Two stages and three components of the postural preparation to action

Body posture asymmetry differences between children with mild scoliosis and children with unilateral cerebral palsy

Patients with unilateral cerebral palsy (CP) often have impaired movement coordination, reduced between-limb synchronization, and less weight bearing on the affected side, which can affect the maintenance of an upright weight-bearing position and gait. This study evaluated whether the different postural patterns of children with unilateral CP could be statistically recognized using cluster analysis. Forty-five outpatients with unilateral CP (mean age, 9 years and 5 months) and 51 able-bodied children with mild scoliosis (mean age, 9 years and 2 months) were included. One observer performed moiré topography (MT) examinations using a CQ Electronic System (Poland) device. A weight distribution analysis on the base of support (BOS) between the body sides was performed simultaneously. A force plate dynamographic platform (PDM), ZEBRIS (Germany), with FootPrint software was used for these measurements. Cluster analysis revealed three groups: Cluster 1 (n = 71, 73.96%), Cluster 2 (n = 8, 8.33%), and Cluster 3 (n = 17, 17.71%). Based on the MT parameters (extracted using a data reduction technique), three typical asymmetrical postural patterns were described: (1) the postural pattern of children with mild scoliosis (SCOL), (2) the progravitational postural pattern (PGPP), and (3) the antigravitational pattern. Patterns two and three were identified in children with unilateral CP.

Dopaminergic modulation of motor coordinaton in Parkinson's disease

BACKGROUND

We applied the idea of synergies and the framework of the uncontrolled manifold hypothesis to explore the effects of dopamine replacement therapy on finger interaction and coordination in patients with early-stage Parkinson's disease (PD).

METHODS

Eight patients performed single-finger and multi-finger force production tasks with both the dominant and non-dominant hand before (off-drug) and after (on-drug) taking their dopaminergic medications. Synergy indices were defined as co-varied adjustments of commands to fingers that stabilized the total force produced by the hand.

RESULTS

PD patients showed significantly lower maximal finger forces off-drug compared to the on-drug condition, while indices of finger individuation (enslaving) were unchanged. The synergy indices were weaker during steady-state force production off-drug compared to on-drug. Anticipatory adjustments of synergies prior to the quick force pulse initiation were delayed and reduced off-drug as compared to the on-drug condition. These drug effects were observed in both the symptomatic and asymptomatic hands of the patients whose symptoms were limited to one side of the body.

CONCLUSIONS

The study demonstrates dopaminergic modulation of motor coordination in PD and supports that the analysis of different components of multi-finger synergies offers a set of indices sensitive to the effects of dopamine replacement therapy in early-stage PD. The results suggest an important role of the basal ganglia in synergy formation and in feed-forward synergy adjustments. Future studies using these methods may yield more objective, quantitative biomarker(s) of motor coordination impairments in PD, and better understanding of subcortical involvement in the neural control of natural actions.

Three components of postural control associated with pushing in symmetrical and asymmetrical stance

A number of occupational and leisure activities that involve pushing are performed in symmetrical or asymmetrical stance. The goal of this study was to investigate early postural adjustments (EPAs), anticipatory postural adjustments (APAs), and compensatory postural adjustments (CPAs) during pushing performed while standing. Ten healthy volunteers stood in symmetrical stance (with feet parallel) or in asymmetrical stance (staggered stance with one foot forward) and were instructed to use both hands to push forward the handle of a pendulum attached to the ceiling. Bilateral EMG activity of the trunk and leg muscles and the center of pressure (COP) displacements in the anterior-posterior (AP) and medial-lateral (ML) directions were recorded and analyzed during the EPAs, APAs, and CPAs. The EMG activity and the COP displacement were different between the symmetrical and asymmetrical stance conditions. The COP displacements in the ML direction were significantly larger in staggered stance than in symmetrical stance. In staggered stance, the EPAs and APAs in the thigh muscles of the backward leg were significantly larger, and the CPAs were smaller than in the forward leg. There was no difference in the EMG activity of the trunk muscles between the stance conditions. The study outcome confirmed the existence of the three components of postural control (EPAs, APAs, and CPAs) in pushing. Moreover, standing asymmetrically was associated with asymmetrical patterns of EMG activity in the lower extremities reflecting the stance-related postural control during pushing. The study outcome provides a basis for studying postural control during other daily activities involving pushing.

Compensatory but not anticipatory adjustments are altered in older adults during lateral postural perturbations

OBJECTIVE

This study investigated anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) and their relationship in older adults during lateral postural perturbations.

METHODS

Unpredictable and predictable postural disturbances were induced by a swinging pendulum that impacted at the shoulder level of two groups of older adults, non-fallers (20) and fallers (20), and in a group of young control subjects (20). The electromyographic (EMG) activity of the postural muscles and the center of pressure (COP) displacement were recorded and quantified within the time intervals typical for APAs and CPAs.

RESULTS

Both groups of older adults (non-fallers and fallers) showed higher magnitude of EMG activity in the lateral muscles and increased COP displacement, particularly, during the CPAs time interval when compared to the young group. Older adults, however, were able to change the electrical activity of the muscles during the predictable task by generating APAs with similar magnitudes of those found in young subjects.

CONCLUSIONS

Compensatory but not anticipatory adjustments are altered in older adults during predictable lateral postural perturbations.

SIGNIFICANCE

These findings provide new data on the role of APAs and CPAs in their relationship in older adults during external lateral perturbations and may advance current rehabilitative management strategies to improve balance control in older individuals.

Bilateral synergies in foot force production tasks

We analysed the effects of task symmetry during bilateral accurate force production tasks performed by the two feet. In particular, we tested a hypothesis that bilateral deficit would lead to higher indices of synergies defined as co-varied adjustments in the two forces across trials that reduced total force variability. The subjects produced steady-state force followed by a quick force pulse into the target. The two feet could be acting both into plantar flexion and into dorsiflexion (symmetrical tasks), or in opposite directions (asymmetrical task). We used the framework of the uncontrolled manifold hypothesis to quantify two variance components, one of which did not change total force (V UCM), while the other did (V ORT). Synergy indices during the asymmetrical task were higher than in either symmetrical task. The difference was due to higher V UCM (compared to the symmetrical plantar flexion task) or lower V ORT (compared to the symmetrical dorsiflexion task). The synergy index showed a drop (anticipatory synergy adjustment, ASA) starting 100-150 ms prior to the force pulse initiation. The ASA tended to be shorter and of a smaller magnitude for the asymmetrical task. This is the first demonstration of bilateral synergies during accurate force production by the legs. We conclude that bilateral deficit has no or weak effects on two-leg synergies. The results fit the earlier introduced scheme with two groups of neural variables defining average performance of a redundant system and patterns of co-variation among its elemental variables, respectively.

Anticipatory synergy adjustments: preparing a quick action in an unknown direction

We studied a mechanism of feed-forward control of a multi-finger action, namely anticipatory synergy adjustments (ASAs), prior to a quick force correction in response to a change in the gain of the visual feedback. Synergies were defined as co-varied across trials adjustments of commands to fingers that stabilized (decreased variance of) the total force. We hypothesized that ASAs would be highly sensitive to prior information about the timing of the action but not to information on its direction, i.e., on whether the gain would go up or down. The subjects produced accurate constant total force by pressing with four fingers on individual force sensors. The feedback signal could change from veridical (the sum of finger forces) to modified, with the middle finger force multiplied by 0.2 or by 1.8. The timing of the gain change and its direction could be known or unknown to the subject in advance. When the timing of the gain change was known, ASA was seen as a drop in the synergy index starting about 250-300 ms prior to the first visible correction of the total force. When the gain change timing was unknown, ASAs started much later, less than 100 ms prior to the total force correction. The magnitude of synergy index changes was significantly larger under the "time known" conditions. Information on the direction of the visual gain change had no effect on the ASA timing, while the ASA magnitude was somewhat larger when this information was not available to the subject. After the total force correction, the synergy index was significantly larger for the force signal computed using the modified gain values as compared to the synergy index value for the actual total force. We conclude that ASAs represent an important feed-forward motor control mechanism that allows preparing for a quick action even when the direction of the action is not known in advance. The results emphasize the subtle control of multi-finger synergies that are specific to the exact contributions of individual fingers to performance variables. The data fit well the central back-coupling hypothesis of synergies and the idea of control with referent body configurations.

Fitts' Law in early postural adjustments

We tested a hypothesis that the classical relation between movement time and index of difficulty (ID) in quick pointing action (Fitts' Law) reflects processes at the level of motor planning. Healthy subjects stood on a force platform and performed quick and accurate hand movements into targets of different size located at two distances. The movements were associated with early postural adjustments that are assumed to reflect motor planning processes. The short distance did not require trunk rotation, while the long distance did. As a result, movements over the long distance were associated with substantial Coriolis forces. Movement kinematics and contact forces and moments recorded by the platform were studied. Movement time scaled with ID for both movements. However, the data could not be fitted with a single regression: Movements over the long distance had a larger intercept corresponding to movement times about 140 ms longer than movements over the shorter distance. The magnitude of postural adjustments prior to movement initiation scaled with ID for both short and long distances. Our results provide strong support for the hypothesis that Fitts' Law emerges at the level of motor planning, not at the level of corrections of ongoing movements. They show that, during natural movements, changes in movement distance may lead to changes in the relation between movement time and ID, for example when the contribution of different body segments to the movement varies and when the action of Coriolis force may require an additional correction of the movement trajectory.

Effects of olivo-ponto-cerebellar atrophy (OPCA) on finger interaction and coordination

OBJECTIVES

We investigated changes in finger interaction and coordination in patients with olivo-ponto-cerebellar atrophy (OPCA) using the recently developed approach to motor synergies based on the principle of motor abundance.

METHODS

OPCA patients and control subjects performed sets of maximal and submaximal force production tasks by the fingers of each of the hands. Indices of multi-finger synergies were quantified within the framework of the uncontrolled manifold hypothesis.

RESULTS

The patients showed lower maximal forces, higher indices of finger interdependence (enslaving), and lower indices of multi-finger synergies stabilizing total force in four-finger tasks. In addition, the patients showed an impaired ability to adjust synergies in preparation to a quick action (small and delayed anticipatory synergy adjustments). The synergy indices showed significant correlations with the clinical scores (both UPDRS total motor scores and ataxia related sub-scores). The observed changes in the indices of finger interaction and coordination were qualitatively similar to those reported earlier for patients with Parkinson's disease; however, the magnitude of the changes was much higher in the OPCA group.

CONCLUSIONS

These findings fit the hypotheses on the role of the cerebellum in assembling motor synergies and in the feed-forward control of action. They suggest that the synergy index measured in artificial, constrained laboratory tasks may be predictive of more general changes in motor behavior.

SIGNIFICANCE

The results suggest that studies of multi-digit synergies may be particularly sensitive to subcortical disorders and may provide a much-needed tool for quantitative assessment of impaired coordination in such patients.

Ajustes posturais antecipatórios e compensatórios ao pegar uma bola em condição de estabilidade e instabilidade postural

Indivíduos jovens pré-selecionam suas estratégias de ajuste postural antes que uma perturbação externa ocorra, com base nas características da tarefa. Entretanto, ainda não é bem conhecido de que maneira o sistema nervoso central lida com os ajustes posturais antecipatórios e compensatórios, mediante alguns treinos de equilíbrio que são comumente usados na prática clínica da Fisioterapia. Treze adultos jovens receberam 20 perturbações posturais externas de pegar uma bola arremessada pelo experimentador sobre condições de estabilidade e instabilidade postural (sobre uma espuma). As atividades eletromiográficas dos músculos tríceps braquial (músculo focal), retoabdominal e paravertebral lombar foram avaliadas nas janelas de tempo típicas dos ajustes posturais antecipatórios e compensatórios, assim como o pico do deslocamento do centro de pressão corporal após a perturbação. A magnitude das integrais da atividade eletromiográfica do músculo tríceps braquial foi significativamente menor em condição de instabilidade postural, não houve diferença estatística entre as condições para as integrais da atividade eletromiográfica dos músculos retoabdominal e paravertebral lombar. O pico do deslocamento anteroposterior do centro de pressão corporal foi similar entre as duas condições. Treino de equilíbrio associado à perturbação externa da postura sobre espuma pode não ser mais eficaz ou eficiente do que sobre uma superfície estável, quando se pretende alterar a atividade dos músculos posturais do tronco. Além disso, este tipo de intervenção pode corroborar para diminuir a ativação antecipatória (ajustes posturais antecipatórios) do músculo focal.

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

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.

Changes in multifinger interaction and coordination in Parkinson's disease

In this study, we tested several hypotheses related to changes in finger interaction and multifinger synergies during multifinger force production tasks in Parkinson's disease. Ten patients with Parkinson's disease, mostly early stage, and 11 healthy control subjects participated in the study. Synergies were defined as covaried adjustment of commands to fingers that stabilized the total force produced by the hand. Both Parkinson's disease patients and control subjects performed accurate isometric force production tasks with the fingers of both the dominant and nondominant hands. The Parkinson's disease patients showed significantly lower maximal finger forces and higher unintended force production (enslaving). These observations suggest that changes in supraspinal control have a major effect on finger individuation. The synergy indexes in the patients were weaker in both steady-state and cyclic force production tasks compared with the controls. These indexes also were stronger in the left (nondominant) hand in support of the dynamic-dominance hypothesis. Half of the patients could not perform the cyclic task at the highest frequency (2 Hz). Anticipatory adjustments of synergies prior to a quick force pulse production were delayed and reduced in the patients compared with the controls. Similar differences were observed between the asymptomatic hands of the patients with symptoms limited to one side of the body and matched hands of control subjects. Our study demonstrates that the elusive changes in motor coordination in Parkinson's disease can be quantified objectively, even in patients at a relatively early stage of the disease. The results suggest an important role of the basal ganglia in synergy formation and demonstrate a previously unknown component of impaired feedforward control in Parkinson's disease reflected in the reduced and delayed anticipatory synergy adjustments.

Postural control in response to an external perturbation: effect of altered proprioceptive information

The purpose of the study was to investigate the role of altered proprioception on anticipatory (APAs) and compensatory (CPAs) postural adjustments and their interaction. Nine healthy adults were exposed to external perturbations induced at the shoulder level while standing with intact or altered proprioception induced by bilateral Achilles tendon vibration. Visual information was altered (eyes open or closed) in both the conditions. Electrical activity of eight trunk and leg muscles and center of pressure (COP) displacements were recorded and quantified within the time intervals typical for APAs and CPAs. The results showed that when proprioceptive information was altered in eyes-open conditions, anticipatory muscle activity was delayed. Moreover, altered proprioceptive information resulted in smaller magnitudes of compensatory muscle activity as well as smaller COP displacements after the perturbation in both eyes-open and eyes-closed conditions. The outcome of the study provides information on the interaction between APAs and CPAs in the presence of altered proprioception.

Early postural adjustments in preparation to whole-body voluntary sway

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

Early and late components of feed-forward postural adjustments to predictable perturbations

OBJECTIVES

The purpose was to investigate two types of feed-forward postural adjustments associated with preparation to predictable external perturbations.

METHODS

Nine subjects stood on a wedge, toes-up or toes-down while a pendulum impacted their shoulders. EMGs of leg and trunk muscles were analyzed within the framework of the uncontrolled manifold hypothesis.

RESULTS

Early postural adjustments (EPAs) were seen 400-500 ms and anticipatory postural adjustments (APAs), 100-150 ms prior to the impact. EPAs and APAs were also seen in the time profiles of muscle modes representing muscle groups with linear scaling of the activation levels. Center of pressure shifts were stabilized by co-varied adjustments in muscle mode magnitudes across trials. The index of these multi-muscle synergies showed two drops (anticipatory synergy adjustments, ASAs), prior to EPA and APA in each subject. The findings were consistent between the two conditions.

CONCLUSIONS

The results show that feed-forward postural adjustments represent a sequence of two phenomena, EPAs and APAs. Each of those is preceded by ASAs that reduce stability of a variable that is to be adjusted during the EPAs and APAs. The findings fit a hierarchical scheme with synergic few-to-many mappings at each level of the hierarchy based on the referent body configuration hypothesis.

SIGNIFICANCE

The results show the complexity of the postural preparation to action. Potentially, they have implications for the current strategies of rehabilitation of patients with neuro-motor disorders characterized by impaired postural control.

Effects of muscle fatigue on multi-muscle synergies

We studied the effects of fatigue of ankle dorsiflexors on multi-muscle synergies defined as co-varied adjustments of elemental variables (M-modes) that stabilize a task-related performance variable (trajectory of the center of pressure, COP). M-modes were defined as muscle groups with parallel changes in activation levels. Healthy participants performed voluntary body sway in the anterior-posterior direction while trying to minimize sway in the medio-lateral direction at 0.25, 0.5, and 0.75 Hz. The trials were repeated before and during fatigue induced with a timed voluntary contraction against a constant load. Factor extraction using the principal component method was used to identify four M-modes within the space of integrated indices of muscle activity. Variance in the M-mode space at different phases across sway cycles was partitioned into two components, one that did not affect the average value of COP shift and the other that did. There were no significant effects of fatigue on variability of performance of the explicit task and on the amplitude of the COP shift. Variance of muscle activation indices and M-mode magnitudes increased during fatigue for muscles (and M-modes) both involved and not involved in the fatiguing exercise. Most of the M-mode variance increase was within the sub-space compatible with the unchanged COP trajectory resulting in an increase of the index of the multi-M-mode synergy. We conclude that one of the adaptive mechanisms to fatigue within a redundant multi-muscle system involves an increase in the variance of activation of non-fatigued muscles with a simultaneous increase in co-variation among muscle activations. The findings can be interpreted within the referent configuration hypothesis on the control of whole-body actions.