Differences in preferred reference frames for postural orientation shown by after-effects of stance on an inclined surface

Noisy galvanic vestibular stimulation influences head stability in young healthy adults while standing on a moving platform

BACKGROUND

The ability to stand with eyes closed on a sinusoidal translational moving platform may be affected by spatial orientation owing to vestibular input information. Moreover, changes in the frequency of the moving platform may affect the sensory reweighting through somatosensory and vestibular sensations. However, it is unclear whether noisy galvanic vestibular stimulation (nGVS), which activates vestibular-related brain regions, affects the stability of individuals standing on a platform moving at different frequencies.

RESEARCH QUESTION

Do vestibular stimulation by nGVS and changes in the frequency of translationally moving platforms affect the standing stability of individuals?

METHODS

Thirty-one healthy young adult participants were provided both sham and nGVS interventions while they maintained a static standing position, with their eyes closed, on an anterior-posterior sinusoidal translation platform. The nGVS was adapted to an optimal intensity below the perceptual threshold (frequency band: 100-640 Hz), and the sham stimulus was adapted to 0 µA. The participants were randomly assessed for postural stability at 0.2, 0.6, and 1.2 Hz moving platform frequencies for 80 s each under both stimulus conditions. Postural stability was calculated as the root mean square (RMS) sway from head accelerations in the anteroposterior (AP) and mediolateral (ML) directions for 50 s between 20 and 70 s during the 80 s period, measured using an inertial sensor placed on the external occipital ridge.

RESULTS

nGVS significantly reduced the RMS sway of head acceleration in the AP direction compared with sham stimulation. Furthermore, nGVS significantly reduced RMS sway in the ML direction compared with sham stimulation at a 1.2 Hz moving platform oscillation.

SIGNIFICANCE

These findings suggest that postural adjustment by the vestibular system influences head stability on a moving platform at specific sinusoidal translation frequencies, suggesting that nGVS may reduce head sway.

The role of torque feedback in standing balance

It has been proposed that sensory force/pressure cues are integrated within a positive feedback mechanism, which accounts for the slow dynamics of human standing behavior and helps align the body with gravity. However, experimental evidence of this mechanism remains scarce. This study tested predictions of a positive torque feedback mechanism for standing balance, specifically that differences between a "reference" torque and actual torque are self-amplified, causing the system to generate additional torque. Seventeen healthy young adults were positioned in an apparatus that permitted normal sway at the ankle until a brake on the apparatus was applied, discreetly "locking" body movement during stance. Once locked, a platform positioned under the apparatus remained in place (0 mm) or slowly translated backward (3 mm or 6 mm), tilting subjects forward. Postural behavior was characterized by two distinct responses: the center of pressure (COP) offset (i.e., change in COP elicited by the surface translation) and the COP drift (i.e., change in COP during the sustained tilt). Model simulations were performed using a linear balance control model containing torque feedback to provide a conceptual basis for the interpretation of experimental results. Holding the body in sustained tilt positions resulted in COP drifting behavior, reflecting attempts of the balance control system to restore an upright position through increases in plantar flexor torque. In line with predictions of positive torque feedback, larger COP offsets led to faster increases in COP over time. These findings provide experimental support for a positive torque feedback mechanism involved in the control of standing balance.NEW & NOTEWORTHY Using model simulations and a novel experimental approach, we tested behavioral predictions of a sensory torque feedback mechanism involved in the control of upright standing. Torque feedback is thought to reduce the effort required to stand and play a functional role in slowly aligning the body with gravity. Our results provide experimental evidence of a torque feedback mechanism and offer new and valuable insights into the sensorimotor control of human balance.

Induced effects of electrical muscle stimulation and visual stimulation on visual sensory reweighting dynamics during standing on a balance board

Providing instruction cues on body motions using stimulations has the potential to induce sensory reweighting dynamics. However, there are currently very few quantitative investigations on the difference in the induced effects on the sensory reweighting dynamics between stimulation methods. We therefore investigated the difference in the induced effects of electrical muscle stimulation (EMS) and visual sensory augmentation (visual SA) on sensory reweighting dynamics during standing on a balance board. Twenty healthy participants controlled their posture to maintain the board horizontally in the balance-board task, which included a pre-test without stimulation, a stimulation test, and a post-test without stimulation. The EMS group (n = 10) received EMS to the tibialis anterior or soleus muscle based on the board tilt. The visual SA group (n = 10) received visual stimuli via a front monitor based on the board tilt. We measured the height of the board marker and calculated the board sway. Before and after the balance-board task, the participants performed static standing with their eyes open and closed. We measured postural sway and calculated the visual reweighting. The visual reweighting showed a strong negative correlation with the balance board sway ratio between the pre- and stimulation tests in the EMS group and a strong positive correlation with that in the visual SA group. Moreover, for those who reduced the balance board sway in the stimulation test, the visual reweighting was significantly different between the stimulation methods, demonstrating that the induced effect on sensory reweighting dynamics is quantitatively different depending on which method is used. Our findings suggest that there is an appropriate stimulation method to change to the targeted sensory weights. Future investigations on the relationship between sensory reweighting dynamics and stimulation methods could contribute to the proposal and implementation of new training methods for learning to control the target weights.

Immediate effect of lower extremity joint manipulation on a lower extremity somatosensory illusion: a randomized, controlled crossover clinical pilot study

Objective: This study explored the influence of lower extremity manipulation on the postural after-effects of standing on an inclined surface.

Methods: Eight healthy individuals (28.0 ± 4.1 years) were recruited for this open-label, crossover study. Participants stood on an incline board for 3 min to develop a known form of somatosensory illusion. After randomization to either a lower-extremity joint manipulation or no intervention, participants immediately stood on a force plate for 3 min with eyes closed. After a 24-h washout period, participants completed the remaining condition. Center of pressure (CoP) position data was measured by a force plate and evaluated using statistical parametric mapping. Pathlength, mean velocity, and RMS were calculated for significant time periods and compared with corrected paired t-tests.

Results: Parametric maps revealed that CoP position of control and intervention conditions differed significantly for two time periods (70–86 s—control: 0.17 ± 1.86 cm/intervention: −1.36 ± 1.54 cm; 141–177 s—control: −0.35 ± 1.61 cm/intervention: −1.93 ± 1.48 cm). CoP pathlength was also significantly decreased for the second period (control: 6.11 ± 4.81 cm/intervention: 3.62 ± 1.92 cm).

Conclusion: These findings suggest that extremity manipulation may be a useful intervention for populations where CoP stability is an issue. This study contributes to the growing body of evidence that manipulation of the extremities can drive global postural changes, as well as influence standing behavior. Further, it suggests these global changes may be driven by alterations in central integration.

Clinical Trial Registration:ClinicalTrials.gov, NCT Number: NCT05226715.

Postural and visual aftereffects to a slanted floor in lying and sitting positions

After lying on a slanted floor for a while with the eyes closed, we may perceive it to be less slanted than at the beginning. After viewing a slanted floor while lying on a flat base, we may perceive it to be more horizontal. We investigated these postural and visual adaptations and their interactions with participants lying and sitting on the floor. The participants were adapted to a floor that was posturally, visually, or jointly slanted, and were asked to estimate the test slants around the adapting slant. The estimates were described as a linear function of the test slant with a high goodness-of-fit over the adapting slant. This supported normalization, not satiation, view. Second, the slope of the function, i.e., sensitivity to slant, in the lying position was low in the postural and visual conditions but high in the joint condition, whereas the sensitivity in the sitting position was equally high in all conditions. This was explained by an increase in visual and non-visual cues to the gravitational vertical in the sitting position, and by an abnormal pattern of intracorporeal hydrostatic pressure in the lying position. Third, in both body positions, the angle at which the slant appeared horizontal, i.e., the subjective horizontal (SH), was larger in the postural condition than in the visual condition. Finally, when the postural and visual adaptations were joint, the SH in the lying position was somewhere between the postural- and visual-alone SHs, whereas the SH in the sitting position approximated the visual-alone SH.

No Difference in the Acute Effects of Randomization vs. Blocking of Units of Lower-Extremity Proprioceptive Training on Balance and Postural Control in Young Healthy Male Adults

Random practice is a form of differential learning and its favorable acute effects on motor performance are well described when visual tasks are practiced. However, no study to date has investigated the acute effects of differential learning using variable proprioceptive stimuli instead of the visual cues. The aim of the present study was to compare the acute effects of randomized versus blocked lower-extremity proprioceptive training stimuli on balance and postural adjustments. In two conditions, healthy young males (n = 15, age = 23 years) performed 16 one-legged landings on a board tilted in four directions: 1) tilt direction unknown and randomized and 2) tilt direction known with order of presentation blocked. Multi-segmental angular sway while balancing on an unstable surface and postural responses to perturbation stimulus by surface tilts were measured before and 4 min after training. Overall frontal-plane postural sway on the unstable surface decreased (p < 0.05, η² = 0.022) in both conditions, while sagittal-plane postural sway remained unchanged. When the surface was toes-up tilted in the perturbation test, the sagittal-plane shank-thigh-pelvis alignment improved in both conditions (p < 0.05, η² = 0.017), but the direction of the segmental positioning was non-uniform across participants. We conclude that randomization vs. blocking of units of lower-extremity proprioceptive training did not affect balance and postural control in our cohort of healthy young adults but the improvements were test-specific.

Postural adjustment as a function of scene orientation

Visual orientation plays an important role in postural control, but the specific characteristics of postural response to orientation remain unknown. In this study, we investigated the relationship between postural response and the subjective visual vertical (SVV) as a function of scene orientation. We presented a virtual room including everyday objects through a head-mounted display and measured head tilt around the naso-occipital axis. The room orientation varied from 165° counterclockwise to 180° clockwise around the center of display in 15° increments. In a separate session, we also conducted a rod adjustment task to record the participant's SVV in the tilted room. We applied a weighted vector sum model to head tilt and SVV error and obtained the weight of three visual cues to orientation: frame, horizon, and polarity. We found significant contributions for all visual cues to head tilt and SVV error. For SVV error, frame cues made the largest contribution, whereas polarity contribution made the smallest. For head tilt, there was no clear difference across visual cue types, although the order of contribution was similar to the SVV. These findings suggest that multiple visual cues to orientation are involved in postural control and imply different representations of vertical orientation across postural control and perception.

Proprioceptive postural control strategies differ among non-injured athletes

Postural control during complex tasks requires adequate sensory integration and somaesthetic reweighting: suboptimal postural strategies can lead to injury. We assessed the ability of healthy athletes to reweight somaesthetic signals during postural perturbations on different surfaces. Thirty-five young (16 ± 1 years), healthy, elite handball players participated in this cross-sectional study. Proprioceptive reweighting was evaluated via vibration of the triceps surae and lumbar muscles on firm and foam surfaces. Postural variables and the electromyographic activity of the gluteus medius (GM), semitendinosus (ST) and fibularis longus (FL) were recorded during the PRE (10 s), VIBRATION (20 s) and POST (20 s) periods. Ankle proprioception was predominantly used on the firm compared to foam support. However, two opposing behaviours were observed: a "rigid" strategy in which reliance on ankle proprioception increased on the foam, and a "plastic" strategy that involved a proximal shift of proprioceptive reliance (p < 0.001). The plastic strategy was associated with a more effective recovery of balance after vibration cessation (p < 0.05). ST activation was higher during POST in the rigid strategy and did not return to the PRE level (p < 0.05) whereas it did in the plastic strategy. Proprioceptive strategies for postural control are highly variable and future studies should evaluate their contribution to injury.

Effect of Exercise Involving Standing Weight Shifting to the Nonparetic Side on an Inclined Surface in the Early Phase After a Stroke: A Randomized Controlled Trial

OBJECTIVE

This study aimed to clarify whether an exercise involving weight shifting to the nonparetic side while standing on an inclined surface improves standing balance in the early phase after stroke.

METHODS

This assessor-blinded, randomized controlled trial included people undergoing inpatient rehabilitation at a university hospital. Participants (N = 52) with hemiparesis caused by a stroke were randomly assigned to an experimental group (n = 26) or control group (n = 26). Participants performed a weight-shifting exercise to the nonparetic side using a goal-directed reaching strategy while standing on an inclined surface that was elevated 5 degrees to the nonparetic side in the experimental group or a flat surface in the control group. The reaching exercise was conducted 30 times per day for 5 days. Primary outcome was the Berg Balance Scale. Secondary outcomes were the posturographic examination (static standing and lateral weight shifting to the nonparetic and paretic sides), Trunk Control Test, Trunk Impairment Scale, Functional Ambulation Category, and Functional Independent Measure motor item scores.

RESULTS

Through intention-to-treat analysis, no significant intervention effects were observed between groups on the Berg Balance Scale. A significant intervention effect was observed, however, with the experimental group on the lateral weight shifting to the nonparetic side in the mean percentage bodyweight values and center-of-pressure moving distance and to the paretic side in center-of-pressure moving distance and Functional Ambulation Category. There were no significant interaction effects concerning other outcomes.

CONCLUSION

These results suggest that standing reaching exercises to the nonparetic side while standing on an inclined surface could improve lateral weight-shifting capacity and gait ability in participants in the early poststroke phase.

IMPACT

This intervention should be incorporated into standard treatment programs focusing on the paretic side during early stroke rehabilitation.

The Effects of Static Stretching On Dynamic Postural Control During Maximum Forward Leaning Task

The purpose of this study was to determine how the application of static stretching to ankle plantar flexors affects postural control during maximum forward leaning. Twenty-six volunteer males (age 21.4 ± 1.2 years) were randomly assigned to stretching and control conditions. Participants conducted 5-min stretching on a stretch board for the stretching condition and were kept standing for 6-min for the control condition. Before and after intervention, the range of motion (ROM) at ankle dorsiflexion and the center of pressure (COP) excursion during maximal forward leaning were determined. Mean anteroposterior COP position, COP velocity and COP areas were calculated to compare the change in postural control. After stretching, ROM was significantly increased. During maximal forward leaning after stretching, both COP position and velocity showed significant increases compared to before stretching. Moreover, COP position and velocity in the stretching condition were significantly higher than in the control condition after stretching. No significant differences were found in COP area before and after stretching. Five-minute stretching increased not only ROM but also the anterior limit of stability while maintaining posture and led to faster COP shift than before stretching. These results indicate that static stretching would improve dynamic postural control as well.

Wearing compression garments differently affects monopodal postural balance in high-level athletes

This study investigated the acute effects of compression garments (CG) on balance control in elite athletes. 15 male professional handball players were recruited. They had to stand as motionless as possible in a monopedal stance on a force plate with the eyes closed and on a wobble board with the eyes open, while wearing CG or not. Centre of foot pressure mean velocity and surface area were calculated. Statistics were first calculated with the data from the whole sample. A hierarchical cluster analysis was also performed in order to categorize the participants’ behaviours into subgroups with similar characteristics. The whole group analysis showed that there were no significant effects attributed to CG. The clustering analysis identified two distinct and homogeneous subgroups of participants. Only athletes with the best balance abilities at baseline could benefit from CG wearing to improve their balance control. These athletes, who swayed less and were more sensitive to somatosensory manipulation due to CG wearing, seem to control balance by adopting a support-dependent preferred sensorimotor tactic. Our findings suggest that amongst high-level athletes, the ability to benefit from CG wearing to improve balance control seems to depend on participants’ intrinsic balance skills and/or preferred sensorimotor tactics.

Glide Time Relates to Mediolateral Plantar Pressure Distribution Rather Than Ski Edging in Ski Skating

The purpose of this study was (i) to assess the differences in relative glide time and both ski edging angle and plantar pressure mediolateral distribution in skiers of different levels and (ii) to further investigate the relationships between the aforementioned variables. Twelve male cross-country skiers (6 national and 6 regional level) skied at 4.2 m s⁻¹ on a 2.5° uphill snow track using the V2 technique. The relative glide time (in percentage of contact time) and mediolateral plantar pressure distribution variables (asymmetry index, ASI) were derived from pressure insole measurements. Ski edging angle variables were calculated from an Inertial Measurement Unit placed on the ski. Minimum, maximum, mean, and range of both ASI and ski edging angle were computed over the gliding phase, giving information about the beginning, end, and throughout the gliding phase. Relative glide time was significantly higher, and minimum and mean ASI were significantly lower in the national- than in the regional-level skiers. Relative glide time was strongly negatively correlated to minimum ASI (i.e., plantar pressure mostly on the foot lateral side at the beginning of gliding phase) and strongly positively correlated to ASI range. These results may reflect a larger body mass transfer above the ski from the beginning of the gliding phase to increase gliding, especially in the national-level skiers. Ski edging angle seems less relevant to discriminate skiers' level of performance. These results have direct consequences on how technique must be taught to young cross-country skiers.

Effects of Shank Vibration on Lean After-Effect

Postural adaptability is related to central sensory integration and reweighting efficiency. Incline-interventions lead to lean after-effect (LAE), but it is not fully known how sensory reweighting may affect the magnitude and duration of LAE. We tasked fifteen young and healthy subjects with performing incline-interventions under conditions designed to perturb proprioception during or after the incline-intervention. We found that support surface configuration affected responses to tendon vibration. Additionally, vibration during an incline-intervention did not inhibit LAE, but vibration during an after-effect significantly affected LAE. Results reinforce claims that postural adaptation is based on modifications of central mechanisms of perception, not peripheral shank proprioceptors and improve our understanding of the role of sensory reweighting and sensory integration into postural adaptability.

Center-of-pressure dynamics of upright standing as a function of sloped surfaces and vision

Upright postural control system exhibits dynamic behavior to produce flexible adaptations to a variety of internal and external perturbations. Understanding the range of postural adaptability in healthy individuals can index the overall state of the system and needs to be defined over various environmental and task constraints. The purpose of the current investigation was to understand the role of vision and support surface angle on the multiple time scales of control that maintain upright posture. Thirteen young, healthy adults performed quiet standing tasks on flat, inclined and declined support surfaces with either eyes open or closed. The variability of the anterior-posterior center of pressure (COP) trajectory was analyzed using linear (COP_length) and non-linear (multiscale entropy - MSE) approaches to index postural dynamics. Sway magnitude - COP_length - was greater in both sloped conditions compared to the flat support surface standing and with the removal of vision. Increased irregularity was revealed during the sloped conditions compared to flat surface standing with additional increases of COP complexity when vision was removed. Overall, a similar range of postural adaptability was revealed for both the singular and combined sensory manipulations suggesting limits to the degree of change of COP dynamics.

Multidimensional Recurrence Quantification Analysis of Multi-muscle Synergy in Elderly during Standing on Slopes

Identifying balance deficits associated with aging is critical to preventing falls in elderly people. The purpose of this study was to investigate the effects of aging on the multi-muscle synergy in lower extremities during standing on sloped surfaces. Eighteen healthy elderly subjects and 18 healthy young subjects were recruited in the experiment. Subjects were required to stand quietly on slopes at 5 different angles for 30 s with and without visual feedback. Surface electromyography signals of muscles in the lower limbs were collected simultaneously during standing. The muscle synergy of synergistic muscles and of antagonistic muscles were quantified by the parameters of multidimensional recurrence quantification analysis (MdRQA). The results showed that the dynamical synergies in synergistic and antagonistic muscle groups were significantly enhanced in elderly group, especially during standing on sloped surfaces (p < 0.05). The MdRQA parameters were significantly increased when standing without visual feedback than with visual feedback (p < 0.05). The aging and the absence of visual feedback led to more deterministic structures in the dynamical coupling of muscle activations, indicating strengthened synergistic contractions of muscles. These changes in elderly may increase the restriction on balance control and reduce the adaptability of motor system to potential external perturbations. This study shed light on the effects of aging on standing balance control and may facilitate to develop novel strategies for evaluation of aging and predication of falls.

Non-invasive Brain Stimulation of the Posterior Parietal Cortex Alters Postural Adaptation

Effective central sensory integration of visual, vestibular, and proprioceptive information is required to promote adaptability in response to changes in the environment during postural control. Patients with a lesion in the posterior parietal cortex (PPC) have an impaired ability to form an internal representation of body position, an important factor for postural control and adaptation. Suppression of PPC excitability has also been shown to decrease postural stability in some contexts. As of yet, it is unknown whether stimulation of the PPC may influence postural adaptation. This investigation aimed to identify whether transcranial direct current stimulation (tDCS) of the bilateral PPC could modulate postural adaptation in response to a bipedal incline postural adaptation task. Using young, healthy subjects, we delivered tDCS over bilateral PPC followed by bouts of inclined stance (incline-interventions). Analysis of postural after-effects identified differences between stimulation conditions for maximum lean after-effect (LAE; p = 0.005) as well as a significant interaction between condition and measurement period for the average position (p = 0.03). We identified impaired postural adaptability following both active stimulation conditions. Results reinforce the notion that the PPC is involved in motor adaptation and extend this line of research to the realm of standing posture. The results further highlight the role of the bilateral PPC in utilizing sensory feedback to update one's internal representation of verticality and demonstrates the diffuse regions of the brain that are involved in postural control and adaptation. This information improves our understanding of the role of the cortex in postural control, highlighting the potential for the PPC as a target for sensorimotor rehabilitation.

Dynamical Analysis of Standing Balance Control on Sloped Surfaces in Individuals with Lumbar Disc Herniation

The changes of balance control mechanism caused by lumbar disc herniation (LDH) has not been well understood. This study aimed to investigate the effects of LDH on the balance control during standing on sloped surfaces. Ten patients with LDH and 10 gender- and age-matched healthy subjects were instructed to stand quietly on a sloped surface at -5°, 0° or +5°, respectively. The trajectories of the center of pressure (COP) of each individual limb and the full-body were recorded. Cross recurrence quantification analysis (CRQA) was applied to assess the coordination of COP components at the anterior-posterior and medial-lateral directions. The patients with LDH presented magnified inter-limb load asymmetry and had more deterministic components in the COP coordination of the less-affected limb and the full-body than the healthy subjects. The LDH led to decreased dynamical degree of freedom and less flexibility in bidirectional controlling the center of mass simultaneously. The effects of sensorimotor deficits due to LDH could be more obviously exhibited as standing on a declined rather than an inclined surface. This study shed light on the effects of LDH on standing balance control and may facilitate to develop novel strategies for evaluation of LDH.

Patterns of muscle activation and modulation of ankle intrinsic stiffness in different postural operating conditions

Intrinsic stiffness describes the dynamic relationship between imposed angular perturbations to a joint and the resulting torque response, due to intrinsic mechanical properties of muscles and joint, and inertia of the limbs. Recently, we showed that ankle intrinsic stiffness changes substantially with sway in normal standing. In the present study, we documented how ankle intrinsic stiffness changes with postural operating conditions. Subjects stood on an apparatus while subjected to ankle position perturbations in five conditions: normal standing, toe-up and toe-down standing, and backward and forward lean. In each condition, ankle intrinsic stiffness was estimated while its modulation with sway was accounted for. The results demonstrated that ankle intrinsic stiffness varies widely, from 0.08 to 0.75 of critical stiffness, across postural operating conditions; however, it is always smaller than the critical stiffness. Therefore, other contributions are necessary to ensure stable standing. The mean intrinsic stiffness was highest in forward lean and lowest in backward lean. Moreover, within each operating condition, the intrinsic stiffness changed with center-of-pressure position in one of three ways, each associated with a distinct muscle activation pattern; these include 1) monotonically increasing stiffness-center of pressure relation, associated with a progressive increase in triceps surae activation, 2) decreasing-increasing stiffness-center of pressure relation, associated with initial activation of tibialis anterior and later activation of triceps surae, and 3) monotonically decreasing stiffness-center of pressure relation, associated with decreasing activation of tibialis anterior. Thus intrinsic stiffness varies greatly within and across postural operating conditions, and a correct understanding of postural control requires accounting for such variations.NEW & NOTEWORTHY Ankle intrinsic stiffness changes with sway in normal standing. We quantified such changes in different postural operating conditions and demonstrated that the intrinsic stiffness changes in a manner associated with different activation patterns of ankle plantarflexors and dorsiflexors, emerging in different operating conditions. Large modulations of the intrinsic stiffness within and across postural operating conditions show that the stiffness importance and contribution change and must be accounted for in the study of postural control.

Tonic Neuromuscular Processing Affects Postural Adaptation Differently in Aging and Parkinson's Disease

The combination of phasic and tonic neuromuscular processes are involved in the maintenance of normal upright posture. The latter is of particular importance in some pathologies, such as Parkinson's Disease (PD), which is known by one of its cardinal symptoms—tonic dysfunction (i.e., rigidity). Changes in tonic function may also occur during healthy aging. In this investigation, somatosensory input was manipulated by changing the support surface orientation for prolonged periods of quiet stance (QS). The aim was to shed light on how long-term tonic responses called postural lean after-effects are affected by aging and age-related neuropathology. Forty one participants were tested: 19 healthy young (25±5 years), 13 healthy older (63±8 years), and 9 adults with PD (63±5 years). Baseline conditions were eyes-closed QS on a stable surface or standing on an unstable, sway-referenced (SR) surface. Four experimental conditions combined two types of toes-up ramp tilt adaptation (120 s of toes-up static 7° tilt or sinusoidal 7° ± 3° tilt) with two types of post-adaptation (120 s of QS or SR). Results revealed postural after-effects during post-adaptation QS showing significant anterior COP shift for both young and older adults (p < 0.0001), but not PD (p > 0.06, n.s.). Compared to young, postural after-effects in older adults showed longer decay constants and did not return to baseline COP within the 120 s post-adaptation period (p < 0.05). Postural after-effects during SR, which appeared as toes-up surface tilt were highly significant in healthy populations (p = 0.001), but took longer to develop in PD. Younger adults showed significantly larger dorsiflexion (p < 0.01) and faster decay constants than older adults (p < 0.05). In summary, (1) postural after-effects decayed to baseline when post-tilt surface was stable but were retained and even grew larger post-adaptation in the SR surface conditions in all groups, (2) postural after-effects differed between healthy age groups, (3) PD showed less adaptation to surface changes. Differences in size and decay of after-effects between healthy and PD groups suggest tonic neuromuscular processes play a role in how adaptable postural control is to changing surface conditions and this is affected by healthy aging and basal ganglia function.

Human Postural Control

From ancient Greece to nowadays, research on posture control was guided and shaped by many concepts. Equilibrium control is often considered part of postural control. However, two different levels have become increasingly apparent in the postural control system, one level sets a distribution of tonic muscle activity (“posture”) and the other is assigned to compensate for internal or external perturbations (“equilibrium”). While the two levels are inherently interrelated, both neurophysiological and functional considerations point toward distinct neuromuscular underpinnings. Disturbances of muscle tone may in turn affect movement performance. The unique structure, specialization and properties of skeletal muscles should also be taken into account for understanding important peripheral contributors to postural regulation. Here, we will consider the neuromechanical basis of habitual posture and various concepts that were rather influential in many experimental studies and mathematical models of human posture control.

Evaluation of postural sway and impact forces during ingress and egress of scissor lifts at elevations

Workers are at risk when entering (ingress) or exiting (egress) elevated scissor lifts. In this study, we recorded ground impact forces and postural sway from 22 construction workers while they performed ingress and egress between a scissor lift and an adjacent work surface with varying conditions: lift opening designs, horizontal and vertical gaps, and sloped work surfaces. We observed higher peak ground shear forces when using a bar-and-chain opening, with larger horizontal gap, with the lift surface more than 0.2 m below the work surface, and presence of a sloped (26°) work surface. Similar trends were observed for postural sway, except that the influence of vertical distance was not significant. To reduce slip/trip/fall risk and postural sway of workers while ingress or egress of an elevated scissor lift, we suggest scissor lifts be equipped with a gate-type opening instead of a bar-and-chain design. We also suggest the lift surface be placed no more than 0.2 m lower than the work surface and the horizontal gap between lift and work surfaces be as small as possible. Selecting a non-sloped surface to ingress or egress a scissor lift is also preferred to reduce risk.

Two Mechanisms of Sensorimotor Set Adaptation to Inclined Stance

Orientation of posture relative to the environment depends on the contributions from the somatosensory, vestibular, and visual systems mixed in varying proportions to produce a sensorimotor set. Here, we probed the sensorimotor set composition using a postural adaptation task in which healthy adults stood on an inclined surface for 3 min. Upon returning to a horizontal surface, participants displayed a range of postural orientations – from an aftereffect that consisted of a large forward postural lean to an upright stance with little or no aftereffect. It has been hypothesized that the post-incline postural change depends on each individual’s sensorimotor set: whether the set was dominated by the somatosensory or vestibular system: Somatosensory dominance would cause the lean aftereffect whereas vestibular dominance should steer stance posture toward upright orientation. We investigated the individuals who displayed somatosensory dominance by manipulating their attention to spatial orientation. We introduced a distraction condition in which subjects concurrently performed a difficult arithmetic subtraction task. This manipulation altered the time course of their post-incline aftereffect. When not distracted, participants returned to upright stance within the 3-min period. However, they continued leaning forward when distracted. These results suggest that the mechanism of sensorimotor set adaptation to inclined stance comprises at least two components. The first component reflects the dominant contribution from the somatosensory system. Since the postural lean was observed among these subjects even when they were not distracted, it suggests that the aftereffect is difficult to overcome. The second component includes a covert attentional component which manifests as the dissipation of the aftereffect and the return of posture to upright orientation.

Regularity of Center of Pressure Trajectories in Expert Gymnasts during Bipedal Closed-Eyes Quiet Standing

We compared postural control of expert gymnasts (G) to that of non-gymnasts (NG) during bipedal closed-eyes quiet standing using conventional and nonlinear dynamical measures of center of foot pressure (COP) trajectories. Earlier findings based on COP classical variables showed that gymnasts exhibited a better control of postural balance but only in demanding stances. We examined whether the effect of expertise in Gymnastic can be uncovered in less demanding stances, from the analysis of the dynamic patterns of COP trajectories. Three dependent variables were computed to describe the subject's postural behavior: the variability of COP displacements (A_CoP), the variability of the COP velocities (V_CoP) and the sample entropy of COP (SEn_CoP) to quantify COP regularity (i.e., predictability). Conventional analysis of COP trajectories showed that NG and G exhibited similar amount and control of postural sway, as indicated by similar A_CoP and V_CoP values observed in NG and G, respectively. These results suggest that the specialized balance training received by G may not transfer to less challenging balance conditions such as the bipedal eyes-closed stance condition used in the present experiment. Interestingly, nonlinear dynamical analysis of COP trajectories regarding COP regularity showed that G exhibited more irregular COP fluctuations relative to NG, as indicated by the higher SEn_CoP values observed for the G than for the NG. The present results showed that a finer-grained analysis of the dynamic patterns of the COP displacements is required to uncover an effect of gymnastic expertise on postural control in nondemanding postural stance. The present findings shed light on the surplus value in the nonlinear dynamical analysis of COP trajectories to gain further insight into the mechanisms involved in the control of bipedal posture.

Individuals with a vestibular-related disorder use a somatosensory-dominant strategy for postural orientation after inclined stance

OBJECTIVES

The visual, somatosensory, and vestibular systems are critical for establishing a sensorimotor set for postural control and orientation. The goal of this study was to assess how individuals with a vestibular-related disorder keep their balance following prolonged stance on an inclined surface. We hypothesize that subjects will show greater reliance on the somatosensory system than age-matched controls as inferred by the presence of a forward postural lean aftereffect following the inclined stance (i.e., a positive response).

RESULTS

The results revealed an underlying somatosensory-dominant strategy for postural control in the vestibular group: 100% of the subjects tested positive compared to 58% in the control group (P=.006).

CONCLUSION

Individuals with a vestibular-related disorder use a somatosensory-dominant strategy for postural orientation following prolonged inclined stance. The implications for the management of this population are discussed.

Plantar Exteroceptive Inefficiency causes an asynergic use of plantar and visual afferents for postural control: Best means of remediation

INTRODUCTION

Some subjects have difficulty to integrate both visual and plantar inputs, showing at the same time a "postural blindness" and a Plantar Exteroceptive Inefficiency (PEI). The former corresponds to a better stability eyes closed (EC) than eyes open (EO), while the latter is defined as a better stability on foam than on firm ground. Clinical studies reported that a manipulation of either plantar or visual input could affect the weight of both cues in postural control, suggesting interdependence in their use. The purpose of the experiment is to characterize the PEI phenomenon better and see if such synergy can be objectified.

METHODS

We recruited 48 subjects (25 ± 3.3 years) and assessed their balance with a force platform, EO, EC, at 40 or 200 cm, on firm ground, Dépron^® foam, Dynachoc^® foam, or on a 3 mm-thick Anterior Bar AB^®. We assessed their sensorial preferences through their PQ and RQ.

RESULTS

The main results are that there normally exists a synergy in the use of plantar and visual afferents, but only at 40 cm and in the absence of PEI.

CONCLUSIONS

Plantar Exteroceptive Inefficiency interferes with the role of vision in postural control, its effects are distance specific, are better revealed by Dépron^® foam and the AB^® improves posture but does not solve visual-podal asynergy. These results also have clinical interests as they indicate the best way in terms of distance and choice of foam to diagnostic PEI. Finally, they suggest restricting the use of the AB^®, commonly employed. These findings can be useful for clinicians concerned with foot, eye, and posture.

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

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

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

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.

Postural Stability Margins as a Function of Support Surface Slopes

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

Effect of home-based training using a slant board with dorsiflexed ankles on walking function in post-stroke hemiparetic patients

[Purpose] To investigate the effects of a 30-day rehabilitation program using a slant board on walking function in post-stroke hemiparetic patients. [Subjects and Methods] Six hemiparetic patients with gait disturbance were studied. The patients were instructed to perform a home-based rehabilitation program using a slant board, thrice daily for 30 days, the exercise included standing on the slant board for 3 minutes, with both ankles dorsiflexed without backrest. For all patients, the Brunnstrom Recovery Stage, Barthel Index, range of motion of the ankle joint, modified Ashworth scale scole for calf muscle, sensory impairments with Numeral Rating Scale, maximum walking speed, number of steps, and Timed “Up and Go” test were serially evaluated at the beginning and end of the 30-day program. [Results] The program significantly increased walking velocity, decreased the number of steps in the 10-m walking test, and decreased Timed “Up and Go” test performance time. [Conclusion] This rehabilitation program using the slant board was safe and improved walking function in patients. The improvement in walking function could be due to a forward shift of the center of gravity, which can be an important part of motor learning for gait improvement.

Influence of Transcranial Direct Current Stimulation to the Cerebellum on Standing Posture Control

Damage to the vestibular cerebellum results in dysfunctional standing posture control. Patients with cerebellum dysfunction have a larger sway in the center of gravity while standing compared with healthy subjects. Transcranial direct current stimulation (tDCS) is a noninvasive technique for selectively exciting or inhibiting specific neural structures with potential applications in functional assessment and treatment of neural disorders. However, the specific stimulation parameters for influencing postural control have not been assessed. In this study, we investigated the influence of tDCS when applied over the cerebellum on standing posture control. Sixteen healthy subjects received tDCS (20 min, 2 mA) over the scalp 2 cm below the inion. In Experiment 1, all 16 subjects received tDCS under three stimulus conditions, Sham, Cathodal, and Anodal, in a random order with the second electrode placed on the forehead. In Experiment 2, five subjects received cathodal stimulation only with the second electrode placed over the right buccinator muscle. Center of gravity sway was measured twice for 60 s before and after tDCS in a standing posture with eyes open and legs closed, and average total locus length, locus length per second, rectangular area, and enveloped area were calculated. In Experiment 1, total locus length and locus length per second decreased significantly after cathodal stimulation but not after anodal or sham stimulation, while no tDCS condition influenced rectangular or enveloped areas. In Experiment 2, cathodal tDCS again significantly reduced total locus length and locus length per second but not rectangular and enveloped areas. The effects of tDCS on postural control are polarity-dependent, likely reflecting the selective excitation or inhibition of cerebellar Purkinje cells. Cathodal tDCS to the cerebellum of healthy subjects can alter body sway (velocity).

The influence of scopolamine on motor control and attentional processes

Background: Motion sickness may be caused by a sensory conflict between the visual and the vestibular systems. Scopolamine, known to be the most effective therapy to control the vegetative symptoms of motion sickness, acts on the vestibular nucleus and potentially the vestibulospinal pathway, which may affect balance and motor tasks requiring both attentional process and motor balance. The aim of this study was to explore the effect of scopolamine on motor control and attentional processes.

Methods: Seven subjects were evaluated on four different tasks before and after a subcutaneous injection of scopolamine (0.2 mg): a one-minute balance test, a subjective visual vertical test, a pointing task and a galvanic vestibular stimulation with EMG recordings.

Results: The results showed that the reaction time and the movement duration were not modified after the injection of scopolamine. However, there was an increase in the center of pressure displacement during the balance test, a decrease in EMG muscle response after galvanic vestibular stimulation and an alteration in the perception of verticality.

Discussion: These results confirm that low doses of scopolamine such as those prescribed to avoid motion sickness have no effect on attentional processes, but that it is essential to consider the responsiveness of each subject. However, scopolamine did affect postural control and the perception of verticality. In conclusion, the use of scopolamine to prevent motion sickness must be considered carefully because it could increase imbalances in situations when individuals are already at risk of falling (e.g., sailing, parabolic flight).

Contribution of Bodily and Gravitational Orientation Cues to Face and Letter Recognition

Sensory information provided by the vestibular system is crucial in cognitive processes such as the ability to recognize objects. The orientation at which objects are most easily recognized--the perceptual upright (PU)--is influenced by body orientation with respect to gravity as detected from the somatosensory and vestibular systems. To date, the influence of these sensory cues on the PU has been measured using a letter recognition task. Here we assessed whether gravitational influences on letter recognition also extend to human face recognition. 13 right-handed observers were positioned in four body orientations (upright, left-side-down, right-side-down, supine) and visually discriminated ambiguous characters ('p'-from-'d'; 'i'-from-'!') and ambiguous faces used in popular visual illusions ('young woman'-from-'old woman'; 'grinning man'-from-'frowning man') in a forced-choice paradigm. The two transition points (e.g., 'p-to-d' and 'd-to-p'; 'young woman-to-old woman' and 'old woman-to-young woman') were fit with a sigmoidal psychometric function and the average of these transitions was taken as the PU for each stimulus category. The results show that both faces and letters are more influenced by body orientation than gravity. However, faces are more optimally recognized when closer in alignment with body orientation than letters--which are more influenced by gravity. Our results indicate that the brain does not utilize a common representation of upright that governs recognition of all object categories. Distinct areas of ventro-temporal cortex that represent faces and letters may weight bodily and gravitational cues differently--possibly to facilitate the specific demands of face and letter recognition.

Cutaneous stimulation at the ankle: a differential effect on proprioceptive postural control according to the participants' preferred sensory strategy

Background

Ankle movements can be partially encoded by cutaneous afferents. However, little is known about the central integration of these cutaneous signals, and whether individual differences exist in this integration. The aim of this study was to determine whether the effect of cutaneous stimulation at the ankle would differ depending on the participants’ preferred sensory strategy appraised by relative proprioceptive weighting (RPw).

Methods

Forty-seven active young individuals free of lower-limb injury stood on a force platform either barefoot or wearing a custom-designed bootee. Vibrations (60 Hz, 0.5 mm) were applied either to the peroneal tendons or to the lumbar paraspinal muscles.

Results

The barefoot RPw was strongly negatively correlated to the absolute change in RPw measured in the bootee condition (r = −0.81, P < 0.001). Participants were then grouped depending on their barefoot RPw value. The RPw was significantly higher in the bootee condition than in the barefoot condition only for participants with low barefoot RPw.

Conclusions

The external cutaneous stimulation given by the bootee increased the weight of ankle proprioceptive signals only for participants with low barefoot RPw. This result confirmed that optimization of the ankle proprioceptive signals provided by cutaneous afferent stimulation has a differential effect depending on the participants’ preferred sensory strategy.

Electronic supplementary material

The online version of this article (doi:10.1186/s13047-016-0140-y) contains supplementary material, which is available to authorized users.

Postural responses to various frequencies of vibration of the triceps surae and forefoot sole during quiet standing

The purpose of this study was to determine the role of somatosensory input to the sensory reference system in quiet standing. We applied vibration (0.5 mm amplitude, 1-60 Hz) to the triceps surae and the forefoot sole to stimulate the muscle spindles and the mechanoreceptors, respectively, and evaluated postural responses. Thirteen young healthy adults who showed backward-lean and forward-lean responses to vibration at high and low frequencies, respectively, participated in the full experiment. The lowest vibration frequencies inducing backward-lean responses (B-LF) were 15-55 Hz for the triceps surae and 16-60 Hz for the forefoot sole. The highest frequencies inducing forward-lean responses (F-HF) were 3-18 Hz for the triceps surae and 1-20 Hz for the forefoot sole. When vibration was simultaneously applied to the triceps surae and forefoot sole at F-HF, no response was induced in 70% of trials. A forward-lean response was induced in the remaining 30% of trials. Simultaneous vibration of the triceps surae and forefoot sole at B-LF induced backward-lean responses in all trials. All postural responses occurred 0.5-4.3 s after vibration onset. Postural responses to high-frequency vibration conceivably occur as a compensatory movement to the illusionary perception that standing position is deviating forward from quiet standing, which must be a reference position. Postural responses to low-frequency vibration possibly occur to equalize the positional information that is received from the triceps surae and the forefoot sole. Both postural responses are likely to involve the sensory reference system, which is located in the supraspinal nervous system.

Human path navigation in a three-dimensional world

Jeffery et al. propose a non-uniform representation of three-dimensional space during navigation. Fittingly, we recently revealed asymmetries between horizontal and vertical path integration in humans. We agree that representing navigation in more than two dimensions increases computational load and suggest that tendencies to maintain upright head posture may help constrain computational processing, while distorting neural representation of three-dimensional navigation.

Postural responses of adults with cerebral palsy to combined base of support and visual field rotation

We employed a virtual environment to examine the postural behaviors of adults with cerebral palsy (CP). Four adults with CP (22-32 years) and nine healthy adults (21-27 years) were tested with a Rod and Frame protocol. They then stood quietly on a platform within a three-wall virtual environment. The platform was either kept stationary or tilted 3(°) into dorsiflexion in the dark or with pitch up and down visual field rotations at 30(°)/s and 45(°)/s. While the visual field rotated, the platform was held tilted for 30 s and then slowly returned to a neutral position over 30 s. Center of pressure (CoP) was recorded and center of mass (CoM) as well as trunk and ankle angles were calculated. Electromyography (EMG) responses of the ankle and the hip muscles were recorded and analyzed using wavelets. Larger angular deviations from vertical and horizontal in the Rod and Frame test indicated that adults with CP were more visually dependent than healthy adults. Adults with CP had difficulty maintaining balance when standing on a stationary platform during pitch upward rotation of the visual scene. When the platform was tilted during visual field rotations, adults with CP took longer to stabilize their posture and had larger CoM oscillations than when in the dark. The inability to compensate for busy visual environments could impede maintenance of functional locomotion in adults with CP. Employing a visual field stimulus for assessment and training of postural behaviors would be more meaningful than testing in the dark.

Trunk orientation, stability, and quadrupedalism

Interesting cases of human quadrupedalism described by Tan and Colleagues (2005–2012) have attracted the attention of geneticists, neurologists, and anthropologists. Since his first publications in 2005, the main attention has focused on the genetic aspects of disorders that lead to quadrupedalism within an evolutionary framework. In recent years this area has undergone a convincing critique (Downey, 2010) and ended with a call “… to move in a different direction … away from thinking solely in terms of genetic abnormality and evolutionary atavism.” We consider quadrupedalism as a “natural experiment” that may contribute to our knowledge of the physiological mechanisms underlying our balance system and our tendency toward normal (upright) posture. Bipedalism necessitates a number of characteristics that distinguish us from our ancestors and present-day mammals, including: size and shape of the bones of the foot, structure of the axial and proximal musculature, and the orientation of the human body and head. In this review we address the results of experimental studies on the mechanisms that stabilize the body in healthy people, as well as how these mechanisms may be disturbed in various forms of clinical pathology. These disturbances are related primarily to automatic rather than voluntary control of posture and suggest that human quadrupedalism is a behavior that can result from adaptive processes triggered by disorders in postural tone and environmental cues. These results will serve as a starting point for comparing and contrasting bi- and quadrupedalism.

Sensorimotor feedback based on task-relevant error robustly predicts temporal recruitment and multidirectional tuning of muscle synergies

We hypothesized that motor outputs are hierarchically organized such that descending temporal commands based on desired task-level goals flexibly recruit muscle synergies that specify the spatial patterns of muscle coordination that allow the task to be achieved. According to this hypothesis, it should be possible to predict the patterns of muscle synergy recruitment based on task-level goals. We demonstrated that the temporal recruitment of muscle synergies during standing balance control was robustly predicted across multiple perturbation directions based on delayed sensorimotor feedback of center of mass (CoM) kinematics (displacement, velocity, and acceleration). The modulation of a muscle synergy's recruitment amplitude across perturbation directions was predicted by the projection of CoM kinematic variables along the preferred tuning direction(s), generating cosine tuning functions. Moreover, these findings were robust in biphasic perturbations that initially imposed a perturbation in the sagittal plane and then, before sagittal balance was recovered, perturbed the body in multiple directions. Therefore, biphasic perturbations caused the initial state of the CoM to differ from the desired state, and muscle synergy recruitment was predicted based on the error between the actual and desired upright state of the CoM. These results demonstrate that that temporal motor commands to muscle synergies reflect task-relevant error as opposed to sensory inflow. The proposed hierarchical framework may represent a common principle of motor control across motor tasks and levels of the nervous system, allowing motor intentions to be transformed into motor actions.

Reorientation to vertical modulated by combined support surface tilt and virtual visual flow in healthy elders and adults with stroke

We explored how changes in visual attention impacted postural motor performance in healthy elders and adults post-stroke within a virtual reality environment, including when vestibular information was not perceptible. Visual dependence in 13 healthy (50-80 years) and 13 adults post-stroke (49-70 years) was assessed with a rod-and-frame task. Three degree support surface dorsiflexion tilts at 30°/s were combined with 30° and 45°/s continuous pitch rotations of the visual environment. The support surface remained tilted for 30 s followed by a 0.1°/s return to neutral during continued visual field rotation. Body displacement and ankle muscle responses were recorded, and wavelet transforms calculated. Muscle frequencies and kinematic measures were examined with functional principal component analysis, and weights compared through mixed model repeated measures ANOVA. Both populations exhibited increased backward sway with pitch upward visual field motion; adults post-stroke produced significantly larger muscle responses. Lateral sway was most regulated when visual flow velocity matched platform velocity. Visual flow summed with direction of support surface instability and visually dependent individuals produced more controlled lateral sway when viewing a dynamic visual field. Provoking postural instability within a dynamic visual flow field could serve as a training tool for postural stabilizing actions, particularly when visual dependence is exhibited.

Postural reorientation does not cause the locomotor after-effect following rotary locomotion

After a period of stepping on a rotating platform, blindfolded subjects demonstrate a tendency to unconsciously turn when stepping in place, an after-effect known as podokinetic after-rotation (PKAR). Recent studies have also reported a change in postural orientation following the adaptive period and have suggested that this is causally related to PKAR. Here, we assess changes in trunk orientation following platform adaptation and determine their relationship to PKAR. Specifically, we determine whether a reorganized standing posture causes PKAR. Ten subjects stepped on a platform rotating at 60°/s for 10 min, with a cadence of 100 steps/min. Following adaptation, a significant PKAR response was seen, with a mean yaw rotation velocity of 6.0 ± 2.2°/s. In addition to this dynamic after-effect, there was a significant twist of the trunk with respect to the feet when standing still (6.9° ± 4.5°; mean ± SD), confirming the presence of a postural reorientation after-effect. However, the magnitudes of the two after-effects did not correlate (r = 0.06, p = 0.87). Furthermore, in a second experiment, a prolonged passive twist of the trunk was used to induce postural reorientation. However, in this case, PKAR was not induced. These results demonstrate that PKAR is not an automatic consequence of reorganized standing posture.

Postural control adjustments during progressive inclination of the support surface in children

One of the most important postural challenges in daily life is to continuously correct the destabilizing torque due to gravity that accelerates the body further away from the upright position. This study examined children's (7.9 years old) (n=7) and adults' (n=10) capacity to generate continuous corrective torque during a progressive perturbation. The experimental task was to maintain an upright quiet standing on a platform that gradually and slowly toes-down tilted to a maximum of 14° without visual cues. The vertical forces applied on the platform and the electromyograms from the tibialis anterior and the gastrocnemius were measured. The results showed that children had a different postural response to the perturbation than adults. When the platform was stationary before the inclination, children shifted their body weight backward whereas adults had a more balanced distribution of their weight. During the inclination, children applied a stronger forward force, suggesting a larger postero-anterior displacement of their body weight. Muscular activities were higher in children for both the tibialis anterior and the gastrocnemius, and their tibialis anterior activation profile was different. In conclusion, this study showed that in children aged from 7 to 10 years old neuromuscular responses were not mature enough to generate continuous postural corrective torque in response to the perturbation.

Task-level feedback can explain temporal recruitment of spatially fixed muscle synergies throughout postural perturbations

Recent evidence suggests that complex spatiotemporal patterns of muscle activity can be explained with a low-dimensional set of muscle synergies or M-modes. While it is clear that both spatial and temporal aspects of muscle coordination may be low dimensional, constraints on spatial versus temporal features of muscle coordination likely involve different neural control mechanisms. We hypothesized that the low-dimensional spatial and temporal features of muscle coordination are independent of each other. We further hypothesized that in reactive feedback tasks, spatially fixed muscle coordination patterns-or muscle synergies-are hierarchically recruited via time-varying neural commands based on delayed task-level feedback. We explicitly compared the ability of spatially fixed (SF) versus temporally fixed (TF) muscle synergies to reconstruct the entire time course of muscle activity during postural responses to anterior-posterior support-surface translations. While both SF and TF muscle synergies could account for EMG variability in a postural task, SF muscle synergies produced more consistent and physiologically interpretable results than TF muscle synergies during postural responses to perturbations. Moreover, a majority of SF muscle synergies were consistent in structure when extracted from epochs throughout postural responses. Temporal patterns of SF muscle synergy recruitment were well-reconstructed by delayed feedback of center of mass (CoM) kinematics and reproduced EMG activity of multiple muscles. Consistent with the idea that independent and hierarchical low-dimensional neural control structures define spatial and temporal patterns of muscle activity, our results suggest that CoM kinematics are a task variable used to recruit SF muscle synergies for feedback control of balance.

Continuous visual field motion impacts the postural responses of older and younger women during and after support surface tilt

The effect of continuous visual flow on the ability to regain and maintain postural orientation was examined. Fourteen young (20-39 years old) and 14 older women (60-79 years old) stood quietly during 3° (30°/s) dorsiflexion tilt of the support surface combined with 30° and 45°/s upward or downward pitch rotations of the visual field. The support surface was held tilted for 30 s and then returned to neutral over a 30-s period while the visual field continued to rotate. Segmental displacement and bilateral tibialis anterior and gastrocnemius muscle EMG responses were recorded. Continuous wavelet transforms were calculated for each muscle EMG response. An instantaneous mean frequency curve (IMNF) of muscle activity, center of mass (COM), center of pressure (COP), and angular excursion at the hip and ankle were used in a functional principal component analysis (fPCA). Functional component weights were calculated and compared with mixed model repeated measures ANOVAs. The fPCA revealed greatest mathematical differences in COM and COP responses between groups or conditions during the period that the platform transitioned from the sustained tilt to a return to neutral position. Muscle EMG responses differed most in the period following support surface tilt indicating that muscle activity increased to support stabilization against the visual flow. Older women exhibited significantly larger COM and COP responses in the direction of visual field motion and less muscle modulation when the platform returned to neutral than younger women. Results on a Rod and Frame test indicated that older women were significantly more visually dependent than the younger women. We concluded that a stiffer body combined with heightened visual sensitivity in older women critically interferes with their ability to counteract posturally destabilizing environments.