Modeling of postural stability borders during heel-toe rocking

Effect of Sway Frequency on the Joint Angle and Center of Pressure in Voluntary Sway

Voluntary sway is the periodic movement of one's body back and forth. The study aimed to clarify the effects of sway frequency on center of pressure and joint angle during voluntary sway. We measured 10 unrestricted voluntary sway conditions with different frequencies and natural pace conditions. The frequencies ranged from 0.1 to 1 Hz in 0.1-Hz increments. The joint angles and centers of pressure during voluntary sway were compared between the conditions. The joint angle amplitude of the trunk and knee were greater in the slow frequency condition than in the fast frequency condition. The trunk and knee joint angles during voluntary sway were considered to change according to the sway frequency.

Resilience of visually guided weight shifting to a proprioceptive perturbation depends on the complexity of the guidance stimulus

BACKGROUND

Whole-body tracking of visual motion cues is used in balance training to improve weight shifting ability in old age and sports.

RESEARCH QUESTION

How tracking of a complex (pink noise) and a periodic visual target motion during anteroposterior weight shifting affects postural and muscle responses to unilateral hip vibration.

METHODS

Twenty-six participants performed 160 anteroposterior weight shifting cycles while tracking the vertical motion of a visual target, concurrently receiving Center of Pressure (CoP) feedback. They were randomly divided to groups; (a) the Constant group tracked a visual target motion constructed by 3 sinusoids of different amplitude, and (b) the Pink group tracked a complex visual target motion constructed by a pink noise generation process. Between the 60th and the 120th cycle, vibration was applied to the right gluteus medius, introducing a sideways CoP deviation. CoP displacement and electromyographic (EMG) responses of soleus, tibialis anterior and peroneus longus were recorded and summarized in blocks of 3 cycles.

RESULTS

Sideways CoP deviation induced at the onset/offset of unilateral hip vibration was smaller for the Pink than the Constant group. The Pink group demonstrated greater tibialis anterior and peroneus longus EMG activity around the most anterior sway peak while soleus EMG was similar for the two groups. Both groups successfully coupled weight shifting amplitude to the target motion, but the Pink group tracked the target motion with a greater delay compared to the Constant group.

SIGNIFICANCE

Whole body tracking of complex visual motions evokes perception-based action and increases ankle muscle co-activation making sway more resilient to a proprioceptive perturbation induced by unilateral hip vibration. Complex visual guidance motions should be considered when designing balance rehabilitation regimes, aiming at improving weight shifting ability and dynamic balance control.

State-Space Characterization of Balance Capabilities in Biped Systems with Segmented Feet

The human ability of keeping balance during various locomotion tasks is attributed to our capability of withstanding complex interactions with the environment and coordinating whole-body movements. Despite this, several stability analysis methods are limited by the use of overly simplified biped and foot structures and corresponding contact models. As a result, existing stability criteria tend to be overly restrictive and do not represent the full balance capabilities of complex biped systems. The proposed methodology allows for the characterization of the balance capabilities of general biped models (ranging from reduced-order to whole-body) with segmented feet. Limits of dynamic balance are evaluated by the Boundary of Balance (BoB) and the associated novel balance indicators, both formulated in the Center of Mass (COM) state space. Intermittent heel, flat, and toe contacts are enabled by a contact model that maps discrete contact modes into corresponding center of pressure constraints. For demonstration purposes, the BoB and balance indicators are evaluated for a whole-body biped model with segmented feet representative of the human-like standing posture in the sagittal plane. The BoB is numerically constructed as the set of maximum allowable COM perturbations that the biped can sustain along a prescribed direction. For each point of the BoB, a constrained trajectory optimization algorithm generates the biped's whole-body trajectory as it recovers from extreme COM velocity perturbations in the anterior-posterior direction. Balance capabilities for the cases of flat and segmented feet are compared, demonstrating the functional role the foot model plays in the limits of postural balance. The state-space evaluation of the BoB and balance indicators allows for a direct comparison between the proposed balance benchmark and existing stability criteria based on reduced-order models [e.g., Linear Inverted Pendulum (LIP)] and their associated stability metrics [e.g., Margin of Stability (MOS)]. The proposed characterization of balance capabilities provides an important benchmarking framework for the stability of general biped/foot systems.

Age induced modifications in the persistency of voluntary sway when actively tracking the complex motion of a visual target

Movement persistency, reflected in systematic cycle to cycle fluctuations of a rhythmical task such as walking or voluntary sway, is compromised with increasing age, making older adults more susceptible to falls. In the present study, we tested whether it is possible to improve rhythmic voluntary sway persistency in old age by actively tracking the complex (i.e. persistent) motion of a visual target. Twenty healthy young and 20 older adults performed 132 cycles of anterior-posterior sway under two conditions: a) self-paced sway and b) sway while tracking the vertical motion of a complex visual target. The persistency of sway cycle amplitude and duration, detected from the center of pressure displacement, was quantified using the Fractal exponent α. We also recorded body kinematics in order to assess the intersegmental coordination that was quantified in the Mean Absolute Relative Phase (MARP) and the Deviation Phase (DPh) between the trunk and the lower limbs. In self-paced sway, older adults showed a lower persistency of cycle duration and a higher MARP and DPh between the trunk and the lower limbs compared to young adults. Tracking the complex visual target motion increased the persistency of cycle amplitude, in young but not in older adults, when compared to the self-paced sway while it decreased the persistency of cycle duration in both groups. The relative phase measures showed a moderate to strong relationship with the persistency of cycle amplitude and duration when older adults swayed in their self-pace. These findings suggest older adults cannot exploit active tracking of the complex visual motion cue to improve voluntary sway persistency. This could be related to the less stable and out of phase intersegmental coordination characterizing rhythmic voluntary sway in old age.

Community-dwelling adults with a history of falling report lower perceived postural stability during a foam eyes closed test than non-fallers

Perceived postural stability has been reported to decrease as sway area increases on firm surfaces. However, changes in perceived stability under increasingly challenging conditions (e.g., removal of sensory inputs) and the relationship with sway area are not well characterized. Moreover, whether perceived stability varies as a function of age or history of falls is unknown. Here we investigate how perceived postural stability is related to sway area and whether this relationship varies as a function of age and fall history while vision and proprioceptive information are manipulated. Sway area was measured in 427 participants from the Baltimore Longitudinal Study of Aging while standing with eyes open and eyes closed on the floor and a foam cushion. Participants rated their stability [0 (completely unstable) to 10 (completely stable)] after each condition, and reported whether they had fallen in the past year. Perceived stability was negatively associated with sway area (cm²) such that individuals who swayed more felt less stable across all conditions (β = - 0.53, p < 0.001). Perceived stability decreased with increasing age (β = - 0.019, p < 0.001), independent of sway area. Fallers had a greater decline in perceived stability across conditions (F = 2.76, p = 0.042) compared to non-fallers, independent of sway area. Perceived postural stability declined as sway area increased during a multisensory balance test. A history of falling negatively impacts perceived postural stability when vision and proprioception are simultaneously challenged. Perceived postural stability may provide additional information useful for identifying individuals at risk of falls.

The influence of ankle muscle activation on postural sway during quiet stance

Although balance during quiet standing is postulated to be influenced by multiple factors, including ankle stiffness, it is unclear how different mechanisms underlying increases in stiffness affect balance control. Accordingly, this study examined the influence of muscle activation and passive ankle stiffness increases on the magnitude and frequency of postural sway. Sixteen young adults participated in six quiet stance conditions including: relaxed standing, four muscle active conditions (10%, 20%, 30% and 40% maximum voluntary contraction (MVC)), and one passive condition wearing an ankle foot orthotic (AFO). Kinetics were collected from a force plate, while whole-body kinematics were collected with a 12-sensor motion capture system. Bilateral electromyographic signals were recorded from the tibialis anterior and medial gastrocnemius muscles. Quiet stance sway amplitude (range and root mean square) and frequency (mean frequency and velocity) in the sagittal plane were calculated from time-varying centre of gravity (COG) and centre of pressure (COP) data. Compared to the relaxed standing condition, metrics of sway amplitude were significantly increased (between 37.5 and 63.2%) at muscle activation levels of 30% and 40% MVC. Similarly, frequency measures increased between 30.5 and 154.2% in the 20-40% MVC conditions. In contrast, passive ankle stiffness, induced through the AFO, significantly decreased sway amplitude (by 23-26%), decreased COG velocity by 13.8%, and increased mean COP frequency by 24.9%. These results demonstrate that active co-contraction of ankle musculature (common in Parkinson's Disease patients) may have differential effects on quiet stance balance control compared to the use of an ankle foot orthotic (common for those recovering from stroke).

Does risk-sensitivity transfer across movements?

An intriguing finding in motor control studies is the marked effect of risk on movement decision making. However, there are inconsistent reports of risk-sensitivity across different movements and tasks, with both risk-seeking and risk-averse behavior observed. This raises the question of whether risk-sensitivity in movement decision making is context dependent and specific to the movement or task being performed. We investigated whether risk-sensitivity transfers between dissimilar movements within a single task. Healthy young adults made arm-reaching movements or whole-body leaning movements to move a cursor as close to the edge of a virtual cliff as possible without moving beyond the edge. They received points on the basis of the cursor's final proximity to the cliff edge. Risk was manipulated by increasing the point penalty associated with the cliff region and/or adding Gaussian noise to the cursor. We compared subjects' movement endpoints with endpoints predicted by a subject-specific, risk-neutral model of movement planning. Subjects demonstrated risk-seeking behavior in both movements that was consistent across risk environments, moving closer to the cliff than the model predicted. However, subjects were significantly more risk-seeking in whole-body movements. Our results present the first evidence of risk-sensitivity in whole-body movements. They also demonstrate that the direction of risk-sensitivity (i.e., risk-seeking or risk-averse) is similar between arm-reaching and whole-body movements, although degree of risk-sensitivity did not transfer from one movement to another. This finding has important implications for the ability of quantitative descriptions of decision making to generalize across movements and, ultimately, decision-making contexts.

A subject-specific postural instability parameter

A mathematical modeling approach is applied for deriving subject-specific stabilometric parameters associated with center-of-pressure sway measurements for assessing balancing ability of subjects in quiet standing on a force platform. Based on the inverted pendulum model, a new combined stabilometric parameter including anthropometric characteristics (body height and mass) is obtained which represents a measure of postural instability. A physical meaning of the subject-specific parameter is related to the effective stiffness of the inverted pendulum model.

On muscle, tendon and high heels

Wearing high heels (HH) places the calf muscle-tendon unit (MTU) in a shortened position. As muscles and tendons are highly malleable tissues, chronic use of HH might induce structural and functional changes in the calf MTU. To test this hypothesis, 11 women regularly wearing HH and a control group of 9 women were recruited. Gastrocnemius medialis (GM) fascicle length, pennation angle and physiological cross-sectional area (PCSA), the Achilles' tendon (AT) length, cross-sectional area (CSA) and mechanical properties, and the plantarflexion torque-angle and torque-velocity relationships were assessed in both groups. Shorter GM fascicle lengths were observed in the HH group (49.6+/-5.7 mm vs 56.0+/-7.7 mm), resulting in greater tendon-to-fascicle length ratios. Also, because of greater AT CSA, AT stiffness was higher in the HH group (136.2+/-26.5 N mm(-1) vs 111.3+/-20.2 N mm(-1)). However, no differences in the GM PCSA to AT CSA ratio, torque-angle and torque-velocity relationships were found. We conclude that long-term use of high-heeled shoes induces shortening of the GM muscle fascicles and increases AT stiffness, reducing the ankle's active range of motion. Functionally, these two phenomena seem to counteract each other since no significant differences in static or dynamic torques were observed.