Stability of vertical posture explored with unexpected mechanical perturbations: synergy indices and motor equivalence

Synergic control of the minimum toe clearance in young and older adults during foot swing on treadmill walking in different speeds

BACKGROUND

The vertical toe position at minimum toe clearance (MTC) in the swing phase is critical for walking safety. Consequently, the joints involved should be strictly controlled and coordinated to stabilize the foot at MTC. The uncontrolled manifold (UCM) hypothesis framework has been used to determine the existence of synergies that stabilize relevant performance variables during walking. However, no study investigated the presence of a multi-joint synergy stabilizing the foot position at MTC and the effects of age and walking speed on this synergy.

RESEARCH QUESTIONS

Is there a multi-joint synergy stabilizing MTC during treadmill walking? Does it depend on the persons' age and walking speed?

METHODS

Kinematic data from 23 young and 15 older adults were analyzed using the UCM approach. The participants walked on a treadmill at three speeds: slow, self-selected, and fast. The sagittal and frontal joint angles from the swing and stance legs and pelvis obliquity were used as motor elements and the vertical toe position at MTC was the performance variable. The variances in the joint space that affected (VORT, 'bad' variance) and did not affect (VUCM, 'good' variance) the toe position at MTC and the synergy index (ΔV) were computed.

RESULTS

The ΔV>0 was revealed for all subjects. Walking speed did not affect ΔV in older adults, whereas ΔV reduced with speed in young adults. ΔV was higher for older than for young adults at self-selected and fast speeds, owing to a lower VORT in the older group.

SIGNIFICANCE

The vertical toe position at MTC was stabilized by a strong multi-joint synergy. In older adults, this synergy was stronger, as they were better at limiting VORT than young adults. Reduced VORT in older adults could be caused by more constrained walking, which may be associated with anxiety due to walking on a treadmill.

Balance and Muscle Synergies During a Single-Limb Stance Task in Individuals With Chronic Ankle Instability

The aim of this study was to investigate balance performance and muscle synergies during a Single-Limb Stance (SLS) task in individuals with Chronic Ankle Instability (CAI) and a group of healthy controls. Twenty individuals with CAI and twenty healthy controls were asked to perform a 30-second SLS task in Open-Eyes (OE) and Closed-Eyes (CE) conditions while standing on a force platform with the injured or the dominant limb, respectively. The activation of 13 muscles of the lower limb, hip, and back was recorded by means of surface electromyography. Balance performance was assessed by identifying the number and the duration of SLS epochs, and the Root-Mean-Square (RMS) in Antero-Posterior (AP) and Medio-Lateral (ML) directions of the body-weight normalized ground reaction forces. The optimal number of synergies, weight vectors, and activation coefficients were also analyzed. CAI group showed a higher number and a shorter duration of SLS epochs and augmented ground reaction force RMS in both AP and ML directions compared to controls. Both groups showed an increase in the RMS in AP and ML forces in CE compared to OE. Both groups showed 4 optimal synergies in CE, while controls showed 5 synergies in OE. CAI showed a significantly higher weight of knee flexor muscles in both OE and CE. In conclusion, muscle synergies analysis provided an in-depth knowledge of motor control mechanisms in CAI individuals. They showed worse balance performance, a lower number of muscle synergies in a CE condition and abnormal knee flexor muscle activation compared to healthy controls.

Voluntary muscle coactivation in quiet standing elicits reciprocal rather than coactive agonist-antagonist control of reactive balance

Muscle coactivation increases in challenging balance conditions as well as with advanced age and mobility impairments. Increased muscle coactivation can occur both in anticipation of (feedforward) and in reaction to (feedback) perturbations, however, the causal relationship between feedforward and feedback muscle coactivation remains elusive. Here, we hypothesized that feedforward muscle coactivation would increase both the body's initial mechanical resistance due to muscle intrinsic properties and the later feedback-mediated muscle coactivation in response to postural perturbations. Young adults voluntarily increased leg muscle coactivation using visual biofeedback before support-surface perturbations. In contrast to our hypothesis, feedforward muscle coactivation did not increase the body's initial intrinsic resistance to perturbations, nor did it increase feedback muscle coactivation. Rather, perturbations with feedforward muscle coactivation elicited a medium- to long-latency increase of feedback-mediated agonist activity but a decrease of feedback-mediated antagonist activity. This reciprocal rather than coactivation effect on ankle agonist and antagonist muscles enabled faster reactive ankle torque generation, reduced ankle dorsiflexion, and reduced center of mass (CoM) motion. We conclude that in young adults, voluntary feedforward muscle coactivation can be independently modulated with respect to feedback-mediated muscle coactivation. Furthermore, our findings suggest feedforward muscle coactivation may be useful for enabling quicker joint torque generation through reciprocal, rather than coactivated, agonist-antagonist feedback muscle activity. As such our results suggest that behavioral context is critical to whether muscle coactivation functions to increase agility versus stability.NEW & NOTEWORTHY Feedforward and feedback muscle coactivation are commonly observed in older and mobility impaired adults and are considered strategies to improve stability by increasing body stiffness prior to and in response to perturbations. In young adults, voluntary feedforward coactivation does not necessarily increase feedback coactivation in response to perturbations. Instead, feedforward coactivation enabled faster ankle torques through reciprocal agonist-antagonist muscle activity. As such, coactivation may promote either agility or stability depending on the behavioral context.

Muscle synergies in Parkinson's disease before and after the deep brain stimulation of the bilateral subthalamic nucleus

The aim of this study is to quantitatively assess motor control changes in Parkinson's disease (PD) patients after bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS), based on a novel muscle synergy evaluation approach. A group of 20 PD patients evaluated at baseline (before surgery, T₀), at 3 months (T₁), and at 12 months (T₂) after STN-DBS surgery, as well as a group of 20 age-matched healthy control subjects, underwent an instrumented gait analysis, including surface electromyography recordings from 12 muscles. A smaller number of muscle synergies was found in PD patients (4 muscle synergies, at each time point) compared to control subjects (5 muscle synergies). The neuromuscular robustness of PD patients-that at T₀ was smaller with respect to controls (PD T₀: 69.3 ± 2.2% vs. Controls: 77.6 ± 1.8%, p = 0.004)-increased at T₁ (75.8 ± 1.8%), becoming not different from that of controls at T₂ (77.5 ± 1.9%). The muscle synergies analysis may offer clinicians new knowledge on the neuromuscular structure underlying PD motor types of behavior and how they can improve after electroceutical STN-DBS therapy.

Muscle synergies for the control of single-limb stance with and without visual information in young individuals

Purpose

Single-limb stance is a demanding postural task featuring a high number of daily living and sporting activities. Thus, it is widely used for training and rehabilitation, as well as for balance assessment. Muscle activations around single joints have been previously described, however, it is not known which are the muscle synergies used to control posture and how they change between conditions of normal and lack of visual information.

Methods

Twenty-two healthy young participants were asked to perform a 30 s single-limb stance task in open-eyes and closed-eyes condition while standing on a force platform with the dominant limb. Muscle synergies were extracted from the electromyographical recordings of 13 muscles of the lower limb, hip, and back. The optimal number of synergies, together with the average recruitment level and balance control strategies were analyzed and compared between the open- and the closed-eyes condition.

Results

Four major muscle synergies, two ankle-dominant synergies, one knee-dominant synergy, and one hip/back-dominant synergy were found. No differences between open- and closed-eyes conditions were found for the recruitment level, except for the hip/back synergy, which significantly decreased (p = 0.02) in the closed-eyes compared to the open-eyes condition. A significant increase (p = 0.03) of the ankle balance strategy was found in the closed-eyes compared to the open-eyes condition.

Conclusion

In healthy young individuals, single-limb stance is featured by four major synergies, both in open- and closed-eyes condition. Future studies should investigate muscle synergies in participants with other age groups, as well as pathological conditions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-021-00392-z.

The Role of Predictability of Perturbation in Control of Posture: A Scoping Review

Efficient maintenance of posture depends on the ability of humans to predict consequences of a perturbation applied to their body. The purpose of this scoping review was to map the literature on the role of predictability of a body perturbation in control of posture. A comprehensive search of MEDLINE, EMBASE, and CINAHL databases was conducted. Inclusion criteria were studies of adults participating in experiments involving body perturbations, reported outcomes of posture and balance control, and studies published in English. Sixty-three studies were selected. The reviewed information resources included the availability of sensory information and the exposure to perturbations in different sequences of perturbation magnitudes or directions. This review revealed that people use explicit and implicit information resources for the prediction of perturbations. Explicit information consists of sensory information related to perturbation properties and timing, whereas implicit information involves learning from repetitive exposures to perturbations of the same properties.

Behavioral synergic relations between eye and postural movements in young adults searching to locate objects in room inside houses

During precise gaze shifts, eye, head, and body movements exhibit synergic relations. In the present study, we tested the existence of behavioural synergic relations between eye and postural movements in a goal-directed, precise, visual search task (locate target objects in large images). More precisely, we tested if postural control could be adjusted specifically to facilitate precise gaze shifts. Participants also performed a free-viewing task (gaze images with no goal) and a fixation task. In both search and free-viewing tasks, young participants (n = 20; mean age = 22 years) were free to move their eyes, head, and body segments as they pleased to self-explore the images with no external perturbation. We measured eye and postural kinematic movements. The results showed significant negative correlations between eye and postural (head and upper back) movements in the precise task, but not in the free-viewing task. The negative correlations were considered to be stabilizing and synergic. Indeed, the further the eyes moved, the more postural variables were adjusted to reduce postural sway. These results suggest that postural control was adjusted to succeed in subtle and active self-induced precise gaze shifts. Furthermore, partial correlations showed significant relations between (1) task performance to find target objects and (2) synergic relations between eye and postural movements. These later results tend to show that synergic eye-postural relations were performed to improve the task performance in the precise visual task.

Anticipatory and pre-planned actions: A comparison between young soccer players and swimmers

The present study investigated whether a difference exists in reactive and proactive control for sport considered open or closed skills dominated. Sixteen young (11–12 years) athletes (eight soccer players and eight swimmers) were asked to be engaged into two games competitions that required either a reactive and a proactive type of control. By means of kinematic (i.e. movement time and duration) and dynamic analysis through the force platform (i.e. Anticipatory Postural Adjustments, APAs), we evaluated the level of ability and stability in reacting and anticipating actions. Results indicated that soccer players outperformed swimmers by showing higher stability and a smaller number of falls during the competition where proactive control was mainly required. Soccer players were able to reach that result by anticipating actions through well-modulated APAs. On the contrary, during the competition where reactive control was mainly required, performances were comparable between groups. Therefore, the development of specific action control is already established at 11–12 years of age and is enhanced by the training specificity.

Muscle Synergy Assessment During Single-Leg Stance

In the study of muscle synergies during the maintenance of single-leg stance there are several methodological issues that must be taken into account before muscle synergy extraction. In particular, it is important to distinguish between epochs of surface electromyography (sEMG) signals corresponding to "well-balanced" and "unbalanced" single-leg stance, since different motor control strategies could be used to maintain balance. The aim of this work is to present and define a robust procedure to distinguish between "well-balanced" and "unbalanced" single-leg stance to be chosen as input for the algorithm used to extract muscle synergies. Our results demonstrate that the proposed approach for the selection of sEMG epochs relative to "well-balanced" and "unbalanced" single-leg stance is robust with respect to the selection of the segmentation threshold, revealing a high consistency in the number of muscle synergies and high similarity among the weight vectors (correlation values range from 0.75 to 0.97). Moreover, differences in terms of average recruitment levels and balance control strategies were detected, suggesting a slightly different modular organization between "well-balanced" and "unbalanced" single-leg stance. In conclusion, this approach can be successfully used as a pre-processing step before muscle synergy extraction, allowing for a better assessment of motor control strategies during the single-leg stance task.

Static, Dynamic, and Cognitive Fit of Exosystems for the Human Operator

OBJECTIVE

To define static, dynamic, and cognitive fit and their interactions as they pertain to exosystems and to document open research needs in using these fit characteristics to inform exosystem design.

BACKGROUND

Initial exosystem sizing and fit evaluations are currently based on scalar anthropometric dimensions and subjective assessments. As fit depends on ongoing interactions related to task setting and user, attempts to tailor equipment have limitations when optimizing for this limited fit definition.

METHOD

A targeted literature review was conducted to inform a conceptual framework defining three characteristics of exosystem fit: static, dynamic, and cognitive. Details are provided on the importance of differentiating fit characteristics for developing exosystems.

RESULTS

Static fit considers alignment between human and equipment and requires understanding anthropometric characteristics of target users and geometric equipment features. Dynamic fit assesses how the human and equipment move and interact with each other, with a focus on the relative alignment between the two systems. Cognitive fit considers the stages of human-information processing, including somatosensation, executive function, and motor selection. Human cognitive capabilities should remain available to process task- and stimulus-related information in the presence of an exosystem. Dynamic and cognitive fit are operationalized in a task-specific manner, while static fit can be considered for predefined postures.

CONCLUSION

A deeper understanding of how an exosystem fits an individual is needed to ensure good human-system performance. Development of methods for evaluating different fit characteristics is necessary.

APPLICATION

Methods are presented to inform exosystem evaluation across physical and cognitive characteristics.