Standing still: is there a role for the cortex?

Linking Dementia Pathology and Alteration in Brain Activation to Complex Daily Functional Decline During the Preclinical Dementia Stages: Protocol for a Prospective Observational Cohort Study

BACKGROUND

Progressive difficulty in performing everyday functional activities is a key diagnostic feature of dementia syndromes. However, not much is known about the neural signature of functional decline, particularly during the very early stages of dementia. Early intervention before overt impairment is observed offers the best hope of reducing the burdens of Alzheimer disease (AD) and other dementias. However, to justify early intervention, those at risk need to be detected earlier and more accurately. The decline in complex daily function (CdF) such as managing medications has been reported to precede impairment in basic activities of daily living (eg, eating and dressing).

OBJECTIVE

Our goal is to establish the neural signature of decline in CdF during the preclinical dementia period.

METHODS

Gait is central to many CdF and community-based activities. Hence, to elucidate the neural signature of CdF, we validated a novel electroencephalographic approach to measuring gait-related brain activation while participants perform complex gait-based functional tasks. We hypothesize that dementia-related pathology during the preclinical period activates a unique gait-related electroencephalographic (grEEG) pattern that predicts a subsequent decline in CdF.

RESULTS

We provide preliminary findings showing that older adults reporting CdF limitations can be characterized by a unique gait-related neural signature: weaker sensorimotor and stronger motor control activation. This subsample also had smaller brain volume and white matter hyperintensities in regions affected early by dementia and engaged in less physical exercise. We propose a prospective observational cohort study in cognitively unimpaired older adults with and without subclinical AD (plasma amyloid-β) and vascular (white matter hyperintensities) pathologies. We aim to (1) establish the unique grEEG activation as the neural signature and predictor of decline in CdF during the preclinical dementia period; (2) determine associations between dementia-related pathologies and incidence of the neural signature of CdF; and (3) establish associations between a dementia risk factor, physical inactivity, and the neural signature of CdF.

CONCLUSIONS

By establishing the clinical relevance and biological basis of the neural signature of CdF decline, we aim to improve prediction during the preclinical stages of ADs and other dementias. Our approach has important research and translational implications because grEEG protocols are relatively inexpensive and portable, and predicting CdF decline may have real-world benefits.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56726.

EEG Dynamics of Locomotion and Balancing: Solution to Neuro-Rehabilitation

The past decade has witnessed tremendous growth in analyzing the cortical representation of human locomotion and balance using Electroencephalography (EEG). With the advanced developments in miniaturized electronics, wireless brain recording systems have been developed for mobile recordings, such as in locomotion. In this review, the cortical dynamics during locomotion are presented with extensive focus on motor imagery, and employing the treadmill as a tool for performing different locomotion tasks. Further, the studies that examine the cortical dynamics during balancing, focusing on two types of balancing tasks, ie, static and dynamic, with the challenges in sensory inputs and cognition (dual-task), are presented. Moreover, the current literature demonstrates the advancements in signal processing methods to detect and remove the artifacts from EEG signals. Prior studies show the electrocortical sources in the anterior cingulate, posterior parietal, and sensorimotor cortex was found to be activated during locomotion. The event-related potential has been observed to increase in the fronto-central region for a wide range of balance tasks. The advanced knowledge of cortical dynamics during mobility can benefit various application areas such as neuroprosthetics and gait/balance rehabilitation. This review will be beneficial for the development of neuroprostheses, and rehabilitation devices for patients suffering from movement or neurological disorders.

Discrete cortical control during quiet stance revealed by desynchronization and rebound of beta oscillations

Postural sway during quiet stance often exhibits a repetition of micro-fall and the subsequent micro-recovery. The classical view -that the quiet bipedal stance is stabilized by the ankle joint stiffness- has been challenged by paradoxical non-spring-like behaviors of calf muscles: gastrocnemius muscles are shortened and then lengthened, respectively, during the micro-fall and the micro-recovery. Here, we examined EEG based brain activity during quiet stance, and identified desynchronization and synchronization of beta oscillations that were associated, respectively, with the micro-fall and the micro-recovery. Based on a widely accepted scenario for beta-band desynchronization during movement and post-movement rebound in the control of discrete voluntary movement, our results reveal that the beta rebound can be considered as a manifestation of stop command to punctuate the motor control for every fall-recovery cycle. Namely, cortical interventions to the automatic postural control are discrete, rather than continuous modulations. The finding is highly compatible with the intermittent control model, rather than the stiffness control model.

Transcranial direct current stimulation suggests not improving postural control during adapted tandem position in people with Parkinson's disease: A pilot study

BACKGROUND

Balance impairments in people with Parkinson's disease (PD) demonstrated mainly in challenging postural tasks, such as increased body oscillation may be attributed to the deficits in the brain structures functionality involved in postural control (e.g., motor cortex, midbrain, and brainstem). Although promising results, the effect of transcranial direct current stimulation (tDCS) on postural control in people with PD is unclear, especially in objective measures such as the center of pressure (CoP) parameters. Thus, we analyzed the effects of a single session of tDCS on the CoP parameters during the adapted tandem position in people with PD.

METHODS

Nineteen people with PD participated in this crossover, randomized, and double-blind study. Anodal tDCS was applied over the primary motor cortex in two conditions of stimulation (2 mA/active and sham) on two different days for 20 min immediately before the postural control evaluation. Participants remained standing in an adapted tandem position for the postural control assessment for 30 s (three trials). CoP parameters were acquired by a force plate.

RESULTS

No significant differences were demonstrated between stimulation conditions (p-value range = 0.15-0.89).

CONCLUSIONS

Our results suggested that a single session of tDCS with 2 mA does not improve the postural control of people with PD during adapted tandem.

EEG Based Cortico-Muscular Connectivity During Standing Early Post Stroke

In this exploratory study we studied brain activation and corticomuscular connectivity during standing in healthy individuals and persons with stroke within 40 days of cerebrovascular accident (CVA). EEG and EMG data were acquired during standing and analysis showed a trend of higher EEG power (hyper activation) in the stroke group. Direct corticomuscular connectivity between sensorimotor cortices and contralateral lower extremity muscles showed lower connectivity between affected motor, premotor, and sensory cortices, and contralateral lower extremity peripheral muscles with moderate effect size. The preliminary data in this paper suggest re-organization in left sensorimotor cortex role in controlling contralateral lower extremity muscles during standing. Correlational analysis in stroke group within 40 days of CVA showed a relationship between higher corticomuscular connectivity and better scores on balance assessments.Clinical Relevance- This study evaluates corticomuscular connectivity during standing in healthy controls and individuals with subacute stroke (within 40 days of injury). Better understanding of cortical control of standing post stroke is important to improve strategies used in mobility rehabilitation.

The 'Postural Rhythm' of the Ground Reaction Force during Upright Stance and Its Conversion to Body Sway-The Effect of Vision, Support Surface and Adaptation to Repeated Trials

The ground reaction force (GRF) recorded by a platform when a person stands upright lies at the interface between the neural networks controlling stance and the body sway deduced from centre of pressure (CoP) displacement. It can be decomposed into vertical (VGRF) and horizontal (HGRF) vectors. Few studies have addressed the modulation of the GRFs by the sensory conditions and their relationship with body sway. We reconsidered the features of the GRFs oscillations in healthy young subjects (n = 24) standing for 90 s, with the aim of characterising the possible effects of vision, support surface and adaptation to repeated trials, and the correspondence between HGRF and CoP time-series. We compared the frequency spectra of these variables with eyes open or closed on solid support surface (EOS, ECS) and on foam (EOF, ECF). All stance trials were repeated in a sequence of eight. Conditions were randomised across different days. The oscillations of the VGRF, HGRF and CoP differed between each other, as per the dominant frequency of their spectra (around 4 Hz, 0.8 Hz and <0.4 Hz, respectively) featuring a low-pass filter effect from VGRF to HGRF to CoP. GRF frequencies hardly changed as a function of the experimental conditions, including adaptation. CoP frequencies diminished to <0.2 Hz when vision was available on hard support surface. Amplitudes of both GRFs and CoP oscillations decreased in the order ECF > EOF > ECS ≈ EOS. Adaptation had no effect except in ECF condition. Specific rhythms of the GRFs do not transfer to the CoP frequency, whereas the magnitude of the forces acting on the ground ultimately determines body sway. The discrepancies in the time-series of the HGRF and CoP oscillations confirm that the body's oscillation mode cannot be dictated by the inverted pendulum model in any experimental conditions. The findings emphasise the robustness of the VGRF "postural rhythm" and its correspondence with the cortical theta rhythm, shed new insight on current principles of balance control and on understanding of upright stance in healthy and elderly people as well as on injury prevention and rehabilitation.

Neural ensemble dynamics in trunk and hindlimb sensorimotor cortex encode for the control of postural stability

The cortex has a disputed role in monitoring postural equilibrium and intervening in cases of major postural disturbances. Here, we investigate the patterns of neural activity in the cortex that underlie neural dynamics during unexpected perturbations. In both the primary sensory (S1) and motor (M1) cortices of the rat, unique neuronal classes differentially covary their responses to distinguish different characteristics of applied postural perturbations; however, there is substantial information gain in M1, demonstrating a role for higher-order computations in motor control. A dynamical systems model of M1 activity and forces generated by the limbs reveals that these neuronal classes contribute to a low-dimensional manifold comprised of separate subspaces enabled by congruent and incongruent neural firing patterns that define different computations depending on the postural responses. These results inform how the cortex engages in postural control, directing work aiming to understand postural instability after neurological disease.

Neural signature of mobility-related everyday function in older adults at-risk of cognitive impairment

Assessment of everyday activities is central to the diagnosis of dementia. Yet, little is known about brain processes associated with everyday functional limitations, particularly during early stages of cognitive decline. Twenty-six older adults (mean = 74.9 y) were stratified by risk using the Montreal Cognitive Assessment battery (MoCA, range: 0- 30) to classify individuals as higher (22-26) and lower risk (27+) of cognitive impairment. We investigated everyday function using a gait task designed to destabilize posture and applied Mobile Brain/Body Imaging. We predicted that participants would increase step width to gain stability, yet the underlying neural signatures would be different for lower versus higher risk individuals. Step width and fronto-parietal activation increased during visually perturbed input. Frontomedial theta increased in higher risk individuals during perturbed and unperturbed inputs. Left sensorimotor beta decreased in lower risk individuals during visually perturbed input. Modulations in theta and beta power were associated with MoCA scores. Our findings suggest that older adults at-risk of cognitive impairment can be characterized by a unique neural signature of everyday function.

Sensory system-specific associations between brain structure and balance

Nearly 75% of older adults in the US report balance problems. Although it is known that aging results in widespread brain atrophy, less is known about how brain structure relates to balance in aging. We collected T1- and diffusion-weighted MRI scans and measured postural sway of 36 young (18-34 years) and 22 older (66-84 years) adults during eyes open, eyes closed, eyes open-foam, and eyes closed-foam conditions. We calculated summary measures indicating visual, proprioceptive, and vestibular contributions to balance. Across both age groups, thinner cortex in multisensory integration regions was associated with greater reliance on visual inputs for balance. Greater gyrification within sensorimotor and parietal cortices was associated with greater reliance on proprioceptive inputs. Poorer vestibular function was correlated with thinner vestibular cortex, greater gyrification within sensorimotor, parietal, and frontal cortices, and lower free water-corrected axial diffusivity across the corona radiata and corpus callosum. These results expand scientific understanding of how individual differences in brain structure relate to balance and have implications for developing brain stimulation interventions to improve balance.

Vertical ground reaction force oscillation during standing on hard and compliant surfaces: The “postural rhythm”

When a person stands upright quietly, the position of the Centre of Mass (CoM), the vertical force acting on the ground and the geometrical configuration of body segments is accurately controlled around to the direction of gravity by multiple feedback mechanisms and by integrative brain centres that coordinate multi-joint movements. This is not always easy and the postural muscles continuously produce appropriate torques, recorded as ground reaction force by a force platform. We studied 23 young adults during a 90 s period, standing at ease on a hard (Solid) and on a compliant support (Foam) with eyes open (EO) and with eyes closed (EC), focusing on the vertical component of the ground reaction force (VGRF). Analysis of VGRF time series gave the amplitude of their rhythmic oscillations (the root mean square, RMS) and of their frequency spectrum. Sway Area and Path Length of the Centre of Pressure (CoP) were also calculated. VGRF RMS (as well as CoP sway measures) increased in the order EO Solid ≈ EC Solid < EO Foam < EC Foam. The VGRF frequency spectra featured prevailing frequencies around 4–5 Hz under all tested conditions, slightly higher on Solid than Foam support. Around that value, the VGRF frequencies varied in a larger range on hard than on compliant support. Sway Area and Path Length were inversely related to the prevailing VGRF frequency. Vision compared to no-vision decreased Sway Area and Path Length and VGRF RMS on Foam support. However, no significant effect of vision was found on VGRF mean frequency for either base of support condition. A description of the VGRF, at the interface between balance control mechanisms and sway of the CoP, can contribute information on how upright balance is maintained. Analysis of the frequency pattern of VGRF oscillations and its role in the maintenance of upright stance should complement the traditional measures of CoP excursions in the horizontal plane.

Influence of Speech and Cognitive Load on Balance and Timed Up and Go

The interaction between oral and/or mental cognitive tasks and postural control and mobility remains unclear. The aim of this study was to analyse the influence of speech production and cognitive load levels on static balance and timed up and go (TUG) during dual-task activities. Thirty healthy young subjects (25 ± 4 years old, 17 women) participated in this study. A control situation and two different cognitive arithmetic tasks were tested: counting backward in increments of 3 and 7 under oral (O) and mental (M) conditions during static balance and the TUG. We evaluated the dual-task cost (DTC) and the effect of speech production (SP) and the level of cognitive load (CL) on these variables. There was a significant increase in the centre of pressure oscillation velocity in static balance when the dual task was performed orally compared to the control situation The DTC was more pronounced for the O than for the M. The SP, but not the CL, had a significant effect on oscillation velocity. There was an increase in TUG associated with the cognitive load, but the mental or oral aspect did not seem to have an influence. Mobility is more affected by SP when the cognitive task is complex. This may be particularly important for the choice of the test and understanding postural control disorders.

Assessment of Biomechanical Predictors of Occurrence of Low-Amplitude N1 Potentials Evoked by Naturally Occurring Postural Instabilities

Naturally occurring postural instabilities that occur while standing and walking elicit specific cortical responses in the fronto-central regions (N1 potentials) followed by corrective balance responses to prevent falling. However, no framework could simultaneously track different biomechanical parameters preceding N1s, predict N1s, and assess their predictive power. Here, we propose a framework and show its utility by examining cortical activity (through electroencephalography [EEG]), ground reaction forces, and head acceleration in the anterior-posterior (AP) direction. Ten healthy young adults carried out a balance task of standing on a support surface with or without sway referencing in the AP direction, amplifying, or dampening natural body sway. Using independent components from the fronto-central cortical region obtained from subject-specific head models, we first robustly validated a prior approach on identifying low-amplitude N1 potentials before early signs of balance corrections. Then, a machine learning algorithm was used to evaluate different biomechanical parameters obtained before N1 potentials, to predict the occurrence of N1s. When different biomechanical parameters were directly compared, the time to boundary (TTB) was found to be the best predictor of the occurrence of upcoming low-amplitude N1 potentials during a balance task. Based on these findings, we confirm that the spatio-temporal characteristics of the center of pressure (COP) might serve as an essential parameter that can facilitate the early detection of postural instability in a balance task. Extending our framework to identify such biomarkers in dynamic situations like walking might improve the implementation of corrective balance responses through brain-machine-interfaces to reduce falls in the elderly.

Cortical activity, kinematics and trunk muscles activity response to pelvis movements during unstable sitting

BACKGROUND

Balance control is a leading component of human motor activities and its impairment is associated with an increased risk of falling, lower back pain due to impaired motor control mechanism. Prolonged sitting position at workplace is one of the risk factors of reduced postural control and lower back pain.

OBJECTIVE

To evaluate theta and alpha waves cortical activity, trunk muscles activity and kinematics in static sitting, dynamic sitting on different platforms: simple wobble board (WB) and wobble board on bearing surface (WBB).

METHODS

The kinematics of body segments, electromyography of five trunk muscles, electroencephalography of 32 scalp electrodes were measured during balance tasks in sitting position for 17 subjects with continuous seated position at workplace.

RESULTS

Cortical power on WBB1 increase in fronto - central (p< 0.05) region while on WBB2 increase in centro - parietal region (p< 0.05). WBB2 increase more muscles compared with WB2. The amplitude of movement of ASIS, Th10 can be seen lower on WBB compared with WB (p< 0.05).

CONCLUSIONS

The study shows that WBB can increase personalized sitting and improve trunk motor control during hours of prolonged sitting.

Postural sway in the moving room scenario: New evidence for functional dissociation between self-motion perception and postural control

Postural control in quiet standing is often explained by a reflexive response to optical flow, the apparent motion of environmental objects in a visual scene. However, moving room experiments show that even small-amplitude body sway can evoke odd sensations or motion sickness, indicating that a consciousness factor may also be involved. Studies targeting perception of self-motion, vection, typically use rapid visual stimuli moving in a single direction to maintain a constant feeling of vection, and there are few studies of vection using low-speed sinusoidal visual stimuli similar to human pendular movement. In the present study we searched for changes in postural control during periods of vection during quiet standing. Participants (N = 19, age = 20.4 ±1.1 years) were shown dynamic visual stimuli in the form of sinusoidally expanding and contracting random dots, and the stimuli speed and visual field were manipulated. Posture was continually evaluated using Center of Pressure (CoP) measurements. Participants were also asked to report feelings of vection, both by pressing a button during the trial and through an overall rating at the end of each trial. Using repeated-measures ANOVA, we assessed changes in the CoP and vection variables between experimental conditions, as well as possible interactions between the variables. The results show that postural reaction and vection were both affected by the visual stimuli and varied with speed. The peripheral visual field was found to couple to stronger feeling of vection and better quality of postural control. However, no significant relationship between postural control and vection, nor evidence of vection interaction to the relationship between optical flow and postural control, was found. Based on our results we conclude that for postural stability during quiet standing, visual cues dominate over any potential consciousness factor arising due to vection.

Visual Effect on Brain Connectome That Scales Feedforward and Feedback Processes of Aged Postural System During Unstable Stance

Older adults with degenerative declines in sensory systems depend strongly on visual input for postural control. By connecting advanced neural imaging and a postural control model, this study investigated the visual effect on the brain functional network that regulates feedback and feedforward processes of the postural system in older adults under somatosensory perturbations. Thirty-six older adults conducted bilateral stance on a foam surface in the eyes-open (EO) and eyes-closed (EC) conditions while their center of pressure (COP) and scalp EEG were recorded. The stochastic COP trajectory was modeled with non-linear stabilogram diffusion analysis (SDA) to characterize shifts in postural control in a continuum of feedback and feedforward processes. The EEG network was analyzed with the phase-lag index (PLI) and minimum spanning tree (MST). The results indicated that visual input rebalanced feedforward and feedback processes for postural sway, resulting in a greater critical point of displacement (CD), short-term effective diffusion coefficients (D_s) and short-term exponent (H_s), but the smaller critical point of time (CT) and long-term exponent (H_l) for the EC state. The EC network demonstrated stronger frontoparietal-occipital connectivity but weaker fronto-tempo-motor connectivity of the theta (4–7 Hz), alpha (8–12 Hz), and beta (13–35 Hz) bands than did the EO network. MST analysis revealed generally greater leaf fraction and maximal betweenness centrality (BC_max) and kappa of the EC network, as compared with those of the EO network. In contrast, the EC network exhibited a smaller diameter and average eccentricity than those of the EO network. The modulation of long-term negative feedback gain of the aged postural system with visual occlusion was positively correlated with leaf fraction, BC_max, and kappa, but negatively correlated with the diameter and average eccentricity for all EEG sub-bands. In conclusion, the aged brain functional network in older adults is tuned to visual information for modulating long-term negative feedback of the postural system under somatosensory perturbations.

Relationship between the level of mental fatigue induced by a prolonged cognitive task and the degree of balance disturbance

This study investigated the effects of mental fatigue (MF) induced by a 90-min AX-continuous performance test (AX-CPT) on balance control by addressing the issue of the heterogeneity of individuals' responses. Twenty healthy young active participants were recruited. They had to carry out two balance tasks (sway as little as possible on a stable support with the eyes open and closed) when standing on a force platform before and after performing a 90-min AX-CPT. The NASA-TLX test was used to assess the subjective manifestations of MF. Objective cognitive performance was measured using results from the AX-CPT. Inter-individual differences in behavioral deterioration due to MF were analyzed with a hierarchical cluster analysis, which categorizes participants' behaviors into subgroups with similar characteristics. The cluster analysis revealed that the achievement of the AX-CPT induced various levels of MF and balance impairments within the whole sample. A significant relationship between the level of MF and the degree of balance disturbance was observed only when participants stood with the eyes open, thus suggesting that inter-individual differences in vulnerability to MF could stem from differences between subjects in the level of engagement of visual attention and/or from differences in field dependency for balance control. These findings show that the completion of the same prolonged demanding cognitive task induces a strong heterogeneity in subjects' responses, with marked individual differences in MF vulnerability that affect balance control differently according to the sensory context.

Long-Lasting Event-Related Beta Synchronizations of Electroencephalographic Activity in Response to Support-Surface Perturbations During Upright Stance: A Pilot Study Associating Beta Rebound and Active Monitoring in the Intermittent Postural Control

Movement related beta band cortical oscillations, including beta rebound after execution and/or suppression of movement, have drawn attention in upper extremity motor control literature. However, fewer studies focused on beta band oscillations during postural control in upright stance. In this preliminary study, we examined beta rebound and other components of electroencephalogram (EEG) activity during perturbed upright stance to investigate supraspinal contributions to postural stabilization. Particularly, we aimed to clarify the timing and duration of beta rebound within a non-sustained, but long-lasting postural recovery process that occurs more slowly compared to upper extremities. To this end, EEG signals were acquired from nine healthy young adults in response to a brief support-surface perturbation, together with the center of pressure, the center of mass and electromyogram (EMG) activities of ankle muscles. Event-related potentials (ERPs) and event-related spectral perturbations were computed from EEG data using the perturbation-onset as a triggering event. After short-latency (<0.3 s) ERPs, our results showed a decrease in high-beta band oscillations (event-related desynchronization), which was followed by a significant increase (event-related synchronization) in the same band, as well as a decrease in theta band oscillations. Unlike during upper extremity motor tasks, the beta rebound in this case was initiated before the postural recovery was completed, and sustained for as long as 3 s with small EMG responses for the first half period, followed by no excessive EMG activities for the second half period. We speculate that those novel characteristics of beta rebound might be caused by slow postural dynamics along a stable manifold of the unstable saddle-type upright equilibrium of the postural control system without active feedback control, but with active monitoring of the postural state, in the framework of the intermittent control.

Stance leg and surface stability modulate cortical activity during human single leg stance

Mobile Electroencephalography (EEG) provides insights into cortical contributions to postural control. Although changes in theta (4–8 Hz) and alpha frequency power (8–12 Hz) were shown to reflect attentional and sensorimotor processing during balance tasks, information about the effect of stance leg on cortical processing related to postural control is lacking. Therefore, the aim was to examine patterns of cortical activity during single-leg stance with varying surface stability. EEG and force plate data from 21 healthy males (22.43 ± 2.23 years) was recorded during unipedal stance (left/right) on a stable and unstable surface. Using source-space analysis, power spectral density was analyzed in the theta, alpha-1 (8–10 Hz) and alpha-2 (10–12 Hz) frequency bands. Repeated measures ANOVA with the factors leg and surface stability revealed significant interaction effects in the left (p = 0.045, η_p² = 0.13) and right motor clusters (F = 16.156; p = 0.001, η_p² = 0.41). Furthermore, significant main effects for surface stability were observed for the fronto-central cluster (theta), left and right motor (alpha-1), as well as for the right parieto-occipital cluster (alpha-1/alpha-2). Leg dependent changes in alpha-2 power may indicate lateralized patterns of cortical processing in motor areas during single-leg stance. Future studies may therefore consider lateralized patterns of cortical activity for the interpretation of postural deficiencies in unilateral lower limb injuries.

Aging-related changes in cortical mechanisms supporting postural control during base of support and optic flow manipulations

Behavioral findings suggest that aging alters the involvement of cortical sensorimotor mechanisms in postural control. However, corresponding accounts of the underlying neural mechanisms remain sparse, especially the extent to which these mechanisms are affected during more demanding tasks. Here, we set out to elucidate cortical correlates of altered postural stability in younger and older adults. 3D body motion tracking and high-density electroencephalography (EEG) were measured while 14 young adults (mean age = 24 years, 43% women) and 14 older adults (mean age = 77 years, 50% women) performed a continuous balance task under four different conditions. Manipulations were applied to the base of support (either regular or tandem (heel-to-toe) stance) and visual input (either static visual field or dynamic optic flow). Standing in tandem, the more challenging position, resulted in increased sway for both age groups, but for the older adults, only this effect was exacerbated when combined with optic flow compared to the static visual display. These changes in stability were accompanied by neuro-oscillatory modulations localized to midfrontal and parietal regions. A cluster of electro-cortical sources localized to the supplementary motor area showed a large increase in theta spectral power (4-7 Hz) during tandem stance, and this modulation was much more pronounced for the younger group. Additionally, the older group displayed widespread mu (8-12 Hz) and beta (13-30 Hz) suppression as balance tasks placed more demands on postural control, especially during tandem stance. These findings may have substantial utility in identifying early cortical correlates of balance impairments in otherwise healthy older adults.

Classification of Rhythmic Cortical Activity Elicited by Whole-Body Balance Perturbations Suggests the Cortical Representation of Direction-Specific Changes in Postural Stability

Postural responses that effectively recover balance following unexpected postural changes need to be tailored to the characteristics of the postural change. We hypothesized that cortical dynamics involved in top-down regulation of postural responses carry information about directional postural changes (i.e., sway) imposed by sudden perturbations to standing balance (i.e., support surface translations). To test our hypothesis, we evaluated the single-trial classification of perturbation-induced directional changes in postural stability from high-density EEG. We analyzed EEG recordings from six young able-bodied individuals and three older individuals with chronic hemiparetic stroke, which were acquired while individuals reacted to low-intensity balance perturbations. Using common spatial patterns for feature extraction and linear discriminant analysis or support vector machines for classification, we achieved classification accuracies above random level (p < 0.05; cross-validated) for the classification of four different sway directions (one vs. the rest scheme). Screening of spectral features (3-50 Hz) revealed that the highest classification performance occurred when low-frequency (3-10 Hz) spectral features were used. Strikingly, the participant-specific classification results were qualitatively similar between young able-bodied individuals and older individuals with chronic hemiparetic stroke. Our findings demonstrate that low-frequency spectral components, corresponding to the cortical theta rhythm, carry direction-specific information about changes in postural stability. Our work presents a new perspective on the cortical representation of postural stability and the possible role of the theta rhythm in the modulation of (directional) reactive balance responses. Importantly, our work provides preliminary evidence that the cortical encoding of direction-specific changes in postural stability is present in chronic hemiparetic stroke.

Functional neuroimaging of human postural control: A systematic review with meta-analysis

Postural instability is a strong risk factor for falls that becomes more prominent with aging. To facilitate treatment and prevention of falls in an aging society, a thorough understanding of the neural networks underlying postural control is warranted. Here, we present a systematic review of the functional neuroimaging literature of studies measuring posture-related neural activity in healthy subjects. Study methods were overall heterogeneous. Eleven out of the 14 studies relied on postural simulation in a supine position (e.g. motor imagery). The key nodes of human postural control involved the brainstem, cerebellum, basal ganglia, thalamus and several cortical regions. An activation likelihood estimation meta-analysis revealed that the anterior cerebellum was consistently activated across the wide range of postural tasks. The cerebellum is known to modulate the brainstem nuclei involved in the control of posture. Hence, this systematic review with meta-analysis provides insight into the neural correlates which underpin human postural control and which may serve as a reference for future neural network and region of interest analyses.

Modulations of Inter-Hemispherical Phase Coupling in Human Single Leg Stance

INTRODUCTION

Recent findings from neuroimaging studies provided initial insights into cortical contributions to postural control. These studies observed enhanced cortical activation and connectivity when task-difficulty and postural instability increased. However, little attention has been paid to the allocation of cortical networks appearing with a decreasing base of support from bipedal to single leg stance. Therefore, the aim of the present study was to investigate modulations of functional connectivity from bipedal to single leg stance.

EXPERIMENTAL PROCEDURES

Cortical activity during bipedal and single leg stance (left) was investigated in 15 male subjects using 128 channel mobile electroencephalography (EEG), while standing on a triaxial force plate. Power spectral density was calculated for theta (4-7 Hz), alpha-1 (8-10 Hz) and alpha-2 (10-12 Hz) frequency bands. Estimations of the phase lag index (PLI) were conducted as a measure of functional connectivity. Moreover, postural control was analyzed by the area of sway and sway velocity.

RESULTS

The results demonstrated a significantly increased area of sway and decreased alpha-2 power in single leg compared to bipedal stance. Furthermore, PLIs within the alpha-2 frequency band showed significantly decreased inter-hemispherical phase coupling in single leg stance, associated with connections involving the left motor region.

DISCUSSION

Altogether, the present findings may indicate modulations of cortical contributions in single leg compared to bipedal stance. The present data suggest that decreased inter-hemispherical functional connectivity, in conjunction with a global increase in cortical excitability, may indicate enhanced alertness and task-specific selective inhibition of motor networks in favor of postural control.

Cortical reactive balance responses to unexpected slippages while walking: a pilot study

Understanding how the human brain cortex behaves when the dynamical balance is unexpectedly challenged can be useful to enable fall prevention strategies during daily activities. In this respect, we designed and tested a novel methodological approach to early detect modifications of the scalp-level signals when steady walking is perturbed. Four young adults were asked to manage unexpected bilateral slippages while steadily walking at their self-selected speed. Lower limb kinematics, electromyographic (EMG) and electroencephalographic (EEG; 13 channels from motor and sensory-motor cortex areas) signals were synchronously recorded. EMG signals from Vastus Medialis (both sides) were used to trigger the analysis of the EEG before and after the perturbation onset. Cortical activity was then assessed and compared pre vs. post perturbation. Specifically, for each gait cycle, the rate of variation of the EEG power spectrum density, named m, was used to describe the cortical responsiveness in five bands of interests: ϑ (4-7 Hz), α (8-12 Hz), β I, β II, β III rhythms (13-15, 15-20, 18-28 Hz). Results revealed a sharp increment of m early after the onset of the perturbation (perturbed step) compared to steady locomotion, for all rhythms. This cortical behavior disappeared during the recovery step. This study promisingly supports the evidence that the proposed approach can distinguish between steady walking and early reactive balance recovery, paving the way for the EEG-based monitoring of the fall risk during daily activities.

The Effects of Textured Insoles on Cortical Activity and Quiet Bipedal Standing With and Without Vision: An EEG Study

Wearing textured insoles (TIs) can reduce static postural sway, but the neurophysiological mechanisms by which these changes occur are not well understood. To address this issue, cortical activity was investigated in this study using electroencephalography (EEG) recordings from 19 scalp locations, in 15 healthy young adults (5 females; mean age = 27 ± 4.09 years) during quiet bipedal standing, under different insole conditions (textured versus smooth), with and without vision. Compared to smooth insoles (SIs), TIs significantly reduced postural sway in two measures; anterior-posterior range and standard deviation. In the EEG data, whole-head analyses showed cortical activity in the upper alpha power band was significantly reduced for textured compared to SIs. Exploratory analyses revealed this effect was significant both with and without vision, and was more pronounced over the parietal, compared to central regions, and over central compared to frontal regions. This trend was observed in low alpha and theta bands, but the effect of insole type was not significant. Textured insoles thus appear to affect not only balance outcomes but also cortical activity. The cortical activity adaptation may represent greater information becoming readily available at the cortical level, enhancing the representation of the body in space.

The effects of textured insoles on quiet standing balance in four stance types with and without vision

Background

Wearing a textured shoe insole can decrease postural sway during static balance. Previous studies assessed bipedal and/or unipedal standing. In contrast, we aimed to investigate if textured insoles modulated postural sway during four stance types (bipedal, standard Romberg, tandem Romberg, and unipedal), with and without vision.

Methods

The repeated measures design involved 28 healthy young adults (13 females; mean age = 26.86 ± 6.6 yrs) performing quiet standing in the four stance types on a force platform, under two different insole conditions (textured insole; TI vs. smooth insole; SI), with eyes open and eyes closed. Postural sway was assessed via the range and standard deviation of the COP excursions in the anterior-posterior and medial-lateral sway, and overall mean velocity.

Results

The main effect of insole type was statistically significant at the alpha p = 0.05 level (p = 0.045). Compared to smooth insoles, textured insoles reduced the standard deviation of anterior-posterior excursions (APSD). While simple main effect analyses revealed this was most pronounced during eyes closed bipedal standing, insole type did not provide a statistically significant interaction with either stance or vision in this measure, or any other. Postural sway showed statistically significant increases across both stance type (bipedal < standard Romberg < tandem Romberg < unipedal), and vision (eyes closed < eyes open), in almost all measures. Stance and vision did have a statistically significant interaction in each measure, reflecting greater postural disturbances with eyes closed when stance stability decreased.

Conclusions

Overall, these results support textured insole use in healthy young adults to reduce postural sway measures. This is because APSD is an index of spatial variability, where a decrease is associated with improved balance and possibly translates to reduced falls risk. Placing a novel texture in the shoe presumably modulated somatosensory inputs. It is important to understand the underlying mechanisms by which textured insoles influence postural sway. As such, utilising a healthy adult group allows us to investigate possible mechanisms of textured insoles. Future research could investigate the potential underlying mechanisms of textured insole effects at a neuromuscular and cortical level, in healthy young adults.

Cortical dynamics during preparation and execution of reactive balance responses with distinct postural demands

The contributions of the cerebral cortex to human balance control are clearly demonstrated by the profound impact of cortical lesions on the ability to maintain standing balance. The cerebral cortex is thought to regulate subcortical postural centers to maintain upright balance and posture under varying environmental conditions and task demands. However, the cortical mechanisms that support standing balance remain elusive. Here, we present an EEG-based analysis of cortical oscillatory dynamics during the preparation and execution of balance responses with distinct postural demands. In our experiment, participants responded to backward movements of the support surface either with one forward step or by keeping their feet in place. To challenge the postural control system, we applied participant-specific high accelerations of the support surface such that the postural demand was low for stepping responses and high for feet-in-place responses. We expected that postural demand modulated the power of intrinsic cortical oscillations. Independent component analysis and time-frequency domain statistics revealed stronger suppression of alpha (9-13 Hz) and low-gamma (31-34 Hz) rhythms in the supplementary motor area (SMA) when preparing for feet-in-place responses (i.e., high postural demand). Irrespective of the response condition, support-surface movements elicited broadband (3-17 Hz) power increase in the SMA and enhancement of the theta (3-7 Hz) rhythm in the anterior prefrontal cortex (PFC), anterior cingulate cortex (ACC), and bilateral sensorimotor cortices (M1/S1). Although the execution of reactive responses resulted in largely similar cortical dynamics, comparison between the bilateral M1/S1 showed that stepping responses corresponded with stronger suppression of the beta (13-17 Hz) rhythm in the M1/S1 contralateral to the support leg. Comparison between response conditions showed that feet-in-place responses corresponded with stronger enhancement of the theta (3-7 Hz) rhythm in the PFC. Our results provide novel insights into the cortical dynamics of SMA, PFC, and M1/S1 during the control of human balance.

Contribution of the Lateral Prefrontal Cortex to Cognitive-Postural Multitasking

There is evidence for cortical contribution to the regulation of human postural control. Interference from concurrently performed cognitive tasks supports this notion, and the lateral prefrontal cortex (lPFC) has been suggested to play a prominent role in the processing of purely cognitive as well as cognitive-postural dual tasks. The degree of cognitive-motor interference varies greatly between individuals, but it is unresolved whether individual differences in the recruitment of specific lPFC regions during cognitive dual tasking are associated with individual differences in cognitive-motor interference. Here, we investigated inter-individual variability in a cognitive-postural multitasking situation in healthy young adults (n = 29) in order to relate these to inter-individual variability in lPFC recruitment during cognitive multitasking. For this purpose, a one-back working memory task was performed either as single task or as dual task in order to vary cognitive load. Participants performed these cognitive single and dual tasks either during upright stance on a balance pad that was placed on top of a force plate or during fMRI measurement with little to no postural demands. We hypothesized dual one-back task performance to be associated with lPFC recruitment when compared to single one-back task performance. In addition, we expected individual variability in lPFC recruitment to be associated with postural performance costs during concurrent dual one-back performance. As expected, behavioral performance costs in postural sway during dual-one back performance largely varied between individuals and so did lPFC recruitment during dual one-back performance. Most importantly, individuals who recruited the right mid-lPFC to a larger degree during dual one-back performance also showed greater postural sway as measured by larger performance costs in total center of pressure displacements. This effect was selective to the high-load dual one-back task and suggests a crucial role of the right lPFC in allocating resources during cognitive-motor interference. Our study provides further insight into the mechanisms underlying cognitive-motor multitasking and its impairments.

Exergames Inherently Contain Cognitive Elements as Indicated by Cortical Processing

Exergames are increasingly used to train both physical and cognitive functioning, but direct evidence whether and how exergames affect cortical activity is lacking. Although portable electroencephalography (EEG) can be used while exergaming, it is unknown whether brain activity will be obscured by movement artifacts. The aims of this study were to assess whether electrophysiological measurements during exergaming are feasible and if so, whether cortical activity changes with additional cognitive elements. Twenty-four young adults performed self-paced sideways leaning movements, followed by two blocks of exergaming in which participants completed a puzzle by leaning left or right to select the correct piece. At the easy level, only the correct piece was shown, while two pieces were presented at the choice level. Brain activity was recorded using a 64-channel passive EEG system. After filtering, an adaptive mixture independent component analysis identified the spatio-temporal sources of brain activity. Results showed that it is feasible to record brain activity in young adults while playing exergames. Furthermore, five spatially different clusters were identified located frontal, bilateral central, and bilateral parietal. The frontal cluster had significantly higher theta power in the exergaming condition with choice compared to self-paced leaning movements and exergaming without choice, while both central clusters showed a significant increase in absolute alpha-2 power in the exergaming conditions compared to the self-paced movements. This is the first study to show that it is feasible to record brain activity while exergaming. Furthermore, results indicated that even a simple exergame without explicit cognitive demands inherently requires cognitive processing. These results pave the way for studying brain activity during various exergames in different populations to help improve their effective use in rehabilitation settings.

Effects of speed and direction of perturbation on electroencephalographic and balance responses

The modulation of perturbation-evoked potential (PEP) N1 as a function of different biomechanical characteristics of perturbation has been investigated before. However, it remains unknown whether the PEP N1 modulation contributes to the shaping of the functional postural response. To improve this understanding, we examined the modulation of functional postural response in relation to the PEP N1 response in ten healthy young subjects during unpredictable perturbations to their upright stance-translations of the support surface in a forward or backward direction at two different amplitudes of constant speed. Using independent components from the fronto-central region, obtained from subject-specific head models created from the MRI, our results show that the latency of onset of the functional postural response after the PEP N1 response was faster for forward than backward perturbations at a constant speed but was not affected by the speed of perturbation. Further, our results reinforce some of the previous findings that suggested that the N1 peak amplitude and peak latency are both modulated by the speed of perturbation but not by the direction of the perturbation. Our results improve the understanding of the relation between characteristics of perturbation and the neurophysiology of reactive balance control and may have implications for the design of brain-machine interfaces for populations with a higher risk of falls.

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.

Perturbation-evoked potentials: Significance and application in balance control research

Historically, balance control was thought to be mediated solely by subcortical structures based on animal research. However, recent findings provide compelling evidence of cortical involvement during balance reactions evoked by whole-body postural perturbations. In humans, an external perturbation elicits an evoked potential, termed the perturbation-evoked potential (PEP). PEPs are widely distributed over fronto-centro-parietal areas with maximal amplitude at the FCz/Cz electrode. From our literature review it is evident that the PEPs are comprised of a small positive potential (P1) that peaks around 30-90ms after perturbation onset, a large negative potential (N1) that peaks around 90-160ms, followed by positive (P2) and negative (N2) potentials between 200 and 400ms. Converging results across multiple studies suggest that these different PEP components are influenced by perturbation characteristics, postural set, environmental, and psychological factors. This review summarizes and integrates seminal research on the PEP, with a special emphasis on the PEP N1. Implications for future studies in PEP research are discussed to encourage further empirical investigation of PEP characteristics in healthy and patient populations.

Neuroimaging of Human Balance Control: A Systematic Review

This review examined 83 articles using neuroimaging modalities to investigate the neural correlates underlying static and dynamic human balance control, with aims to support future mobile neuroimaging research in the balance control domain. Furthermore, this review analyzed the mobility of the neuroimaging hardware and research paradigms as well as the analytical methodology to identify and remove movement artifact in the acquired brain signal. We found that the majority of static balance control tasks utilized mechanical perturbations to invoke feet-in-place responses (27 out of 38 studies), while cognitive dual-task conditions were commonly used to challenge balance in dynamic balance control tasks (20 out of 32 studies). While frequency analysis and event related potential characteristics supported enhanced brain activation during static balance control, that in dynamic balance control studies was supported by spatial and frequency analysis. Twenty-three of the 50 studies utilizing EEG utilized independent component analysis to remove movement artifacts from the acquired brain signals. Lastly, only eight studies used truly mobile neuroimaging hardware systems. This review provides evidence to support an increase in brain activation in balance control tasks, regardless of mechanical, cognitive, or sensory challenges. Furthermore, the current body of literature demonstrates the use of advanced signal processing methodologies to analyze brain activity during movement. However, the static nature of neuroimaging hardware and conventional balance control paradigms prevent full mobility and limit our knowledge of neural mechanisms underlying balance control.

Body sway adaptation to addition but not withdrawal of stabilizing visual information is delayed by a concurrent cognitive task

The aim of this study was to test the effects of a concurrent cognitive task on the promptness of the sensorimotor integration and reweighting processes following addition and withdrawal of vision. Fourteen subjects stood in tandem while vision was passively added and removed. Subjects performed a cognitive task, consisting of counting backward in steps of three, or were "mentally idle." We estimated the time intervals following addition and withdrawal of vision at which body sway began to change. We also estimated the time constant of the exponential change in body oscillation until the new level of sway was reached, consistent with the current visual state. Under the mentally idle condition, mean latency was 0.67 and 0.46 s and the mean time constant was 1.27 and 0.59 s for vision addition and withdrawal, respectively. Following addition of vision, counting backward delayed the latency by about 300 ms, without affecting the time constant. Following withdrawal, counting backward had no significant effect on either latency or time constant. The extension by counting backward of the time interval to stabilization onset on addition of vision suggests a competition for allocation of cortical resources. Conversely, the absence of cognitive task effect on the rapid onset of destabilization on vision withdrawal, and on the relevant reweighting time course, advocates the intervention of a subcortical process. Diverting attention from a challenging standing task discloses a cortical supervision on the process of sensorimotor integration of new balance-stabilizing information. A subcortical process would instead organize the response to removal of the stabilizing sensory input.NEW & NOTEWORTHY This study is the first to test the effect of an arithmetic task on the time course of balance readjustment following visual withdrawal or addition. Performing such a cognitive task increases the time delay following addition of vision but has no effect on withdrawal dynamics. This suggests that sensorimotor integration following addition of a stabilizing signal is performed at a cortical level, whereas the response to its withdrawal is "automatic" and accomplished at a subcortical level.

Cortical Modulation of Motor Control Biofeedback among the Elderly with High Fall Risk during a Posture Perturbation Task with Augmented Reality

The cerebral cortex provides sensorimotor integration and coordination during motor control of daily functional activities. Power spectrum density based on electroencephalography (EEG) has been employed as an approach that allows an investigation of the spatial–temporal characteristics of neuromuscular modulation; however, the biofeedback mechanism associated with cortical activation during motor control remains unclear among elderly individuals. Thirty one community-dwelling elderly participants were divided into low fall-risk potential (LF) and high fall-risk potential (HF) groups based upon the results obtained from a receiver operating characteristic analysis of the ellipse area of the center of pressure. Electroencephalography (EEG) was performed while the participants stood on a 6-degree-of-freedom Stewart platform, which generated continuous perturbations and done either with or without the virtual reality scene. The present study showed that when there was visual stimulation and poor somatosensory coordination, a higher level of cortical response was activated in order to keep postural balance. The elderly participants in the LF group demonstrated a significant and strong correlation between postural-related cortical regions; however, the elderly individuals in the HF group did not show such a relationship. Moreover, we were able to clarify the roles of various brainwave bands functioning in motor control. Specifically, the gamma and beta bands in the parietal–occipital region facilitate the high-level cortical modulation and sensorimotor integration, whereas the theta band in the frontal–central region is responsible for mediating error detection during perceptual motor tasks. Finally, the alpha band is associated with processing visual challenges in the occipital lobe.With a variety of motor control demands, increment in brainwave band coordination is required to maintain postural stability. These investigations shed light on the cortical modulation of motor control among elderly participants with varying fall-risk potentials. The results suggest that, although elderly adults may be without neurological deficits, inefficient central modulation during challenging postural conditions could be an internal factor that contributes to the risk of fall. Furthermore, training that helps to improve coordinated sensorimotor integration may be a useful approach to reduce the risk of fall among elderly populations or when patients suffer from neurological deficits.

Do quiet standing centre of pressure measures within specific frequencies differ based on ability to recover balance in individuals with stroke?

OBJECTIVE

To determine whether quiet standing measures at specific frequency levels (representative of reactive control) differed between individuals with stroke based on their ability to recover balance (Failed or Successful Responses to external perturbations).

METHODS

Individuals with stroke completed a clinical assessment, including 30 s of quiet standing and lean-and-release postural perturbations, at admission to in-patient rehabilitation. Quiet standing centre of pressure (COP) signals were calculated and discrete wavelet decomposition was performed. Net COP amplitude, between-limb synchronization, and ratios of individual-limb COP were determined for each frequency level of interest, and for the non-decomposed signal (all frequency levels). Outcome measures were compared between individuals who exhibited Failed and Successful Responses during (a) unconstrained and (b) encouraged-use lean-and-release trials.

RESULTS

Individuals with Failed Responses during the unconstrained lean-and-release trials displayed greater net COP amplitude than those with Successful Responses, specifically within a frequency range of 0.40-3.20Hz.

CONCLUSIONS

Reduced ability to recover balance among individuals with stroke may be reflected in impaired reactive control of quiet standing.

SIGNIFICANCE

These results provide insight into the mechanism by which reactive control of quiet standing is impaired in individuals with stroke, and may inform assessment and rehabilitation strategies for post-stroke reactive balance control.

The role of the cerebral cortex in postural responses to externally induced perturbations

The ease with which we avoid falling down belies a highly sophisticated and distributed neural network for controlling reactions to maintain upright balance. Although historically these reactions were considered within the sub cortical domain, mounting evidence reveals a distributed network for postural control including a potentially important role for the cerebral cortex. Support for this cortical role comes from direct measurement associated with moments of induced instability as well as indirect links between cognitive task performance and balance recovery. The cerebral cortex appears to be directly involved in the control of rapid balance reactions but also setting the central nervous system in advance to optimize balance recovery reactions even when a future threat to stability is unexpected. In this review the growing body of evidence that now firmly supports a cortical role in the postural responses to externally induced perturbations is presented. Moreover, an updated framework is advanced to help understand how cortical contributions may influence our resistance to falls and on what timescale. The implications for future studies into the neural control of balance are discussed.

Evidence for beta corticomuscular coherence during human standing balance: Effects of stance width, vision, and support surface

The role of the cerebral cortex in maintaining human standing balance remains unclear. Beta corticomuscular coherence (CMC) provides a measure of communication between the sensory-motor cortex and muscle, but past literature has not demonstrated significant beta CMC during human stance. This study evaluated the effects of stance width, vision, and surface compliance on beta CMC during human stance using methods to enhance sensitivity to CMC. Ten healthy, young adults stood for three 60-s trials in each of a wide or narrow stance width while on a firm surface and in narrow stance on a foam surface, each with eyes open or closed. Beta CMC was calculated between contralateral electroencephalographic and electromyographic recordings. Electromyography was recorded from bilateral tibialis anterior and gastrocnemius lateralis muscles. CMC magnitude was defined as the average integrated area of coherence spectrum above a significance threshold. Measures of center-of-pressure (COP) sway were derived from force plates under the subjects' feet. Results of CMC from four muscles across six stance conditions (a total of 24 combinations) demonstrated significant average CMC magnitude from every subject in 20 combinations and significant average CMC magnitude in nine of 10 subjects in the remaining four combinations. The CMC magnitude was significantly larger in the wide-stance condition than in the narrow-stance condition with eyes open. No significant differences were detected when comparing eyes-open to eyes-closed conditions or when comparing firm- to foam-surface conditions. Correlations between CMC magnitude and COP sway elicited some significant relationships, but there was no consistent direction or pattern of correlation based on muscle or stance condition. Results demonstrate that significant beta CMC is evident during human standing balance, and that beta CMC is responsive to changes in mechanical, but not visual or surface, conditions.