Analyzing gastrocnemius EMG-activity and sway data from quiet and perturbed standing

Effects of kinesio taping on static balance performance and muscle activity in children with developmental coordination disorder: a single-group pretest-posttest study

OBJECTIVE

To compare the effects of various kinesio tape applications on static balance and muscle activity in children with developmental coordination disorder.  Methods: Four taping conditions were applied to 48 children with developmental coordination disorder: no taping, gastrocnemius taping, tibialis anterior taping; and peroneus longus taping. Postural sway and electromyographic data were assessed, with eyes closed (30 s), standing still in 2-leg stance, dominant-leg stance, and non-dominant-leg stance.

RESULTS

Kinesio taping significantly reduced postural sway in both anteroposterior and mediolateral directions for dominant-leg stance and non-dominant-leg stance, but not 2-leg stance. During single-leg stances, anteroposterior sway was significantly lower for the gastrocnemius taping condition than for the no taping, tibialis anterior and peroneus longus taping conditions, and significantly lower in the tibialis anterior and peroneus longus taping conditions than in the no taping condition (gastrocnemius < tibialis anterior = peroneus longus < no taping). In addition, mediolateral sway was significantly lower in the tibialis anterior and peroneus longus taping conditions than in the no taping and gastrocnemius taping conditions, and significantly lower in the gastrocnemius taping condition than in the no taping condition (tibialis anterior = peroneus longus < gastrocnemius < no taping). Electromyographic data showed that muscle activity was significantly greater only for muscles where kinesio tape was applied.

CONCLUSION

Various kinesio tape applications can differentially reduce postural sway and increase muscle activity during single-leg stances in children with developmental coordination disorder.

Posturographic Standards for Optimal Control of Human Standing Posture

Static posturography is a simple non-invasive technique commonly used in contemporary labs and clinics to quantify the central nervous system adaptive mechanisms involved in the control of posture and balance. Its diagnostic value, however, is quite limited due to the lack of posturographic standards for stable posture. To solve this problem, in this research, we aimed to establish reference values for the stable human posture using our novel parameters of static posturography including the sway anteroposterior directional index (DIAP), the mediolateral directional index (DIML), the stability vector amplitude (SVamp), and the stability vector azimuth (SVaz). Towards this end, in a population of young (mean age 22 yrs), healthy able-bodied volunteers (50 males and 50 females), trajectories of postural sway, based upon the center-of-pressure (COP), were assessed. The experiment consisted of ten 60s trials that were carried out 5 times while subjects were standing quietly on the force plate with eyes open (EO test) and 5 times with eyes closed (EC test). Results showed that in young healthy subjects, regardless of gender, the basic variables of COP remained at the following levels: SVamp = 9.2 ± 1.6 mm/s, SVaz = 0.9 ± 0.1 rad, and directional indices DIAP = 0.7 ± 0.05, DIML = 0.56 ± 0.06. Some of the measures were sensitive to visual input (EC trials) and showed a weak to moderate correlation with anthropometric features. These measures can be recommended as reference values that characterize the most stable erect posture.

Influence of age on postural control during dual task: a centre of pressure motion and electromyographic analysis

BACKGROUND

Dual task influences postural control. A cognitive task seems to reduce muscle excitation during a postural balance, especially in older adults (OA).

AIM

The aim of this study is to evaluate the effect of three cognitive tasks on muscle excitation and static postural control in OA and young adults (YA) in an upright posture maintenance task.

METHODS

31 YA and 30 OA were evaluated while performing a modified Romberg Test in five different conditions over a force plate: open eyes, closed eyes, spatial-memory brooks' test, counting backwards aloud test and mental arithmetic task. The surface electromyographic signals of Tibialis anterior (TA), Lateral Gastrocnemius (GL), Peroneus Longus (PL), and Erector Spinae (ES) was acquired with an 8-channel surface electromyographic system. The following variables were computed for both the electromyographic analysis and the posturographic assessment: Root mean square (RMS), centre of pressure (CoP) excursion (Path) and velocity, sway area, RMS of the CoP Path and 50%, 95% of the power frequency. Mixed ANOVA was used to detect differences with group membership as factor between and type of task as within. The analysis was performed on the differences between each condition from OE.

RESULTS

An interaction effect was found for Log (logarithmic) Sway Area. A main effect for task emerged on all posturographic variables except Log 95% frequencies and for Log PL and ES RMS. A main effect for group was never detected.

DISCUSSION AND CONCLUSION

This study indicates a facilitating effect of mental secondary task on posturographic variables. Non-silent secondary task causes increase in ES and TA muscle activation and a worsening in static postural control performance.

Repeatability and sensitivity of passive mechanical stiffness measurements in the triceps surae muscle-tendon complex

Measurements of muscle-tendon unit passive mechanical properties are often used to illustrate acute and chronic responses to a training stimulus. The purpose of this study was to quantify the inter-session repeatability of triceps surae passive stiffness measurements in athletic and non-athletic populations, with the view to discussing its usefulness both as a muscle-tendon profiling tool and a control measure for studies with multiple data collection sessions. The study also aimed to observe the effects of quiet standing on passive stiffness parameters. Twenty-nine men (10 cyclists, nine triathletes, 10 controls) visited the laboratory on three separate occasions, where passive stiffness tests were carried out using an isokinetic dynamometer and B-mode ultrasound. Participants were fully rested on two of the sessions and subjected to 20 min of quiet standing in the other. The passive stiffness assessment generally showed only moderate inter-session repeatability but was still able to detect inter-group differences, with triathletes showing higher passive stiffness than cyclists (p < 0.05). Furthermore, quiet standing impacted passive stiffness by causing a reduction in ankle joint range of motion, although mechanical resistance to stretch in the muscle-tendon unit at a given joint angle was relatively unaffected. These findings show that passive stiffness assessment is appropriate for detecting inter-group differences in the triceps surae and even the effects of a low-intensity task such as quiet standing, despite showing some inter-session variation. However, the inter-session variation suggests that passive stiffness testing might not be suitable as a control measure when testing participants on multiple sessions.

Maturation of the postural control in adolescent girls: A 3-year follow-up study

BACKGROUND

Stable posture is a manifestation of the appropriate functioning of the neuromuscular system that is essential for proper motor development and control. Balance and stability of the erect posture are shaped during the entire childhood to culminate in its full efficiency in adolescent subjects.

METHODS

In this 3-year follow-up study, the process of the postural control maturation has been assessed in a group of 18 girls at the transition period between childhood to adolescence. Their balance and postural stability control were assessed using standard static posturography supplemented by two postural stability tests: the rising-on-toes (ROT), and the maximum forward lean (MFL), all performed with (EO) and without vision (EC). Balance control was analyzed with the sway vector (SV) and sway directional indices, whereas the anteroposterior trajectories of the center-of- pressure (COP) during forward-leaning and the raise-on-toes tests were used to determine changes in postural stability control.

RESULTS

The study documented that stability control in girls aged 11-13 is shaped according to their own pace of development. Their postural sway was characterized by the lower COP velocity but very sensitive to visual input. The directional sway measures remained at the same level for the entire period of observation. MFL and ROT tests provided similar information on postural stability and its dependence on visual input. These tests allow for more thorough assessment of postural stability to compare with quiet stance testing.

SIGNIFICANCE

Subtle changes in postural control in adolescents could be assessed based on the results of combined static and dynamic tests. In particular, the ROT test can be recommended for the assessment of postural stability.

A comprehensive method for assessing postural control during dynamic balance testing

Postural control, despite its complexity, has been investigated based on single or multiple domain parameters, mainly under static conditions. The purpose of this study was to investigate whether semi-squatting in one leg, in contrast to simply standing in one leg, can challenge the postural control in a more dynamic manner similar to those encountered during sporting activities, using posturographic-based parameters coupled with EMG data of the ankle musculature. Our findings revealed that the decreased stability induced with single-leg semi-squatting (SLSQ) required primarily the contribution of the tibialis anterior and the peroneus brevis, as opposed to the medial gastrocnemius and lateral gastrocnemius who were the main controllers of body posture during single-leg standing (SLST) with open eyes. The lower variability found in the CoP-based parameters and the EMG activity of the muscle under investigation suggests that postural control can be more accurately assessed under dynamic conditions such as with SLSQ compared to the more static SLST test. Multi-factorial analysis of postural control combining posturographic and EMG data, particularly under dynamic conditions, can provide useful information in the diagnosis and rehabilitation of clinical cases where the assessment of muscle dysfunction is required to design a rehabilitation program and monitor patient progress. •Simultaneous recordings of posturographic-based parameters and the EMG activity of the ankle/foot musculature suggest that postural control is challenged more during SLSQ.•Postural control with SLSQ is mainly controlled by the tibialis anterior and peroneus brevis in response to a greater anteroposterior- compared to mediolateral-directed sway of the body.•The limited body sway elicited with the traditional SLST test is mainly controlled by the gastrocnemius muscle.•Postural control may be assessed more accurately under dynamic conditions such as with SLSQ as opposed to the standard SLST test.

Effect of sensory stimulation applied under the great toe on postural ability in patients with fibromyalgia

Fibromyalgia (FM) is a chronic pain syndrome, characterised by several symptoms. One of the most prevalent symptoms in FM is balance impairment that compromise the autonomy, function and performance status of patients.Purpose: The main objective of the present study was to evaluate the effect of sensory stimulation provided by the use of a low additional thickness of 0.8 mm placed under the great toes bilaterally on the centre of pressure (CoP) measures in patients with FM. It was hypothesised that postural ability would change with a low focal additional thickness used to compute these measures.Materials and Method: Twenty-four patients with FM voluntarily participated in this study. Postural performance during quiet standing was investigated through the CoP displacements recorded using a force-plate. Sensory stimulation was provided by a small additional thickness of 0.8 mm placed under the great toe bilaterally and two conditions were compared: additional thickness 0 (control) and 0.8 mm.Results: An improvement of body balance through spatial parameters with sensory cutaneous stimulation applied under the great toe bilaterally were observed in patients with FM. Our results showed a significant decrease of surface area and mean speed of CoP, associated to a significant decrease of variance of speed. An additional observation is that sagittal (Y) mean position of the CoP gets more anterior (+ 5 mm) relative to control condition.Conclusion: These findings brings new clinical perspectives in the development of intervention strategies in the management of patients with FM and balance disorders, completing validated therapeutic strategies.

Step Response of Human Motor System as a Measure of Postural Stability in Children

Postural sway is a product of the neuromuscular system that is commonly used in contemporary labs and clinics for the assessment of postural stability. In this study, we analyzed the transient responses of the neuromuscular system during the rise-on-toes (ROT) movement in eighteen 11 yrs old girls. Their center of pressure (COP) trajectories were recorded with standard force-platform during the transition from quiet stance to standing on toes. To assess the robustness of children's postural stability, we compared the ROT trajectories while the movement was performed with and without vision. Our results confirmed that the dynamic characteristics of the COP step response were significantly modified by visual feedback. In particular, the ROT test performed with eyes closed (EC) was characterized by a four-fold increase of COP chaotic oscillations at the target (tiptoe) position. This resulted in a substantial increase in the movement's index of difficulty (ID) thus to achieve adequate accuracy of the target-oriented movement the COP velocity was decreased accordingly. This inherent strategy of the brain controller allowed for precise positioning of the COP within the reduced size of the target. In conclusion, the dynamics of the ROT movement is always precisely adjusted to the stability of the upright posture, and thus, the dynamic characteristics of the COP step response are also sensitive measures of postural stability and the ROT can be recommended as a useful test for this assessment in the general population.

Characteristics of Standing Postural Control in Women under Additional Load

The aim of this study was to evaluate the effect of additional load on postural-stability control in young women. To evaluate postural control in the 34 women in this study (mean age, 20.8 years), we measured postural sway (center of pressure, COP) in a neutral stance (with eyes open) in three trials of 30 s each. Three load conditions were used in the study: 0, 14, and 30 kg. In analysis, we used three COP parameters, variability (linear), mean sway velocity (linear), and entropy (nonlinear). Results suggested that a considerable load on a young woman’s body (approximately 48% of body weight) had significant influence on stability. Specifically, heavy loads triggered random movements, increased the dynamics of postural-stability control, and required more attention to control standing posture. The results of our study indicate that inferior postural control mainly results from insufficient experience in lifting such a load.

Analysis of center of mass acceleration and muscle activation in hemiplegic paralysis during quiet standing

Hemiplegic paralysis after stroke may augment postural instability and decrease the balance control ability for standing. The center of mass acceleration (COMacc) is considered to be an effective indicator of postural stability for standing balance control. However, it is less studied how the COMacc could be affected by the muscle activities on lower-limbs in post-stroke hemiplegic patients. This study aimed to examine the effects of hemiplegic paralysis in post-stroke individuals on the amplitude and structural variabilities of COMacc and surface electromyography (sEMG) signals during quiet standing. Eleven post-stroke hemiplegic patients and the same number of gender- and age-matched healthy volunteers participated in the experiment. The sEMG signals of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of the both limbs, and the COMacc in the anterior-posterior direction with and without visual feedback (VF vs. NVF) were recorded simultaneously during quiet standing. The sEMG and COMacc were analyzed using root mean square (RMS) or standard deviation (SD), and a modified detrended fluctuation analysis based on empirical mode decomposition (EMD-DFA). Results showed that the SD and the scale exponent α of EMD-DFA of the COMacc from the patients were significantly higher than the values from the controls under both VF (p < 0.01) and NVF (p < 0.001) conditions. The RMSs of TA and LG on the non-paretic limbs were significantly higher than those on paretic limbs (p < 0.05) for both the patients and controls (p < 0.05). The TA of both the paretic and non-paretic limbs of the patients showed augmented α values than the TA of the controls (p < 0.05). The α of the TA and LG of non-paretic limbs, and the α of COMacc were significantly increased after removing visual feedback in patients (p < 0.05). These results suggested an increased amplitude variability but decreased structural variability of COMacc, associated with asymmetric muscle contraction between the paretic and the non-paretic limbs in hemiplegic paralysis, revealing a deficiency in integration of sensorimotor information and a loss of flexibility of postural control due to stroke.

Posturographic characteristics of the standing posture and the effects of the treatment of obesity on obese young women

To determine the impact of body weight on quiet standing postural sway characteristics in young women, this research compared spontaneous oscillations of the center of foot pressure (COP) between 32 obese (BMI: 36.4 ± 5.2 kg/m²), and 26 normal-weight (BMI: 21.4 ± 1.5 kg/m²) women and assessed the influence of obesity treatment and body weight reduction on postural sway. Trajectories of the COP were assessed while the subjects were standing quietly with eyes open (EO) and closed (EC). Both in the sagittal (AP) and frontal (ML) planes the sway range, average velocity, and maximal velocity of COP were calculated. Moreover, the total average and maximal velocities were computed. In the obese group, the tests were performed twice–before and after the obesity treatment. A greater (18% in EC) AP sway range and a substantial reduction of ML sway (25% in EO, 22% in EC) were observed in the obese women. The total COP velocities (average and maximal) were decreased in obese women (20% and 20% in EO) as well as the velocities in the frontal plane (EO: 33%, 41%; EC: 34%, 40%). Body weight reduction resulted in significant changes in postural sway. The following parameters increased: ML sway range (28% in EO), average (20% in EO, 16% in EC) and maximal ML (20% in EO) velocities. The results indicate that young obese women in the habitual standing position are characterized by the destabilizing influence of mass in the sagittal plane only in the absence of a visual control. This effect is dominated by the stabilizing mass effect in the frontal plane, which affects overall postural stability when standing. The reduction of body mass enables a decrease in ML static stability, likely due to natural changes in the base of support while standing.

The center of pressure and ankle muscle co-contraction in response to anterior-posterior perturbations

Though both contraction of agonist muscles and co-contraction of antagonistic muscle pairs across the ankle joint are essential to postural stability, they are perceived to operate independently of each other, In an antagonistic setup, agonist muscles contract generating moment about the joint, while antagonist muscles contract generating stiffness across the joint. While both work together in maintaining robustness in the face of external perturbations, contractions of agonist muscles and co-contractions of antagonistic muscle pairs across the ankle joint play different roles in responding to and adapting to external perturbations. To determine their respective roles, we exposed participants to repeated perturbations in both large and small magnitudes. The center of pressure (COP) and a co-contraction index (CCI) were used to quantify the activation of agonist muscles and antagonistic muscle pairs across the ankle joint. Our results found that participants generated moment of a large magnitude across the ankle joint—a large deviation in the COP curve—in response to perturbations of a large magnitude (p <0.05), whereas the same participants generated higher stiffness about the ankle—a larger value in CCI—in response to perturbations of a small magnitude (p <0.05). These results indicate that participants use different postural strategies pertaining to circumstances. Further, the moment across the ankle decreased with repetitions of the same perturbation (p <0.05), and CCI tended to remain unchanged even in response to a different perturbation following repetition of the same perturbation (p <0.05). These findings suggest that ankle muscle contraction and co-contraction play different roles in regaining and maintaining postural stability. This study demonstrates that ankle moment and stiffness are not correlated in response to external perturbations.

The Relationship between Postural Stability and Lower-Limb Muscle Activity Using an Entropy-Based Similarity Index

The aim of this study is to see if the centre of pressure (COP) measurements on the postural stability can be used to represent the electromyography (EMG) measurement on the activity data of lower limb muscles. If so, the cost-effective COP data measurements can be used to indicate the level of postural stability and lower limb muscle activity. The Hilbert-Huang Transform method was used to analyse the data from the experimental designed to examine the correlation between lower-limb muscles and postural stability. We randomly selected 24 university students to participate in eight scenarios and simultaneously measured their COP and EMG signals during the experiments. The Empirical Mode Decomposition was used to identify the intrinsic-mode functions (IMF) that can distinguish between the COP and EMG at different states. Subsequently, similarity indices and synchronization analyses were used to calculate the correlation between the lower-limb muscle strength and the postural stability. The IMF5 of the COP signals and the IMF6 of the EMG signals were not significantly different and the average frequency was 0.8 Hz, with a range of 0-2 Hz. When the postural stability was poor, the COP and EMG had a high synchronization with index values within the range of 0.010-0.015. With good postural stability, the synchronization indices were between 0.006 and 0.080 and both exhibited low synchronization. The COP signals and the low frequency EMG signals were highly correlated. In conclusion, we demonstrated that the COP may provide enough information on postural stability without the EMG data.

Influence of Posturographic Protocol on Postural Stability Sways During Bipedal Stance After Ankle Muscle Fatigue

The aim of this study was to analyze the persistence of exercise-induced changes in postural stability and to verify if they last long enough to be captured by two sequential posturographic tests. The study, including 12 healthy young men (M age = 20.7 year, SD = 0.7), comprised two sessions (Sessions I and II). Each session included one physical exercise, along with two posturographic measurements taken prior to and after the effort, respectively. During Session I, open-eye test was followed by closed-eye test. This order was reversed during Session II, when closed-eye test was followed by open-eye test. The physical exercise protocol included repeated standing dual-heel raise until refusal. Regardless of the test order, markedly stronger effects of exercise-induced fatigue were documented during the first posturographic measurement. Only one reliable posturographic measurement can be taken if the fatigue protocol results in a short-term disruption of postural stability. The adverse effects of exercise-induced fatigue may no longer be observed during the subsequent test. As a result, the extent of post-exercise changes in postural stability may be underestimated leading to erroneous conclusions.

The use of force-plate posturography in the assessment of postural instability

Force-plate posturography is a simple method that is commonly used in the contemporary laboratory and clinic to assess postural control. Despite the obvious advantages and popularity of the method, universal standards for posturographic tests have not been developed thus far: most postural assessments are based on the standard spatiotemporal metrics of the center-of-foot pressure (COP) recorded during quiet stance. Unfortunately, the standard COP characteristics are strongly dependent on individual experimental design and are susceptible to distortions such as the noise of signal digitalization, which often makes the results from different laboratories incomparable and unreliable. The COP trajectories were recorded in subjects standing still, with eyes open (EO) and then, with eyes closed (EC). The 168 subjects were divided into 3 experimental groups: young adults, older adults, and patients with Parkinson's disease. Three novel output measures: the sway directional index (DI), the sway ratio (SR), and the sway vector (SV) were applied to assess the postural stability in the experimental groups. The controlled variables: age, pathology, and visual conditions, uniquely affected the output measures. The basic attributes of the SV: its reference position, magnitude, and azimuth, provided a unique set of descriptors for postural control that allowed me unambiguously to differentiate the decline in postural stability caused by natural ageing and Parkinson's disease. As shown in previous investigations, the SV attributes, when optimally filtered with a low-pass filter, were highly independent of the trial length and the sampling frequency, and were unaffected by the sampling noise. In conclusion, the SV may be recommended as the useful standard in static posturography.

A Physiological Perspective on Treadmill and Sit-to-Stand Workstations

Active workstations, such as treadmill and sit-to-stand workstations, enable office employees to break prolonged sitting with bouts of light-intensity walking and/or standing. Compared with sitting, walking and/or standing accumulated during the workday using these workstations will increase muscle contractions, which may influence blood flow, energy expenditure, metabolism, musculoskeletal health, and brain function. Physiological responses when using treadmill and sit-to-stand workstations may vary due to differences in muscle contraction type (dynamic vs. static) and may thus affect cardio-metabolic and musculoskeletal health and brain function in different ways.

Influence of transcutaneous electrical nerve stimulation on weight distribution in lower leg muscles

[Purpose] The purpose of this study was to compare the effects of transcutaneous electrical nerve stimulation (TENS), with and without visual input, on weight distribution following exercise-induced fatigue in the dorsiflexor and plantar flexor muscles of the ankle. [Subjects and Methods] This study had a cross-sectional design. Nineteen healthy adults (10 males, 9 females; mean age 21±0.8 years) were recruited to participate in a single group repeated measurements study lasting three days. On the first day, following exercise-induced fatigue, the standing position was maintained for 30 minutes, after which the postural sway was measured with eyes open (EO) and eyes closed (EC). On the second day, TENS was applied to the ankle dorsiflexors in the standing position for 30 minutes following exercise-induced fatigue. On the last day, TENS was applied to the plantar flexors, and the postural sway was measured with EO and EC following the same exercise-induced fatigue. [Results] On level terrain, with and without visual input, there was a significant difference between the baseline values and those following TENS on the tibialis anterior. On uneven terrain (simulated by a cushion), with and without visual input, there was a significant difference between the baseline values and those following TENS on the gastrocnemius. [Conclusion] Clinically, during walking on a flat surface for only a short period of time, TENS should be applied to the tibialis anterior. If walking training is performed on a variety of terrains for a longer time, TENS should be applied to the gastrocnemius.

Movement strategies for maintaining standing balance during arm tracking in people with multiple sclerosis

The purpose of this study was to quantify hip and ankle movement strategies during a standing arm tracking task in people with multiple sclerosis (MS). Full-body kinematics and kinetics were assessed with motion analysis cameras and force plates in nine MS and nine age-matched control subjects. While standing, participants used their dominant hand to track a target moving around a large horizontal or vertical figure eight on a screen in front of them. The target moved at constant speed, or linearly increasing speeds, with a frequency between 0.05 Hz and 0.35 Hz. Hip and ankle moments and angles during tracking were calculated from kinematic and kinetic measurements. Ratios of peak-to-peak (PP) hip/ankle moments (kinetics) and angles (kinematics) were calculated to determine the strategies of the hips and ankles used to maintain balance during arm movements. Center of mass (CoM) root mean square (RMS) acceleration was calculated as a measure of overall balance performance. The MS group produced larger PP hip/ankle moments at all speeds compared with the control group (P < 0.05). The CoM RMS acceleration increased with tracking speed for both groups but was not significantly different between groups. Additionally, the ratios of hip to ankle moments were highly correlated with the Berg Balance Scale during horizontal steady-speed tracking in MS. These results suggest that people with MS increase the use of the hip during standing arm tracking compared with age-matched control subjects. This adapted strategy might allow people with MS to achieve balance performance similar to control subjects, possibly increasing the importance of the hip in maintaining balance during voluntary movements.

Physiological interdependence of the cardiovascular and postural control systems under orthostatic stress

The cardiovascular system has been observed to respond to changes in human posture and the environment. On the same lines, frequent fallers have been observed to suffer from cardiovascular deficits. The present article aims to demonstrate the existence of interactions between the cardiovascular and postural control systems. The behavior of the two systems under orthostatic challenge was studied through novel adaptations of signal processing techniques. To this effect, the interactions between the two systems were assessed with two metrics, coherence and phase lock value, based on the wavelet transform. Measurements from the cardiovascular system (blood pressure), lower limb muscles (surface electromyography), and postural sway (center of pressure) were acquired from young healthy adults (n = 28, men = 12, age = 20-28 yr) during quiet stance. The continuous wavelet transform was applied to decompose the representative signals on a time-scale basis in a frequency region of 0.01 to 0.1 Hz. Their linear coupling was quantified through a coherence metric, and the synchrony was characterized via the phase information. The outcomes of this study present evidence that the cardiovascular and postural control systems work together to maintain homeostasis under orthostatic challenge. The inferences open a new direction of study for effects under abnormalities and extreme environmental conditions.

Effect of Ankle-foot Orthosis on Lower Limb Muscle Activities and Static Balance of Stroke Patients Authors' Names

[Purpose] This study examined the effects of an ankle-foot orthosis worn during balance training on lower limb muscle activity and static balance of chronic stroke patients. [Subjects] The subjects were twenty-five inpatients receiving physical therapy for chronic stroke. [Methods] The chronic stroke patients were divided into two groups: thirteen patients were assigned to the ankle-foot orthosis group, while the remaining twelve patients wore only their shoes. Each group performed balance training for 20 minutes, twice per day, 5 days per week, for 6 weeks. The lower limb muscle activities of the paralyzed side tibialis anterior, medial gastrocnemius, and the stability index were measured before and after the 6-week intervention. [Results] Comparison of the groups indicated a significant difference in the muscle activity of the paralyzed side tibialis anterior and the stability index of the eyes-open standing position. After the intervention, the ankle-foot orthosis group evidenced a significant difference in the muscle activities of the paralyzed side tibialis anterior and paralyzed side medial gastrocnemius as well as the stability index of the eyes-open standing position, eyes-closed standing position, eyes-open standing position on a sponge, and eyes-closed standing position on a sponge. The group that only wore their shoes showed significant differences in the stability indexes of eyes-open standing and eyes-open standing on a sponge. [Conclusion] Using the ankle-foot orthosis was effective during the initial training of lower limb muscle activities and the static balance training of chronic stroke patients. However, it was not effective for a variety of dynamic situations.

Activation of selected ankle muscles during exercises performed on rigid and compliant balance platforms

STUDY DESIGN

Experimental laboratory study.

OBJECTIVE

To compare how the design of 2 balance platforms affects ankle musculature activation for various weight-bearing exercises.

BACKGROUND

Balance platforms are widely used in both training and rehabilitation, and a better understanding of how platform design and type of exercise modify the demands on the ankle musculature may be helpful in staging exercise progression.

METHODS

Surface electromyography was used to measure the activation level of the fibularis longus, tibialis anterior, and medial gastrocnemius while performing 4 exercises on 2 different balance platforms (compliant and rigid). Twenty-four (12 females, 12 males) healthy, sedentary subjects participated in the study. Analysis of variance was used for statistical analysis.

RESULTS

There was no significant interaction between balance platforms and exercises (P>.05), and the type of platform did not influence muscle activation for the 3 muscles monitored (P>.05). The highest activation level for the fibularis longus and medial gastrocnemius was obtained during single-leg stance, and for the tibialis anterior during the single-leg squat (P<.05).

CONCLUSION

In this study, although the demands on the ankle musculature were similar for selected exercises performed on a compliant versus a rigid balance platform, muscle activation level varied based on the exercise.

Influence of wearing an unstable shoe on thigh and leg muscle activity and venous response in upright standing

PURPOSE

To quantify the effect of unstable shoe wearing on muscle activity and haemodynamic response during standing.

METHODS

Thirty volunteers were divided into 2 groups: the experimental group wore an unstable shoe for 8 weeks, while the control group used a conventional shoe for the same period. Muscle activity of the medial gastrocnemius, tibialis anterior, rectus femoris and biceps femoris and venous circulation were assessed in quiet standing with the unstable shoe and barefoot.

RESULTS

In the first measurement there was an increase in medial gastrocnemius activity in all volunteers while wearing the unstable shoe. On the other hand, after wearing the unstable shoe for eight weeks these differences were not verified. Venous return increased in subjects wearing the unstable shoe before and after training.

CONCLUSIONS

The unstable shoe produced changes in electromyographic characteristics which were advantageous for venous circulation even after training accommodation by the neuromuscular system.

Comparison of walking parameters obtained from the young, elderly and adults with support

Data mining techniques are highly useful in the study of various medical signals and images in order to obtain useful information to better predict the diagnosis or prognosis or treatment options for the patient. Study of the human walking pattern helps us understand the variability of motion during activities such as high performance walking and normal walking. A comparison of the parameters quantifying this variability in motion in normal young and elderly subjects and the subjects who need support will aid in better understanding of the relationship among walking patterns, age and disabilities. In this study, we measured the tri-axial acceleration along three directions: anteroposterior, lateral and vertical. We also measured gyrational pitch, roll and yaw. These parameters were obtained using sensors attached to the back, left thigh and right thigh of the three classes of subjects (normal, elderly and adults with support) during the three types of exercises: 10-m normal walk, 10-m high performance walk and stepping. These recorded signals were then subjected to wavelet packet decomposition, and three entropies, namely approximate entropy and two bispectral entropies, were obtained from the resultant wavelet coefficients. On analysing these entropies, we could observe the following: (1) the entropy steadily decreases with the increase in age and with the presence of impairments, and (2) the entropy decreases among all the three types of exercises, namely normal walking and high performance walking. We feel that the results of this work can help in the design of supporting devices for elderly subjects.

To freeze or not to freeze? Affective and cognitive perturbations have markedly different effects on postural control

Similar effects have been reported for diverting attention from postural control and increased anxiety on the characteristics of center-of-pressure (COP) time series (decreased excursions and elevated mean power frequency). These effects have also received similar interpretations in terms of increased postural stiffness, suggesting that cognitive and affective manipulations have similar influences on postural control. The present experiment tested this hypothesis by comparing postural conditions involving manipulations of attention (diverting attention from posture using cognitive and motor dual tasks) and anxiety (standing at a height), and by complementing posturography with electromyographic analyses to directly examine neuromuscular stiffness control. Affective and cognitive manipulations had markedly different effects. Unlike the height condition, diverting attention from balance induced smaller COP amplitudes and higher sway frequencies. In addition, more regular COP trajectories (lower sample entropy) were found in the height condition than the dual-task conditions, suggesting elevated attentional investment in posture under the affective manipulation. Finally, based on an analysis of the cross-correlation function between anterior-posterior COP time series and enveloped calf muscle activity, indications of tighter anticipatory neuromuscular control of posture were found for the height condition only. Our data suggest that affective and cognitive perturbations have qualitatively different effects on postural control, and thus are likely to be associated with different control processes, as evidenced by differences in neuromuscular regulation and attentional investment in posture.

Entropy of balance--some recent results

BACKGROUND

Entropy when applied to biological signals is expected to reflect the state of the biological system. However the physiological interpretation of the entropy is not always straightforward. When should high entropy be interpreted as a healthy sign, and when as marker of deteriorating health? We address this question for the particular case of human standing balance and the Center of Pressure data.

METHODS

We have measured and analyzed balance data of 136 participants (young, n = 45; elderly, n = 91) comprising in all 1085 trials, and calculated the Sample Entropy (SampEn) for medio-lateral (M/L) and anterior-posterior (A/P) Center of Pressure (COP) together with the Hurst self-similarity (ss) exponent alpha using Detrended Fluctuation Analysis (DFA). The COP was measured with a force plate in eight 30 seconds trials with eyes closed, eyes open, foam, self-perturbation and nudge conditions.

RESULTS

1) There is a significant difference in SampEn for the A/P-direction between the elderly and the younger groups Old > young. 2) For the elderly we have in general A/P > M/L. 3) For the younger group there was no significant A/P-M/L difference with the exception for the nudge trials where we had the reverse situation, A/P < M/L. 4) For the elderly we have, Eyes Closed > Eyes Open. 5) In case of the Hurst ss-exponent we have for the elderly, M/L > A/P.

CONCLUSIONS

These results seem to be require some modifications of the more or less established attention-constraint interpretation of entropy. This holds that higher entropy correlates with a more automatic and a less constrained mode of balance control, and that a higher entropy reflects, in this sense, a more efficient balancing.

Steadiness in plantar flexor muscles and its relation to postural sway in young and elderly adults

To investigate the functional significance of force fluctuations during voluntary contraction with a select muscle group, we examined the association between force fluctuations during voluntary contraction with plantar flexor muscles and postural sway during quiet standing in 20 young and 20 elderly adults. Young and elderly subjects maintained a quiet standing position on a force platform. They also performed a force-matching task with unilateral isometric plantar flexion. A positive correlation was found in young and elderly adults between the coefficient of variation (CV) of center of pressure during quiet standing and the CV of force during plantar flexion only at contraction intensities of < or =5% maximum voluntary contraction that corresponded to muscle activity during quiet standing. The electromyogram power in the medial gastrocnemius was greater in the elderly than in young adults by approximately 10 Hz during quiet standing and at low contraction intensities during plantar flexion. Fluctuations in motor output during low-intensity plantar flexion were associated with postural sway during quiet standing in both young and elderly adults.

Can quiet standing posture predict compensatory postural adjustment?

OBJECTIVE

The aim of this study was to analyze whether quiet standing posture is related to compensatory postural adjustment.

INTRODUCTION

The latest data in clinical practice suggests that static posture may play a significant role in musculoskeletal function, even in dynamic activities. However, no evidence exists regarding whether static posture during quiet standing is related to postural adjustment.

METHODS

Twenty healthy participants standing on a movable surface underwent unexpected, standardized backward and forward postural perturbations while kinematic data were acquired; ankle, knee, pelvis and trunk positions were then calculated. An initial and a final video frame representing quiet standing posture and the end of the postural perturbation were selected in such a way that postural adjustments had occurred between these frames. The positions of the body segments were calculated in these initial and final frames, together with the displacement of body segments during postural adjustments between the initial and final frames. The relationship between the positions of body segments in the initial and final frames and their displacements over this time period was analyzed using multiple regressions with a significance level of p < or = 0.05.

RESULTS

We failed to identify a relationship between the position of the body segments in the initial and final frames and the associated displacement of the body segments.

DISCUSSION

The motion pattern during compensatory postural adjustment is not related to quiet standing posture or to the final posture of compensatory postural adjustment. This fact should be considered when treating balance disturbances and musculoskeletal abnormalities.

CONCLUSION

Static posture cannot predict how body segments will behave during compensatory postural adjustment.

Differences among lower leg muscles in long-term activity during ambulatory condition without any moderate to high intensity exercise

The present study aimed to investigate differences among the soleus (Sol), medial gastrocnemius (MG) and tibialis anterior (TA) in electromyogram (EMG) activities during ambulatory condition without any moderate to high intensity exercise. From 10:00 to 17:00, seven healthy graduate students participated in EMG recordings, which included the measurements during maximal voluntary efforts. During the long-term EMG recoding, the subjects were instructed to perform normal daily routines, including desk work and the attendance of lectures. EMG signals from the three muscles were averaged every 0.1s and expressed as a percentage (%MVE) of those obtained with maximal voluntary efforts, averaged over 1s. An EMG burst which had an amplitude >2%MVE and a duration >0.1s was defined as muscular activity. Regardless of muscles examined, the amplitude of the greater part of all bursts observed over the recording time was less than 30%MVE. The summed duration of all bursts over the recording time was significantly greater in Sol than in MG and TA, without a significant difference in the summed number of all bursts among the three muscles. The percentage of the summed duration of bursts at less than 10%MVE to that over the recording time was significantly higher in Sol and TA than in MG, but the corresponding value at 20< or =%MVE<30 was lower. Thus, EMG responses during ambulatory condition without any moderate to high intensity exercise differed among the three muscles, even between synergists: Sol was predominantly activated with low burst amplitudes as compared to MG.