations, smooth pursuits, and saccadic eye movements, with combinations of absent, fixed and oscillating large-field visual backgrounds to generate different forms of retinal flow, on postural control in healthy young and older females. Participants were presented with computer generated visual stimuli, whilst postural sway and gaze fixations were simultaneously assessed with a force platform and eye tracking equipment, respectively. The results showed that fixed backgrounds and stationary gaze fixations attenuated postural sway. In contrast, oscillating backgrounds and smooth pursuits increased postural sway. There were no differences regarding saccades. There were also no differences in postural sway or gaze errors between age groups in any visual condition. The stabilizing effect of the fixed visual stimuli show how retinal flow and extraocular factors guide postural adjustments. The destabilizing effect of oscillating visual backgrounds and smooth pursuits may be related to more challenging conditions for determining body shifts from retinal flow, and more complex extraocular signals, respectively. Because the older participants matched the young group's performance in all conditions, decreases of posture and gaze control during stance may not be a direct consequence of healthy aging. Further research examining extraocular and retinal mechanisms of balance control and the effects of eye movements, during locomotion, is needed to better inform fall prevention interventions.

Local Stability of the Trunk in Patients with Degenerative Cerebellar Ataxia During Walking.

PubMed

Chini, Giorgia; Ranavolo, Alberto; Draicchio, Francesco; Casali, Carlo; Conte, Carmela; Martino, Giovanni; Leonardi, Luca; Padua, Luca; Coppola, Gianluca; Pierelli, Francesco; Serrao, Mariano

2017-02-01

This study aims to evaluate trunk local stability in a group of patients with degenerative primary cerebellar ataxia and to correlate it with spatio-temporal parameters, clinical variables, and history of falls. Sixteen patients affected by degenerative cerebellar ataxia and 16 gender- and age-matched healthy adults were studied by means of an inertial sensor to measure trunk kinematics and spatio-temporal parameters during over-ground walking. Trunk local dynamic stability was quantified by the maximum Lyapunov exponent with short data series of the acceleration data. According to this index, low values indicate more stable trunk dynamics, while high values denote less stable trunk dynamics. Disease severity was assessed by means of International Cooperative Ataxia Rating Scale (ICARS) according to which higher values correspond to more severe disease, while lower values correspond to less severe disease.Patients displayed a higher short-term maximum Lyapunov exponent than controls in all three spatial planes, which was correlated with the age, onset of the disease, and history of falls. Furthermore, the maximum Lyapunov exponent was negatively correlated with ICARS balance, ICARS posture, and ICARS total scores.These findings indicate that trunk local stability during gait is lower in patients with cerebellar degenerative ataxia than that in healthy controls and that this may increase the risk of falls. Local dynamic stability of the trunk seems to be an important aspect in patients with ataxia and could be a useful tool in the evaluation of rehabilitative and pharmacological treatment outcomes.

Age-related changes in posture response under a continuous and unexpected perturbation.

PubMed

Tsai, Yi-Ching; Hsieh, Lin-Fen; Yang, Saiwei

2014-01-22

Aging is a critical factor to influence the functional performance during daily life. Without an appropriate posture control response when experiencing an unexpected external perturbation, fall may occur. A novel six-degree-of freedom platform with motion control protocol was designed to provide a real-life simulation of unexpected disturbance in order to discriminate the age-related changes of the balance control and the recovery ability. Twenty older adults and 20 healthy young adults participated in the study. The subjects stood barefoot on the novel movable platform, data of the center of mass (COM) excursion, joint rotation angle and electromyography (EMG) were recorded and compared. The results showed that the older adults had similar patterns of joint movement and COM excursion as the young adults during the balance reactive-recovery. However, larger proximal joint rotation in elderly group induced larger COM sway envelop and therefore loss of the compensatory strategy of posture recovery. The old adults also presented a lower muscle power. In order to keep an adequate joint stability preventing from falling, the EMG activity was increased, but the asymmetric pattern might be the key reason of unstable postural response. This novel design of moveable platform and test protocol comprised the computerized dynamic posturography (CDP) demonstrate its value to assess the possible sensory, motor, and central adaptive impairments to balance control and could be the training tool for posture inability person. © 2013 Elsevier Ltd. All rights reserved.

Practice of Contemporary Dance Promotes Stochastic Postural Control in Aging

PubMed Central

Ferrufino, Lena; Bril, Blandine; Dietrich, Gilles; Nonaka, Tetsushi; Coubard, Olivier A.

2011-01-01

As society ages and the frequency of falls increases, counteracting gait and posture decline is a challenging issue for countries of the developed world. Previous studies have shown that exercise and hazard management help to improve balance and/or decrease the risks for falling in normal aging. Motor activity based on motor-skill learning, particularly dance, can also benefit balance and decreases falls with age. Recent studies have suggested that older dancers have better balance, posture, or gait than non-dancers. Additionally, clinical or laboratory measures have shown improvements in some aspects of balance after dance interventions in elderly trainees. This study examined the impact of contemporary dance (CD) and of fall prevention (FP) programs on postural control of older adults. Posturography of quiet upright stance was performed in 41 participants aged 59–86 years before and after 4.4-month training in either CD or FP once a week. Though classical statistic scores failed to show any effect, dynamic analyses of the center-of-pressure displacements revealed significant changes after training. Specifically, practice of CD enhanced the critical time interval in diffusion analysis, and reduced recurrence and mathematical stability in recurrence quantification analysis, whereas practice of FP induced or tended to induce the reverse patterns. Such effects were obtained only in the eyes open condition. We suggest that CD training based on motor improvisation favored stochastic posture inducing plasticity in motor control, while FP training based on more stereotyped behaviors did not. PMID:22232582

Effects of Inspired CO2 and Breathing Resistance on Neurocognitive and Postural Stability in U.S. Navy Divers

DTIC Science & Technology

2015-08-01

Wii Balance Board . Amplitude and sample entropy...of the subtests. Balance testing Alterations in postural stability (i.e., balance ) were assessed using a Nintendo Wii Balance Board (Nintendo...29. P. Scaglioni-Solano, L. F. Aragón-Vargas, "Validity and Reliability of the Nintendo Wii Balance Board to Assess Standing Balance and

Vibration-enhanced posture stabilization achieved by tactile supplementation: may blind individuals get extra benefits?

PubMed

Magalhães, Fernando Henrique; Kohn, André Fabio

2011-08-01

Diminished balance ability poses a serious health risk due to the increased likelihood of falling, and impaired postural stability is significantly associated with blindness and poor vision. Noise stimulation (by improving the detection of sub-threshold somatosensory information) and tactile supplementation (i.e., additional haptic information provided by an external contact surface) have been shown to improve the performance of the postural control system. Moreover, vibratory noise added to the source of tactile supplementation (e.g., applied to a surface that the fingertip touches) has been shown to enhance balance stability more effectively than tactile supplementation alone. In view of the above findings, in addition to the well established consensus that blind subjects show superior abilities in the use of tactile information, we hypothesized that blind subjects may take extra benefits from the vibratory noise added to the tactile supplementation and hence show greater improvements in postural stability than those observed for sighted subjects. If confirmed, this hypothesis may lay the foundation for the development of noise-based assistive devices (e.g., canes, walking sticks) for improving somatosensation and hence prevent falls in blind individuals. Copyright © 2011 Elsevier Ltd. All rights reserved.

The influence of unilateral saccular impairment on functional balance performance and self-report dizziness.

PubMed

McCaslin, Devin L; Jacobson, Gary P; Grantham, Sarah L; Piker, Erin G; Verghese, Susha

2011-09-01

Postural stability in humans is largely maintained by vestibular, visual, and somatosensory inputs to the central nervous system. Recent clinical advances in the assessment of otolith function (e.g., cervical and ocular vestibular evoked myogenic potentials [cVEMPs and oVEMPs], subjective visual vertical [SVV] during eccentric rotation) have enabled investigators to identify patients with unilateral otolith impairments. This research has suggested that patients with unilateral otolith impairments perform worse than normal healthy controls on measures of postural stability. It is not yet known if patients with unilateral impairments of the saccule and/or inferior vestibular nerve (i.e., unilaterally abnormal cVEMP) perform differently on measures of postural stability than patients with unilateral impairments of the horizontal SCC (semicircular canal) and/or superior vestibular nerve (i.e., unilateral caloric weakness). Further, it is not known what relationship exists, if any, between otolith system impairment and self-report dizziness handicap. The purpose of this investigation was to determine the extent to which saccular impairments (defined by a unilaterally absent cVEMP) and impairments of the horizontal semicircular canal (as measured by the results of caloric testing) affect vestibulospinal function as measured through the Sensory Organization Test (SOT) of the computerized dynamic posturography (CDP). A secondary objective of this investigation was to measure the effects, if any, that saccular impairment has on a modality-specific measure of health-related quality of life. A retrospective cohort study. Subjects were assigned to one of four groups based on results from balance function testing: Group 1 (abnormal cVEMP response only), Group 2 (abnormal caloric response only), Group 3 (abnormal cVEMP and abnormal caloric response), and Group 4 (normal control group). Subjects were 92 adult patients: 62 were seen for balance function testing due to complaints of dizziness, vertigo, or unsteadiness, and 30 served as controls. All subjects underwent videonystagmography or electronystagmography (VNG/ENG), vestibular evoked myogenic potentials (VEMPs), self-report measures of self-perceived dizziness disability/handicap (Dizziness Handicap Inventory), and tests of postural control (Neurocom Equitest). Subjects were categorized into one of four groups based on balance function test results. All variables were subjected to a multifactor analysis of variance (ANOVA). The Dizziness Handicap Inventory (DHI) total scores and equilibrium scores served as the dependent variables. Results showed that patients with abnormal unilateral saccular or inferior vestibular nerve function (i.e., abnormal cVEMP) demonstrated significantly impaired postural control when compared to normal participants. However, this group demonstrated significantly better postural stability when compared to the group with abnormal caloric responses alone and the group with abnormal caloric responses and abnormal cVEMP results. Patients with an abnormal cVEMP did not differ significantly on the DHI compared to the other two impaired groups. We interpret these findings as evidence that a significantly asymmetrical cVEMP in isolation negatively impacts performance on measures of postural control compared to normal subjects but not compared to patients with significant caloric weaknesses. However, patients with a unilaterally abnormal cVEMP do not differ from patients with significant caloric weaknesses in regard to self-perceived dizziness handicap. American Academy of Audiology.

Rocker bottom soles alter the postural response to backward translation during stance.

PubMed

Albright, Bruce C; Woodhull-Smith, Whitney M

2009-07-01

Shoes with rocker bottom soles are utilized by persons with diabetic peripheral neuropathy to reduce plantar pressures during gait. This population also has a high risk for falls. This study analyzed the effects of shoes with rocker bottom soles on the postural response during perturbed stance. Participants were 20 healthy subjects (16 women, 4 men) ages 22-25 years. Canvas shoes were modified by the addition of crepe sole material to represent two forms of rocker bottom shoes and a control shoe. Subjects stood on a dynamic force plate programmed to move backward at a velocity that produced an automatic postural response without stepping. Force plate data were collected for five trials per shoe type. Sway variables for center of pressure (COP) and center of mass (COM) included: mean sway amplitude, sway variance, time to peak, anterior and posterior peak velocities, functional stability margin, and peak duration time. Compared to control, both the experimental shoes had significantly larger COP and COM values for mean sway amplitude, sway variance and peak duration. The functional stability margins were significantly smaller for the experimental shoes while their anterior and posterior peak velocities were slower and time to peaks were significantly longer. In young healthy adults, shoes with rocker bottom soles had a destabilizing effect to perturbed stance, thereby increasing the potential for imbalance. These results raise concerns that footwear with rocker bottom sole modifications to accommodate an insensate foot may increase the risk of falls.

[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.

Postural stability and quality of life after guided and self-training among older adults residing in an institutional setting

PubMed Central

Tuunainen, Eeva; Rasku, Jyrki; Jäntti, Pirkko; Moisio-Vilenius, Päivi; Mäkinen, Erja; Toppila, Esko; Pyykkö, Ilmari

2013-01-01

Purpose To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly’s daily routine and making it more active and exhausting. PMID:24072969

Effects of ballates, step aerobics, and walking on balance in women aged 50-75 years.

PubMed

Clary, Sarah; Barnes, Cathleen; Bemben, Debra; Knehans, Allen; Bemben, Michael

2006-01-01

This study examined the effectiveness of Ballates training (strengthening of the central core musculature by the inception of balance techniques) compared to more traditional exercise programs, such as step aerobics and walking, on balance in women aged 50- 75 years. Participants were randomly assigned to one of three supervised training groups (1 hour/day, 3 days/week, 13 weeks), Ballates (n = 12), step aerobics (n = 17), or walking (n =15). Balance was measured by four different methods (modified Clinical Test for the Sensory Interaction on Balance - mCTSIB; Unilateral Stance with Eyes Open - US-EO or Eyes Closed - US-EC; Tandem Walk - TW; Step Quick Turn - SQT) using the NeuroCom Balance Master. A 2-way (Group and Trial) repeated measures ANOVA and post-hoc Bonferroni Pair-wise Comparisons were used to evaluate changes in the dependent variables used to describe stability and balance (sway velocity, turn sway, speed, and turn time). Measures of static postural stability and dynamic balance were similar for the three groups prior to training. Following the different exercise interventions, sway velocity on firm and foam surfaces (mCTSIB) with eyes closed (p < 0.05) increased for the Ballates group while the other two exercise groups either maintained or decreased their sway velocity following the training, therefore suggesting that these two groups either maintained or improved their balance. There were significant improvements in speed during the TW test (p < 0.01), and turn time (p < 0.01) and sway (p < 0.05) during the SQT test for each of the three groups. In general, all three training programs improved dynamic balance, however, step aerobics and walking programs resulted in be better improvements in postural stability or static balance when compared to the Ballates program. Key PointsExercise training can improve balanceNeed to consider both static and dynamic aspects of balance individuallyImproved balance can reduce the risk of fall.

PREHAB vs. REHAB - presurgical treatment in vestibular schwannoma surgery enhances recovery of postural control better than postoperative rehabilitation: Retrospective case series.

PubMed

Tjernström, Fredrik; Fransson, Per-Anders; Kahlon, Babar; Karlberg, Mikael; Lindberg, Sven; Siesjö, Peter; Magnusson, Måns

2018-01-01

To evaluate post-surgical postural stability when treating patients with remaining vestibular function with intratympanic gentamicin (PREHAB) prior to schwannoma surgery. 44 consecutive patients with some form remaining vestibular function scheduled for vestibular schwannoma surgery. 20 were medically deafferented with intratympanic gentamicin before surgery and 24 were not. Both groups were of the same age, had the same tumor size, same type of surgery, and same perioperative sensory rehabilitation (training exercises), and no surgical complications. Postural stability measured as energy expenditure while standing on a force platform during vibratory stimulation of the calf muscles, performed prior to surgery (or gentamicin treatment) and 6 months after surgery. Patients pretreated with gentamicin had significantly better postural stability at the time for follow-up (p < 0.05) and displayed a better adaptive capacity when faced with a postural challenge (p < 0.01). They were also able to use vision more efficiently to control their stability (p < 0.05). By separating the sensory loss (through intratympanic gentamicin, that ablates the remaining vestibular function) from the intracranial surgical trauma, the postural control system benefited from a better short-term (adaptation) and long-term (habituation) recovery, when experiencing a postural challenge or resolving a sensory conflict. The benefits could be attributed to; active and continuous motor learning as the vestibular function slowly attenuates; no concomitant central nervous dysfunction due to effects from neurosurgery, thus allowing time for a separate unimpeded recovery process with more limited challenges and objectives; and the initiation and certain progression of sensory reweighting processes allowed prior to surgery. In contrast, worse compensation could be due to; immobilization from nausea after surgery, harmful amount of stress and cognitive dysfunction from the combination of surgical and sensory trauma and an abrupt vestibular deafferentation and its consequences on sensory reweighting.

Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65.

PubMed

Buatois, Séverine; Gueguen, René; Gauchard, Gérome C; Benetos, Athanase; Perrin, Philippe P

2006-01-01

A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to identify those at high-risk of recurrent falls. Copyright (c) 2006 S. Karger AG, Basel.

Unraveling the mechanisms underlying postural instability in Parkinson's disease using dynamic posturography.

PubMed

Nonnekes, Jorik; de Kam, Digna; Geurts, Alexander C H; Weerdesteyn, Vivian; Bloem, Bastiaan R

2013-12-01

Postural instability, one of the cardinal symptoms of Parkinson's disease (PD), has devastating consequences for affected patients. Better strategies to prevent falls are needed, but this calls for an improved understanding of the complex mechanisms underlying postural instability. We must also improve our ability to timely identify patients at risk of falling. Dynamic posturography is a promising avenue to achieve these goals. The latest moveable platforms can deliver 'real-life' balance perturbations, permitting study of everyday fall circumstances. Dynamic posturography studies have shown that PD patients have fundamental problems in scaling their postural responses in accordance with the need of the actual balance task at hand. On-going studies evaluate the predictive ability of impaired posturography performance for daily life falls. We also review recent work aimed at exploring balance correcting steps in PD, and the presumed interaction between startle pathways and postural responses.

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.

Effect of Seat Surface Inclination on Postural Stability and forward Reaching Efficiency in Children with Spastic Cerebral Palsy

ERIC Educational Resources Information Center

Cherng, Rong-Ju; Lin, Hui-Chen; Ju, Yun-Huei; Ho, Chin-Shan

2009-01-01

The purpose of this study was to examine the effect of seat surface inclination on postural stability and forward reaching efficiency in 10 children with spastic cerebral palsy (CP) and 16 typically developing (TD) children. The children performed a static sitting and a forward reaching task while sitting on a height- and inclination-adjustable…

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.

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.

Divergent Effects of Cognitive Load on Quiet Stance and Task-Linked Postural Coordination

ERIC Educational Resources Information Center

Mitra, Suvobrata; Knight, Alec; Munn, Alexandra

2013-01-01

Performing a cognitive task while maintaining upright stance can lead to increased or reduced body sway depending on tasks and experimental conditions. Because greater sway is commonly taken to indicate loosened postural control, and vice versa, the precise impact of cognitive load on postural stability has remained unclear. In much of the large…

Static Postural Stability Is Normal in Dyslexic Children.

ERIC Educational Resources Information Center

Brown, Brian; And Others

1985-01-01

An experiment on 15 dyslexic and 23 carefully matched control subjects (10- to 12-year-old males), examining their ability to maintain standing posture with eyes open and closed and with standard and tandem foot placement, revealed no differences under any condition tested and no differences in use of visual information to maintain their posture.…

Postural Hypo-Reactivity in Autism Is Contingent on Development and Visual Environment: A Fully Immersive Virtual Reality Study

ERIC Educational Resources Information Center

Greffou, Selma; Bertone, Armando; Hahler, Eva-Maria; Hanssens, Jean-Marie; Mottron, Laurent; Faubert, Jocelyn

2012-01-01

Although atypical motor behaviors have been associated with autism, investigations regarding their possible origins are scarce. This study assessed the visual and vestibular components involved in atypical postural reactivity in autism. Postural reactivity and stability were measured for younger (12-15 years) and older (16-33 years) autistic…

Effects of Dyslexia on Postural Control in Adults

ERIC Educational Resources Information Center

Patel, M.; Magnusson, M.; Lush, D.; Gomez, S.; Fransson, P. A.

2010-01-01

Dyslexia has been shown to affect postural control. The aim of the present study was to investigate the difference in postural stability measured as torque variance in an adult dyslexic group (n=14, determined using the Adult Dyslexia Checklist (ADCL) and nonsense word repetition test) and an adult non-dyslexic group (n=39) on a firm surface and…

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.

Contribution of supraspinal systems to generation of automatic postural responses

PubMed Central

Deliagina, Tatiana G.; Beloozerova, Irina N.; Orlovsky, Grigori N.; Zelenin, Pavel V.

2014-01-01

Different species maintain a particular body orientation in space due to activity of the closed-loop postural control system. In this review we discuss the role of neurons of descending pathways in operation of this system as revealed in animal models of differing complexity: lower vertebrate (lamprey) and higher vertebrates (rabbit and cat). In the lamprey and quadruped mammals, the role of spinal and supraspinal mechanisms in the control of posture is different. In the lamprey, the system contains one closed-loop mechanism consisting of supraspino-spinal networks. Reticulospinal (RS) neurons play a key role in generation of postural corrections. Due to vestibular input, any deviation from the stabilized body orientation leads to activation of a specific population of RS neurons. Each of the neurons activates a specific motor synergy. Collectively, these neurons evoke the motor output necessary for the postural correction. In contrast to lampreys, postural corrections in quadrupeds are primarily based not on the vestibular input but on the somatosensory input from limb mechanoreceptors. The system contains two closed-loop mechanisms – spinal and spino-supraspinal networks, which supplement each other. Spinal networks receive somatosensory input from the limb signaling postural perturbations, and generate spinal postural limb reflexes. These reflexes are relatively weak, but in intact animals they are enhanced due to both tonic supraspinal drive and phasic supraspinal commands. Recent studies of these supraspinal influences are considered in this review. A hypothesis suggesting common principles of operation of the postural systems stabilizing body orientation in a particular plane in the lamprey and quadrupeds, that is interaction of antagonistic postural reflexes, is discussed. PMID:25324741

The effect of exhausting aerobic exercise on the timing of anticipatory postural adjustments.

PubMed

Strang, A J; Choi, H J; Berg, W P

2008-03-01

The aim of the study was to investigate the influence of exhausting aerobic exercise on the timing of anticipatory postural adjustments (APAs). The APAs of 12 participants were recorded at baseline, after a .VO2max running test, and again following a 45-min rest period. APAs were induced using a rapid bilateral arm-raising maneuver, and were analyzed in the rectus abdominis, hamstring group, gluteal group, and lumbar and thoracic paraspinal muscles using electromyography. Postural stability was assessed by monitoring anterior/posterior displacement of the center of pressure using a force plate. We hypothesized that APA onset would be ear lier following exhausting aerobic exercise as compared to the baseline measures, but that this effect would be transient (i.e., APA onset following the rest period would not differ from that at baseline). Exhausting aerobic exercise resulted in a significantly earlier APA in one of the 5 muscles evaluated, the thoracic paraspinal group, and this effect persisted 45-min postexercise. Exhausting aerobic exercise did not affect postural stability during the rapid arm-raising maneuver. The findings lend tentative support for the notion that earlier APAs constitute a functional adaptation by the motor system to maintain postural stability in the presence of fatigue.

Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults

PubMed Central

Yu, Shu-Han

2017-01-01

In a postural-suprapostural task, appropriate prioritization is necessary to achieve task goals and maintain postural stability. A “posture-first” principle is typically favored by elderly people in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. Using a postural-suprapostural task with a motor suprapostural goal, this study investigated differences between young and older adults in dual-task cost across varying task prioritization paradigms. Eighteen healthy young (mean age: 24.8 ± 5.2 years) and 18 older (mean age: 68.8 ± 3.7 years) adults executed a designated force-matching task from a stabilometer board using either a stabilometer stance (posture-focus strategy) or force-matching (supraposture-focus strategy) as the primary task. The dual-task effect (DTE: % change in dual-task condition; positive value: dual-task benefit, negative value: dual-task cost) of force-matching error and reaction time (RT), posture error, and approximate entropy (ApEn) of stabilometer movement were measured. When using the supraposture-focus strategy, young adults exhibited larger DTE values in each behavioral parameter than when using the posture-focus strategy. The older adults using the supraposture-focus strategy also attained larger DTE values for posture error, stabilometer movement ApEn, and force-matching error than when using the posture-focus strategy. These results suggest that the supraposture-focus strategy exerted an increased dual-task benefit for posture-motor dual-tasking in both healthy young and elderly adults. The present findings imply that the older adults should make use of the supraposture-focus strategy for fall prevention during dual-task execution. PMID:28151943

Improving posture-motor dual-task with a supraposture-focus strategy in young and elderly adults.

PubMed

Yu, Shu-Han; Huang, Cheng-Ya

2017-01-01

In a postural-suprapostural task, appropriate prioritization is necessary to achieve task goals and maintain postural stability. A "posture-first" principle is typically favored by elderly people in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. Using a postural-suprapostural task with a motor suprapostural goal, this study investigated differences between young and older adults in dual-task cost across varying task prioritization paradigms. Eighteen healthy young (mean age: 24.8 ± 5.2 years) and 18 older (mean age: 68.8 ± 3.7 years) adults executed a designated force-matching task from a stabilometer board using either a stabilometer stance (posture-focus strategy) or force-matching (supraposture-focus strategy) as the primary task. The dual-task effect (DTE: % change in dual-task condition; positive value: dual-task benefit, negative value: dual-task cost) of force-matching error and reaction time (RT), posture error, and approximate entropy (ApEn) of stabilometer movement were measured. When using the supraposture-focus strategy, young adults exhibited larger DTE values in each behavioral parameter than when using the posture-focus strategy. The older adults using the supraposture-focus strategy also attained larger DTE values for posture error, stabilometer movement ApEn, and force-matching error than when using the posture-focus strategy. These results suggest that the supraposture-focus strategy exerted an increased dual-task benefit for posture-motor dual-tasking in both healthy young and elderly adults. The present findings imply that the older adults should make use of the supraposture-focus strategy for fall prevention during dual-task execution.

Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome.

PubMed

Yilmaz Yelvar, Gul Deniz; Çirak, Yasemin; Dalkilinç, Murat; Demir, Yasemin Parlak; Baltaci, Gul; Kömürcü, Mahmut; Yelvar, Gul Deniz Yilmaz

2016-06-30

Postural control allows performance of daily and sports activities. The previous studies show that postural sway inceases in orthopaedic injuries such as osteoarthritis and total knee arthroplasty. To compare postural sway, risk of falling and function between individuals with and without patellofemoral pain syndrome (PFS). This study included 22 subjects with patellofemoral pain syndrome, age-matched pain-free 22 females serving as a control group. Visual anolog scale and Kujala were used to evaluate the pain. Posturographic assesment was performed by Tetrax posturographic device. Biering Modified Sorenson test for extensor endurance and sit-up test for flexor endurance were used for the evaluation of trunk endurance. Timed get-up and go test was used for lower extremity function. The Student's t Test was used to compare variables between the groups. The Pearson correlation coefficients were calculated to examine correlation between the quantitative variables. Postural sway included eyes open without pillow, eyes open on pillow, eyes closed on pillow, risk of falling, function and postural stabilization included flexor endurance, extansor endurance are impared in patient with patellofemoral pain syndrome when compare to controls. In subjects with PFPS increased postural sway significantly associated with body mass index (r= 0.52), pain duration (r= 0.43), postural control (extansor endurance) (r= -0.50) and risk of falling (r= 0.62) on pillow with open eyes. In addition we found function significantly related with postural control (extansor endurance and flexor endurance) (r= -0.59 and r= -0.59) and risk of falling (r= 0.77)CONCLUSIONS: Decreased neuromuscular control of the trunk core and increased postural sway and falling risk were found in patients with PFPS. Patients may be evaluated for deficits in postural control and falling risk before treatment.

Velocity dependence of vestibular information for postural control on tilting surfaces

PubMed Central

Kluzik, JoAnn; Hlavacka, Frantisek

2016-01-01

Vestibular information is known to be important for postural stability on tilting surfaces, but the relative importance of vestibular information across a wide range of surface tilt velocities is less clear. We compared how tilt velocity influences postural orientation and stability in nine subjects with bilateral vestibular loss and nine age-matched, control subjects. Subjects stood on a force platform that tilted 6 deg, toes-up at eight velocities (0.25 to 32 deg/s), with and without vision. Results showed that visual information effectively compensated for lack of vestibular information at all tilt velocities. However, with eyes closed, subjects with vestibular loss were most unstable within a critical tilt velocity range of 2 to 8 deg/s. Subjects with vestibular deficiency lost their balance in more than 90% of trials during the 4 deg/s condition, but never fell during slower tilts (0.25–1 deg/s) and fell only very rarely during faster tilts (16–32 deg/s). At the critical velocity range in which falls occurred, the body center of mass stayed aligned with respect to the surface, onset of ankle dorsiflexion was delayed, and there was delayed or absent gastrocnemius inhibition, suggesting that subjects were attempting to actively align their upper bodies with respect to the moving surface instead of to gravity. Vestibular information may be critical for stability at velocities of 2 to 8 deg/s because postural sway above 2 deg/s may be too fast to elicit stabilizing responses through the graviceptive somatosensory system, and postural sway below 8 deg/s may be too slow for somatosensory-triggered responses or passive stabilization from trunk inertia. PMID:27486101

Spinocerebellar ataxia in monozygotic twins.

PubMed

Anderson, John H; Christova, Peka S; Xie, Ting-dong; Schott, Kelly S; Ward, Kenneth; Gomez, Christopher M

2002-12-01

Although phenotypic heterogeneity in autosomal dominant spinocerebellar ataxia (SCA) has been explained in part by genotypic heterogeneity, clinical observations suggest the influence of additional factors. To demonstrate, quantitate, and localize physiologic abnormalities attributable to nongenetic factors in the development of hereditary SCA. Quantitative assessments of ocular motor function and postural control in 2 sets of identical twins, one with SCA type 2 and the other with episodic ataxia type 2. University laboratory. Saccadic velocity and amplitude, pursuit gain, and dynamic posturography. We found significant differences in saccade velocity, saccade metrics, and postural stability between each monozygotic twin. The differences point to differential involvement between twins of discrete regions in the cerebellum and brainstem. These results demonstrate the presence of quantitative differences in the severity, rate of progression, and regional central nervous system involvement in monozygotic twins with SCA that must be owing to the existence of nongermline or external factors.

Smart mug to measure hand's geometrical mechanical impedance.

PubMed

Hondori, Hossein Mousavi; Tech, Ang Wei

2011-01-01

A novel device, which looks like a mug, has been proposed for measuring the impedance of human hand. The device is designed to have convenient size and light weight similar to an ordinary coffee mug. It contains a 2-axis inertia sensor to monitor vibration and a small motor to carry an eccentric mass (m=100 gr, r=2 cm, rpm=600). The centrifugal force due to the rotating mass applies a dynamic force to the hand that holds the mug. Correlation of the acceleration signals with the perturbing force gives the geometrical mechanical impedance. Experimental results on a healthy subject shows that impedance is posture dependant while it changes with the direction of the applied perturbing force. For nine postures the geometrical impedance is obtained all of which have elliptical shapes. The method can be used for assessment of spasticity and monitoring stability in patients with stroke or similar problems.

Vestibular ablation and a semicircular canal prosthesis affect postural stability during head turns

PubMed Central

Thompson, Lara A.; Haburcakova, Csilla; Lewis, Richard F.

2016-01-01

In our study, we examined postural stability during head turns for two rhesus monkeys: one, single animal study contrasted normal and mild bilateral vestibular ablation and a second animal study contrasted severe bilateral vestibular ablation with and without prosthetic stimulation. The monkeys freely stood, unrestrained on a balance platform and made voluntary head turns between visual targets. To quantify each animals’ posture, motions of the head and trunk, as well as torque about the body’s center-of-mass, were measured. In the mildly ablated animal, we observed less foretrunk sway in comparison to the normal state. When the canal prosthesis provided electric stimulation to the severely ablated animal, it showed a decrease in trunk sway during head turns. Because the rhesus monkey with severe bilateral vestibular loss exhibited a decrease in trunk sway when receiving vestibular prosthetic stimulation, we propose that the prosthetic electrical stimulation partially restored head velocity information. Our results provide an indication that a semicircular canal prosthesis may be an effective way to improve postural stability in patients with severe peripheral vestibular dysfunction. PMID:27405997

Space flight and neurovestibular adaptation

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Bloomberg, J. J.; Harm, D. L.; Paloski, W. H.

1994-01-01

Space flight represents a form of sensory stimulus rearrangement requiring modification of established terrestrial response patterns through central reinterpretation. Evidence of sensory reinterpretation is manifested as postflight modifications of eye/head coordination, locomotor patterns, postural control strategies, and illusory perceptions of self or surround motion in conjunction with head movements. Under normal preflight conditions, the head is stabilized during locomotion, but immediately postflight reduced head stability, coupled with inappropriate eye/head coordination, results in modifications of gait. Postflight postural control exhibits increased dependence on vision which compensates for inappropriate interpretation of otolith and proprioceptive inputs. Eye movements compensatory for perceived self motion, rather than actual head movements have been observed postflight. Overall, the in-flight adaptive modification of head stabilization strategies, changes in head/eye coordination, illusionary motion, and postural control are maladaptive for a return to the terrestrial environment.

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.

Active ocular vergence improves postural control in elderly as close viewing distance with or without a single cognitive task.

PubMed

Matheron, Eric; Yang, Qing; Delpit-Baraut, Vincent; Dailly, Olivier; Kapoula, Zoï

2016-01-01

Performance of the vestibular, visual, and somatosensory systems decreases with age, reducing the capacity of postural control, and increasing the risk of falling. The purpose of this study is to measure the effects of vision, active vergence eye movements, viewing distance/vergence angle and a simple cognitive task on postural control during an upright stance, in completely autonomous elderly individuals. Participated in the study, 23 elderly subjects (73.4 ± 6.8 years) who were enrolled in a center dedicated to the prevention of falling. Their body oscillations were measured with the DynaPort(®) device, with three accelerometers, placed at the lumbosacral level, near the center of mass. The conditions were the following: eyes open fixating on LED at 20 cm or 150 cm (vergence angle 17.0° and 2.3° respectively) with or without additional cognitive tasks (counting down from one hundred), performing active vergence by alternating the fixation between the far and the near LED (convergence and divergence), eyes closed after having fixated the far LED. The results showed that the postural stability significantly decreased when fixating on the LED at a far distance (weak convergence angle) with or without cognitive tasks; active convergence-divergence between the LEDs improved the postural stability while eye closure decreased it. The privilege of proximity (with increased convergence at near), previously established with foot posturography, is shown here to be valid for accelerometry with the center of mass in elderly. Another major result is the beneficial contribution of active vergence eye movements to better postural stability. The results bring new perspectives for the role of eye movement training to preserve postural control and autonomy in elderly. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Locomotor Sensory Organization Test: How Sensory Conflict Affects the Temporal Structure of Sway Variability During Gait.

PubMed

Chien, Jung Hung; Mukherjee, Mukul; Siu, Ka-Chun; Stergiou, Nicholas

2016-05-01

When maintaining postural stability temporally under increased sensory conflict, a more rigid response is used where the available degrees of freedom are essentially frozen. The current study investigated if such a strategy is also utilized during more dynamic situations of postural control as is the case with walking. This study attempted to answer this question by using the Locomotor Sensory Organization Test (LSOT). This apparatus incorporates SOT inspired perturbations of the visual and the somatosensory system. Ten healthy young adults performed the six conditions of the traditional SOT and the corresponding six conditions on the LSOT. The temporal structure of sway variability was evaluated from all conditions. The results showed that in the anterior posterior direction somatosensory input is crucial for postural control for both walking and standing; visual input also had an effect but was not as prominent as the somatosensory input. In the medial lateral direction and with respect to walking, visual input has a much larger effect than somatosensory input. This is possibly due to the added contributions by peripheral vision during walking; in standing such contributions may not be as significant for postural control. In sum, as sensory conflict increases more rigid and regular sway patterns are found during standing confirming the previous results presented in the literature, however the opposite was the case with walking where more exploratory and adaptive movement patterns are present.

Can an anti-gravity treadmill improve stability of children with cerebral palsy?

PubMed

Birgani, P M; Ashtiyani, M; Rasooli, A; Shahrokhnia, M; Shahrokhi, A; Mirbagheri, M M

2016-08-01

We aimed to study the effects of an anti-gravity treadmill (AlterG) training on balance and postural stability in children with cerebral palsy (CP). AlterG training was performed 3 days/week for 8 weeks, with up to 45 minutes of training per session. The subject was evaluated before and after the 8-week training. The effects of training on the balance and postural stability was evaluated based on the Romberg test that was performed by using a posturography device. The parameters quantifying Center-of-Pressure (CoP) were calculated using different analytical approaches including power spectral density and principal components analyses. All of the key parameters including the Stabilogram, the Fast Fourier Transform (FFT) Energy, the Eigenvectors, and the Eigenvalues of CoP were modified between 14%-84%. The results indicated that the balance features were improved substantially after training. The clinical implication is that the AlterG has the potential to effectively improve postural stability in children with cerebral palsy.

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

PubMed

Lee, Myung-Mo; Shin, Doo-Chul; Song, Chang-Ho

2016-07-01

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

Feet deformities are correlated with impaired balance and postural stability in seniors over 75

PubMed Central

Puszczalowska-Lizis, Ewa; Bujas, Przemyslaw; Omorczyk, Jaroslaw; Jandzis, Slawomir

2017-01-01

Objective Understanding the factors and mechanisms that determine balance in seniors appears vital in terms of their self-reliance and overall safety. The study aimed to determine the relationship between the features of feet structure and the indicators of postural stability in the elderly. Methods The study group comprised 80 seniors (41F, 39M; aged 75–85 years). CQ-ST podoscope and the CQ-Stab 2P two-platform posturograph were used as primary research tools. The data were analyzed based on Spearman’s rank correlation and forward stepwise regression. Results Analysis of forward stepwise regression identified the left foot length in females and Clarke’s angle of the left foot in men as significant and independent predictors of postural up to 30% of the variance of dependent variables. Conclusions Longer feet provide older women with better stability, whereas in men, the lowering of the longitudinal arch results in postural deterioration. In the elderly, the left lower limb shows greater activity in the stabilizing processes in the standing position than the right one. In gerontological rehabilitation special attention should be paid to the individually tailored, gender-specific treatment, with a view to enhancing overall safety and quality of seniors’ lives. PMID:28877185

Gaze and viewing angle influence visual stabilization of upright posture

PubMed Central

Ustinova, KI; Perkins, J

2011-01-01

Focusing gaze on a target helps stabilize upright posture. We investigated how this visual stabilization can be affected by observing a target presented under different gaze and viewing angles. In a series of 10-second trials, participants (N = 20, 29.3 ± 9 years of age) stood on a force plate and fixed their gaze on a figure presented on a screen at a distance of 1 m. The figure changed position (gaze angle: eye level (0°), 25° up or down), vertical body orientation (viewing angle: at eye level but rotated 25° as if leaning toward or away from the participant), or both (gaze and viewing angle: 25° up or down with the rotation equivalent of a natural visual perspective). Amplitude of participants’ sagittal displacement, surface area, and angular position of the center of gravity (COG) were compared. Results showed decreased COG velocity and amplitude for up and down gaze angles. Changes in viewing angles resulted in altered body alignment and increased amplitude of COG displacement. No significant changes in postural stability were observed when both gaze and viewing angles were altered. Results suggest that both the gaze angle and viewing perspective may be essential variables of the visuomotor system modulating postural responses. PMID:22398978

Validity of the Instrumented Push and Release Test to Quantify Postural Responses in Persons With Multiple Sclerosis.

PubMed

El-Gohary, Mahmoud; Peterson, Daniel; Gera, Geetanjali; Horak, Fay B; Huisinga, Jessie M

2017-07-01

To test the validity of wearable inertial sensors to provide objective measures of postural stepping responses to the push and release clinical test in people with multiple sclerosis. Cross-sectional study. University medical center balance disorder laboratory. Total sample N=73; persons with multiple sclerosis (PwMS) n=52; healthy controls n=21. Stepping latency, time and number of steps required to reach stability, and initial step length were calculated using 3 inertial measurement units placed on participants' lumbar spine and feet. Correlations between inertial sensor measures and measures obtained from the laboratory-based systems were moderate to strong and statistically significant for all variables: time to release (r=.992), latency (r=.655), time to stability (r=.847), time of first heel strike (r=.665), number of steps (r=.825), and first step length (r=.592). Compared with healthy controls, PwMS demonstrated a longer time to stability and required a larger number of steps to reach stability. The instrumented push and release test is a valid measure of postural responses in PwMS and could be used as a clinical outcome measures for patient care decisions or for clinical trials aimed at improving postural control in PwMS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Inverse dynamic investigation of voluntary leg lateral movements in weightlessness: a new microgravity-specific strategy.

PubMed

Pedrocchi, Alessandra; Baroni, Guido; Pedotti, Antonio; Massion, Jean; Ferrigno, Giancarlo

2005-04-01

This study deals with the quantitative assessment of exchanged forces and torques at the restraint point during whole body posture perturbation movements in long-term microgravity. The work was based on the results of a previous study focused on trunk bending protocol, which suggested that the minimization of the torques exchanged at the restraint point could be a strategy for movement planning in microgravity (J. Biomech. 36(11) (2003) 1691). Torques minimization would lead to the optimization of muscles activity, to the minimization of energy expenditure and, ultimately, to higher movement control capabilities. Here, we focus on leg lateral abduction from anchored stance. The analysis was based on inverse dynamic modelling, leading to the estimation of the total angular momentum at the supporting ankle joint. Results agree with those obtained for trunk bending movements and point out a consistent minimization of the torques exchanged at the restraint point in weightlessness. Given the kinematic features of the examined motor task, this strategy was interpreted as a way to master the rotational dynamic effects on the frontal plane produced by leg lateral abduction. This postural stabilizing effects was the result of a multi-segmental compensation strategy, consisting of the counter rotation of the supporting limb and trunk accompanying the leg raising. The observed consistency of movement-posture co-ordination patterns among lateral leg raising and trunk bending is put forward as a novel interpretative issue of the adaptation mechanisms of the motor system to sustained microgravity, especially if one considers the completely different kinematics of the centre of mass, which was observed in weightlessness for these two motor tasks.

Cognitive tasks promote automatization of postural control in young and older adults.

PubMed

Potvin-Desrochers, Alexandra; Richer, Natalie; Lajoie, Yves

2017-09-01

Researchers looking at the effects of performing a concurrent cognitive task on postural control in young and older adults using traditional center-of-pressure measures and complexity measures found discordant results. Results of experiments showing improvements of stability have suggested the use of strategies such as automatization of postural control or stiffening strategy. This experiment aimed to confirm in healthy young and older adults that performing a cognitive task while standing leads to improvements that are due to automaticity of sway by using sample entropy. Twenty-one young adults and twenty-five older adults were asked to stand on a force platform while performing a cognitive task. There were four cognitive tasks: simple reaction time, go/no-go reaction time, equation and occurrence of a digit in a number sequence. Results demonstrated decreased sway area and variability as well as increased sample entropy for both groups when performing a cognitive task. Results suggest that performing a concurrent cognitive task promotes the adoption of an automatic postural control in young and older adults as evidenced by an increased postural stability and postural sway complexity. Copyright © 2017 Elsevier B.V. All rights reserved.

Emergence of postural patterns as a function of vision and translation frequency

NASA Technical Reports Server (NTRS)

Buchanan, J. J.; Horak, F. B.; Peterson, B. W. (Principal Investigator)

1999-01-01

Emergence of postural patterns as a function of vision and translation frequency. We examined the frequency characteristics of human postural coordination and the role of visual information in this coordination. Eight healthy adults maintained balance in stance during sinusoidal support surface translations (12 cm peak to peak) in the anterior-posterior direction at six different frequencies. Changes in kinematic and dynamic measures revealed that both sensory and biomechanical constraints limit postural coordination patterns as a function of translation frequency. At slow frequencies (0.1 and 0.25 Hz), subjects ride the platform (with the eyes open or closed). For fast frequencies (1.0 and 1.25 Hz) with the eyes open, subjects fix their head and upper trunk in space. With the eyes closed, large-amplitude, slow-sway motion of the head and trunk occurred for fast frequencies above 0.5 Hz. Visual information stabilized posture by reducing the variability of the head's position in space and the position of the center of mass (CoM) within the support surface defined by the feet for all but the slowest translation frequencies. When subjects rode the platform, there was little oscillatory joint motion, with muscle activity limited mostly to the ankles. To support the head fixed in space and slow-sway postural patterns, subjects produced stable interjoint hip and ankle joint coordination patterns. This increase in joint motion of the lower body dissipated the energy input by fast translation frequencies and facilitated the control of upper body motion. CoM amplitude decreased with increasing translation frequency, whereas the center of pressure amplitude increased with increasing translation frequency. Our results suggest that visual information was important to maintaining a fixed position of the head and trunk in space, whereas proprioceptive information was sufficient to produce stable coordinative patterns between the support surface and legs. The CNS organizes postural patterns in this balance task as a function of available sensory information, biomechanical constraints, and translation frequency.

Effect of stump flexion contracture with and without prosthetic alignment intervention towards postural stability among transtibial prosthesis users

NASA Astrophysics Data System (ADS)

Ghazali, M. F.; Razak, N. A. Abd; Abu Osman, N. A.; Gholizadeh, H.

2017-06-01

Knee flexion contracture on a stump side is a phenomenon in which the stump cannot move in normal range of motion (ROM) or cannot be fully extended. This study has been carried out by using Biodex Stability System (BSS) in order to investigate the effect of stump flexion contracture towards the postural stability among the transtibial prosthesis users with the intervention of alignment accommodation. The BSS provides the reading of anterior-posterior stability index (APSI), medial-lateral stability index (MLSI), and overall stability index (OSI). Higher reading of the index indicates lesser stability. Each of the subjects had been tested in three different sessions that were Visit 1 (before contracture improvement), Visit 2 (after contracture improvement without alignment readjustment), and Visit 3 (after contracture improvement with alignment readjustment). The APSI reading was significantly higher during Visit 2 compared to Visit 1 and Visit 3. The OSI during Visit 2 was also found significantly higher compared to Visit 3. In Visit 2, the degree of contracture was significantly improved with 44.1% less than Visit 1. The stability index in anterior-posterior aspect (APSI) was proven to be lower as the prosthetic alignment was adjusted according to the ROM of knee. This finding explained that the alignment set up based on the adaptation with the stump’s ROM can contribute positively in maintaining postural stability.

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.

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

Assessing postural stability via the correlation patterns of vertical ground reaction force components.

PubMed

Hong, Chih-Yuan; Guo, Lan-Yuen; Song, Rong; Nagurka, Mark L; Sung, Jia-Li; Yen, Chen-Wen

2016-08-02

Many methods have been proposed to assess the stability of human postural balance by using a force plate. While most of these approaches characterize postural stability by extracting features from the trajectory of the center of pressure (COP), this work develops stability measures derived from components of the ground reaction force (GRF). In comparison with previous GRF-based approaches that extract stability features from the GRF resultant force, this study proposes three feature sets derived from the correlation patterns among the vertical GRF (VGRF) components. The first and second feature sets quantitatively assess the strength and changing speed of the correlation patterns, respectively. The third feature set is used to quantify the stabilizing effect of the GRF coordination patterns on the COP. In addition to experimentally demonstrating the reliability of the proposed features, the efficacy of the proposed features has also been tested by using them to classify two age groups (18-24 and 65-73 years) in quiet standing. The experimental results show that the proposed features are considerably more sensitive to aging than one of the most effective conventional COP features and two recently proposed COM features. By extracting information from the correlation patterns of the VGRF components, this study proposes three sets of features to assess human postural stability during quiet standing. As demonstrated by the experimental results, the proposed features are not only robust to inter-trial variability but also more accurate than the tested COP and COM features in classifying the older and younger age groups. An additional advantage of the proposed approach is that it reduces the force sensing requirement from 3D to 1D, substantially reducing the cost of the force plate measurement system.

Stability analysis via the concept of Lyapunov exponents: a case study in optimal controlled biped standing

NASA Astrophysics Data System (ADS)

Sun, Yuming; Wu, Christine Qiong

2012-12-01

Balancing control is important for biped standing. In spite of large efforts, it is very difficult to design balancing control strategies satisfying three requirements simultaneously: maintaining postural stability, improving energy efficiency and satisfying the constraints between the biped feet and the ground. In this article, a proportional-derivative (PD) controller is proposed for a standing biped, which is simplified as a two-link inverted pendulum with one additional rigid foot-link. The genetic algorithm (GA) is used to search for the control gain meeting all three requirements. The stability analysis of such a deterministic biped control system is carried out using the concept of Lyapunov exponents (LEs), based on which, the system stability, where the disturbance comes from the initial states, and the structural stability, where the disturbance comes from the PD gains, are examined quantitively in terms of stability region. This article contributes to the biped balancing control, more significantly, the method shown in the studied case of biped provides a general framework of systematic stability analysis for certain deterministic nonlinear dynamical systems.

Postural stability is compromised by fatiguing overhead work.

PubMed

Nussbaum, Maury A

2003-01-01

In a laboratory setting, 16 participants performed a repetitive overhead tapping task for 3 hours or until self-terminated due to substantial shoulder discomfort. Several measures of postural sway and stability were obtained using a force plate, both during quiet standing and during performance of the tapping task. Sway area and peak sway velocity showed consistent increases with time, whereas changes in average velocity and peak whole-body center-of-mass acceleration were either small or nonsignificant. Although relatively insensitive to several task variables, changes in sway areas and peak velocities were substantially larger in trials terminated by the participants. It is argued that fatigue plays a more important role than simple task duration in causing the observed increases in sway, and hence decreases in postural stability. Potential whole-body consequences of localized musculoskeletal stresses appear supported by the results, and implications for safety, risks of falls, and work scheduling are discussed.

Optimal coordination and control of posture and movements.

PubMed

Johansson, Rolf; Fransson, Per-Anders; Magnusson, Måns

2009-01-01

This paper presents a theoretical model of stability and coordination of posture and locomotion, together with algorithms for continuous-time quadratic optimization of motion control. Explicit solutions to the Hamilton-Jacobi equation for optimal control of rigid-body motion are obtained by solving an algebraic matrix equation. The stability is investigated with Lyapunov function theory and it is shown that global asymptotic stability holds. It is also shown how optimal control and adaptive control may act in concert in the case of unknown or uncertain system parameters. The solution describes motion strategies of minimum effort and variance. The proposed optimal control is formulated to be suitable as a posture and movement model for experimental validation and verification. The combination of adaptive and optimal control makes this algorithm a candidate for coordination and control of functional neuromuscular stimulation as well as of prostheses. Validation examples with experimental data are provided.

Space flight and changes in spatial orientation

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Bloomberg, Jacob J.; Harm, Deborah L.; Paloski, William H.

1992-01-01

From a sensory point of view, space flight represents a form of stimulus rearrangement requiring modification of established terrestrial response patterns through central reinterpretation. Evidence of sensory reinterpretation is manifested as postflight modifications of eye/head coordination, locomotor patterns, postural control strategies, and illusory perceptions of self or surround motion in conjunction with head movements. Under normal preflight conditions, the head is stabilized during locomotion, but immediately postflight reduced head stability, coupled with inappropriate eye/head coordination, results in modifications of gait. Postflight postural control exhibits increased dependence on vision which compensates for inappropriate interpretation of otolith and proprioceptive inputs. Eye movements compensatory for perceived self motion, rather than actual head movements have been observed postflight. Overall, the in-flight adaptive modification of head stabilization strategies, changes in head/eye coordination, illusionary motion, and postural control are maladaptive for a return to the terrestrial environment. Appropriate countermeasures for long-duration flights will rely on preflight adaptation and in-flight training.

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.

Postural stability in a population of dancers, healthy non-dancers, and vestibular neuritis patients.

PubMed

Martin-Sanz, Eduardo; Ortega Crespo, Isabel; Esteban-Sanchez, Jonathan; Sanz, Ricardo

2017-09-01

Several studies have indicated better balance control in dancers than in control participants, but some controversy remains. The aim of our study is to evaluate the postural stability in a cohort of dancers, non-dancers, compensated, and non-compensated unilateral vestibular neuritis (VN). This is a prospective study of control subjects, dancers, and VN patients between June 2009 and December 2015. Dancers from the Dance Conservatory of Madrid and VN patients were referred to our department for analysis. After the clinical history, neuro-otological examination, audiogram, and caloric tests, the diagnosis was done. Results from clinical examination were used for the categorization of compensation situation. A computerized dynamic posturography was performed to every subject. Forty dancers and 38 women formed both 'dancer' and 'normal' cohorts. Forty-two compensated and 39 uncompensated patients formed both 'compensated' and 'uncompensated' cohorts. Dancers had significantly greater antero-posterior (AP) body sway than controls during condition 5 and 6 in the Sensory Organization Test (SOT) (p < .05). When we compared the uncompensated cohort with both control and dancers groups, we found significant greater body sway in every SOT studied condition (p < .05). While mean AP body say in SOT 5 and 6, showed greater values in compensated patients than the control group, the mean analysis did not show any statistical difference between the compensated and dancer groups, in such SOT conditions. Dancers demonstrated greater sways than non-dancers when they relied their postural control on vestibular input alone. Compensated patients had a similar posturographic pattern that the dancers cohort, suggesting a similar shift from visual to somatosensory information.

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.

Postural control and ventilatory drive during voluntary hyperventilation and carbon dioxide rebreathing.

PubMed

David, Pascal; Laval, David; Terrien, Jérémy; Petitjean, Michel

2012-01-01

The present study sought to establish links between hyperventilation and postural stability. Eight university students were asked to stand upright under two hyperventilation conditions applied randomly: (1) a metabolic hyperventilation induced by 5 min of hypercapnic-hyperoxic rebreathing (CO(2)-R); and, (2) a voluntary hyperventilation (VH) of 3 min imposed by a metronome set at 25 cycles per min. Recordings were obtained with eyes open, with the subjects standing on a force plate over 20-s periods. Ventilatory response, displacements in the centre of pressure in both the frontal and sagittal planes and fluctuations in the three planes of the ground reaction force were monitored in the time and frequency domains. Postural changes related to respiratory variations were quantified by coherence analysis. Myoelectric activities of the calf muscles were recorded using surface electromyography. Force plate measurements revealed a reduction in postural stability during both CO(2)-R and VH conditions, mainly in the sagittal plane. Coherence analysis provided evidence of a ventilatory origin in the vertical ground reaction force fluctuations during VH. Electromyographic analyses showed different leg muscles strategies, assuming the existence of links between the control of respiration and the control of posture. Our results suggest that the greater disturbing effects caused by voluntary hyperventilation on body balance are more compensated when respiration is under automatic control. These findings may have implications for understanding the organisation of postural and respiratory activities and suggest that stability of the body may be compromised in situations in which respiratory demand increases and requires voluntary control.

Postural stability and the influence of concurrent muscle activation--Beneficial effects of jaw and fist clenching.

PubMed

Ringhof, Steffen; Leibold, Timo; Hellmann, Daniel; Stein, Thorsten

2015-10-01

Recent studies reported on the potential benefits of submaximum clenching of the jaw on human postural control in upright unperturbed stance. However, it remained unclear whether these effects might also be observed among active controls. The purpose of the present study, therefore, was to comparatively examine the influence of concurrent muscle activation in terms of submaximum clenching of the jaw and submaximum clenching of the fists on postural stability. Posturographic analyses were conducted with 17 healthy young adults on firm and foam surfaces while either clenching the jaw (JAW) or clenching the fists (FIST), whereas habitual standing served as the control condition (CON). Both submaximum tasks were performed at 25% maximum voluntary contraction, assessed, and visualized in real time by means of electromyography. Statistical analyses revealed that center of pressure (COP) displacements were significantly reduced during JAW and FIST, but with no differences between both concurrent clenching activities. Further, a significant increase in COP displacements was observed for the foam as compared to the firm condition. The results showed that concurrent muscle activation significantly improved postural stability compared with habitual standing, and thus emphasize the beneficial effects of jaw and fist clenching for static postural control. It is suggested that concurrent activities contribute to the facilitation of human motor excitability, finally increasing the neural drive to the distal muscles. Future studies should evaluate whether elderly or patients with compromised postural control might benefit from these physiological responses, e.g., in the form of a reduced risk of falling. Copyright © 2015 Elsevier B.V. All rights reserved.

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.

Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis.

PubMed

Soysal Tomruk, Melda; Uz, Muhammed Zahid; Kara, Bilge; İdiman, Egemen

2016-05-01

Decreased postural control, sensory integration deficits and fatigue are important problems that cause functional impairments in patients with multiple sclerosis (pwMS). To examine the effect of modified clinical Pilates exercises on sensory interaction and balance, postural control and fatigue in pwMS. Eleven patients with multiple sclerosis and 12 healthy matched controls were recruited in this study. Limits of stability and postural stability tests were used to evaluate postural control by Biodex Balance System and sensory interaction assessed. Fatigue was assessed by Modified Fatigue Impact Scale. Pilates exercises were applied two times a week for 10 weeks and measurements were repeated to pwMS after exercise training. Postural control and fatigue (except psychosocial parameter) of pwMS were significantly worser than healthy controls (p<0.05). Significant improvements occurred in sensory interaction (eyes open, foam surface) and total, physical and cognitive scores of fatigue after 10-week modified clinical Pilates training (p<0.05). No significant changes were detected in postural control after the pilates exercises (p>0.05). Ten-week Pilates training is effective to improve sensory interaction and to decrease fatigue. Pilates exercises can be applied safely in ambulatory pwMS for enhance sensory interaction and balance and combat fatigue. More investigations are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Specificity of learning: why infants fall over a veritable cliff.

PubMed

Adolph, K E

2000-07-01

Nine-month-old infants were tested at the precipice of safe and risky gaps in the surface of support. Their reaching and avoidance responses were compared in two postures, an experienced sitting posture and a less familiar crawling posture. The babies avoided reaching over risky gaps in the sitting posture but fell into risky gaps while attempting to reach in the crawling posture. This dissociation between developmental changes in posture suggests that (a) each postural milestone represents a different, modularly organized control system and (b) infants' adaptive avoidance responses are based on information about their postural stability relative to the gap size. Moreover, the results belie previous accounts suggesting that avoidance of a disparity in depth of the ground surface depends on general knowledge such as fear of heights, associations between depth information and falling, or knowledge that the body cannot be supported in empty space.

Effects of deep breathing on internal oblique and multifidus muscle activity in three sitting postures

PubMed Central

Ko, Min-Joo; Jung, Eun-Joo; Kim, Moon-Hwan; Oh, Jae-Seop

2018-01-01

[Purpose] This study was to investigate differences in the level of activity of the external oblique (EO), internal oblique (IO), and multifidus (MF) muscles with deep breathing in three sitting postures. [Subjects and Methods] Sixteen healthy women were recruited. The muscle activity (EO, IO, MF) of all subjects was measured in three sitting postures (slumped, thoracic upright, and lumbo-pelvic upright sitting postures) using surface electromyography. The activity of the same muscles was then remeasured in the three sitting postures during deep breathing. [Results] Deep breathing significantly increased activity in the EO, IO, and MF compared with normal breathing. Comparing postures, the activity of the MF and IO muscles was highest in the lumbo-pelvic upright sitting posture. [Conclusion] An lumbo-pelvic upright sitting posture with deep breathing could increase IO and MF muscle activity, thus improving lumbo-pelvic region stability. PMID:29706695

Developmental Approach for Behavior Learning Using Primitive Motion Skills.

PubMed

Dawood, Farhan; Loo, Chu Kiong

2018-05-01

Imitation learning through self-exploration is essential in developing sensorimotor skills. Most developmental theories emphasize that social interactions, especially understanding of observed actions, could be first achieved through imitation, yet the discussion on the origin of primitive imitative abilities is often neglected, referring instead to the possibility of its innateness. This paper presents a developmental model of imitation learning based on the hypothesis that humanoid robot acquires imitative abilities as induced by sensorimotor associative learning through self-exploration. In designing such learning system, several key issues will be addressed: automatic segmentation of the observed actions into motion primitives using raw images acquired from the camera without requiring any kinematic model; incremental learning of spatio-temporal motion sequences to dynamically generates a topological structure in a self-stabilizing manner; organization of the learned data for easy and efficient retrieval using a dynamic associative memory; and utilizing segmented motion primitives to generate complex behavior by the combining these motion primitives. In our experiment, the self-posture is acquired through observing the image of its own body posture while performing the action in front of a mirror through body babbling. The complete architecture was evaluated by simulation and real robot experiments performed on DARwIn-OP humanoid robot.

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).

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.

Leg extensor muscle strength, postural stability, and fear of falling after a 2-month home exercise program in women with severe knee joint osteoarthritis.

PubMed

Rätsepsoo, Monika; Gapeyeva, Helena; Sokk, Jelena; Ereline, Jaan; Haviko, Tiit; Pääsuke, Mati

2013-01-01

BACKGROUND AND OBJECTIVE. The aim of this study was to compare the leg extensor muscle strength, the postural stability, and the fear of falling in the women with severe knee joint osteoarthritis (OA) before and after a 2-month home exercise program (HEP). MATERIAL AND METHODS. In total, 17 women aged 46-72 years with late-stage knee joint OA scheduled for total knee arthroplasty participated in this study before and after the 2-month HEP with strengthening, stretching, balance, and step exercises. The isometric peak torque (PT) of the leg extensors and postural stability characteristics when standing on a firm or a foam surface for 30 seconds were recorded. The fear of falling and the pain intensity (VAS) were estimated. RESULTS. A significant increase in the PT and the PT-to-body weight (PT-to-BW) ratio of the involved leg as well as the bilateral PT and the PT-to-BW ratio was found after the 2-month HEP compared with the data before the HEP (P<0.05). The PT and the PT-to-BW ratio of the involved leg were significantly lower compared with the uninvolved leg before the HEP (P<0.05). The center of the pressure sway length (foam surface) decreased significantly after the HEP (P<0.05). Significant correlations were found between the PT of the involved leg and the bilateral PT and the fear of falling and between the PT of the involved leg and the postural sway (foam surface) before the HEP. CONCLUSIONS. After the 2-month HEP, the leg extensor muscle strength increased and the postural sway length on a foam surface decreased. The results indicate that the increased leg extensor muscle strength improves postural stability and diminishes the fear of falling in women with late-stage knee joint OA.

Continuous Cognitive Task Promotes Greater Postural Stability than an Internal or External Focus of Attention in Older Adults.

PubMed

Richer, Natalie; Polskaia, Nadia; Lajoie, Yves

2017-01-01

Background/Study Context: Recent evidence suggests that removing attention from postural control using either an external focus or a cognitive task will improve stability in healthy young adults. Due to increases in attentional requirements of upright stance in older adults, it is unclear if similar benefits would be observed in this population. The aim of the present study was to examine the effect of attentional focus and of a continuous cognitive task on postural control in older adults. Sixteen healthy older adults (71.9 ± 4.32 years) were asked to stand quietly on a force platform with feet together in three different conditions: internal focus (minimizing movement of the hips), external focus (minimizing movement of markers placed on the hips), and cognitive task (silently counting the occurrence of a single digit in a 3-digit number sequence). A one-way analysis of variance with repeated measures on condition was performed for each postural control measure. Hypotheses were partially supported because the cognitive task led to greater stability than both focus conditions, as evidenced by a smaller sway area (p < .01, η p 2 = .41), reduced sway variability (anterior-posterior: p = .001, η p 2 = .37; medial-lateral: p < .0001, η p 2 = .49), and higher mean power frequency in the anterior-posterior direction (p = .01, η p 2 = .78). However, no difference was observed between internal and external focus conditions. A continuous, attention-demanding cognitive task significantly improved stability in older adults compared with an internal or external focus of attention. This suggests that older adults were able to effectively allocate their attention away from postural control, allowing a more automatic type of control to operate. Future studies should investigate a variety of cognitive tasks to determine the degree of postural improvement that can be observed in older adults.

Fingertip touch improves postural stability in patients with peripheral neuropathy.

PubMed

Dickstein, R; Shupert, C L; Horak, F B

2001-12-01

The purpose of this work was to determine whether fingertip touch on a stable surface could improve postural stability during stance in subjects with somatosensory loss in the feet from diabetic peripheral neuropathy. The contribution of fingertip touch to postural stability was determined by comparing postural sway in three touch conditions (light, heavy and none) in eight patients and eight healthy control subjects who stood on two surfaces (firm or foam) with eyes open or closed. In the light touch condition, fingertip touch provided only somatosensory information because subjects exerted less than 1 N of force with their fingertip to a force plate, mounted on a vertical support. In the heavy touch condition, mechanical support was available because subjects transmitted as much force to the force plate as they wished. In the no touch condition, subjects held the right forefinger above the force plate. Antero-posterior (AP) and medio-lateral (ML) root mean square (RMS) of center of pressure (CoP) sway and trunk velocity were larger in subjects with somatosensory loss than in control subjects, especially when standing on the foam surface. The effects of light and heavy touch were similar in the somatosensory loss and control groups. Fingertip somatosensory input through light touch attenuated both AP and ML trunk velocity as much as heavy touch. Light touch also reduced CoP sway compared to no touch, although the decrease in CoP sway was less effective than with heavy touch, particularly on the foam surface. The forces that were applied to the touch plate during light touch preceded movements of the CoP, lending support to the suggestion of a feedforward mechanism in which fingertip inputs trigger the activation of postural muscles for controlling body sway. These results have clinical implications for understanding how patients with peripheral neuropathy may benefit from a cane for postural stability in stance.

Changes in the body posture of women occurring with age

PubMed Central

2013-01-01

Background A current topic in the field of geriatrics still needing a great deal of study is the changes in body posture occurring with age. Symptoms of these changes can be observed starting between the ages of 40–50 years with a slow progression that increases after 60 years of age. The aims of this study were to evaluate parameters characterizing the posture of women over the age of 60 years compared with a control group and to determine the dynamics of body posture changes in the following decades. Methods The study included 260 randomly selected women. The study group consisted of 130 women between the ages of 60–90 years (Older Women). The control group (Younger Women) consisted of 130 women between the ages of 20–25 years (posture stabilization period). The photogrammetric method was used to evaluate body posture using the phenomenon of the projection chamber. The study was conducted according to generally accepted principles. Results In the analysis of parameters characterizing individual slope curves, results were varied among different age groups. The lumbar spine slope did not show significant differences between different age groups (p = 0.6952), while statistically significant differences (p = 0.0000) were found in the thoracic-lumbar spine slope (p = 0.0033) and upper thoracic spine slope. Body angle was shown to increase with age (p = 0.0000). Thoracic kyphosis depth significantly deepened with age (p = 0.0002), however, the thoracic kyphosis angle decreased with age (p = 0.0000). An increase in asymmetries was noticed, provided by a significantly higher angle of the shoulder line (p = 0.0199) and the difference in height of the lower shoulder blade angle (p = 0.0007) measurements in the group of older women. Conclusions Changes in the parameters describing body posture throughout consecutive decades were observed. Therapy for women over the age of 60 years should involve strengthening of the erector spinae muscles and controlling body posture with the aim of reducing trunk inclination and deepening of thoracic kyphosis. Moreover, exercises shaping lumbar lordosis should be performed to prevent its flattening. PMID:24119004

Functional asymmetry of posture and body system regulation

NASA Technical Reports Server (NTRS)

Boloban, V. N.; Otsupok, A. P.

1980-01-01

The manifestation of functional asymmetry during the regulation of an athlete's posture and a system of bodies and its effect on the execution of individual and group acrobatic exercises were studied. Functional asymmetry of posture regulation was recorded in acrobats during the execution of individual and group exercises. It was shown that stability is maintained at the expense of bending and twisting motions. It is important to consider whether the functional asymmetry of posture regulation is left or right sided in making up pairs and groups of acrobats.

Spinal lordosis optimizes the requirements for a stable erect posture.

PubMed

Wagner, Heiko; Liebetrau, Anne; Schinowski, David; Wulf, Thomas; de Lussanet, Marc H E

2012-04-16

Lordosis is the bending of the lumbar spine that gives the vertebral column of humans its characteristic ventrally convex curvature. Infants develop lordosis around the time when they acquire bipedal locomotion. Even macaques develop a lordosis when they are trained to walk bipedally. The aim of this study was to investigate why humans and some animals develop a lumbar lordosis while learning to walk bipedally. We developed a musculoskeletal model of the lumbar spine, that includes an asymmetric, dorsally shifted location of the spinal column in the body, realistic moment arms, and physiological cross-sectional areas (PCSA) of the muscles as well as realistic force-length and force-velocity relationships. The model was used to analyze the stability of an upright body posture. According to our results, lordosis reduces the local joint torques necessary for an equilibrium of the vertebral column during an erect posture. At the same time lordosis increases the demands on the global muscles to provide stability. We conclude that the development of a spinal lordosis is a compromise between the stability requirements of an erect posture and the necessity of torque equilibria at each spinal segment.

Spinal lordosis optimizes the requirements for a stable erect posture

PubMed Central

2012-01-01

Background Lordosis is the bending of the lumbar spine that gives the vertebral column of humans its characteristic ventrally convex curvature. Infants develop lordosis around the time when they acquire bipedal locomotion. Even macaques develop a lordosis when they are trained to walk bipedally. The aim of this study was to investigate why humans and some animals develop a lumbar lordosis while learning to walk bipedally. Results We developed a musculoskeletal model of the lumbar spine, that includes an asymmetric, dorsally shifted location of the spinal column in the body, realistic moment arms, and physiological cross-sectional areas (PCSA) of the muscles as well as realistic force-length and force-velocity relationships. The model was used to analyze the stability of an upright body posture. According to our results, lordosis reduces the local joint torques necessary for an equilibrium of the vertebral column during an erect posture. At the same time lordosis increases the demands on the global muscles to provide stability. Conclusions We conclude that the development of a spinal lordosis is a compromise between the stability requirements of an erect posture and the necessity of torque equilibria at each spinal segment. PMID:22507595

Vestibular and Somatosensory Covergence in Postural Equilibrium Control: Insights from Spaceflight and Bed Rest Studies

NASA Technical Reports Server (NTRS)

Mulavara, A. P.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Lee, S. M. C.; Miller, C. A.; Peters, B. T.; Phillips, T.; Platts, S. H.;

Light touch leads to increased stability in quiet and perturbed balance: Equivalent effects between post-stroke and healthy older individuals.

PubMed

Martinelli, Alessandra Rezende; Coelho, Daniel Boari; Teixeira, Luis Augusto

2018-04-01

Cerebral damage provoked by stroke may lead to deficits of quiet balance control and of the recovery of body equilibrium following an unanticipated postural perturbation. In this investigation we aimed to evaluate the effect of light touch (LT) of an earth-fixed surface on balance stability in individuals with post-stroke hemiparesis, taking performance of age-matched healthy participants as reference. Evaluations were made in conditions of full and no visual information. Analysis of quiet balance showed that LT induced higher balance stability, with reduced amplitude and velocity of postural sway. Evaluation of the effect of LT on automatic postural responses was made in the task of recovering body equilibrium following a mechanical perturbation of balance leading to fast forward body sway. Results showed that LT led to reduced amplitude of center of mass displacement following the perturbation, in addition to reduced amplitude and velocity of center of pressure under the feet, and lower activation of the lower legs muscles. Those effects of LT were observed in both the post-stroke and control groups, and did not interact with vision availability. Our results indicated then that individuals who suffered a cerebral stroke can stabilize perturbed and non-perturbed postural responses by lightly touching a stable surface to a similar extent of healthy older individuals. Copyright © 2018 Elsevier B.V. All rights reserved.

Seat surface inclination may affect postural stability during Boccia ball throwing in children with cerebral palsy.

PubMed

Tsai, Yung-Shen; Yu, Yi-Chen; Huang, Po-Chang; Cheng, Hsin-Yi Kathy

2014-12-01

The aim of the study was to examine how seat surface inclination affects Boccia ball throwing movement and postural stability among children with cerebral palsy (CP). Twelve children with bilateral spastic CP (3 with gross motor function classification system Level I, 5 with Level II, and 4 with Level III) participated in this study. All participants underwent pediatric reach tests and ball throwing performance analyses while seated on 15° anterior- or posterior-inclined, and horizontal surfaces. An electromagnetic motion analysis system was synchronized with a force plate to assess throwing motion and postural stability. The results of the pediatric reach test (p = 0.026), the amplitude of elbow movement (p = 0.036), peak vertical ground reaction force (PVGRF) (p < 0.001), and movement range of the center of pressure (COP) (p < 0.020) were significantly affected by seat inclination during throwing. Post hoc comparisons showed that anterior inclination allowed greater amplitude of elbow movement and PVGRF, and less COP movement range compared with the other inclines. Posterior inclination yielded less reaching distance and PVGRF, and greater COP movement range compared with the other inclines. The anterior-inclined seat yielded superior postural stability for throwing Boccia balls among children with bilateral spastic CP, whereas the posterior-inclined seat caused difficulty. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Development of Patient Transfer Techniques based on Postural-stability Principles for the Care Helpers in Nursing Homes and Evaluation of Effectiveness].

PubMed

Ma, Ryewon; Jung, Dukyoo

2016-02-01

This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

Dynamic stability during running gait termination: Predictors for successful control of forward momentum in children and adults.

PubMed

Cesar, Guilherme M; Sigward, Susan M

2016-08-01

Reported differences between children and adults with respect to COM horizontal and vertical position to maintain dynamic stability during running deceleration suggest that this relationship may not be as important in children. This study challenged the current dynamic stability paradigm by determining the features of whole body posture that predicted forward velocity and momentum of running gait termination in adults and children. Sixteen adults and 15 children ran as fast as possible and stopped at pre-determined location. Separate regression analyses determined whether COM posterior and vertical positions and functional limb length (distance between COM and stance foot) predicted velocity and momentum for adults and children. COM posterior position was the strongest predictor of forward velocity and momentum in both groups supporting the previously established relationship during slower tasks. COM vertical position also predicted momentum in children, not adults. Higher COM position in children was related to greater momentum; consistent with previously reported differences between children and adults in COM position across running deceleration. COM vertical position was related to momentum but not velocity in children suggesting that strategies used to terminate running may be driven by demands imposed not just by velocity, but also the mass being decelerated. Copyright © 2016. Published by Elsevier B.V.

The effect of a single massage based on the tensegrity principle on postural stability in young women.

PubMed

Cieślik, Błażej; Podsiadły, Ireneusz; Kuczyński, Michał; Ostrowska, Bożena

2017-11-06

The aim of this study was to investigate the effects of normalized muscle tension via tensegrity-based massage on postural stability in a sample of female young adults. Nineteen females aged 21.8 ± 1.9 years were recruited presenting abnormal tension at muscles adhering to any of the following structural sites: superior iliac spine, lateral sacropelvic surface, linea aspera at 1/2 of femur length, and superior nuchal line of the occiput. Balance and postural control were assessed during bipedal stance using a force platform in multiple conditions: hard surface or soft foam surface with the head in either a neutral posture or tilted backward. Baseline and 3-min and 15-min post-treatment measures were collected while barefoot and eyes closed. Main outcomes measures included center of pressure variability, range, radius, and velocity in the anteroposterior (AP) mediolateral (ML) dimensions. In the solid surface with neutral head posture condition only AP COP measures decreased significantly (p< 0.05). In the soft surface condition, significant differences were observed in the AP and ML dimensions among most measures (p< 0.05). A single application of tensegrity-based massage positively influenced postural control in young adult females, particularly in the AP direction.

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.

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

Effects of weight management program on postural stability and neuromuscular function among obese children: study protocol for a randomized controlled trial.

PubMed

Sun, Fenghua; Wang, Li-Juan; Wang, Lin

2015-04-10

Childhood obesity is one of the most critical public health problems in the world. It is associated with low neuromuscular function and postural deformities. Whether weight loss can improve postural stability and neuromuscular control, benefit daily activities, or prevent injury is unknown. Therefore, this study attempts to investigate the effect of a 6 month weight management program on postural stability and neuromuscular control among obese children. We will conduct a prospective, single-blind, randomized controlled trial with 120 prepubescent obese children. Participants will be randomly assigned to a weight management group or a control group. The weight management group will participate in a dietary and exercise program. The control group will receive health education. After the intervention, participants will be followed for 6 months with no active intervention. The primary and secondary outcomes will be assessed at the baseline, and after 6 months and 12 months. Primary outcome measures will include body weight, body height, body mass index, waist circumference, hip circumference, and body fat percentage. Secondary outcome measures will include three-dimensional functional biomechanics in different tasks, proprioception tests of the knee and ankle, neuromuscular response of the leg muscles, and muscle strength tests of the knee and ankle. Furthermore, adverse events will be recorded and analyzed. An intention-to-treat analysis will be performed if any participants withdraw from the trial. The important features of this trial include the randomization procedures and large sample size. This study attempts to estimate the effect of weight loss intervention on outcomes, including daily life function, postural stability, and neuromuscular control in prepubescent obese children. Therefore, our results can be useful for obese children, medical staff, and healthcare decision makers. Chinese Clinical Trial Registry ChiCTR-IOB-15005874.

Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces

PubMed Central

Pletcher, Erin R.; Williams, Valerie J.; Abt, John P.; Morgan, Paul M.; Parr, Jeffrey J.; Wohleber, Meleesa F.; Lovalekar, Mita; Sell, Timothy C.

2017-01-01

Context: Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. Objective: To present a normative database of SOT scores from a US Military Special Operations population that can be used for future comparison. Design: Cross-sectional study. Setting: Human performance research laboratory. Patients or Other Participants: A total of 542 active military operators from Naval Special Warfare Combatant-Craft Crewmen (n = 149), Naval Special Warfare Command, Sea, Air, and Land (n = 101), US Army Special Operations Command (n = 171), and Air Force Special Operations Command (n = 121). Main Outcome Measure(s): Participants performed each of the 6 SOT conditions 3 times. Scores for each condition, total equilibrium composite score, and ratio scores for the somatosensory, visual, and vestibular systems were recorded. Results: Differences were present across all groups for SOT conditions 1 (P < .001), 2 (P = .001), 4 (P > .001), 5 (P > .001), and 6 (P = .001) and total equilibrium composite (P = .000), visual (P > .001), vestibular (P = .002), and preference (P > .001) NeuroCom scores. Conclusions: Statistical differences were evident in the distribution of postural stability across US Special Operations Forces personnel. This normative database for postural stability, as assessed by the NeuroCom SOT, can provide context when clinicians assess a Special Operations Forces population or any other groups that maintain a high level of conditioning and training. PMID:28140624

Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces.

PubMed

Pletcher, Erin R; Williams, Valerie J; Abt, John P; Morgan, Paul M; Parr, Jeffrey J; Wohleber, Meleesa F; Lovalekar, Mita; Sell, Timothy C

2017-02-01

Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. To present a normative database of SOT scores from a US Military Special Operations population that can be used for future comparison. Cross-sectional study. Human performance research laboratory. A total of 542 active military operators from Naval Special Warfare Combatant-Craft Crewmen (n = 149), Naval Special Warfare Command, Sea, Air, and Land (n = 101), US Army Special Operations Command (n = 171), and Air Force Special Operations Command (n = 121). Participants performed each of the 6 SOT conditions 3 times. Scores for each condition, total equilibrium composite score, and ratio scores for the somatosensory, visual, and vestibular systems were recorded. Differences were present across all groups for SOT conditions 1 (P < .001), 2 (P = .001), 4 (P > .001), 5 (P > .001), and 6 (P = .001) and total equilibrium composite (P = .000), visual (P > .001), vestibular (P = .002), and preference (P > .001) NeuroCom scores. Statistical differences were evident in the distribution of postural stability across US Special Operations Forces personnel. This normative database for postural stability, as assessed by the NeuroCom SOT, can provide context when clinicians assess a Special Operations Forces population or any other groups that maintain a high level of conditioning and training.

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.

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.

Inflight Treadmill Exercise Can Serve as Multi-Disciplinary Countermeasure System

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

A Trunk Support System to Identify Posture Control Mechanisms in Populations Lacking Independent Sitting

PubMed Central

Goodworth, Adam D.; Wu, Yen-Hsun; Felmlee, Duffy; Dunklebarger, Ellis; Saavedra, Sandra

2016-01-01

Populations with moderate-to-severe motor control impairments often exhibit degraded trunk control and/or lack the ability to sit unassisted. These populations need more research, yet their underdeveloped trunk control complicates identification of neural mechanisms behind their movements. The purpose of this study was to overcome this barrier by developing the first multi-articulated trunk support system to identify visual, vestibular, and proprioception contributions to posture in populations lacking independent sitting. The system provided external stability at a user-specific level on the trunk, so that body segments above the level of support required active posture control. The system included a tilting surface (controlled via servomotor) as a stimulus to investigate sensory contributions to postural responses. Frequency response and coherence functions between the surface tilt and trunk support were used to characterize system dynamics and indicated that surface tilts were accurately transmitted up to 5Hz. Feasibility of collecting kinematic data in participants lacking independent sitting was demonstrated in two populations: two typically developing infants, ~2-8 months, in a longitudinal study (8 sessions each) and four children with moderate-to-severe cerebral palsy (GMFCS III-V). Adaptability in the system was assessed by testing 16 adults (ages 18-63). Kinematic responses to continuous pseudorandom surface tilts were evaluated across 0.046–2Hz and qualitative feedback indicated that the trunk support and stimulus were comfortable for all subjects. Concepts underlying the system enable both research for, and rehabilitation in, populations lacking independent sitting. PMID:27046877

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.

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.

Effect of somatosensory and neurofeedback training on balance in older healthy adults: a preliminary investigation.

PubMed

Azarpaikan, Atefeh; Taheri Torbati, Hamidreza

2017-10-23

The aim of this study was to assess the effectiveness of balance training with somatosensory and neurofeedback training on dynamic and static balance in healthy, elderly adults. The sample group consisted of 45 healthy adults randomly assigned to one of the three test groups: somatosensory, neurofeedback, and a control. Individualization of the balance program started with pre-tests for static and dynamic balances. Each group had 15- and 30-min training sessions. All groups were tested for static (postural stability) and dynamic balances (Berg Balance Scale) in acquisition and transfer tests (fall risk of stability and timed up and go). Improvements in static and dynamic balances were assessed by somatosensory and neurofeedback groups and then compared with the control group. Results indicated significant improvements in static and dynamic balances in both test groups in the acquisition test. Results revealed a significant improvement in the transfer test in the neurofeedback and somatosensory groups, in static and dynamic conditions, respectively. The findings suggest that these methods of balance training had a significant influence on balance. Both the methods are appropriate to prevent falling in adults. Neurofeedback training helped the participants to learn static balance, while somatosensory training was effective on dynamic balance learning. Further research is needed to assess the effects of longer and discontinuous stimulation with somatosensory and neurofeedback training on balance in elderly adults.

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes.

PubMed

Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon

2014-02-01

Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

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.

Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients.

PubMed

Cabanas-Valdés, Rosa; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Caballero-Gómez, Fernanda Mª; du Port de Pontcharra-Serra, Helena; German-Romero, Ana; Urrútia, Gerard

2017-11-01

Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended. A randomized controlled trial. Outpatient services. Seventy-nine stroke survivors. In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition. Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index. A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points ( p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points ( p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points ( p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points ( p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points ( p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises. Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

Reflex-mediated dynamic neuromuscular stabilization in stroke patients: EMG processing and ultrasound imaging.

PubMed

Yoon, Hyun S; You, Joshua Sung H

2017-07-20

Postural core instability is associated with poor dynamic balance and a high risk of serious falls. Both neurodevelopmental treatment (NDT) and dynamic neuromuscular stabilization (DNS) core stabilization exercises have been used to improve core stability, but the outcomes of these treatments remain unclear. This study was undertaken to examine the therapeutic effects of NDT and DNS core stabilization exercises on muscular activity, core stability, and core muscle thickness. Ten participants (5 healthy adults; 5 hemiparetic stroke patients) were recruited. Surface electromyography (EMG) was used to determine core muscle activity of the transversus abdominis/internal oblique (TrA/IO), external oblique (EO), and rectus abdominis (RA) muscles. Ultrasound imaging was used to measure transversus abdominals/internal oblique (TrA/IO) thickness, and a pressure biofeedback unit (PBU) was used to measure core stability during the DNS and NDT core exercise conditions. Data are reported as median and range and were compared using nonparametric Mann - Whitney U test and Wilcoxon signed rank test at p< 0.05. Both healthy and hemiparetic stroke groups showed greater median EMG amplitude in the TrA/IO muscles, core stability, and muscle thickness values during the DNS exercise condition than during the NDT core exercise condition, respectively (p< 0.05). However, the relative changes in the EMG amplitude, core stability, and muscle thickness values were greater during the DNS exercise condition than during the NDT core exercise condition in the hemiparetic stroke patient group (p< 0.05). Our novel results provide the first clinical evidence that DNS is more effective than NDT in both healthy and hemiparetic stroke subjects to provide superior deep core muscle activation, core stabilization, and muscle thickness. Moreover, such advantageous therapeutic benefits of the DNS core stabilization exercise over the NDT exercise were more apparent in the hemiparetis stroke patients than normal controls.

Measuring Postural Stability: Strategies For Signal Acquisition And Processing

NASA Astrophysics Data System (ADS)

Riedel, Susan A.; Harris, Gerald F.

1987-01-01

A balance platform was used to collect postural stability data from 60 children, approximately half of whom have been diagnosed with cerebral palsy. The data was examined with respect to its frequency content, resulting in an improved strategy for frequency estimation. With a reliable assessment of the frequency domain characteristics, the signal stationarity could then be examined. Significant differences in signal stationarity were observed when the epoch length was changed, as well as between the normal and cerebral palsy populations.

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.

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

Use of an adaptive neuro-fuzzy inference system to obtain the correspondence among balance, gait, and depression for Parkinson's disease

NASA Astrophysics Data System (ADS)

Woo, Youngkeun; Lee, Juwon; Hwang, Sujin; Hong, Cheol Pyo

2013-03-01

The purpose of this study was to investigate the associations between gait performance, postural stability, and depression in patients with Parkinson's disease (PD) by using an adaptive neuro-fuzzy inference system (ANFIS). Twenty-two idiopathic PD patients were assessed during outpatient physical therapy by using three clinical tests: the Berg balance scale (BBS), Dynamic gait index (DGI), and Geriatric depression scale (GDS). Scores were determined from clinical observation and patient interviews, and associations among gait performance, postural stability, and depression in this PD population were evaluated. The DGI showed significant positive correlation with the BBS scores, and negative correlation with the GDS score. We assessed the relationship between the BBS score and the DGI results by using a multiple regression analysis. In this case, the GDS score was not significantly associated with the DGI, but the BBS and DGI results were. Strikingly, the ANFIS-estimated value of the DGI, based on the BBS and the GDS scores, significantly correlated with the walking ability determined by using the DGI in patients with Parkinson's disease. These findings suggest that the ANFIS techniques effectively reflect and explain the multidirectional phenomena or conditions of gait performance in patients with PD.

Examining the effects of postural constraints on estimating reach.

PubMed

Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

2007-07-01

The tendency to overestimate has consistently been reported in studies of reachability estimation. According to one of the more prominent explanations, the postural stability hypothesis, the perceived reaching limit depends on the individual's perceived postural constraints. To test that proposition, the authors compared estimates of reachability of 38 adults (a) in the seated posture (P1) and (b) in the more demanding posture of standing on one foot and leaning forward (P2). Although there was no difference between conditions for total error, results for the distribution and direction of error indicated that participants overestimated in the P1 condition and underestimated in the P2 condition. It therefore appears that perceived postural constraints could be a factor in judgments of reachability. When participants in the present study perceived greater postural demands, they may have elected to program a more conservative strategy that resulted in underestimation.

Anticipatory control of impending postural perturbation in elite springboard divers.

PubMed

Popa, T; Bonifazi, M; della Volpe, R; Rossi, A; Mazzocchio, R

2008-12-01

Among athletes, elite springboard divers (ED) should develop an optimal anticipatory control of postural stability, as a result of specific training. Postural strategies of ED and healthy subjects (HS) while expecting an impending perturbation were compared. The mean center of pressure (COP) position was analyzed during control quiet stance (cQS) and during anticipatory quiet stance (aQS(1-4)), i.e., in expectation of four backward translations of the support surface. During cQS, COP position in ED was not significantly different as compared to HS. During aQS(1-4,) a significant increase in the mean COP position was observed in both groups with ED adopting a more forward inclined vertical alignment than HS. In ED specific training may have resulted in a reference frame offset in a more anterior direction while expecting an impending perturbation. We suggest that leaning more forward may represent a more reliable way of coping with predictable perturbations of postural stability.

Embodied prosthetic arm stabilizes body posture, while unembodied one perturbs it.

PubMed

Imaizumi, Shu; Asai, Tomohisa; Koyama, Shinichi

2016-10-01

Senses of ownership (this arm belongs to me) and agency (I am controlling this arm) originate from sensorimotor system. External objects can be integrated into the sensorimotor system following long-term use, and recognized as one's own body. We examined how an (un)embodied prosthetic arm modulates whole-body control, and assessed the components of prosthetic embodiment. Nine unilateral upper-limb amputees participated. Four frequently used their prosthetic arm, while the others rarely did. Their postural sway was measured during quiet standing with or without their prosthesis. The frequent users showed greater sway when they removed the prosthesis, while the rare users showed greater sway when they fitted the prosthesis. Frequent users reported greater everyday feelings of postural stabilization by prosthesis and a larger sense of agency over the prosthesis. We suggest that a prosthetic arm maintains or perturbs postural control, depending on the prosthetic embodiment, which involves sense of agency rather than ownership. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of Human Body Bipedal Stability for Neuromotor Disabilities

NASA Astrophysics Data System (ADS)

Baritz, Mihaela; Cristea, Luciana; Rogozea, Liliana; Cotoros, Diana; Repanovici, Angela

2009-04-01

The analysis of different biomechanical aspects of balance and equilibrium is presented in the first part of the paper. We analyzed the posture, balance and stability of human body for a normal person and for a person with loco-motor or neuro-motor disabilities (in the second part). In the third part of the paper we presented the methodology and the experimental setup used to record the human body behavior in postural stability for persons with neuro-motors disabilities. The results and the conclusions are presented in the final part of the paper and also in the future work meant to establish the computer analysis for rehabilitation neuromotor disabilities.

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.

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.

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.

A test of fixed and moving reference point control in posture.

PubMed

Lee, I-Chieh; Pacheco, Matheus M; Newell, Karl M

2017-01-01

This study investigated two contrasting assumptions of the regulation of posture: namely, fixed and moving reference point control. These assumptions were tested in terms of time-dependent structure and data distribution properties when stability is manipulated. Fifteen male participants performed a tightrope simulated balance task that is, maintaining a tandem stance while holding a pole. Pole length (and mass) and the standing support surface (fixed surface/balance board) were manipulated so as to mechanically change the balance stability. The mean and standard deviation (SD) of COP length were reduced with pole length increment but only in the balance board surface condition. Also, the SampEn was lower with greater pole length for the balance board but not the fixed surface. More than one peak was present in the distribution of COP in the majority of trials. Collectively, the findings provide evidence for a moving reference point in the maintenance of postural stability for quiet standing. Copyright © 2016 Elsevier B.V. All rights reserved.

NASA's Functional Task Test: Providing Information for an Integrated Countermeasure System

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Feiveson, A. H.; Laurie, S. S.; Lee, S. M. C.; Mulavara, A. P.; Peters, B. T.; Platts, S. H.; Ploutz-Snyder, L. L.; Reschke, M. F.; Ryder, J. W.;

Balance and postural skills in normal-weight and overweight prepubertal boys.

PubMed

Deforche, Benedicte I; Hills, Andrew P; Worringham, Charles J; Davies, Peter S W; Murphy, Alexia J; Bouckaert, Jacques J; De Bourdeaudhuij, Ilse M

2009-01-01

This study investigated differences in balance and postural skills in normal-weight versus overweight prepubertal boys. Fifty-seven 8-10-year-old boys were categorized overweight (N = 25) or normal-weight (N = 32) according to the International Obesity Task Force cut-off points for overweight in children. The Balance Master, a computerized pressure plate system, was used to objectively measure six balance skills: sit-to-stand, walk, step up/over, tandem walk (walking on a line), unilateral stance and limits of stability. In addition, three standardized field tests were employed: standing on one leg on a balance beam, walking heel-to-toe along the beam and the multiple sit-to-stand test. Overweight boys showed poorer performances on several items assessed on the Balance Master. Overweight boys had slower weight transfer (p < 0.05), lower rising index (p < 0.05) and greater sway velocity (p < 0.001) in the sit-to-stand test, greater step width while walking (p < 0.05) and lower speed when walking on a line (p < 0.01) compared with normal-weight counterparts. Performance on the step up/over test, the unilateral stance and the limits of stability were comparable between both groups. On the balance beam, overweight boys could not hold their balance on one leg as long (p < 0.001) and had fewer correct steps in the heel-to-toe test (p < 0.001) than normal-weight boys. Finally, overweight boys were slower in standing up and sitting down five times in the multiple sit-to-stand task (p < 0.01). This study demonstrates that when categorised by body mass index (BMI) level, overweight prepubertal boys displayed lower capacity on several static and dynamic balance and postural skills.

Clinical, Biomechanical, and Physiological Translational Interpretations of Human Resting Myofascial Tone or Tension

PubMed Central

Masi, Alfonse T.; Nair, Kalyani; Evans, Tyler; Ghandour, Yousef

2010-01-01

Background Myofascial tissues generate integrated webs and networks of passive and active tensional forces that provide stabilizing support and that control movement in the body. Passive [central nervous system (CNS)–independent] resting myofascial tension is present in the body and provides a low-level stabilizing component to help maintain balanced postures. This property was recently called “human resting myofascial tone” (HRMT). The HRMT model evolved from electromyography (EMG) research in the 1950s that showed lumbar muscles usually to be EMG-silent in relaxed gravity-neutral upright postures. Methods Biomechanical, clinical, and physiological studies were reviewed to interpret the passive stiffness properties of HRMT that help to stabilize various relaxed functions such as quiet balanced standing. Biomechanical analyses and experimental studies of the lumbar multifidus were reviewed to interpret its passive stiffness properties. The lumbar multifidus was illustrated as the major core stabilizing muscle of the spine, serving an important passive biomechanical role in the body. Results Research into muscle physiology suggests that passive resting tension (CNS-independent) is generated in sarcomeres by the molecular elasticity of low-level cycling cross-bridges between the actomyosin filaments. In turn, tension is complexly transmitted to intimately enveloping fascial matrix fibrils and other molecular elements in connective tissue, which, collectively, constitute the myofascial unit. Postural myofascial tonus varies with age and sex. Also, individuals in the population are proposed to vary in a polymorphism of postural HRMT. A few people are expected to have outlier degrees of innate postural hypotonicity or hypertonicity. Such biomechanical variations likely predispose to greater risk of related musculoskeletal disorders, a situation that deserves greater attention in clinical practice and research. Axial myofascial hypertonicity was hypothesized to predispose to ankylosing spondylitis. This often-progressive deforming condition of vertebrae and sacroiliac joints is characterized by stiffness features and particular localization of bony lesions at entheseal sites. Such unique features imply concentrations and transmissions of excessive force, leading to tissue micro-injury and maladaptive repair reactions. Conclusions The HRMT model is now expanded and translated for clinical relevance to therapists. Its passive role in helping to maintain balanced postures is supported by biomechanical principles of myofascial elasticity, tension, stress, stiffness, and tensegrity. Further research is needed to determine the molecular basis of HRMT in sarcomeres, the transmission of tension by the enveloping fascial elements, and the means by which the myofascia helps to maintain efficient passive postural balance in the body. Significant deficiencies or excesses of postural HRMT may predispose to symptomatic or pathologic musculoskeletal disorders whose mechanisms are currently unexplained. PMID:21589685

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.

Effects of circumferential ankle pressure on ankle proprioception, stiffness, and postural stability: a preliminary investigation.

PubMed

You, Sung H; Granata, Kevin P; Bunker, Linda K

2004-08-01

Cross-sectional repeated-measures design. Determine the effects of circumferential ankle pressure (CAP) intervention on proprioceptive acuity, ankle stiffness, and postural stability. The application of CAP using braces, taping, and adaptive shoes or military boots is widely used to address chronic ankle instability (CAI). An underlying assumption is that the CAP intervention might improve ankle stability through increased proprioceptive acuity and stiffness in the ankle. METHOD AND MEASURES: A convenience sample of 10 subjects was recruited from the local university community and categorized according to proprioceptive acuity (high, low) and ankle stability (normal, CAI). Proprioceptive acuity was measured when blindfolded subjects were asked to accurately reproduce a self-selected target ankle position before and after the application of CAP. Proprioceptive acuity was determined in 5 different ankle joint position sense tests: neutral, inversion, eversion, plantar flexion, and dorsiflexion. Joint position angles were recorded electromechanically using a potentiometer. Passive ankle stiffness was computed from the ratio of applied static moment versus angular displacement. Active ankle stiffness was determined from biomechanical analyses of ankle motion following a mediolateral perturbation. Postural stability was quantified from the center of pressure displacement in the mediolateral and the anteroposterior directions in unipedal stance. All measurements were recorded with and without CAP applied by a pediatric blood pressure cuff. Data were analyzed using a separate mixed-model analysis of variance (ANOVA) for each dependent variable. Post hoc comparison using Tukey's honestly significant difference (HSD) test was performed if significant interactions were obtained. Significance level was set at P<.05 for all analyses. Significant group (high versus low proprioceptive acuity) x CAP interactions were identified for postural stability. Passive ankle stiffness was not increased by an application of CAP. Active ankle stiffness was significantly different between the high and low proprioceptive acuity groups and was not affected by an application of CAP. Significant group (normal versus CAI) x CAP interactions were observed for mediolateral center-of-pressure displacement with a main effect of group on neutral joint position sense. Application of CAP increased proprioceptive acuity and demonstrated trends toward increased active stiffness in the ankle, hence improved postural stability. The effects tend to be limited to individuals with low proprioceptive acuity.

The effects of arm crank ergometry, cycle ergometry and treadmill walking on postural sway in healthy older females.

PubMed

Hill, M W; Oxford, S W; Duncan, M J; Price, M J

2015-01-01

Older adults are increasingly being encouraged to exercise but this may lead to muscle fatigue, which can adversely affect postural stability. Few studies have investigated the effects of upper body exercise on postural sway in groups at risk of falling, such as the elderly. The purpose of this study was to compare the effects arm crank ergometry (ACE), cycle ergometry (CE) and treadmill walking (TM) on postural sway in healthy older females. In addition, this study sought to determine the time necessary to recover postural control after exercise. A total of nine healthy older females participated in this study. Participants stood on a force platform to assess postural sway which was measured by displacement of the centre of pressure before and after six separate exercise trials. Each participant completed three incremental exercise tests to 85% of individual's theoretical maximal heart rate (HRMAX) for ACE, CE and TM. Subsequent tests involved 20-min of ACE, CE and TM exercise at a relative workload corresponding to 50% of each individual's predetermined heart rate reserve (HRE). Post fatigue effects and postural control recovery were measured at different times after exercise (1, 3, 5, 10, 15 and 30-min). None of the participants exhibited impaired postural stability after ACE. In contrast, CE and TM elicited significant post exercise balance impairments, which lasted for ∼ 10 min post exercise. We provide evidence of an exercise mode which does not elicit post exercise balance impairments. Older adults should exercise caution immediately following exercise engaging the lower limbs to avoid fall risk. Copyright © 2014 Elsevier B.V. All rights reserved.

The effects of balance and postural stability exercises on spa based rehabilitation programme in patients with ankylosing spondylitis.

PubMed

Gunay, Selim M; Keser, Ilke; Bicer, Zemzem T

2018-01-01

Ankylosing spondylitis (AS) can cause severe functional disorders that lead to loss of balance. The aim of this study was to investigate the effects of balance and postural stability exercises on spa based rehabilitation programme in AS subjects. Twenty-one participants were randomized to the study (n= 11) and control groups (n= 10). Patients balance and stability were assessed with the Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, Single Leg Stance Test (SLST) and Functional Reach Test (FRT). AS spesicied measures were used for assessing to other parameters. The treatment plan for both groups consisted of conventional transcutaneous electrical nerve stimulation (TENS), spa and land-based exercises 5 days per week for 3 weeks. The study group performed exercises based on postural stability and balance with routine physiotherapy practice in thermal water and in exercise room. The TUG, SLST and FUT scores were significantly increased in the study group. In both groups, the BASMI, BASFI, BASDAI and ASQoL scores decreased significantly by the end of the treatment period (p< 0.05). In AS rehabilitation, performing balance and stability exercises in addition to spa based routine approaches can increase the duration of maintaining balance and can improve the benefits of physiotherapy.

Short-term effects of 890-nanometer radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study.

PubMed

Hsieh, Ru-Lan; Lo, Min-Tzu; Liao, Wei-Cheng; Lee, Wen-Chung

2012-05-01

To investigate the effects of short-term light therapy with 890-nm radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis (OA). A double-blind, randomized, placebo-controlled study. Rehabilitation clinic. Women (n=62) and men (n=10) with a mean age of 61.2 years (range, 40-88y). All patients fulfilled the combined clinical and radiographic criteria for knee OA as established by the American College of Rheumatology, and all had obtained a Kellgren-Lawrence score of 2 or more. Participants received 6 sessions, lasting 40 minutes each, of active or placebo radiation treatment over the knee joints for 2 weeks (wavelength, 890nm; radiant power output, 6.24W; power density, 34.7mW/cm(2) for 40 minutes; total energy, 41.6J/cm(2) per knee per session). Participants were assessed weekly over 4 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and physical function. Physical activity (timed stair climbing, 10-m fast-speed walking, and chair-rising time) and postural stability (using the postural stability evaluation system) were also assessed. The pain score on WOMAC was the primary outcome variable. Data were analyzed by repeated-measures analysis of covariance. Compared with baseline, no significant improvement was observed between groups for pain (P=.546), stiffness (P=.573), or physical function (P=.904). No significant improvement was noted for physical activity including the 10-m fast-speed walking time (P=.284), stair-climbing time (P=.202), stair-descending time (P=.468), chair-rising time (P=.499), or postural stability (P=.986) at the 4 follow-up assessments. Follow-up assessments were conducted after 1 week of treatment (thus, after 3 treatments); after 2 weeks of treatment (thus, after 6 treatments); and 1 and 2 weeks, respectively, after treatment was terminated. Although we found a significant time effect for the 10-m fast-speed walking time (P<.001) in the 2 groups, and a significant group effect in the improvement of stair-climbing time in the treatment group (P=.032), the group × time interaction effects were not significant. Short-term 890-nm radiation therapy for patients with knee OA provided no beneficial effect in improving pain, physical activity, and postural stability. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Using data from the Microsoft Kinect 2 to determine postural stability in healthy subjects: A feasibility trial

PubMed Central

Smeragliuolo, Anna H.; Long, John Davis; Bumanlag, Silverio Joseph; He, Victor; Lampe, Anna

2017-01-01

The objective of this study was to determine whether kinematic data collected by the Microsoft Kinect 2 (MK2) could be used to quantify postural stability in healthy subjects. Twelve subjects were recruited for the project, and were instructed to perform a sequence of simple postural stability tasks. The movement sequence was performed as subjects were seated on top of a force platform, and the MK2 was positioned in front of them. This sequence of tasks was performed by each subject under three different postural conditions: “both feet on the ground” (1), “One foot off the ground” (2), and “both feet off the ground” (3). We compared force platform and MK2 data to quantify the degree to which the MK2 was returning reliable data across subjects. We then applied a novel machine-learning paradigm to the MK2 data in order to determine the extent to which data from the MK2 could be used to reliably classify different postural conditions. Our initial comparison of force plate and MK2 data showed a strong agreement between the two devices, with strong Pearson correlations between the trunk centroids “Spine_Mid” (0.85 ± 0.06), “Neck” (0.86 ± 0.07) and “Head” (0.87 ± 0.07), and the center of pressure centroid inferred by the force platform. Mean accuracy for the machine learning classifier from MK2 was 97.0%, with a specific classification accuracy breakdown of 90.9%, 100%, and 100% for conditions 1 through 3, respectively. Mean accuracy for the machine learning classifier derived from the force platform data was lower at 84.4%. We conclude that data from the MK2 has sufficient information content to allow us to classify sequences of tasks being performed under different levels of postural stability. Future studies will focus on validating this protocol on large populations of individuals with actual balance impairments in order to create a toolkit that is clinically validated and available to the medical community. PMID:28196139

Using data from the Microsoft Kinect 2 to determine postural stability in healthy subjects: A feasibility trial.

PubMed

Dehbandi, Behdad; Barachant, Alexandre; Smeragliuolo, Anna H; Long, John Davis; Bumanlag, Silverio Joseph; He, Victor; Lampe, Anna; Putrino, David

2017-01-01

The objective of this study was to determine whether kinematic data collected by the Microsoft Kinect 2 (MK2) could be used to quantify postural stability in healthy subjects. Twelve subjects were recruited for the project, and were instructed to perform a sequence of simple postural stability tasks. The movement sequence was performed as subjects were seated on top of a force platform, and the MK2 was positioned in front of them. This sequence of tasks was performed by each subject under three different postural conditions: "both feet on the ground" (1), "One foot off the ground" (2), and "both feet off the ground" (3). We compared force platform and MK2 data to quantify the degree to which the MK2 was returning reliable data across subjects. We then applied a novel machine-learning paradigm to the MK2 data in order to determine the extent to which data from the MK2 could be used to reliably classify different postural conditions. Our initial comparison of force plate and MK2 data showed a strong agreement between the two devices, with strong Pearson correlations between the trunk centroids "Spine_Mid" (0.85 ± 0.06), "Neck" (0.86 ± 0.07) and "Head" (0.87 ± 0.07), and the center of pressure centroid inferred by the force platform. Mean accuracy for the machine learning classifier from MK2 was 97.0%, with a specific classification accuracy breakdown of 90.9%, 100%, and 100% for conditions 1 through 3, respectively. Mean accuracy for the machine learning classifier derived from the force platform data was lower at 84.4%. We conclude that data from the MK2 has sufficient information content to allow us to classify sequences of tasks being performed under different levels of postural stability. Future studies will focus on validating this protocol on large populations of individuals with actual balance impairments in order to create a toolkit that is clinically validated and available to the medical community.

Effects of stretching and fatigue on peak torque, muscle imbalance, and stability.

PubMed

Costa, Pablo B; Ruas, Cassio V; Smith, Cory M

2018-01-01

The present study examined the acute effects of hamstrings stretching and fatigue on knee extension and flexion peak torque (PT), hamstrings to quadriceps (H:Q) ratio, and postural stability. Seventeen women (mean±SD age=21.8±2.1 years; body mass=63.0±10.5 kg; height=164.7±6.2 cm) and eighteen men (25.8±4.6 years; 83.6±13.2 kg; 175.3±6.0 cm) took part in three laboratory visits. The first visit was a familiarization session, and the subsequent two visits were randomly assigned as a control or stretching condition. For the testing visits, subjects performed a postural stability assessment, stretched (or sat quietly during the control condition), performed a 50-repetition unilateral isokinetic fatigue protocol, and repeated the postural stability assessment. There were no significant differences between control and stretching conditions for initial quadriceps and hamstrings PT, initial H:Q ratio, quadriceps and hamstrings PT fatigue indexes, H:Q ratio Fatigue Index, rating of perceived exertion (RPE), or postural stability (P>0.05). When analyzing 5 intervals of 10 repetitions, significant declines in quadriceps PT were found in all intervals for both conditions (P<0.05). However, a decline in hamstrings PT was only found until the fourth interval (i.e., repetitions 31 to 40) for the stretching condition (P<0.05). Stretching the hamstrings immediately prior to long-duration activities may eventually cause adverse effects in force-generating capacity of this muscle group to occur earlier when fatiguing tasks are involved. Nevertheless, no changes were found for the H:Q ratios after stretching when compared to no-stretching.

Cognition and balance control: does processing of explicit contextual cues of impending perturbations modulate automatic postural responses?

PubMed

Coelho, Daniel Boari; Teixeira, Luis Augusto

2017-08-01

Processing of predictive contextual cues of an impending perturbation is thought to induce adaptive postural responses. Cueing in previous research has been provided through repeated perturbations with a constant foreperiod. This experimental strategy confounds explicit predictive cueing with adaptation and non-specific properties of temporal cueing. Two experiments were performed to assess those factors separately. To perturb upright balance, the base of support was suddenly displaced backwards in three amplitudes: 5, 10 and 15 cm. In Experiment 1, we tested the effect of cueing the amplitude of the impending postural perturbation by means of visual signals, and the effect of adaptation to repeated exposures by comparing block versus random sequences of perturbation. In Experiment 2, we evaluated separately the effects of cueing the characteristics of an impending balance perturbation and cueing the timing of perturbation onset. Results from Experiment 1 showed that the block sequence of perturbations led to increased stability of automatic postural responses, and modulation of magnitude and onset latency of muscular responses. Results from Experiment 2 showed that only the condition cueing timing of platform translation onset led to increased balance stability and modulation of onset latency of muscular responses. Conversely, cueing platform displacement amplitude failed to induce any effects on automatic postural responses in both experiments. Our findings support the interpretation of improved postural responses via optimized sensorimotor processes, at the same time that cast doubt on the notion that cognitive processing of explicit contextual cues advancing the magnitude of an impending perturbation can preset adaptive postural responses.

Study I: effects of 0.06% and 0.10% blood alcohol concentration on human postural control.

PubMed

Modig, F; Patel, M; Magnusson, M; Fransson, P A

2012-03-01

Alcohol intoxication causes many accidental falls presented at emergency departments, with the injury severity often related to level of blood alcohol concentration (BAC). One way to evaluate the decline in postural control and the fall risk is to assess standing stability when challenged. The study objective was to comprehensively investigate alcohol-related impairments on postural control and adaptive motor learning at specific BAC levels. Effects of alcohol intoxication at 0.06% and 0.10% BAC were examined with posturography when unperturbed or perturbed by calf vibration. Twenty-five participants (mean age 25.1 years) were investigated standing with either eyes open or closed. Our results revealed several significant findings: (1) stability declined much faster from alcohol intoxication between 0.06% and 0.10% BAC (60-140%) compared with between 0.0% and 0.06% BAC (30%); (2) sustained exposure to repeated balance perturbations augmented the alcohol-related destabilization; (3) there were stronger effects of alcohol intoxication on stability in lateral direction than in anteroposterior direction; and (4) there was a gradual degradation of postural control particularly in lateral direction when the balance perturbations were repeated at 0.06% and 0.10% BAC, indicating adaptation deficits when intoxicated. To summarize, alcohol has profound deteriorating effects on human postural control, which are dose dependent, time dependent and direction specific. The maximal effects of alcohol intoxication on physiological performance might not be evident initially, but may be revealed first when under sustained sensory-motor challenges. Copyright © 2011 Elsevier B.V. All rights reserved.

Effectuation of adaptive stability and postural alignment strategies are decreased by alcohol intoxication.

PubMed

Hafström, A; Modig, F; Magnusson, M; Fransson, P A

2014-06-01

Human stability control is a complex process comprising contributions from several partly independent mechanisms such as coordination, feedback and feed-forward control, and adaptation. Acute alcohol intoxication impairs these functions and is recognized as a major contributor to fall traumas. The study aimed to investigate how alcohol intoxication at .06% and .10% blood alcohol concentration (BAC) affected the movement spans and control of posture alignment. The angular positions of the head, shoulder, hip and knees relative to the ankles were measured with a 3D motion analysis system in 25 healthy adults during standing with eyes open or closed and with or without vibratory balance perturbations. Alcohol intoxication significantly increased the movement spans of the head, shoulders, hip and knees in anteroposterior and lateral directions during quiet stance (p < or = .047 and p < or = .003) and balance perturbations (p<.001, both directions). Alcohol intoxication also decreased the ability to reduce the movement spans through adaptation in both anteroposterior (p < or = .011) and lateral (p < or = .004) directions. When sober and submitted to balance perturbations, the subjects aligned the head, shoulders, hip and knees more forward relative to the ankle joint (p < .001), hence adopting a more resilient posture increasing the safety margin for backward falls. Alcohol intoxication significantly delayed this forward realignment (p < or = .022). Alcohol intoxication did not cause any significant posture realignment in the lateral direction. Thus, initiation of adaptive posture realignments to alcohol or other disruptions might be context dependent and associated with reaching a certain level of stability threats. Copyright © 2014 Elsevier B.V. All rights reserved.

“Cerebellar contribution to visuo-attentional alpha rhythm: insights from weightlessness”

PubMed Central

Cebolla, A. M.; Petieau, M.; Dan, B.; Balazs, L.; McIntyre, J.; Cheron, G.

2016-01-01

Human brain adaptation in weightlessness follows the necessity to reshape the dynamic integration of the neural information acquired in the new environment. This basic aspect was here studied by the electroencephalogram (EEG) dynamics where oscillatory modulations were measured during a visuo-attentional state preceding a visuo-motor docking task. Astronauts in microgravity conducted the experiment in free-floating aboard the International Space Station, before the space flight and afterwards. We observed stronger power decrease (~ERD: event related desynchronization) of the ~10 Hz oscillation from the occipital-parietal (alpha ERD) to the central areas (mu ERD). Inverse source modelling of the stronger alpha ERD revealed a shift from the posterior cingulate cortex (BA31, from the default mode network) on Earth to the precentral cortex (BA4, primary motor cortex) in weightlessness. We also observed significant contribution of the vestibular network (BA40, BA32, and BA39) and cerebellum (lobule V, VI). We suggest that due to the high demands for the continuous readjustment of an appropriate body posture in free-floating, this visuo-attentional state required more contribution from the motor cortex. The cerebellum and the vestibular network involvement in weightlessness might support the correction signals processing necessary for postural stabilization, and the increased demand to integrate incongruent vestibular information. PMID:27883068

Detecting dynamical boundaries from kinematic data in biomechanics

NASA Astrophysics Data System (ADS)

Ross, Shane D.; Tanaka, Martin L.; Senatore, Carmine

2010-03-01

Ridges in the state space distribution of finite-time Lyapunov exponents can be used to locate dynamical boundaries. We describe a method for obtaining dynamical boundaries using only trajectories reconstructed from time series, expanding on the current approach which requires a vector field in the phase space. We analyze problems in musculoskeletal biomechanics, considered as exemplars of a class of experimental systems that contain separatrix features. Particular focus is given to postural control and balance, considering both models and experimental data. Our success in determining the boundary between recovery and failure in human balance activities suggests this approach will provide new robust stability measures, as well as measures of fall risk, that currently are not available and may have benefits for the analysis and prevention of low back pain and falls leading to injury, both of which affect a significant portion of the population.

Brain-state classification and a dual-state decoder dramatically improve the control of cursor movement through a brain-machine interface

NASA Astrophysics Data System (ADS)

Sachs, Nicholas A.; Ruiz-Torres, Ricardo; Perreault, Eric J.; Miller, Lee E.

2016-02-01

Objective. It is quite remarkable that brain machine interfaces (BMIs) can be used to control complex movements with fewer than 100 neurons. Success may be due in part to the limited range of dynamical conditions under which most BMIs are tested. Achieving high-quality control that spans these conditions with a single linear mapping will be more challenging. Even for simple reaching movements, existing BMIs must reduce the stochastic noise of neurons by averaging the control signals over time, instead of over the many neurons that normally control movement. This forces a compromise between a decoder with dynamics allowing rapid movement and one that allows postures to be maintained with little jitter. Our current work presents a method for addressing this compromise, which may also generalize to more highly varied dynamical situations, including movements with more greatly varying speed. Approach. We have developed a system that uses two independent Wiener filters as individual components in a single decoder, one optimized for movement, and the other for postural control. We computed an LDA classifier using the same neural inputs. The decoder combined the outputs of the two filters in proportion to the likelihood assigned by the classifier to each state. Main results. We have performed online experiments with two monkeys using this neural-classifier, dual-state decoder, comparing it to a standard, single-state decoder as well as to a dual-state decoder that switched states automatically based on the cursor’s proximity to a target. The performance of both monkeys using the classifier decoder was markedly better than that of the single-state decoder and comparable to the proximity decoder. Significance. We have demonstrated a novel strategy for dealing with the need to make rapid movements while also maintaining precise cursor control when approaching and stabilizing within targets. Further gains can undoubtedly be realized by optimizing the performance of the individual movement and posture decoders.

Brain-state classification and a dual-state decoder dramatically improve the control of cursor movement through a brain-machine interface.

PubMed

Sachs, Nicholas A; Ruiz-Torres, Ricardo; Perreault, Eric J; Miller, Lee E

2016-02-01

It is quite remarkable that brain machine interfaces (BMIs) can be used to control complex movements with fewer than 100 neurons. Success may be due in part to the limited range of dynamical conditions under which most BMIs are tested. Achieving high-quality control that spans these conditions with a single linear mapping will be more challenging. Even for simple reaching movements, existing BMIs must reduce the stochastic noise of neurons by averaging the control signals over time, instead of over the many neurons that normally control movement. This forces a compromise between a decoder with dynamics allowing rapid movement and one that allows postures to be maintained with little jitter. Our current work presents a method for addressing this compromise, which may also generalize to more highly varied dynamical situations, including movements with more greatly varying speed. We have developed a system that uses two independent Wiener filters as individual components in a single decoder, one optimized for movement, and the other for postural control. We computed an LDA classifier using the same neural inputs. The decoder combined the outputs of the two filters in proportion to the likelihood assigned by the classifier to each state. We have performed online experiments with two monkeys using this neural-classifier, dual-state decoder, comparing it to a standard, single-state decoder as well as to a dual-state decoder that switched states automatically based on the cursor's proximity to a target. The performance of both monkeys using the classifier decoder was markedly better than that of the single-state decoder and comparable to the proximity decoder. We have demonstrated a novel strategy for dealing with the need to make rapid movements while also maintaining precise cursor control when approaching and stabilizing within targets. Further gains can undoubtedly be realized by optimizing the performance of the individual movement and posture decoders.

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.

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.

Scaling of avian bipedal locomotion reveals independent effects of body mass and leg posture on gait.

PubMed

Daley, Monica A; Birn-Jeffery, Aleksandra

2018-05-22

Birds provide an interesting opportunity to study the relationships between body size, limb morphology and bipedal locomotor function. Birds are ecologically diverse and span a large range of body size and limb proportions, yet all use their hindlimbs for bipedal terrestrial locomotion, for at least some part of their life history. Here, we review the scaling of avian striding bipedal gaits to explore how body mass and leg morphology influence walking and running. We collate literature data from 21 species, spanning a 2500× range in body mass from painted quail to ostriches. Using dynamic similarity theory to interpret scaling trends, we find evidence for independent effects of body mass, leg length and leg posture on gait. We find no evidence for scaling of duty factor with body size, suggesting that vertical forces scale with dynamic similarity. However, at dynamically similar speeds, large birds use relatively shorter stride lengths and higher stride frequencies compared with small birds. We also find that birds with long legs for their mass, such as the white stork and red-legged seriema, use longer strides and lower swing frequencies, consistent with the influence of high limb inertia on gait. We discuss the observed scaling of avian bipedal gait in relation to mechanical demands for force, work and power relative to muscle actuator capacity, muscle activation costs related to leg cycling frequency, and considerations of stability and agility. Many opportunities remain for future work to investigate how morphology influences gait dynamics among birds specialized for different habitats and locomotor behaviors. © 2018. Published by The Company of Biologists 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

Postural perturbations: new insights for treatment of balance disorders

NASA Technical Reports Server (NTRS)

Horak, F. B.; Henry, S. M.; Shumway-Cook, A.; Peterson, B. W. (Principal Investigator)

1997-01-01

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.

Haptic cues for orientation and postural control in sighted and blind individuals

NASA Technical Reports Server (NTRS)

Jeka, J. J.; Easton, R. D.; Bentzen, B. L.; Lackner, J. R.

1996-01-01

Haptic cues from fingertip contact with a stable surface attenuate body sway in subjects even when the contact forces are too small to provide physical support of the body. We investigated how haptic cues derived from contact of a cane with a stationary surface at low force levels aids postural control in sighted and congenitally blind individuals. Five sighted (eyes closed) and five congenitally blind subjects maintained a tandem Romberg stance in five conditions: (1) no cane; (2,3) touch contact (< 2 N of applied force) while holding the cane in a vertical or slanted orientation; and (4,5) force contact (as much force as desired) in the vertical and slanted orientations. Touch contact of a cane at force levels below those necessary to provide significant physical stabilization was as effective as force contact in reducing postural sway in all subjects, compared to the no-cane condition. A slanted cane was far more effective in reducing postural sway than was a perpendicular cane. Cane use also decreased head displacement of sighted subjects far more than that of blind subjects. These results suggest that head movement control is linked to postural control through gaze stabilization reflexes in sighted subjects; such reflexes are absent in congenitally blind individuals and may account for their higher levels of head displacement.

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.

Unsteady locomotion: integrating muscle function with whole body dynamics and neuromuscular control

PubMed Central

Biewener, Andrew A.; Daley, Monica A.

2009-01-01

Summary By integrating studies of muscle function with analysis of whole body and limb dynamics, broader appreciation of neuromuscular function can be achieved. Ultimately, such studies need to address non-steady locomotor behaviors relevant to animals in their natural environments. When animals move slowly they likely rely on voluntary coordination of movement involving higher brain centers. However, when moving fast, their movements depend more strongly on responses controlled at more local levels. Our focus here is on control of fast-running locomotion. A key observation emerging from studies of steady level locomotion is that simple spring-mass dynamics, which help to economize energy expenditure, also apply to stabilization of unsteady running. Spring-mass dynamics apply to conditions that involve lateral impulsive perturbations, sudden changes in terrain height, and sudden changes in substrate stiffness or damping. Experimental investigation of unsteady locomotion is challenging, however, due to the variability inherent in such behaviors. Another emerging principle is that initial conditions associated with postural changes following a perturbation define different context-dependent stabilization responses. Distinct stabilization modes following a perturbation likely result from proximo-distal differences in limb muscle architecture, function and control strategy. Proximal muscles may be less sensitive to sudden perturbations and appear to operate, in such circumstances, under feed-forward control. In contrast, multiarticular distal muscles operate, via their tendons, to distribute energy among limb joints in a manner that also depends on the initial conditions of limb contact with the ground. Intrinsic properties of these distal muscle–tendon elements, in combination with limb and body dynamics, appear to provide rapid initial stabilizing mechanisms that are often consistent with spring-mass dynamics. These intrinsic mechanisms likely help to simplify the neural control task, in addition to compensating for delays inherent to subsequent force- and length-dependent neural feedback. Future work will benefit from integrative biomechanical approaches that employ a combination of modeling and experimental techniques to understand how the elegant interplay of intrinsic muscle properties, body dynamics and neural control allows animals to achieve stability and agility over a variety of conditions. PMID:17704070

Postural Control in Young People with Visual Impairments and Various Risks of Falls

ERIC Educational Resources Information Center

Sadowska, Dorota; Stemplewski, Rafal; Szeklicki, Robert

2017-01-01

Introduction: Early diagnosis of postural control deficiencies facilitates implementation of an individual rehabilitation plan to prevent falls. The aim of the study was to assess the risk of falling in individuals with visual impairments, and to compare performance-based and theoretical limits of stability in subjects with various risks of…

A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia.

PubMed

Tran, Susan T; Thomas, Staci; DiCesare, Christopher; Pfeiffer, Megan; Sil, Soumitri; Ting, Tracy V; Williams, Sara E; Myer, Gregory D; Kashikar-Zuck, Susmita

2016-07-22

Adolescents with juvenile fibromyalgia (JFM) tend to be very sedentary and avoid participation in physical activity. A prior study suggested that JFM patients show altered biomechanics compared to healthy adolescents which may make them more prone to pain/injury during exercise. A new intervention combining well established cognitive behavioral therapy (CBT) techniques with specialized neuromuscular exercise -Fibromyalgia Integrative Training for Teens (FIT Teens) was developed and shown to be promising in improving functioning in adolescents with JFM. In contrast to traditional exercise programs such as aerobic or resistance training, neuromuscular training is a tailored approach which targets gait, posture, balance and movement mechanics which form the foundation for safe exercise participation with reduced risk for injury or pain (and hence more tolerable by JFM patients). The aim of this pilot feasibility study was to establish whether objective biomechanical assessment including sophisticated 3-D motion analysis would be useful in measuring improvements in strength, balance, gait, and functional performance after participation in the 8-week FIT Teens program. Eleven female participants with JFM (ages 12-18 years) completed pre- and post-treatment assessments of biomechanics, including walking gait analysis, lower extremity strength assessment, functional performance, and dynamic postural stability. Descriptive data indicated that mechanics of walking gait and functional performance appeared to improve after treatment. Hip abduction strength and dynamic postural control also demonstrated improvements bilaterally. Overall, the results of this pilot study offer initial evidence for the utility of biomechanical assessment to objectively demonstrate observable changes in biomechanical performance after an integrated training intervention for youth with JFM. If replicated in larger controlled studies, findings would suggest that through the FIT Teens intervention, adolescents with JFM can progress towards normalized strength and biomechanics, which may enhance their ability to engage in physical exercise.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

PubMed

Chisholm, Amanda E; Alamro, Raed A; Williams, Alison M M; Lam, Tania

2017-04-11

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI). Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking. We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking. Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

Stochastic analysis of motor-control stability, polymer based force sensing, and optical stimulation as a preventive measure for falls

NASA Astrophysics Data System (ADS)

Landrock, Clinton K.

Falls are the leading cause of all external injuries. Outcomes of falls include the leading cause of traumatic brain injury and bone fractures, and high direct medical costs in the billions of dollars. This work focused on developing three areas of enabling component technology to be used in postural control monitoring tools targeting the mitigation of falls. The first was an analysis tool based on stochastic fractal analysis to reliably measure levels of motor control. The second focus was on thin film wearable pressure sensors capable of relaying data for the first tool. The third was new thin film advanced optics for improving phototherapy devices targeting postural control disorders. Two populations, athletes and elderly, were studied against control groups. The results of these studies clearly show that monitoring postural stability in at-risk groups can be achieved reliably, and an integrated wearable system can be envisioned for both monitoring and treatment purposes. Keywords: electro-active polymer, ionic polymer-metal composite, postural control, motor control, fall prevention, sports medicine, fractal analysis, physiological signals, wearable sensors, phototherapy, photobiomodulation, nano-optics.

THE RELATIONSHIP BETWEEN VARIOUS MODES OF SINGLE LEG POSTURAL CONTROL ASSESSMENT

PubMed Central

Schmitz, Randy

2012-01-01

Purpose/Background: While various techniques have been developed to assess the postural control system, little is known about the relationship between single leg static and functional balance. The purpose of the current study was to determine the relationship between the performance measures of several single leg postural stability tests. Methods: Forty six recreationally active college students (17 males, 29 females, 21±3 yrs, 173±10 cm) performed six single leg tests in a counterbalanced order: 1) Firm Surface-Eyes Open, 2) Firm Surface-Eyes Closed, 3) Multiaxial Surface-Eyes Open, 4) Multiaxial Surface-Eyes Closed, 5) Star Excursion Balance Test (posterior medial reach), 6) Single leg Hop-Stabilization Test. Bivariate correlations were conducted between the six outcome variables. Results: Mild to moderate correlations existed between the static tests. No significant correlations existed involving either of the functional tests. Conclusions: The results indicate that while performance of static balance tasks are mildly to moderately related, they appear to be unrelated to functional reaching or hopping movements, supporting the utilization of a battery of tests to determine overall postural control performance. Level of Evidence: 3b PMID:22666640

Postural Stability When Leaning from Perceived Upright

NASA Technical Reports Server (NTRS)

Vanya, Robert D.; Grounds, John F.; Wood, Scott J.

2011-01-01

The transition between quiet stance and gait requires the volitional movement of one?s center of mass (COM) toward a limit of stability (LOS). The goal of this study was to measure the effect of leaning from perceived upright on postural stability when voluntarily maintaining fixed stance positions and during perturbations of the support surface. The COM was derived from force plate data in 12 healthy subjects while standing with feet positioned so that lateral base of support was equal to foot length. For all conditions, arms were folded and subjects were instructed to lean without bending at the hips or lifting their feet. The LOS was determined during maximal voluntary leans with eyes open and closed. The COM was then displayed on a monitor located in front of the subject. Subjects were visually guided to lean toward a target position, maintain this position for 10s, return to upright, and then repeat the same targeted lean maneuver with eyes closed. Targets were randomly presented at 2? in 8 directions and between 2-6? in these same directions according to the asymmetric LOS. Subjects were then verbally guided to lean between 2? back and 4? forward prior to a perturbation of the support surface in either a forward or backward direction. The average LOS was 5.8? forward, 2.9? back, and 4.8? in left/right directions, with no significant difference between eyes open and closed. Center of pressure (COP) velocity increased as subjects maintained fixed stance positions farther from upright, with increased variability during eyes closed conditions. The time to stability and COP path length increased as subjects leaned opposite to the direction of the support surface perturbations. We conclude that postural stability is compromised as subjects lean away from perceived upright, except for perturbations that induce sway in the direction opposite the lean. The asymmetric LOS relative to perceived upright favors postural stability for COM movements in the forward direction.

The effects of a high-intensity free-weight back-squat exercise protocol on postural stability in resistance-trained males.

PubMed

Thiele, R M; Conchola, E C; Palmer, T B; DeFreitas, J M; Thompson, B J

2015-01-01

The purpose of this study was to investigate the effects of a high-intensity free-weight back-squat exercise on postural stability characteristics in resistance-trained males. Eighteen college-aged (mean ± SD: age = 22.9 ± 2.9 years; height = 175.8 ± 6.4 cm; mass = 86.3 ± 9.3 kg), resistance-trained males performed postural stability testing before and after completing five sets of eight repetitions of back-squat exercises at 80% of one-repetition maximum. A commercial balance testing device was used to assess sway index at pre- and at 0, 5, 10, 15 and 20 min post-exercise. Each balance assessment consisted of four, 20-s static stance conditions: eyes-open firm surface, eyes-closed firm surface, eyes-open soft surface and eyes-closed soft surface. Sway index was greater (P = 0.001-0.020) at Post 0 than at all other time points. No differences (P > 0.05) were observed between any other time phases. Sway index was greater (P < 0.001) for eyes-closed soft surface than all other conditions. These findings revealed sway index for all conditions significantly increased following completion of the back-squat; however, sway index recovered within 5 min of exercise. Higher sway index values as a result of neuromuscular fatigue induced by a back-squat exercise may have performance and injury risk consequences to subsequent activities that rely on postural stability. However, these findings suggest balance impairments may recover in ~5 min following high-intensity lower body resistance exercise.

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

The postural stability of children with foetal alcohol spectrum disorders during one-leg stance: A feasibility study

PubMed Central

2018-01-01

Background Postural control may be impaired in children with foetal alcohol spectrum disorders (FASD). The study assessed the protocol feasibility in terms of (1) recruiting children with FASD in a rural, small town; (2) using the measurement instruments in a real-life setting; (3) the one-leg standing (OLS) task and (4) presenting preliminary results on postural stability of children with and without FASD. Methods Nine-year-old children diagnosed with and without FASD were invited to participate. Twenty-eight children performed OLS. Feasibility outcomes included recruitment, measurement instrument use and task instruction. Postural stability outcomes included standing duration, centre of pressure (COP) and body segment acceleration. Results Participants recruitment was feasible in terms of the (1) ability to sample a reasonable participant number in a rural town setting and the capacity to increase the sample size if more schools are included in the sampling frame and (2) use of assent and consent forms that were appropriate for this population. The measurement instruments were user-friendly, cost-effective and time-efficient. Instructions for the task require amendment to address foot placement of the non-weight–bearing leg. There was a significant difference between cases and controls on mean COP velocity (p = 0.001) and the pelvis segment acceleration in the mediolateral direction (p = 0.01) and the anteroposterior direction (p = 0.027). The control children took longer to achieve postural control. The girls demonstrated a significant difference for the COP anteroposterior displacement (p = 0.008) and velocity (p = 0.049). Conclusions The recruitment of children with and without FASD in a rural, small town and the administration of measurement instruments in a real-life, school-based setting was feasible. However, the verbal instructions for the task require revision. The male control group took longer to achieve postural control because the task was performed differently between the two groups. However, the case girls were slower to achieve postural control than control girls though performing the task similarly. PMID:29707515

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 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

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.

The Effect of a Short-Term and Long-Term Whole-Body Vibration in Healthy Men upon the Postural Stability

PubMed Central

Piecha, Magdalena; Juras, Grzegorz; Król, Piotr; Sobota, Grzegorz; Polak, Anna; Bacik, Bogdan

2014-01-01

The study aimed to establish the short-term and long-term effects of whole-body vibration on postural stability. The sample consisted of 28 male subjects randomly allocated to four comparative groups, three of which exercised on a vibration platform with parameters set individually for the groups. The stabilographic signal was recorded before the test commenced, after a single session of whole-body vibration, immediately after the last set of exercises of the 4-week whole-body vibration training, and one week after the training ended. The subjects were exposed to vibrations 3 times a week for 4 weeks. Long-term vibration training significantly shortened the rambling and trembling paths in the frontal plane. The path lengths were significantly reduced in the frontal plane one week after the training end date. Most changes in the values of the center of pressure (COP) path lengths in the sagittal and frontal plane were statistically insignificant. We concluded that long-term vibration training improves the postural stability of young healthy individuals in the frontal plane. PMID:24520362

The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults.

PubMed

Pata, Rachel W; Lord, Katrina; Lamb, Jamie

2014-07-01

Falls are a common problem in older adults. Impaired balance, mobility and postural stability are risk factors for falling. Limited research has been performed on Pilates exercise and the ability to decrease fall risk. In this quasi-experimental study, 35 adults (61-87 years old) participated in an 8-week Pilates based exercise program. Blind examiners conducted the Timed Up and Go (TUG), Forward Reach Test, and Turn 180 Test before and after the intervention. Number of falls, perception of Pilates, and fear of falling was also recorded. Thirty-two (91.4%) participants completed post-test measures. Significant improvements were seen in the TUG (p <0.001) and Turn 180 Test (p = 0.002). Improvements were also demonstrated in the Forward Reach Test (p = 0.049). A positive perception of the Pilates program and decreased fear of falling was shown. Results suggest a Pilates based exercise program may be effective in improving balance, mobility and postural stability to decrease fall risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case-control study.

PubMed

MacRae, Catharine Siân; Critchley, Duncan; Lewis, Jeremy S; Shortland, Adam

2018-01-01

Differences in postural control and gait have been identified between people with and without chronic low back pain (CLBP); however, many previous studies present data from small samples, or have used methodologies with questionable reliability. This study, employing robust methodology, hypothesised that there would be a difference in postural control, and spatiotemporal parameters of gait in people with CLBP compared with asymptomatic individuals. This cross-sectional case-control study age-matched and gender-matched 16 CLBP and 16 asymptomatic participants. Participants were assessed barefoot (1) standing, over three 40 s trials, under four posture challenging conditions (2) during gait. Primary outcome was postural stability (assessed by root mean squared error of centre of pressure (CoP) displacement (CoP RMSEAP ) and mean CoP velocity (CoP VELAP ), both in the anteroposterior direction); gait outcomes were hip range of movement and peak moments, walking speed, cadence and stride length, assessed using force plates and a motion analysis system. There were no differences between groups in CoP RMSEAP (P=0.26), or CoP VELAP (P=0.60) for any standing condition. During gait, no differences were observed between groups for spatiotemporal parameters, maximum, minimum and total ranges of hip movement, or peak hip flexor or extensor moments in the sagittal plane. In contrast to previous research, this study suggests that people with mild to moderate CLBP present with similar standing postural control, and parameters of gait to asymptomatic individuals. Treatments directed at influencing postural stability (eg, standing on a wobble board) or specific parameters of gait may be an unnecessary addition to a treatment programme.

Anticipatory postural adjustments and anticipatory synergy adjustments: Preparing to a postural perturbation with predictable and unpredictable direction

PubMed Central

Piscitelli, Daniele; Falaki, Ali; Solnik, Stanislaw; Latash, Mark L.

2016-01-01

We explored two aspects of feed-forward postural control, anticipatory postural adjustments (APAs) and anticipatory synergy adjustments (ASAs) seen prior to self-triggered unloading with known and unknown direction of the perturbation. In particular, we tested two main hypotheses predicting contrasting changes in APAs and ASAs. The first hypothesis predicted no major changes in ASAs. The second hypothesis predicted delayed APAs with predominance of co-contraction patterns when perturbation direction was unknown. Healthy subjects stood on the force plate and help a bar with two loads acting in the forward and backward directions. They pressed a trigger that released one of the loads causing a postural perturbation. In different series, the direction of the perturbation was either known (the same load released in all trials) or unknown (the subjects did not know which of the two loads would be released). Surface electromyograms were recorded and used to quantify APAs, synergies stabilizing center of pressure coordinate (within the uncontrolled manifold hypothesis), and ASA. APAs and ASAs were seen in all conditions. APAs were delayed and predominance of co-contraction patterns was seen under the conditions with unpredictable direction of perturbation. In contrast, no significant changes in synergies and ASAs were seen. Overall, these results show that feed-forward control of vertical posture has two distinct components, reflected in APAs and ASAs, which show qualitatively different adjustments with changes in predictability of the direction of perturbation. These results are interpreted within the recently proposed hierarchical scheme of the synergic control of motor tasks. The observations underscore the complexity of the feed-forward postural control, which involves separate changes in salient performance variables (such as coordinate of the center of pressure) and in their stability properties. PMID:27866261

Anticipatory postural adjustments and anticipatory synergy adjustments: preparing to a postural perturbation with predictable and unpredictable direction.

PubMed

Piscitelli, Daniele; Falaki, Ali; Solnik, Stanislaw; Latash, Mark L

2017-03-01

We explored two aspects of feed-forward postural control, anticipatory postural adjustments (APAs) and anticipatory synergy adjustments (ASAs) seen prior to self-triggered unloading with known and unknown direction of the perturbation. In particular, we tested two main hypotheses predicting contrasting changes in APAs and ASAs. The first hypothesis predicted no major changes in ASAs. The second hypothesis predicted delayed APAs with predominance of co-contraction patterns when perturbation direction was unknown. Healthy subjects stood on the force plate and held a bar with two loads acting in the forward and backward directions. They pressed a trigger that released one of the loads causing a postural perturbation. In different series, the direction of the perturbation was either known (the same load released in all trials) or unknown (the subjects did not know which of the two loads would be released). Surface electromyograms were recorded and used to quantify APAs, synergies stabilizing center of pressure coordinate (within the uncontrolled manifold hypothesis), and ASA. APAs and ASAs were seen in all conditions. APAs were delayed, and predominance of co-contraction patterns was seen under the conditions with unpredictable direction of perturbation. In contrast, no significant changes in synergies and ASAs were seen. Overall, these results show that feed-forward control of vertical posture has two distinct components, reflected in APAs and ASAs, which show qualitatively different adjustments with changes in predictability of the direction of perturbation. These results are interpreted within the recently proposed hierarchical scheme of the synergic control of motor tasks. The observations underscore the complexity of the feed-forward postural control, which involves separate changes in salient performance variables (such as coordinate of the center of pressure) and in their stability properties.

Postural steadiness during quiet stance does not associate with ability to recover balance in older women.

PubMed

Mackey, Dawn C; Robinovitch, Stephen N

2005-10-01

Fall risk depends on ability to maintain balance during daily activities, and on ability to recover balance following a perturbation such as a slip or trip. We examined whether similar neuromuscular variables govern these two domains of postural stability. We conducted experiments with 25 older women (mean age=78 yrs, SD=7 yrs). We acquired measures of postural steadiness during quiet stance (mean amplitude, velocity, and frequency of centre-of-pressure movement when standing with eyes open or closed, on a rigid or compliant surface). We also measured ability to recover balance using the ankle strategy after release from a forward leaning position (based on the maximum release angle where recovery was possible, and corresponding values of reaction time, rate of ankle torque generation, and peak ankle torque). We found that balance recovery variables were not strongly or consistently correlated with postural steadiness variables. The maximum release angle associated with only three of the sixteen postural steadiness variables (mean frequency in rigid, eyes open condition (r=0.36, P=.041), and mean amplitude (r=0.41, P=.038) and velocity (r=0.49, P=.015) in compliant, eyes closed condition). Reaction time and peak torque did not correlate with any steadiness variables, and rate of torque generation correlated moderately with the mean amplitude and velocity of the centre-of-pressure in the compliant, eyes closed condition (r=0.48-0.60). Our results indicate that postural steadiness during quiet stance is not predictive of ability to recover balance with the ankle strategy. Accordingly, balance assessment and fall prevention programs should individually target these two components of postural stability.

Older adults prioritize postural stability in the anterior-posterior direction to regain balance following volitional lateral step.

PubMed

Porter, Shaun; Nantel, Julie

2015-02-01

Postural control in the medial-lateral (ML) direction is of particular interest regarding the assessment of changes in postural control, as it is highly related to the risk of falling. To determine the postural strategies used to regain balance following a voluntary lateral step and compare these strategies between young and older adults. Sixteen older adults (60-90 years) and 14 young adults (20-40 years) were asked to stand quietly for 30s, walk in place and then take a lateral step and stand quietly (30s). Balance Post was divided into 10s intervals. Center of pressure displacement (CoP) and velocity (VCoP) in the anterio-posterior (AP) and ML directions were analyzed. In both groups, CoP and VCoP in AP and ML increased in Post1 compared to Pre (P<0.001). Dissimilar to young adults, VCoP-Post2, Post3 ML were larger than Pre (P=0.01) in older adults. Age correlated with all VCoP (Pre and Post) in both ML (P<0.05) and AP directions (P<0.01). Dissimilar to young adults, older adults use different postural strategies in ML and AP directions and prioritized postural stability in the AP direction to recover balance after completing a lateral step. In the ML direction, older adults took up to 30s to regain balance. Considering that age was related to larger CoP displacement and velocity, the AP strategy to recover postural balance following a lateral step could become less efficient as older adults age and therefore increasing the risk of falls. Copyright © 2015 Elsevier B.V. All rights reserved.

Aerodynamic tricks for pitching oscillation and visual stabilization in a hovering bird

NASA Astrophysics Data System (ADS)

Su, Jian-Yuan; Ting, Shang-Chieh; Yang, Jing-Tang

2010-11-01

We experimentally investigate how small birds attain a stabilized vision and body posture during hovering. Wing-beats of finches and passerines executing asymmetrical hovering provide lift merely during the downstroke. The downstroke lift is significantly greater than the bird weight, thereby causing a pitch-up swing of the bird body. A hovering bird skillfully and unceasingly tunes the position and orientation of lift force to stabilize its vision, so that the eye displacement is approximately one-tenth less than the tail, causing an illusion that the bird body is rotating about the eye. The hovering birds also spread and fold periodically their tail with an evident phase relationship with respect to the beating wings. We found that hovering birds use their tail to intercept the strong downward air-flow induced by the downstroking wings, and sophisticatedly spread their tail upon the arrival of the downward air-flow, rendering a pitch-up moment that effectively counteracts the pitch-down body rotation. Hence during hovering the bird essentially undergoes a dynamically-stable pitching oscillation, and concurrently attains a stabilized vision.

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

Does increased postural threat lead to more conscious control of posture?

PubMed

Huffman, J L; Horslen, B C; Carpenter, M G; Adkin, A L

2009-11-01

Although it is well established that postural threat modifies postural control, little is known regarding the underlying mechanism(s) responsible for these changes. It is possible that changes in postural control under conditions of elevated postural threat result from a shift to a more conscious control of posture. The purpose of this study was to determine the influence of elevated postural threat on conscious control of posture and to determine the relationship between conscious control and postural control measures. Forty-eight healthy young adults stood on a force plate at two different surface heights: ground level (LOW) and 3.2-m above ground level (HIGH). Centre of pressure measures calculated in the anterior-posterior (AP) direction were mean position (AP-MP), root mean square (AP-RMS) and mean power frequency (AP-MPF). A modified state-specific version of the Movement Specific Reinvestment Scale was used to measure conscious motor processing (CMP) and movement self-consciousness (MSC). Balance confidence, fear of falling, perceived stability, and perceived and actual anxiety indicators were also collected. A significant effect of postural threat was found for movement reinvestment as participants reported more conscious control and a greater concern about their posture at the HIGH height. Significant correlations between CMP and MSC with AP-MP were observed as participants who consciously controlled and were more concerned for their posture leaned further away from the platform edge. It is possible that changes in movement reinvestment can influence specific aspects of posture (leaning) but other aspects may be immune to these changes (amplitude and frequency).

Physical therapy as conservative management for cervical pain and headaches in an adolescent with neurofibromatosis type 1: a case study.

PubMed

Helmers, Kristin M; Irwin, Kent E

2009-12-01

: Neurofibromatosis is a group of genetic disorders that affect the development and growth of nerve cell tissues. These disorders include tumors of myelin-producing supportive cells that grow on nerves and can cause changes in bone formation, skin integrity, and nerve transmission. Common musculoskeletal impairments associated with neurofibromatosis type 1 (NF 1) include cervical pain, muscle weakness, muscle stiffness, headaches, and postural deviations. : This case study describes successful physical therapy management and outcomes for cervical pain and headaches in a 17-year-old girl with a 16-year history of NF 1. Difficulties in driving, studying, lifting, and participating in recreational activities were all associated with the patient's pain, decreased cervical range of motion, decreased scapular strength, and postural deviations. : Physical therapy interventions included posture training, dynamic shoulder/scapular strengthening, cervical stabilization, stretching, ultrasound, interferential current, and a progressive home exercise program. : By the end of 13 weeks (20 sessions) of physical therapy, the patient was completely pain free, demonstrated increased cervical range of motion, and had improvements in scapular strength. She returned to full and unrestricted recreational activities, driving, studying, and household chores. Furthermore, scores on the Neck Disability Index improved from 44 of 50 (complete disability) to 2 of 50 (no disability). : Physical therapy may be a viable option for conservative management of musculoskeletal dysfunction and functional limitations resulting from NF 1.

Effect of Sitting Pause Times on Balance After Supine to Standing Transfer in Dim Light.

PubMed

Johnson, Eric G; Albalwi, Abdulaziz A; Al-Dabbak, Fuad M; Daher, Noha S

2017-06-01

The risk of falling for older adults increases in dimly lit environments. Longer sitting pause times, before getting out of bed and standing during the night, may improve postural stability. The purpose of this study was to measure the effect of sitting pause times on postural sway velocity immediately after a supine to standing transfer in a dimly lit room in older adult women. Eighteen healthy women aged 65 to 75 years who were able to independently perform supine to standing transfers participated in the study. On each of 2 consecutive days, participants assumed the supine position on a mat table and closed their eyes for 45 minutes. Then, participants were instructed to open their eyes and transfer from supine to sitting, with either 2- or 30-second pause in the sitting position followed by standing. The sitting pause time order was randomized. A significant difference was observed in postural sway velocity between the 2- and 30-second sitting pause times. The results revealed that there was less postural sway velocity after 30-second than 2-second sitting pause time (0.61 ± 0.19 vs 1.22 ± 0.68, P < .001). Falls related to bathroom usage at night are the most common reported falls among older adults. In the present study, the investigators studied the effect of sitting pause times on postural sway velocity after changing position from supine to standing in a dimly lit environment. The findings showed that the mean postural sway velocity was significantly less after 30-second sitting pause time compared with 2-second sitting pause time. Postural sway velocity decreased when participants performed a sitting pause of 30 seconds before standing in a dimly lit environment. These results suggest that longer sitting pause times may improve adaptability to dimly lit environments, contributing to improved postural stability and reduced risk of fall in older adult women when getting out of bed at night.

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.

Human-Derived Disturbance Estimation and Compensation (DEC) Method Lends Itself to a Modular Sensorimotor Control in a Humanoid Robot.

PubMed

Lippi, Vittorio; Mergner, Thomas

2017-01-01

The high complexity of the human posture and movement control system represents challenges for diagnosis, therapy, and rehabilitation of neurological patients. We envisage that engineering-inspired, model-based approaches will help to deal with the high complexity of the human posture control system. Since the methods of system identification and parameter estimation are limited to systems with only a few DoF, our laboratory proposes a heuristic approach that step-by-step increases complexity when creating a hypothetical human-derived control systems in humanoid robots. This system is then compared with the human control in the same test bed, a posture control laboratory. The human-derived control builds upon the identified disturbance estimation and compensation (DEC) mechanism, whose main principle is to support execution of commanded poses or movements by compensating for external or self-produced disturbances such as gravity effects. In previous robotic implementation, up to 3 interconnected DEC control modules were used in modular control architectures separately for the sagittal plane or the frontal body plane and successfully passed balancing and movement tests. In this study we hypothesized that conflict-free movement coordination between the robot's sagittal and frontal body planes emerges simply from the physical embodiment, not necessarily requiring a full body control. Experiments were performed in the 14 DoF robot Lucy Posturob (i) demonstrating that the mechanical coupling from the robot's body suffices to coordinate the controls in the two planes when the robot produces movements and balancing responses in the intermediate plane, (ii) providing quantitative characterization of the interaction dynamics between body planes including frequency response functions (FRFs), as they are used in human postural control analysis, and (iii) witnessing postural and control stability when all DoFs are challenged together with the emergence of inter-segmental coordination in squatting movements. These findings represent an important step toward controlling in the robot in future more complex sensorimotor functions such as walking.

Human-Derived Disturbance Estimation and Compensation (DEC) Method Lends Itself to a Modular Sensorimotor Control in a Humanoid Robot

PubMed Central

Lippi, Vittorio; Mergner, Thomas

2017-01-01

The high complexity of the human posture and movement control system represents challenges for diagnosis, therapy, and rehabilitation of neurological patients. We envisage that engineering-inspired, model-based approaches will help to deal with the high complexity of the human posture control system. Since the methods of system identification and parameter estimation are limited to systems with only a few DoF, our laboratory proposes a heuristic approach that step-by-step increases complexity when creating a hypothetical human-derived control systems in humanoid robots. This system is then compared with the human control in the same test bed, a posture control laboratory. The human-derived control builds upon the identified disturbance estimation and compensation (DEC) mechanism, whose main principle is to support execution of commanded poses or movements by compensating for external or self-produced disturbances such as gravity effects. In previous robotic implementation, up to 3 interconnected DEC control modules were used in modular control architectures separately for the sagittal plane or the frontal body plane and successfully passed balancing and movement tests. In this study we hypothesized that conflict-free movement coordination between the robot's sagittal and frontal body planes emerges simply from the physical embodiment, not necessarily requiring a full body control. Experiments were performed in the 14 DoF robot Lucy Posturob (i) demonstrating that the mechanical coupling from the robot's body suffices to coordinate the controls in the two planes when the robot produces movements and balancing responses in the intermediate plane, (ii) providing quantitative characterization of the interaction dynamics between body planes including frequency response functions (FRFs), as they are used in human postural control analysis, and (iii) witnessing postural and control stability when all DoFs are challenged together with the emergence of inter-segmental coordination in squatting movements. These findings represent an important step toward controlling in the robot in future more complex sensorimotor functions such as walking. PMID:28951719

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

The effects of whole body vibration combined biofeedback postural control training on the balance ability and gait ability in stroke patients.

PubMed

Uhm, Yo-Han; Yang, Dae-Jung

2017-11-01

[Purpose] The purpose of this study was to examine the effect of biofeedback postural control training using whole body vibration in acute stroke patients on balance and gait ability. [Subjects and Methods] Thirty stroke patients participated in this study and were divided into a group of 10, a group for biofeedback postural control training combined with a whole body vibration, one for biofeedback postural control training combined with an aero-step, and one for biofeedback postural control training. Biorescue was used to measure the limits of stability, balance ability, and Lukotronic was used to measure step length, gait ability. [Results] In the comparison of balance ability and gait ability between the groups for before and after intervention, Group I showed a significant difference in balance ability and gait ability compared to Groups II and III. [Conclusion] This study showed that biofeedback postural control training using whole body vibration is effective for improving balance ability and gait ability in stroke patients.

Delayed Compensatory Postural Adjustments After Lateral Perturbations Contribute to the Reduced Ability of Older Adults to Control Body Balance.

PubMed

Claudino, Renato; Dos Santos, Marcio José; Mazo, Giovana Zarpellon

2017-10-01

The goal of this study was to investigate the timing of compensatory postural adjustments in older adults during body perturbations in the mediolateral direction, circumstances that increase their risk of falls. The latencies of leg and trunk muscle activation to body perturbations at the shoulder level and variables of center of pressure excursion, which characterize postural stability, were analyzed in 40 older adults (nonfallers and fallers evenly split) and in 20 young participants. The older adults exhibited longer latencies of muscular activation in eight out of 15 postural muscles as compared with young participants; for three muscles, the latencies were longer for the older fallers than nonfallers. Simultaneously, the time for the center of pressure displacement reached its peak after the perturbation was significant longer in both groups of older adults. The observed delays in compensatory postural adjustments may affect the older adults' ability to prompt control body balance after postural disturbances and predispose them to falls.

Both anticipatory and compensatory postural adjustments are adapted while catching a ball in unstable standing posture.

PubMed

Scariot, Vanessa; Rios, Jaqueline L; Claudino, Renato; Dos Santos, Eloá C; Angulski, Hanna B B; Dos Santos, Marcio J

2016-01-01

The main objective of this study was to analyze the role of balance exercises on anticipatory (APA) and compensatory (CPA) postural adjustments in different conditions of postural stability. Sixteen subjects were required to catch a ball while standing on rigid floor, trampoline and foam cushion surfaces. Electromyographic activities (EMG) of postural muscles were analyzed during time windows typical for APAs and CPAs. Overall there were a reciprocal activation of the muscles around the ankle and co-activations between ventral and dorsal muscles of the thigh and trunk during the catching a ball task. Compared to the rigid floor, the tibialis anterior activation was greater during the trampoline condition (CPA: p = 0.006) and the soleus muscle inhibition was higher during foam cushion condition (APA: p = 0.001; CPA: p = 0.007). Thigh and trunk muscle activities were similar across the conditions. These results advance the knowledge in postural control during body perturbations standing on unstable surfaces. Published by Elsevier Ltd.

Postural control in restless legs syndrome with medication intervention using pramipexole.

PubMed

Ahlgrén-Rimpiläinen, Aulikki; Lauerma, Hannu; Kähkönen, Seppo; Aalto, Heikki; Tuisku, Katinka; Holi, Matti; Pyykkö, Ilmari; Rimpiläinen, Ilpo

2014-02-01

Central dopamine regulation is involved in postural control and in the pathophysiology of restless legs syndrome (RLS) and Parkinson's disease (PD). Postural control abnormalities have been detected in PD, but there are no earlier studies with regard to RLS and postural control. Computerized force platform posturography was applied to measure the shift and the velocity (CPFV) of center point of forces (CPF) with eyes open (EO) and eyes closed (EC) in controls (n = 12) and prior and after a single day intervention with pramipexole in RLS subjects (n = 12). CPFV (EO) was significantly lower in the RLS group (p < 0.05) than in controls. After pramipexole intake, the difference disappeared and the subjective symptom severity diminished. Pramipexole did not significantly influence CPFV (EC) or CPF shift direction. Subjects with RLS used extensively visual mechanisms to control vestibule-spinal reflexes to improve or compensate the postural stability. Further research is needed to clarify altered feedback in the central nervous system and involvement of dopamine and vision in the postural control in RLS.

Between-day reliability of time-to-contact measures used to assess postural stability.

PubMed

Wheat, Jonathan S; Haddad, Jeffrey M; Scaife, Robert

2012-02-01

Traditional measures of postural stability consider movement of the center of pressure (COP) or the center of mass (COM) without regard to the boundary of support (BOS). A potentially more appropriate measure is postural time-to-contact (TtC) which defines the spatio-temporal proximity of the COM or COP to the BOS. Given the increasing popularity of TtC measures, it is important to determine their reliability. Therefore, the purpose of this study was to determine the effects of the number of trials and trial duration on the reliability of postural TtC measures. COP data were collected (100 Hz) in 16 young healthy participants during 10 trials (60-s duration) of quiet standing with eyes open on two occasions - seven days apart. Postural TtC of each trial was calculated using two different methods. The intersession reliability of the TtC measures was assessed by calculating between session intraclass correlation coefficients (ICC(2,1)) using different combinations of the number of trials (1-10) and trial duration (10, 20, 30, 40, 50 and 60s). Both TtC methods were very reliable. Additionally, both measures of TtC were more reliable than the standard deviation of the anterior-posterior COP and slightly more reliable than path length. This difference was most pronounced when fewer and shorter trials were used. Copyright © 2011 Elsevier B.V. All rights reserved.

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

The change of sleeping and lying posture of Japanese black cows after moving into new environment.

PubMed

Fukasawa, Michiru; Komatsu, Tokushi; Higashiyama, Yumi

2018-04-25

The environmental change is one of the stressful events in livestock production. Change in environment disturbed cow behavior and cows needed several days to reach stable behavioral pattern, especially sleeping posture (SP) and lying posture (LP) have been used as an indicator for relax and well-acclimated to its environment. The aim of this study examines how long does Japanese black cow required for stabilization of SP and LP after moving into new environment. Seven pregnant Japanese black cows were used. Cows were moved into new tie-stall shed and measured sleeping and lying posture 17 times during 35 experimental days. Both SP and LP were detected by accelerometer fixed on middle occipital and hip-cross, respectively. Daily total time, frequency, and average bout of both SP and LP were calculated. Daily SP time was the shortest on day 1, and increased to the highest on day3. It decreased until day 9, after that stabilized about 65 min /day till the end of experiment. The longest average SP bout was shown on day 1, and it decreased to stabilize till day 7. Daily LP time was changed as same manner as daily SP time. The average SP bout showed the longest on day 1, and it decreased to stable level till day 7. On the other hand, the average LP bout showed the shortest on day1, and it was increased to stable level till on day 7. These results showed that pregnant Japanese black cows needed 1 week to stabilize their SP. However, there were different change pattern between the average SP and LP bout, even though the change pattern of daily SP and LP time were similar.

No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial.

PubMed

Rolighed, Lars; Rejnmark, Lars; Sikjaer, Tanja; Heickendorff, Lene; Vestergaard, Peter; Mosekilde, Leif; Christiansen, Peer

2015-05-01

Impairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk. We aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients. A randomized placebo-controlled trial. We included 46 PHPT patients, mean age 58 (range 29-77) years and 35 (76%) were women. Daily treatment with 70 μg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX. Changes in QoL and measures of muscle strength and function. Preoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50-94 nmol/l) compared with placebo (57-52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P<0.01), muscle strength in the knee flexion and extension (P<0.001), and muscle function tests (P<0.01) after surgical cure. Postural stability improved during standing with eyes closed (P<0.05), but decreased with eyes open (P<0.05). Patients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters. © 2015 European Society of Endocrinology.

Pharmacodynamic and pharmacokinetic effects of MK-0343, a GABA(A) alpha2,3 subtype selective agonist, compared to lorazepam and placebo in healthy male volunteers.

PubMed

de Haas, S L; de Visser, S J; van der Post, J P; Schoemaker, R C; van Dyck, K; Murphy, M G; de Smet, M; Vessey, L K; Ramakrishnan, R; Xue, L; Cohen, A F; van Gerven, J M A

2008-01-01

The use of non-selective gamma-aminobutyric acid (GABA) enhancers, such as benzodiazepines in the treatment of anxiety disorders is still widespread but hampered by unfavourable side effects. some of these may be associated with binding properties to certain subtypes of the GABA(A) receptor that are unnecessary for therapeutic effects. MK-0343 was designed to be a less sedating anxiolytic, based on reduced efficacy at the alpha1 subtype and significant efficacy at alpha2 and alpha3 subtypes of the GABA(A) receptor. This paper is a double-blind, four-way cross-over (n = 12) study to investigate the effects of MK-0343 (0.25 and 0.75 mg) in comparison to placebo and an anxiolytic dose (2 mg) of the non-selective agonist lorazepam. Effects were measured by eye movements, body sway, Visual Analogue scales (VAS) and memory tests. Lorazepam impaired saccadic peak velocity (SPV), VAs alertness scores, postural stability and memory and increased saccadic latency and inaccuracy. MK-0343 0.75 mg was equipotent with lorazepam as indicated by SPV (-42.4 deg/s), saccadic latency (0.02 s) and VAS alertness scores (1.50 ln mm), while effects on memory and postural stability were smaller. MK-0343 0.25 mg only affected postural stability to a similar extent as MK-0343 0.75 mg. The effect profile of MK-0343 0.75 mg is different from the full agonist lorazepam, which could reflect the selective actions of this compound. Although less effect on VAS alertness was expected, diminished effects on memory and postural stability were present. Clinical studies in anxiety patients should show whether this dose of MK-0343 is therapeutically effective with a different side-effect profile.

Body movements during the off-ice execution of back spins in figure skating.

PubMed

Mapelli, Andrea; Rodano, Renato; Fiorentini, Angelo; Giustolisi, Andrea; Sidequersky, Fernanda V; Sforza, Chiarella

2013-10-01

Using an optoelectronic motion capture system, we quantitatively assessed the arrangement of body segments and the displacement of the horizontal projection of the center of mass (CM) in seven skaters performing off-ice back spins on a rotating device (spinner). The position of the CM at the beginning of the spins was not a determining factor, but its rapid stabilization towards the center of the spinner, together with the achievement of a stable arrangement of trunk and limbs, was crucial to get the dynamic equilibrium, necessary for a lasting performance. At full spinning, however, there was an indicative variety of individual body postures. A final deceleration, associable with the loss of body equilibrium, was detected in the last spin of most of skaters. In conclusion, the current investigation demonstrated that the off-ice execution of back spin, a critical movement of ice skating, can be measured in laboratory, thus providing quantitative information to both the skaters and the coaches. The analysis is not invasive, and it may be proposed also for longitudinal evaluations of skating and postural training. Copyright © 2013 Elsevier Ltd. All rights reserved.

Do children perceive postural constraints when estimating reach or action planning?

PubMed

Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

2009-03-01

Estimation of whether an object is reachable from a specific body position constitutes an important aspect in effective motor planning. Researchers who estimate reachability by way of motor imagery with adults consistently report the tendency to overestimate, with some evidence of a postural effect (postural stability hypothesis). This idea suggests that perceived reaching limits depend on an individual's perceived postural constraints. Based on previous work with adults, the authors expected a significant postural effect with the Reach 2 condition, as evidenced by reduced overestimation. Furthermore, the authors hypothesized that the postural effect would be greater in younger children. They then tested these propositions among children aged 7, 9, and 11 years by asking them to estimate reach while seated (Reach 1) and in the more demanding posture of standing on 1 foot and leaning forward (Reach 2). Results indicated no age or condition difference, therefore providing no support for a postural effect. When the authors compared these data to a published report of adults, a developmental difference emerged. That is, adults recognize the perceived postural constraint of the standing position resulting in under- rather than overestimation, as displayed in the seated condition. Although preliminary, these observations suggest that estimates of reach (action planning) continue to be refined between late childhood and young adulthood.

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

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

Stability and Control of Human Trunk Movement During Walking.

PubMed

Wu, Q.; Sepehri, N.; Thornton-Trump, A. B.; Alexander, M.

1998-01-01

A mathematical model has been developed to study the control mechanisms of human trunk movement during walking. The trunk is modeled as a base-excited inverted pendulum with two-degrees of rotational freedom. The base point, corresponding to the bony landmark of the sacrum, can move in three-dimensional space in a general way. Since the stability of upright posture is essential for human walking, a controller has been designed such that the stability of the pendulum about the upright position is guaranteed. The control laws are developed based on Lyapunov's stability theory and include feedforward and linear feedback components. It is found that the feedforward component plays a critical role in keeping postural stability, and the linear feedback component, (resulting from viscoelastic function of the musculoskeletal system) can effectively duplicate the pattern of trunk movement. The mathematical model is validated by comparing the simulation results with those based on gait measurements performed in the Biomechanics Laboratory at the University of Manitoba.

Classification of posture maintenance data with fuzzy clustering algorithms

NASA Technical Reports Server (NTRS)

Bezdek, James C.

1992-01-01

Sensory inputs from the visual, vestibular, and proprioreceptive systems are integrated by the central nervous system to maintain postural equilibrium. Sustained exposure to microgravity causes neurosensory adaptation during spaceflight, which results in decreased postural stability until readaptation occurs upon return to the terrestrial environment. Data which simulate sensory inputs under various sensory organization test (SOT) conditions were collected in conjunction with Johnson Space Center postural control studies using a tilt-translation device (TTD). The University of West Florida applied the fuzzy c-meams (FCM) clustering algorithms to this data with a view towards identifying various states and stages of subjects experiencing such changes. Feature analysis, time step analysis, pooling data, response of the subjects, and the algorithms used are discussed.

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.

Stiffness and Damping in Postural Control Increase with Age

PubMed Central

Cenciarini, Massimo; Loughlin, Patrick J.; Sparto, Patrick J.; Redfern, Mark S.

2011-01-01

Upright balance is believed to be maintained through active and passive mechanisms, both of which have been shown to be impacted by aging. A compensatory balance response often observed in older adults is increased co-contraction, which is generally assumed to enhance stability by increasing joint stiffness. We investigated the effect of aging on standing balance by fitting body sway data to a previously-developed postural control model that includes active and passive stiffness and damping parameters. Ten young (24 ± 3 y) and seven older (75 ± 5 y) adults were exposed during eyes-closed stance to perturbations consisting of lateral pseudorandom floor tilts. A least-squares fit of the measured body sway data to the postural control model found significantly larger active stiffness and damping model parameters in the older adults. These differences remained significant even after normalizing to account for different body sizes between the young and older adult groups. An age effect was also found for the normalized passive stiffness, but not for the normalized passive damping parameter. This concurrent increase in active stiffness and damping was shown to be more stabilizing than an increase in stiffness alone, as assessed by oscillations in the postural control model impulse response. PMID:19770083

Haptic stabilization of posture: changes in arm proprioception and cutaneous feedback for different arm orientations

NASA Technical Reports Server (NTRS)

Rabin, E.; Bortolami, S. B.; DiZio, P.; Lackner, J. R.

1999-01-01

Postural sway during quiet stance is attenuated by actively maintained contact of the index finger with a stationary surface, even if the level of applied force (<1 N) cannot provide mechanical stabilization. In this situation, changes in force level at the fingertip lead changes in center of foot pressure by approximately 250 ms. These and related findings indicate that stimulation of the fingertip combined with proprioceptive information about the hand and arm can serve as an active sensor of body position relative to the point of contact. A geometric analysis of the relationship between hand and torso displacement during body sway led to the prediction that arm and hand proprioceptive and finger somatosensory information about body sway would be maximized with finger contact in the plane of body sway. Therefore, the most postural stabilization should be possible with such contact. To test this analysis, subjects touched a laterally versus anteriorly placed surface while in each of two stances: the heel-to-toe tandem Romberg stance that reduces medial-lateral stability and the heel-to-heel, toes-outward, knees-bent, "duck stance" that reduces fore-aft stability. Postural sway was always least with finger contact in the unstable plane: for the tandem stance, lateral fingertip contact was significantly more effective than frontal contact, and, for the duck stance, frontal contact was more effective than lateral fingertip contact. Force changes at the fingertip led changes in center of pressure of the feet by approximately 250 ms for both fingertip contact locations for both test stances. These results support the geometric analysis, which showed that 1) arm joint angles change by the largest amount when fingertip contact is maintained in the plane of greatest sway, and 2) the somatosensory cues at the fingertip provide both direction and amplitude information about sway when the finger is contacting a surface in the unstable plane.

Haptic stabilization of posture: changes in arm proprioception and cutaneous feedback for different arm orientations.

PubMed

Rabin, E; Bortolami, S B; DiZio, P; Lackner, J R

1999-12-01

Postural sway during quiet stance is attenuated by actively maintained contact of the index finger with a stationary surface, even if the level of applied force (<1 N) cannot provide mechanical stabilization. In this situation, changes in force level at the fingertip lead changes in center of foot pressure by approximately 250 ms. These and related findings indicate that stimulation of the fingertip combined with proprioceptive information about the hand and arm can serve as an active sensor of body position relative to the point of contact. A geometric analysis of the relationship between hand and torso displacement during body sway led to the prediction that arm and hand proprioceptive and finger somatosensory information about body sway would be maximized with finger contact in the plane of body sway. Therefore, the most postural stabilization should be possible with such contact. To test this analysis, subjects touched a laterally versus anteriorly placed surface while in each of two stances: the heel-to-toe tandem Romberg stance that reduces medial-lateral stability and the heel-to-heel, toes-outward, knees-bent, "duck stance" that reduces fore-aft stability. Postural sway was always least with finger contact in the unstable plane: for the tandem stance, lateral fingertip contact was significantly more effective than frontal contact, and, for the duck stance, frontal contact was more effective than lateral fingertip contact. Force changes at the fingertip led changes in center of pressure of the feet by approximately 250 ms for both fingertip contact locations for both test stances. These results support the geometric analysis, which showed that 1) arm joint angles change by the largest amount when fingertip contact is maintained in the plane of greatest sway, and 2) the somatosensory cues at the fingertip provide both direction and amplitude information about sway when the finger is contacting a surface in the unstable plane.

Impact of visual and somatosensory deprivation on dynamic balance in adolescent idiopathic scoliosis.

PubMed

Kuo, Fang-Chuan; Wang, Nai-Hwei; Hong, Chang-Zern

2010-11-01

A cross-sectional study of balance control in adolescents with idiopathic scoliosis (AIS). To investigate the impact of visual and somatosensory deprivation on the dynamic balance in AIS patients and to discuss electromyographic (EMG) and posture sway findings. Most studies focus on posture sway in quiet standing controls with little effort on examining muscle-activated patterns in dynamic standing controls. Twenty-two AIS patients and 22 age-matched normal subjects were studied. To understand how visual and somatosensory information could modulate standing balance, balance tests with the Biodex stability system were performed on a moving platform under 3 conditions: visual feedback provided (VF), eyes closed (EC), and standing on a sponge pad with visual feedback provided (SV). Muscular activities of bilateral lumbar multifidi, gluteus medii, and gastrocnemii muscles were recorded with a telemetry EMG system. AIS patients had normal balance index and amplitude and duration of EMG similar to those of normal subjects in the balance test. However, the onset latency of right gastrocnemius was earlier in AIS patients than in normal subjects. In addition, body-side asymmetry was noted on muscle strength and onset latency in AIS subjects. Under EC condition, lumbar multifidi, and gluteus medii activities were higher than those under SV and VF conditions (P < 0.05). Under SV condition, the medial-lateral tilting angle was less than that under VF and EC conditions. In addition, the active duration of right gluteus medius was shorter under SV condition (P < 0.05). The dynamic balance control is particularly disruptive under visual deprivation with increasing lumbar multifidi and gluteus medii activities for compensation. Sponge pad can cause decrease in frontal plane tilting and gluteus medii effort. The asymmetric muscle strength and onset timing are attributed to anatomic deformation as opposed to neurologic etiological factors.

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.

Treatment of a patient with posterior cortical atrophy (PCA) with chiropractic manipulation and Dynamic Neuromuscular Stabilization (DNS): A case report.

PubMed

Francio, Vinicius T; Boesch, Ron; Tunning, Michael

2015-03-01

Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient's perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option.

Visual-vestibular processing deficits in mild traumatic brain injury.

PubMed

Wright, W G; Tierney, R T; McDevitt, J

2017-01-01

The search for reliable and valid signs and symptoms of mild traumatic brain injury (mTBI), commonly synonymous with concussion, has lead to a growing body of evidence that individuals with long-lasting, unremitting impairments often experience visual and vestibular symptoms, such as dizziness, postural and gait disturbances. Investigate the role of visual-vestibular processing deficits following concussion. A number of clinically accepted vestibular, oculomotor, and balance assessments as well as a novel virtual reality (VR)-based balance assessment device were used to assess adults with post-acute concussion (n = 14) in comparison to a healthy age-matched cohort (n = 58). Significant between-group differences were found with the VR-based balance device (p = 0.001), with dynamic visual motion emerging as the most discriminating balance condition. The symptom reports collected after performing the oculomotor and vestibular tests: rapid alternating horizontal eye saccades, optokinetic stimulation, and gaze stabilization, were all sensitive to health status (p < 0.05), despite the absence of oculomotor abnormalities being observed, except for near-point convergence. The BESS, King-Devick, and Dynamic Visual Acuity tests did not detect between-group differences. Postural and visual-vestibular tasks most closely linked to spatial and self-motion perception had the greatest discriminatory outcomes. The current findings suggest that mesencephalic and parieto-occipital centers and pathways may be involved in concussion.

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.

Artificial Intelligence Software for Assessing Postural Stability

NASA Technical Reports Server (NTRS)

Lieberman, Erez; Forth, Katharine; Paloski, William

2013-01-01

A software package reads and analyzes pressure distributions from sensors mounted under a person's feet. Pressure data from sensors mounted in shoes, or in a platform, can be used to provide a description of postural stability (assessing competence to deficiency) and enables the determination of the person's present activity (running, walking, squatting, falling). This package has three parts: a preprocessing algorithm for reading input from pressure sensors; a Hidden Markov Model (HMM), which is used to determine the person's present activity and level of sensing-motor competence; and a suite of graphical algorithms, which allows visual representation of the person's activity and vestibular function over time.

Comparing Postural Stability Entropy Analyses to Differentiate Fallers and Non-Fallers

PubMed Central

Fino, Peter C.; Mojdehi, Ahmad R.; Adjerid, Khaled; Habibi, Mohammad; Lockhart, Thurmon E.; Ross, Shane D.

2015-01-01

The health and financial cost of falls has spurred research to differentiate the characteristics of fallers and non-fallers. Postural stability has received much of the attention with recent studies exploring various measures of entropy. This study compared the discriminatory ability of several entropy methods at differentiating two paradigms in the center-of-pressure (COP) of elderly individuals: 1.) eyes open (EO) versus eyes closed (EC) and 2.) fallers (F) versus non-fallers (NF). Methods were compared using the area under the curve (AUC) of the receiver-operating characteristic (ROC) curves developed from logistic regression models. Overall, multiscale entropy (MSE) and composite multiscale entropy (CompMSE) performed the best with AUCs of 0.71 for EO/EC and 0.77 for F/NF. When methods were combined together to maximize the AUC, the entropy classifier had an AUC of for 0.91 the F/NF comparison. These results suggest researchers and clinicians attempting to create clinical tests to identify fallers should consider a combination of every entropy method when creating a classifying test. Additionally, MSE and CompMSE classifiers using polar coordinate data outperformed rectangular coordinate data, encouraging more research into the most appropriate time series for postural stability entropy analysis. PMID:26464267

Comparing Postural Stability Entropy Analyses to Differentiate Fallers and Non-fallers.

PubMed

Fino, Peter C; Mojdehi, Ahmad R; Adjerid, Khaled; Habibi, Mohammad; Lockhart, Thurmon E; Ross, Shane D

2016-05-01

The health and financial cost of falls has spurred research to differentiate the characteristics of fallers and non-fallers. Postural stability has received much of the attention with recent studies exploring various measures of entropy. This study compared the discriminatory ability of several entropy methods at differentiating two paradigms in the center-of-pressure of elderly individuals: (1) eyes open (EO) vs. eyes closed (EC) and (2) fallers (F) vs. non-fallers (NF). Methods were compared using the area under the curve (AUC) of the receiver-operating characteristic curves developed from logistic regression models. Overall, multiscale entropy (MSE) and composite multiscale entropy (CompMSE) performed the best with AUCs of 0.71 for EO/EC and 0.77 for F/NF. When methods were combined together to maximize the AUC, the entropy classifier had an AUC of for 0.91 the F/NF comparison. These results suggest researchers and clinicians attempting to create clinical tests to identify fallers should consider a combination of every entropy method when creating a classifying test. Additionally, MSE and CompMSE classifiers using polar coordinate data outperformed rectangular coordinate data, encouraging more research into the most appropriate time series for postural stability entropy analysis.

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

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.

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke.

PubMed

Rajachandrakumar, Roshanth; Fraser, Julia E; Schinkel-Ivy, Alison; Inness, Elizabeth L; Biasin, Lou; Brunton, Karen; McIlroy, William E; Mansfield, Avril

2017-02-01

Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with sub-acute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Augmented feedback of COM and COP modulates the regulation of quiet human standing relative to the stability boundary.

PubMed

Kilby, Melissa C; Slobounov, Semyon M; Newell, Karl M

2016-06-01

The experiment manipulated real-time kinematic feedback of the motion of the whole body center of mass (COM) and center of pressure (COP) in anterior-posterior (AP) and medial-lateral (ML) directions to investigate the variables actively controlled in quiet standing of young adults. The feedback reflected the current 2D postural positions within the 2D functional stability boundary that was scaled to 75%, 30% and 12% of its original size. The findings showed that the distance of both COP and COM to the respective stability boundary was greater during the feedback trials compared to a no feedback condition. However, the temporal safety margin of the COP, that is, the virtual time-to-contact (VTC), was higher without feedback. The coupling relation of COP-COM showed stable in-phase synchronization over all of the feedback conditions for frequencies below 1Hz. For higher frequencies (up to 5Hz), there was progressive reduction of COP-COM synchronization and local adaptation under the presence of augmented feedback. The findings show that the augmented feedback of COM and COP motion differentially and adaptively influences spatial and temporal properties of postural motion relative to the stability boundary while preserving the organization of the COM-COP coupling in postural control. Copyright © 2016. Published by Elsevier B.V.

Changes in the Vestibular System with Age: An Abstracted Bibliography,

DTIC Science & Technology

1981-04-30

group." COMMENT: Similar to other articles in this series, showing significant loss of afferents (and possibly efferents) in the vestibular nerve. k...marked dependence of postural stability on vision . In them, the disturbing optokinetic stimulus leads to a marked ipsilateral postural deviation or...SUBJECTS (Number-age): N/A EXPERIMENTAL PROCEDURES: Review FINDINGS: 1. No mention of vestibular functioning. 2. Review sections on vision , audition

The Efficacy of a Perceptive Rehabilitation on Postural Control in Patients with Chronic Nonspecific Low Back Pain

ERIC Educational Resources Information Center

Paolucci, Teresa; Fusco, Augusto; Iosa, Marco; Grasso, Maria R.; Spadini, Ennio; Paolucci, Stefano; Saraceni, Vincenzo M.; Morone, Giovanni

2012-01-01

Patients with chronic low back pain have a worse posture, probably related to poor control of the back muscles and altered perception of the trunk midline. The aim of this study was to evaluate the efficacy of a perceptive rehabilitation in terms of stability and pain relief in patients with chronic nonspecific low back pain. Thirty patients were…

Automated Assessment of Postural Stability (AAPS)

DTIC Science & Technology

2017-10-01

evaluation capability, 15 healthy subjects (7 male, 8 female) were required to perform the BESS test, while simultaneously being tracked by a Kinect 2.0...scale, specific behaviors corresponding to deficits in postural control while simultaneously spotting the subject to prevent falls. The subject under...of the error detection algorithm, we simultaneously collected data using a Kinect sensor and a 12-Camera Qualisys system. Qualisys data have been post

Motion synthesis and force distribution analysis for a biped robot.

PubMed

Trojnacki, Maciej T; Zielińska, Teresa

2011-01-01

In this paper, the method of generating biped robot motion using recorded human gait is presented. The recorded data were modified taking into account the velocity available for robot drives. Data includes only selected joint angles, therefore the missing values were obtained considering the dynamic postural stability of the robot, which means obtaining an adequate motion trajectory of the so-called Zero Moment Point (ZMT). Also, the method of determining the ground reaction forces' distribution during the biped robot's dynamic stable walk is described. The method was developed by the authors. Following the description of equations characterizing the dynamics of robot's motion, the values of the components of ground reaction forces were symbolically determined as well as the coordinates of the points of robot's feet contact with the ground. The theoretical considerations have been supported by computer simulation and animation of the robot's motion. This was done using Matlab/Simulink package and Simulink 3D Animation Toolbox, and it has proved the proposed method.

Postural Stability in Young Adults with Down Syndrome in Challenging Conditions

PubMed Central

Bieć, Ewa; Zima, Joanna; Wójtowicz, Dorota; Wojciechowska-Maszkowska, Bożena; Kręcisz, Krzysztof; Kuczyński, Michał

2014-01-01

To evaluate postural control and performance in subjects with Down syndrome (SwDS), we measured postural sway (COP) in quiet stance in four 20-second tests: with eyes open or closed and on hard or foam surface. Ten SwDS and eleven healthy subjects participated, aged 29.8 (4.8) and 28.4 (3.9), respectively. The time-series recorded with the sampling rate of 100 Hz were used to evaluate postural performance (COP amplitude and mean velocity) and strategies (COP frequency, fractal dimension and entropy). There were no intergroup differences in the amplitude except the stance on foam pad with eyes open when SwDS had larger sway. The COP velocity and frequency were larger in SwDS than controls in all trials on foam pad. During stances on the foam pad SwDS increased fractal dimension showing higher complexity of their equilibrium system, while controls decreased sample entropy exhibiting more conscious control of posture in comparison to the stances on hard support surface. This indicated that each group used entirely different adjustments of postural strategies to the somatosensory challenge. It is proposed that the inferior postural control of SwDS results mainly from insufficient experience in dealing with unpredictable postural stimuli and deficit in motor learning. PMID:24728178

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.

Temporal parameter change of human postural control ability during upright swing using recursive least square method

NASA Astrophysics Data System (ADS)

Goto, Akifumi; Ishida, Mizuri; Sagawa, Koichi

2010-01-01

The purpose of this study is to derive quantitative assessment indicators of the human postural control ability. An inverted pendulum is applied to standing human body and is controlled by ankle joint torque according to PD control method in sagittal plane. Torque control parameters (KP: proportional gain, KD: derivative gain) and pole placements of postural control system are estimated with time from inclination angle variation using fixed trace method as recursive least square method. Eight young healthy volunteers are participated in the experiment, in which volunteers are asked to incline forward as far as and as fast as possible 10 times over 10 [s] stationary intervals with their neck joint, hip joint and knee joint fixed, and then return to initial upright posture. The inclination angle is measured by an optical motion capture system. Three conditions are introduced to simulate unstable standing posture; 1) eyes-opened posture for healthy condition, 2) eyes-closed posture for visual impaired and 3) one-legged posture for lower-extremity muscle weakness. The estimated parameters Kp, KD and pole placements are applied to multiple comparison test among all stability conditions. The test results indicate that Kp, KD and real pole reflect effect of lower-extremity muscle weakness and KD also represents effect of visual impairment. It is suggested that the proposed method is valid for quantitative assessment of standing postural control ability.

Nonlinear Variability of Body Sway in Patients with Phobic Postural Vertigo

PubMed Central

Schniepp, Roman; Wuehr, Max; Pradhan, Cauchy; Novozhilov, Sergej; Krafczyk, Siegbert; Brandt, Thomas; Jahn, Klaus

2013-01-01

Background: Subjective postural imbalance is a key symptom in the somatoform phobic postural vertigo (PPV). It has been assumed that more attentional control of body posture and / or co-contraction of leg muscles during standing is used to minimize the physiological body sway in PPV. Here we analyze nonlinear variability of body sway in patients with PPV in order to disclose changes in postural control strategy associated with PPV. Methods: Twenty patients with PPV and 20 age-matched healthy subjects (HS) were recorded on a stabilometer platform with eyes open (EO), eyes closed (EC), and while standing on a foam rubber with eyes closed (ECF). Spatio-temporal changes of the center of pressure (CoP) displacement were analyzed to assess the structure of postural variability by computing the scaling exponent α and the sample entropy (SEn) of the time series. Results: With EO on firm ground α and SEn of CoP displacement were significantly lower in patients (p < 0.001). For more difficult conditions (EC, ECF) postural variability in PPV assimilated to that of HS. Conclusion: Postural control in PPV patients differs from HS under normal stance condition. It is characterized by a reduced scaling behavior and higher regularity. These changes in the structure of postural variability might suggest an inappropriate attentional involvement with stabilizing strategies, which are used by HS only for more demanding balance tasks. PMID:23966974

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.

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.

Postural compensation for vestibular loss and implications for rehabilitation.

PubMed

Horak, Fay B

2010-01-01

This chapter summarizes the role of the vestibular system in postural control so that specific and effective rehabilitation can be designed that facilitates compensation for loss of vestibular function. Patients with bilateral or unilateral loss of peripheral vestibular function are exposed to surface perturbations to quantify automatic postural responses. Studies also evaluated the effects of audio- and vibrotactile-biofeedback to improve stability in stance and gait. The most important role of vestibular information for postural control is to control orientation of the head and trunk in space with respect to gravitoinertial forces, particularly when balancing on unstable surfaces. Vestibular sensory references are particularly important for postural control at high frequencies and velocities of self-motion, to reduce trunk drift and variability, to provide an external reference frame for the trunk and head in space; and to uncouple coordination of the trunk from the legs and the head-in-space from the body CoM. The goal of balance rehabilitation for patients with vestibular loss is to help patients 1) use remaining vestibular function, 2) depend upon surface somatosensory information as their primary postural sensory system, 3) learn to use stable visual references, and 4) identify efficient and effective postural movement strategies.

THE COMPARISON OF THE LUMBAR MULTIFIDUS MUSCLES FUNCTION BETWEEN GYMNASTIC ATHLETES WITH SWAY-BACK POSTURE AND NORMAL POSTURE.

PubMed

Mahdavie, Elnaz; Rezasoltani, Asghar; Simorgh, Leila

2017-08-01

The prevalence of sway back posture (SBP) is very high among elite gymnasts. This posture may be partly due to the improper function of lumbar multifidus muscles (LMM) as lumbar stabilizers muscles. The aim of this study was to compare the thicknesses of LMM measured at rest and during the contraction elicited during an arm lift between elite gymnasts with SBP and normal posture. Observational, descriptive, comparative. The participants consist of twenty gymnasts between the ages of 17 and 30 who had trained in gymnastics for more than ten years. They were assigned to two groups: SBP (n=10) and control (n=10). Posture analysis with grid paper and plumb line was performed for all subjects. The thickness of LMM on dominant side of spinal column was measured by a real-time ultrasound at five lumbar levels. The thickness of the LMM was measured both at rest and during the contraction elicited during an arm lift. The variation between the LMM thickness between the muscle at rest and muscle at the peak of contraction was regarded as LMM muscle function. The thickness of LMM was less in SBP group than the control group at all lumbar segments. The variation in LMM thickness between the state of rest and muscle contraction was significantly less in athletes with SBP than controls when compared at all levels of the lumbar spine (p < 0.05). The function of LMM may be disturbed in athletes with SBP as demonstrated by decreased thicknesses of LMM found in gymnasts with SBP. Additionally, the thickness of the LMM as a strong antigravity and stabilizing muscle group was decreased during arm raising in gymnasts with SBP. 3a.

Aging effect on step adjustments and stability control in visually perturbed gait initiation.

PubMed

Sun, Ruopeng; Cui, Chuyi; Shea, John B

2017-10-01

Gait adaptability is essential for fall avoidance during locomotion. It requires the ability to rapidly inhibit original motor planning, select and execute alternative motor commands, while also maintaining the stability of locomotion. This study investigated the aging effect on gait adaptability and dynamic stability control during a visually perturbed gait initiation task. A novel approach was used such that the anticipatory postural adjustment (APA) during gait initiation were used to trigger the unpredictable relocation of a foot-size stepping target. Participants (10 young adults and 10 older adults) completed visually perturbed gait initiation in three adjustment timing conditions (early, intermediate, late; all extracted from the stereotypical APA pattern) and two adjustment direction conditions (medial, lateral). Stepping accuracy, foot rotation at landing, and Margin of Dynamic Stability (MDS) were analyzed and compared across test conditions and groups using a linear mixed model. Stepping accuracy decreased as a function of adjustment timing as well as stepping direction, with older subjects exhibited a significantly greater undershoot in foot placement to late lateral stepping. Late adjustment also elicited a reaching-like movement (i.e. foot rotation prior to landing in order to step on the target), regardless of stepping direction. MDS measures in the medial-lateral and anterior-posterior direction revealed both young and older adults exhibited reduced stability in the adjustment step and subsequent steps. However, young adults returned to stable gait faster than older adults. These findings could be useful for future study of screening deficits in gait adaptability and preventing falls. Copyright © 2017 Elsevier B.V. All rights reserved.

Understanding balance differences in individuals with multiple sclerosis with mild disability: an investigation of differences in sensory feedback on postural control during a Romberg task.

PubMed

Denommé, Luke T; Mandalfino, Patricia; Cinelli, Michael E

2014-06-01

A major presenting symptom in 'individuals with multiple sclerosis with mild balance disability' (IwMS) is poor postural control, resulting from slowed spinal somatosensory conduction. Postural control deficits in IwMS are most apparent when vision is removed and the base of support is reduced such is the case during tandem and single support stances. The current study used center of pressure (COP) measurements to determine whether postural control differences exist between IwMS and either 'healthy age-matched individuals' (HAMI) or 'community-dwelling older adults' (OA). Postural control was evaluated using a Romberg standing task, which required participants to stand with their feet together and hands by their sides for 45 s with either their eyes open or closed. Results revealed that COP velocity root mean square was greater in IwMS and their COP position was closer to their self-selected maximum stability limits (e.g., greater Standing Index proportion) when vision was removed compared to HAMI. Conversely, IwMS displayed similar postural control characteristics to OA. The current study highlights two novel findings: (1) the utility of novel COP measurements to assess differences in the level of postural control in IwMS; and (2) the benefit of assessing postural control levels in IwMS to not only a population with a fully intact and functional postural control system (HAMI) but also to another population that is thought to experience postural control deficits (OA).

The role of haptic cues from rough and slippery surfaces in human postural control

NASA Technical Reports Server (NTRS)

Jeka, J. J.; Lackner, J. R.

1995-01-01

Haptic information is critically important in complex sensory-motor tasks such as manipulating objects. Its comparable importance in spatial orientation is only beginning to be recognized. We have shown that postural sway in humans is significantly reduced by lightly touching a stable surface with a fingertip at contact force levels far below those physically necessary to stabilize the body. To investigate further the functional relationship between contact forces at the hand and postural equilibrium, we had subjects stand in the tandem Romberg stance while being allowed physically supportive (force contact) and non-physically supportive (touch contact) amounts of index fingertip force on surfaces with different frictional characteristics. Mean sway amplitude (MSA) was reduced by over 50% with both touch and force contact of the fingertip, compared to standing without fingertip contact. No differences in MSA were observed when touching rough or slippery surfaces. The amplitude of EMG activity in the peroneal muscles and the timing relationships between fingertip forces, body sway and EMG activity suggested that with touch contact of the finger or with force contact on a slippery surface long-loop "reflexes" involving postural muscles were stabilizing sway. With force contact of the fingertip on a rough surface, MSA reduction was achieved primarily through physical support of the body. This pattern of results indicates that light touch contact cues from the fingertip in conjunction with proprioceptive signals about arm configuration are providing information about body sway that can be used to reduce MSA through postural muscle activation.

Postural control in 13-year-old soccer players

PubMed Central

Bieć, Ewa

2010-01-01

To evaluate the effect of early systematic soccer training on postural control we measured center-of-pressure (COP) variability, range, mean velocity and frequency in bipedal quiet stance with eyes open (EO) and closed (EC) in 44 boys aged 13 (25 boys who practiced soccer for 5–6 years and 19 healthy boys who did not practice sports). The soccer players had better stability, particularly in the medial–lateral plane (M/L); their COP variability and range were lower than in controls in both EO (p < 0.05) and EC (p < 0.0005) condition indicating that the athletes were less dependent on vision than non-athletes. Improved stability of athletes was accompanied by a decrease in COP frequency (p < 0.001 in EO, and p < 0.04 in EC) which accounted for lower regulatory activity of balance system in soccer players. The athletes had lower COP mean velocity than controls (p < 0.0001 in both visual condition), with larger difference in the M/L than A/P plane (p < 0.00001 and p < 0.05, respectively). Postural behavior was more variable within the non-athletes than soccer players, mainly in the EC stances (p < 0.005 for all COP parameters). We conclude that: (1) soccer training described was efficient in improving the M/L postural control in young boys; (2) athletes developed specific postural strategies characterized by decreased COP frequency and lower reliance on vision. PMID:20582432

Whiplash-associated disorders affect postural reactions to antero-posterior support surface translations during sitting.

PubMed

Côté, Julie N; Patenaude, Isabelle; St-Onge, Nancy; Fung, Joyce

2009-06-01

Previous studies have shown that individuals with WAD display decreased postural stability during standing and walking tasks. However, their ability to maintain seated upright posture has never been investigated. The objective of this study was to characterize kinematic and electromyographic postural stabilization patterns in individuals with chronic WAD and to compare these patterns with those in an able-bodied control group. Ten individuals with WAD and an age- and gender-matched group of healthy individuals were exposed to sudden forward and backward support surface translations while they were seated. Neck and trunk muscle activity and angular displacements as well as centers of mass (COMs) linear displacements at four levels of the head and trunk were computed. The displacement onset of the combined head, arms and trunk COM was significantly delayed in persons with WAD. However, their peak trunk angles were smaller and were reached sooner. In the WAD group, the activation onset of the lumbar erector spinae was less affected by perturbation direction and the sternocleidomastoid muscle, a neck flexor, showed a trend towards being activated later, compared to the healthy group. These results suggest that individuals with WAD may alter stretch reflex threshold and/or elicit a learned response for pain avoidance that may be direction-specific. Such findings highlight the importance of assessing both spatial and temporal characteristics across different levels of the spinal musculoskeletal system to evaluate multidirectional postural responses in WAD individuals.

Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.

PubMed

Fujisawa, Toshiaki; Miyamoto, Eriko; Takuma, Shigeru; Shibuya, Makiko; Kurozumi, Akihiro; Kimura, Yukifumi; Kamekura, Nobuhito; Fukushima, Kazuaki

2009-01-01

Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. Nine hospitalized patients undergoing oral surgery of less than 2 h duration under general anesthesia (air-oxygensevoflurane) were studied. A dynamic balance test, assessing the ability of postural control against unpredictable perturbation stimuli (Stability System; Biodex Medical), a walking analysis test using sheets with foot pressure sensors (Walk Way-MG1000; Anima), and two simple psychomotor function tests were performed before anesthesia (baseline), and 150 and 210 min after the emergence from anesthesia. Only the double-stance phase in the walking analysis test showed a significant difference between baseline and results at 150 min. None of the other variables showed any differences among results at baseline and at 150 and 210 min. The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.

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.

Effect of smart phone use on dynamic postural balance.

PubMed

Cho, Sung-Hak; Choi, Mun-Hee; Goo, Bong-Oh

2014-07-01

[Purpose] The present study investigated what kind of effect smart phone use has on dynamic postural balance. [Subjects] The study subjects were 30 healthy students in their 20's who were recruited from a University in Busan, Korea. [Methods] The present experiment was quasi-experimental research which measured the postural balance (Biodex) of subjects while they sent text messages via smart phones in the standing position with the eyes open, and while they used two-way SNS. [Results] There were significant differences between standing and the dual-task situations. Among dual tasks using smart phones, SNS using situations showed the highest instability. [Conclusion] The use of smart phones in less stable conditions such as while walking or in moving vehicles should be discouraged.