Manually controlled human balancing using visual, vestibular and proprioceptive senses involves a common, low frequency neural process

Different montages of transcranial direct current stimulation on postural stability in chronic low back pain patients: A randomized sham-controlled study

BACKGROUND

Impairment in both the motor and cognitive aspects of postural control is a critical issue in patients with chronic low back pain (CLBP) who experience high pain anxiety (HPA).

OBJECTIVE

This study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) on postural control during cognitive postural tasks in CLBP patients with HPA.

METHODS

This study included 66 patients randomly assigned to three groups: DLPFC a-tDCS, DLPFC c-tDCS, and sham tDCS. All groups received 20 minutes of tDCS, but the stimulation was gradually turned off in the sham group. Postural stability indices were assessed using the Biodex Balance System.

RESULTS

Both the a-tDCS and c-tDCS groups showed a significant reduction in most postural stability indices at static and dynamic levels after the interventions (immediately, 24 hours, and one-week follow-up) during the cognitive postural task (P< 0.01). Additionally, there was a significant improvement in postural balance in the a-tDCS and c-tDCS groups compared to the sham tDCS group (P< 0.01). Furthermore, the a-tDCS group showed significantly greater improvement than the c-tDCS group (P< 0.01).

CONCLUSION

Based on the results, both a-tDCS and c-tDCS over the DLPFC had positive effects on postural control during cognitive postural tasks in CLBP patients with HPA.

Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design

The aim of this research was to study the effect of a horseback-riding programme on postural control in a group of autistic children (ASD). Nine children aged 9 to 12 years participated in this study through a multiple baseline across subjects design. The whole programme took place over nine months. Participants followed a previously developed specific horseback-riding programme, consisting of 45-minute sessions held twice a week for at least three months. To evaluate postural control, the average velocity of the centre of pressure displacement was measured by means of a posturographic platform. Results indicated that this intervention with horses had a positive effect on the postural control in children with ASDs.

Transcranial direct current stimulation over dorsolateral prefrontal cortex improves postural stability in non-specific chronic low back pain patients with high fear of pain: A randomized sham-controlled trial

Deficits in postural stability in response to environmental challenges are seen in chronic low back pain (CLBP) patients with high fear of pain (HFP). Hence, it is essential to follow effective approaches to treat postural stability deficits and improve the health status of these patients. The current study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on postural stability in non-specific CLBP patients with HFP. In this randomized clinical trial study, 75 patients were randomly assigned to left DLPFC a-tDCS, left DLPFC c-tDCS and sham stimulation groups (n = 25 in each group). All groups received a single-session 2 mA tDCS for 20 min, but the stimulation was slowly turned off after 30 s in the sham group. Before, immediately, 24 h and 1 week after the interventions, postural stability indices were assessed using a Biodex Balance System. A significant reduction in most indices was shown in both a-tDCS and c-tDCS groups after interventions (immediately, 24 h and 1 week follow-up) during static and dynamic postural tasks compared with the sham tDCS group (p < .01). In addition, some tests showed a significant difference between a-tDCS and c-tDCS (p < .05). The findings indicated positive effects of both a-tDCS and c-tDCS on the left DLPFC, with more efficacy of a-tDCS on postural stability in LBP patients with HFP.

Audio-Vestibular Findings in Individuals with Takayasu's Arteritis

Takayasu's Arteritis is defined as inflammatory disease of the large blood vessels with unknown cause mostly affecting the aorta and its main branches. The patients diagnosed with Takayasu's arteritis are reported to have complaint of chronic dizziness. However, literature lacks detailed clinical evaluation of the auditory vestibular function in such patients. The current study documents the findings of auditory and vestibular evaluations in a rare syndrome. It was observed that patients with Takayasu's arteritis had abnormal auditory and vestibular evoked potentials.

Idiosyncratic Characteristics of Postural Sway in Normal and Perturbed Standing

Objective

Are people with a characteristically large physiological sway rendered particularly unstable when standing on a moving surface? Is postural sway in standing individuals idiosyncratic? In this study, we examine postural sway in individuals standing normally, and when subtle continuous sinusoidal disturbances are applied to their support platform. We calculate consistency between conditions to verify if sway can be considered characteristic of each individual. We also correlate two different aspects of participants’ responses to disturbance; their sway velocity and their regulation of body orientation.

Methods

Nineteen healthy adults (age 29.2 ± 3.2 years) stood freely on footplates coaxially aligned with their ankles and attached to a motorized platform. They had their eyes closed, and hips and knees locked with a light wooden board attached to their body. Participants either stood quietly on a fixed platform or on a slowly tilting platform (0.1 Hz sinusoid; 0.2 and 0.4 deg). Postural sway size was separated into two entities: (1) the spontaneous sway velocity component (natural random relatively rapid postural adjustments, RMS body angular velocity) and (2) the evoked tilt gain component (much slower 0.1 Hz synchronous tilt induced by the movement of the platform, measured as peak-to-peak (p-p) gain, ratio of body angle to applied footplate rotation).

Results

There was no correlation between the velocity of an individual’s sway and their evoked tilt gain (r = 0.34, p = 0.15 and r = 0.30, p = 0.22). However, when considered separately, each of the two measurements showed fair to good absolute agreement within conditions. Spontaneous sway velocity consistently increased as participants were subjected to increasing disturbance. Participants who swayed more (or less) did so across all conditions [ICC_(3,k) = 0.95]. Evoked tilt gain also showed consistency between conditions [ICC_(3,k) = 0.79], but decreased from least to most disturbed conditions.

Conclusion

The two measurements remain consistent between conditions. Consistency between conditions of two very distinct unrelated measurements reflects the idiosyncratic nature of postural sway. However, sway velocity and tilt gain are not related, which supports the idea that the short-term regulation of stability and the longer-term regulation of orientation are controlled by different processes.

Parameters of the crossing points between center of pressure and center of mass signals are potential markers of postural control efficiency

Posturographic signals were recorded for 384 subjects of different ages and with old persons with gait disturbances. Four conditions were used: Eyes Open/Closed vs. Head Normal/Bent Back. ‘Center of Pressure’ (CoP) signals were decomposed into ‘Center of Mass’ (CoM) and the remaining difference between Center of Pressure and Center of Mass (CoPM). The Zero-Crossing points in which the Center of Mass and Center of Pressure paths cross each other have been extracted. Velocity of CoM, velocity of CoPM and acceleration of CoPM in Zero-Crossing points were analyzed to be potential markers of balance efficiency. Three factors causing the deterioration of balance quality were analyzed: closing eyes, bending the head back and patient age. The influence of the given factors was measured using the significance p of the t-Student test and Cohen's d effect size and applied to differences for the logarithms of three of the mentioned above variables measured without and with the given deteriorating factor. In the majority of comparisons, the proposed new parameters of balance quality possessed higher statistical power to detect deteriorated balance quality than the standard parameters: standard deviation of the signal and ellipse area covering 90% of the signal envelope. Most valuable are the velocity and acceleration of CoPM for the medio-lateral direction. Logarithms of the analyzed parameters are proposed to be used in analyses because they possess normal or close to normal distribution and they are less sensitive to single high values occurring often in measurements.

Sensorimotor Manipulations of the Balance Control Loop-Beyond Imposed External Perturbations

Standing balance relies on the integration of multiple sensory inputs to generate the motor commands required to stand. Mechanical and sensory perturbations elicit compensatory postural responses that are interpreted as a window into the sensorimotor processing involved in balance control. Popular methods involve imposed external perturbations that disrupt the control of quiet stance. Although these approaches provide critical information on how the balance system responds to external disturbances, the control mechanisms involved in correcting for these errors may differ from those responsible for the regulation of quiet standing. Alternative approaches use manipulations of the balance control loop to alter the relationship between sensory and motor cues. Coupled with imposed perturbations, these manipulations of the balance control loop provide unique opportunities to reveal how sensory and motor signals are integrated to control the upright body. In this review, we first explore imposed perturbation approaches that have been used to investigate the neural control of standing balance. We emphasize imposed perturbations that only elicit balance responses when the disturbing stimuli are relevant to the balance task. Next, we highlight manipulations of the balance control loop that, when carefully implemented, replicate and/or alter the sensorimotor dynamics of quiet standing. We further describe how manipulations of the balance control loop can be used in combination with imposed perturbations to characterize mechanistic principles underlying the control of standing balance. We propose that recent developments in the use of robotics and sensory manipulations will continue to enable new possibilities for simulating and/or altering the sensorimotor control of standing beyond compensatory responses to imposed external perturbations.

Long-latency reflexes for inter-effector coordination reflect a continuous state feedback controller

Successful performance in many everyday tasks requires compensating unexpected mechanical disturbance to our limbs and body. The long-latency reflex plays an important role in this process because it is the fastest response to integrate sensory information across several effectors, like when linking the elbow and shoulder or the arm and body. Despite the dozens of studies on inter-effector long-latency reflexes, there has not been a comprehensive treatment of how these reveal the basic control organization that sets constraints on any candidate model of neural feedback control such as optimal feedback control. We considered three contrasting ways that controllers can be organized: multiple independent controllers vs. a multiple-input multiple-output (MIMO) controller, a continuous feedback controller vs. an intermittent feedback controller, and a direct MIMO controller vs. a state feedback controller. Following a primer on control theory and review of the relevant evidence, we conclude that continuous state feedback control best describes the organization of inter-effector coordination by the long-latency reflex.

Postural Control of Elderly Adults on Inclined Surfaces

This study analyzed the postural control of older adults on inclined surfaces, and was conducted in 17 elderly adults and 18 young adults of both genders. Ground reaction forces and moments were collected using two AMTI force platforms, one of which was in a horizontal position (HOR), while the other was inclined 14° in relation to the horizontal plane. Each participant executed three 70 s-trials of bipedal standing with their eyes open and eyes closed in three inclination conditions: the HOR, the inclined position at ankle dorsi-flexion (UP), and the inclined position at ankle plantar-flexion (DOWN). Spectral analysis, global (mean velocity-Velm, ellipse area-Area and F80), and structural stabilometric descriptors (sway density curve-SDC, detrended fluctuation analysis-DFA, sample entropy-SEn) were employed to assess the center of pressure sway. Velm and F80 were greater for the elderly, whereas SDC, DFA, and SEn were smaller for this group. Global, SDC and DFA variables were sensitive to visual deprivation, however the relative difference from the EO to EC condition was higher in young than in elderly. The DOWN condition was more stable than the UP condition for both young and older adults. With regard to the UP condition, the challenge observed is essentially associated with the corresponding biomechanical constraints. In conclusion, the elderly showed significant differences compared to the young, but age per se may not necessarily result in compromised postural control.

Difference in Postural Control during Quiet Standing between Young Children and Adults: Assessment with Center of Mass Acceleration

The development of upright postural control has often been investigated using time series of center of foot pressure (COP), which is proportional to the ankle joint torque (i.e., the motor output of a single joint). However, the center of body mass acceleration (COM_acc), which can reflect joint motions throughout the body as well as multi-joint coordination, is useful for the assessment of the postural control strategy at the whole-body level. The purpose of the present study was to investigate children’s postural control during quiet standing by using the COM_acc. Ten healthy children and 15 healthy young adults were instructed to stand upright quietly on a force platform with their eyes open or closed. The COM_acc as well as the COP in the anterior–posterior direction was obtained from ground reaction force measurement. We found that both the COM_acc and COP could clearly distinguish the difference between age groups and visual conditions. We also found that the sway frequency of COM_acc in children was higher than that in adults, for which differences in biomechanical and/or neural factors between age groups may be responsible. Our results imply that the COM_acc can be an alternative force platform measure for assessing developmental changes in upright postural control.

Models of Postural Control: Shared Variance in Joint and COM Motions

This paper investigated the organization of the postural control system in human upright stance. To this aim the shared variance between joint and 3D total body center of mass (COM) motions was analyzed using multivariate canonical correlation analysis (CCA). The CCA was performed as a function of established models of postural control that varied in their joint degrees of freedom (DOF), namely, an inverted pendulum ankle model (2DOF), ankle-hip model (4DOF), ankle-knee-hip model (5DOF), and ankle-knee-hip-neck model (7DOF). Healthy young adults performed various postural tasks (two-leg and one-leg quiet stances, voluntary AP and ML sway) on a foam and rigid surface of support. Based on CCA model selection procedures, the amount of shared variance between joint and 3D COM motions and the cross-loading patterns we provide direct evidence of the contribution of multi-DOF postural control mechanisms to human balance. The direct model fitting of CCA showed that incrementing the DOFs in the model through to 7DOF was associated with progressively enhanced shared variance with COM motion. In the 7DOF model, the first canonical function revealed more active involvement of all joints during more challenging one leg stances and dynamic posture tasks. Furthermore, the shared variance was enhanced during the dynamic posture conditions, consistent with a reduction of dimension. This set of outcomes shows directly the degeneracy of multivariate joint regulation in postural control that is influenced by stance and surface of support conditions.

Adaptive intermittent control: A computational model explaining motor intermittency observed in human behavior

It is a fundamental question how our brain performs a given motor task in a real-time fashion with the slow sensorimotor system. Computational theory proposed an influential idea of feed-forward control, but it has mainly treated the case that the movement is ballistic (such as reaching) because the motor commands should be calculated in advance of movement execution. As a possible mechanism for operating feed-forward control in continuous motor tasks (such as target tracking), we propose a control model called "adaptive intermittent control" or "segmented control," that brain adaptively divides the continuous time axis into discrete segments and executes feed-forward control in each segment. The idea of intermittent control has been proposed in the fields of control theory, biological modeling and nonlinear dynamical system. Compared with these previous models, the key of the proposed model is that the system speculatively determines the segmentation based on the future prediction and its uncertainty. The result of computer simulation showed that the proposed model realized faithful visuo-manual tracking with realistic sensorimotor delays and with less computational costs (i.e., with fewer number of segments). Furthermore, it replicated "motor intermittency", that is, intermittent discontinuities commonly observed in human movement trajectories. We discuss that the temporally segmented control is an inevitable strategy for brain which has to achieve a given task with small computational (or cognitive) cost, using a slow control system in an uncertain variable environment, and the motor intermittency is the side-effect of this strategy.

Periodic change in phase relationship between target and hand motion during visuo-manual tracking task: behavioral evidence for intermittent control

When one performs visuo-manual tracking tasks, velocity profile of hand movements shows discontinuous patterns even if the target moves smoothly. A crucial factor of this "intermittency" is considerable delay in the sensorimotor feedback loop, and several researchers have suggested that the cause is intermittent correction of motor commands. However, when and how the brain monitors task performance and updates motor commands in a continuous motor task is uncertain. We examined how tracking error was affected by the timing of target disappearance during a tracking task. Results showed that tracking error, defined as the average phase difference between target and hand, varied periodically in all conditions. Hand preceded target at one specific phase but followed it at another, implying that motor control was not performed in a temporally uniform manner. Tracking stability was evaluated by the variance in phase difference, and changed depending on the timing of target-removal. The variability was larger when target disappeared around turning points than that when it disappeared around the center of motion. This shows that visual information at turning points is more effectively exploited for motor control of sinusoidal target tracking, suggesting that our brain controls hand movements with intermittent reference to visual information.

Modelling the learning of biomechanics and visual planning for decision-making of motor actions

Recent experiments showed that the bio-mechanical ease and end-point stability associated to reaching movements are predicted prior to movement onset, and that these factors exert a significant influence on the choice of movement. As an extension of these results, here we investigate whether the knowledge about biomechanical costs and their influence on decision-making are the result of an adaptation process taking place during each experimental session or whether this knowledge was learned at an earlier stage of development. Specifically, we analysed both the pattern of decision-making and its fluctuations during each session, of several human subjects making free choices between two reaching movements that varied in path distance (target relative distance), biomechanical cost, aiming accuracy and stopping requirement. Our main result shows that the effect of biomechanics is well established at the start of the session, and that, consequently, the learning of biomechanical costs in decision-making occurred at an earlier stage of development. As a means to characterise the dynamics of this learning process, we also developed a model-based reinforcement learning model, which generates a possible account of how biomechanics may be incorporated into the motor plan to select between reaching movements. Results obtained in simulation showed that, after some pre-training corresponding to a motor babbling phase, the model can reproduce the subjects' overall movement preferences. Although preliminary, this supports that the knowledge about biomechanical costs may have been learned in this manner, and supports the hypothesis that the fluctuations observed in the subjects' behaviour may adapt in a similar fashion.

Loss of balance during balance beam walking elicits a multifocal theta band electrocortical response

Determining the neural correlates of loss of balance during walking could lead to improved clinical assessment and treatment for individuals predisposed to falls. We used high-density electroencephalography (EEG) combined with independent component analysis (ICA) to study loss of balance during human walking. We examined 26 healthy young subjects performing heel-to-toe walking on a treadmill-mounted balance beam as well as walking on the treadmill belt (both at 0.22 m/s). ICA identified clusters of electrocortical EEG sources located in or near anterior cingulate, anterior parietal, superior dorsolateral-prefrontal, and medial sensorimotor cortex that exhibited significantly larger mean spectral power in the theta band (4-7 Hz) during walking on the balance beam compared with treadmill walking. Left and right sensorimotor cortex clusters produced significantly less power in the beta band (12-30 Hz) during walking on the balance beam compared with treadmill walking. For each source cluster, we also computed a normalized mean time/frequency spectrogram time locked to the gait cycle during loss of balance (i.e., when subjects stepped off the balance beam). All clusters except the medial sensorimotor cluster exhibited a transient increase in theta band power during loss of balance. Cluster spectrograms demonstrated that the first electrocortical indication of impending loss of balance occurred in the left sensorimotor cortex at the transition from single support to double support prior to stepping off the beam. These findings provide new insight into the neural correlates of walking balance control and could aid future studies on elderly individuals and others with balance impairments.

Refractoriness in sustained visuo-manual control: is the refractory duration intrinsic or does it depend on external system properties?

Researchers have previously adopted the double stimulus paradigm to study refractoriness in human neuromotor control. Currently, refractoriness, such as the Psychological Refractory Period (PRP) has only been quantified in discrete movement conditions. Whether refractoriness and the associated serial ballistic hypothesis generalises to sustained control tasks has remained open for more than sixty years. Recently, a method of analysis has been presented that quantifies refractoriness in sustained control tasks and discriminates intermittent (serial ballistic) from continuous control. Following our recent demonstration that continuous control of an unstable second order system (i.e. balancing a 'virtual' inverted pendulum through a joystick interface) is unnecessary, we ask whether refractoriness of substantial duration (~200 ms) is evident in sustained visual-manual control of external systems. We ask whether the refractory duration (i) is physiologically intrinsic, (ii) depends upon system properties like the order (0, 1(st), and 2(nd)) or stability, (iii) depends upon target jump direction (reversal, same direction). Thirteen participants used discrete movements (zero order system) as well as more sustained control activity (1(st) and 2(nd) order systems) to track unpredictable step-sequence targets. Results show a substantial refractory duration that depends upon system order (250, 350 and 550 ms for 0, 1(st) and 2(nd) order respectively, n=13, p<0.05), but not stability. In sustained control refractoriness was only found when the target reverses direction. In the presence of time varying actuators, systems and constraints, we propose that central refractoriness is an appropriate control mechanism for accommodating online optimization delays within the neural circuitry including the more variable processing times of higher order (complex) input-output relations.

The modulatory influence of end-point controllability on decisions between actions

Recent work has shown that human subjects are able to predict the biomechanical ease of potential reaching movements and use these predictions to influence their choices. Here, we examined how reach decisions are influenced by specific biomechanical factors related to the control of end-point stability, such as aiming accuracy or stopping control. Human subjects made free choices between two potential reaching movements that varied in terms of path distance and biomechanical cost in four separate blocks that additionally varied two constraints: the width of the targets (narrow or wide) and the requirement of stopping in them. When movements were unconstrained (very wide targets and no requirement of stopping), subjects' choices were strongly biased toward directions aligned with the direction of maximal mobility. However, as the movements became progressively constrained, factors related to the control of the end point gained relevance, thus reducing this bias. This demonstrates that, before movement onset, constraints such as stopping and aiming participate in a remarkably adaptive and flexible action selection process that trades off the advantage of moving along directions of maximal mobility for unconstrained movements against exploiting biomechanical anisotropies to facilitate control of end-point stability whenever the movement constraints require it. These results support a view of decision making between motor actions as a highly context-dependent gradual process in which the subjective desirability of potential actions is influenced by their dynamic properties in relation to the intrinsic properties of the motor apparatus.

Stability control of grasping objects with different locations of center of mass and rotational inertia

The objective of this study was to observe how the digits of the hand adjust to varying location of the center of mass (CoM) above or below the grasp and rotational inertia (RI) of a handheld object. Such manipulations do not immediately affect the equilibrium equations while stability control is affected. Participants were instructed to hold a handle, instrumented with 5 force-torque transducers and a 3-D rotational tilt sensor, while either the location of the CoM or the RI values were adjusted. On the whole, people use 2 mechanisms to adjust to the changed stability requirements; they increase the grip force and redistribute the total moment between the normal and tangential forces offsetting internal torques. The increase in grip force, an internal force, and offsetting internal torques allows for increases in joint and hand rotational apparent stiffness while not creating external forces-torques that would unbalance the equations of equilibrium.

Prehension of half-full and half-empty glasses: time and history effects on multi-digit coordination

We explored how digit forces and indices of digit coordination depend on the history of getting to a particular set of task parameters during static prehension tasks. The participants held in the right hand an instrumented handle with a light-weight container attached on top of the handle. At the beginning of each trial, the container could be empty, filled to the half with water (0.4 l), or filled to the top (0.8 l). The water was pumped in/out of the container at a constant, slow rate over 10 s. At the end of each trial, the participants always held a half-filled container that has just been filled (Empty-Half), emptied (Full-Half) or stayed half-filled throughout the trial (Half-Only). Indices of covariation (synergy indices) of elemental variables (forces and moments of force produced by individual digits) stabilizing such performance variables as total normal force, total tangential force, and total moment of force were computed at two levels of an assumed control hierarchy. At the upper level, the task is shared between the thumb and virtual finger (an imagined digit with the mechanical action equal to that of the four fingers), while at the lower level the action of the virtual finger is shared among the actual four fingers. Filling or emptying the container led to a drop in the safety margin (proportion of grip force over the slipping threshold) below the values observed in the Half-Only condition. Synergy indices at both levels of the hierarchy showed changes over the Full-Half and Empty-Half condition. These changes could be monotonic (typical of moment of force and normal force) or non-monotonic (typical of tangential force). For both normal and tangential forces, higher synergy indices at the higher level of the hierarchy corresponded to lower indices at the lower level. Significant differences in synergy indices across conditions were seen at the final steady state showing that digit coordination during steady holding an object is history dependent. The observations support an earlier hypothesis on a trade-off between synergies at the two levels of a hierarchy. They also suggest that, when a change in task parameters is expected, the neural strategy may involve producing less stable (easier to change) actions. The results suggest that synergy indices may be highly sensitive to changes in a task variable and that effects of such changes persist after the changes are over.

Human control of an inverted pendulum: is continuous control necessary? Is intermittent control effective? Is intermittent control physiological?

Human motor control is often explained in terms of engineering 'servo' theory. Recently, continuous, optimal control using internal models has emerged as a leading paradigm for voluntary movement. However, these engineering paradigms are designed for high band-width, inflexible, consistent systems whereas human control is low bandwidth and flexible using noisy sensors and actuators. By contrast, engineering intermittent control was designed for bandwidth-limited applications. Our general interest is whether intermittent rather than continuous control is generic to human motor control. Currently, it would be assumed that continuous control is the superior and physiologically natural choice for controlling unstable loads, for example as required for maintaining human balance. Using visuo-manual tracking of an unstable load, we show that control using gentle, intermittent taps is entirely natural and effective. The gentle tapping method resulted in slightly superior position control and velocity minimisation, a reduced feedback time delay, greater robustness to changing actuator gain and equal or greater linearity with respect to the external disturbance. Control was possible with a median contact rate of 0.8±0.3 s(-1). However, when optimising position or velocity regulation, a modal contact rate of 2 s(-1) was observed. This modal rate was consistent with insignificant disturbance-joystick coherence beyond 1-2 Hz in both tapping and continuous contact methods. For this load, these results demonstrate a motor control process of serial ballistic trajectories limited to an optimum rate of 2 s(-1). Consistent with theoretical reasoning, our results suggest that intermittent open loop action is a natural consequence of human physiology.

Active Control of Bias for the Control of Posture and Movement

Posture and movement are fundamental, intermixed components of motor coordination. Current approaches consider either that 1) movement is an active, anticipatory process and posture is a passive feedback process or 2) movement and posture result from a common passive process. In both cases, the presence of a passive component renders control scarcely robust and stable in the face of transmission delays and low feedback gains. Here we show in a model that posture and movement could result from the same active process: an optimal feedback control that drives the body from its estimated state to its goal in a given (planning) time by acting through muscles on the insertion position (bias) of compliant linkages (tendons). Computer simulations show that iteration of this process in the presence of noise indifferently produces realistic postural sway, fast goal-directed movements, and natural transitions between posture and movement.

Attentional influences on the performance of secondary physical tasks during posture control

We examined the influence of attentional focus and cognitive load on motor performance in a dynamic stick balancing task during the maintenance of upright posture. Dynamical analyses of postural fluctuations revealed the existence of a drift and correct mechanism, with correlational structure reflecting the demands of the stick balancing task. In contrast, experimentally manipulated attentional foci (internal, external) did not influence the variability of postural or fingertip trajectories. However, dual-task cognitive stick balancing performance resulted in decreased variability of postural and fingertip time series. These results are discussed in the context of dual timescale models for posture control and stick balancing.

Is the stabilization of quiet upright stance in humans driven by synchronized modulations of the activity of medial and lateral gastrocnemius muscles?

A matrix of 120 electromyogram (EMG) electrodes (8 rows and 15 columns) was used to investigate individual activation patterns of the medial (MG) and lateral gastrocnemius (LG) muscles during forward sways of the body in human quiet stance. This matrix was positioned on the right calf of eight subjects after identification of the MG and LG contours with ultrasound scanning. Gray-scale images were generated with the maxima and minima of the cross-correlation function between the envelope of each EMG signal and the body center of pressure (CoP) for individual forward sways. These images were automatically segmented to reduce the data set into representative and local values of EMG-CoP cross-correlation for each muscle. On average, modulations in EMG amplitude preceded the onset of forward sways with a variable timing, with both gastrocnemius muscles being similarly and synchronously modulated in 193 out of 236 sways. Variations in the timing of activation between muscles were less frequent, although consistent across subjects and significantly correlated with changes in the direction and velocity of body sways. Interestingly, the time shift between EMG and CoP traces sometimes varied consistently along different channels of the same column of electrodes, either in proximal-to-distal or distal-to-proximal direction. The variable EMG-CoP cross-correlation delay was not congruent with the delay expected for the propagation of surface potentials along muscle fibers. Comparison of surface EMGs with intramuscular EMGs recorded from six subjects demonstrated that surface potentials provide high spatial selectivity, thus supporting the notion of selective activation of motor units during quiet standing. Hence, the stabilization of the quiet standing posture likely relies on flexible rather than stereotyped mechanisms of control.

Paradoxical muscle movement during postural control

Undisturbed human standing is primarily characterized by sway of the whole body about the ankle joints and is regulated primarily by the calf muscles. Traditionally, in accord with normal ideas of postural control, ankle stiffness, enhanced by spindle mediated muscle stretch reflexes, has been considered to be important for maintaining the upright human stance. This idea predicts that during forward sway, the calf muscles are stretched and the mechanoreflex response enhances muscle activity to maintain posture and balance. Muscle contractile displacement is expected to be positively correlated with bodily sway. However, recent experiments have revealed problems with these ideas. Using a new ultrasound technique for viewing and measuring the dynamic contractile displacements of the calf muscles, it has been shown that calf muscle movement is usually poorly or negatively correlated with bodily sway. The shortening of the contractile tissue during forward sway and vice versa is described as paradoxical muscle movements. This paradoxical muscle movement can be explained by the fact that the Achilles tendon, which transmits the calf muscle force, is compliant in relation the bodily load. There are two main consequences of the compliant Achilles tendon. First, the body is unstable: it cannot be stabilized by intrinsic ankle stiffness alone and thus requires modulation of muscle activity to maintain balance. Second, contractile displacement is mechanically decoupled from bodily sway, which implies that stretch-reflex mechanisms mediated by the calf muscle spindles are unable to successfully modulate muscle activity to maintain balance. This leaves uncertain the postural role of the numerous calf muscle spindles: it is predicted that they signal the effective motor output rather than bodily sway.

The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture

Humans can stand using sensory information solely from the ankle muscles. Muscle length and tension in the calf muscles (gastrocnemius and soleus) are unlikely to signal postural sways on account of balance-related modulation in agonist activity. These facts pose two questions: (1) Which ankle muscles provide the proprioceptive information? (2) Which peripheral mechanism could modulate agonist activity? To address these issues, subjects were asked to stand normally on two force plates. Ultrasound and surface EMG were recorded from the calf and tibialis anterior (TA) muscles. For all nine subjects, changes in muscle length of TA were mainly (84 +/- 9% whole trial duration) orthodoxly correlated with bodily sway (centre of gravity, CoG), i.e. in accordance with passive ankle rotation. When orthodox, TA had the highest correlation with CoG (-0.66 +/- 0.07, deep compartment, P < 0.001). For five subjects, the superficial TA compartment showed counter-intuitive changes in muscle length with CoG, probably due to the flattening of the foot and proximal attachment geometry. Gastrocnemius and soleus were usually (duration 71 +/- 23 and 81 +/- 16%, respectively) active agonists (paradoxically correlated with CoG) but, for short periods of time, they could be orthodox and then presented a moderate correlation (0.38 +/- 0.16 and 0.28 +/- 0.09, respectively) with CoG. Considering the duration and extent to which muscle length is orthodox and correlated with CoG, TA may be a better source of proprioceptive information than the active agonists (soleus and gastrocnemius). Therefore, if a peripheral feedback mechanism modulates agonist activity then reciprocal inhibition acted by TA on the calf muscles is more likely to be effective than the autogenic pathway.

Visual control of stable and unstable loads: what is the feedback delay and extent of linear time-invariant control?

Human balance is commonly described using linear-time-invariant (LTI) models. The feedback time delay determines the position of balance in the motor-control hierarchy. The extent of LTI control illuminates the automaticity of the control process. Using non-parametric analysis, we measured the feedback delay, extent of LTI control and visuo-motor transfer function in six randomly disturbed, visuo-manual compensatory tracking tasks analogous to standing with small mechanical perturbations and purely visual information. The delay depended primarily on load order (2nd: 220+/-30 ms, 1st: 124+/-20 ms), and secondarily on visual magnification (extent 2nd: 34 ms, 1st: 8 ms) and was unaffected by load stability. LTI control explained 1st order and stable loads relatively well. For unstable (85% passive stabilisation) 2nd order loads, LTI control accounted for 40% of manual output at 0.1 Hz decreasing below 10% as frequency increased through the important 1-3 Hz region where manual power and visuo-motor gain are high. Visual control of unstable 2nd order loads incurs substantial feedback delays and the control process will not be LTI. These features do not result from exclusive use of visual inputs because we found much shorter delays and a greater degree of LTI control when subjects visually controlled a 1st order load. Rather, these results suggest that delay and variability are inevitable when more flexible, intentional mechanisms are required to control 2nd order unstable loads. The high variability of quiet standing, and movement generally, may be indicative of flexible, variable delay, intentional mechanisms rather than the automatic LTI responses usually reported in response to large perturbations.

An overview of age-related changes in postural control during quiet standing tasks using classical and modern stabilometric descriptors

Age-related changes in postural control during quiet standing likely result from underlying pathological conditions or from the low specificity of classical stabilometric parameters, which are vulnerable to base of support configurations and anthropometric differences. This study focuses on the identification of changes in postural control with natural aging by using conventional and recent stabilometric analysis, and on the interpretation of the stabilometric parameters according to a recently proposed framework of postural control. Quiet standing stabilometric tests were applied to 57 subjects equally divided into young, middle-aged and aged groups (19-29, 38-51 and 65-73 years, respectively) with eyes open and closed conditions. In addition to estimation of classical descriptors, center of pressure time series were approached according to a diffusion-like process and the recently proposed sway density curve. Two out of 10 estimated descriptors identified between-group differences. Aged subjects exhibited higher sway frequencies, possibly resulting from the increase of torque bursts produced by the plantar flexors, and stronger negative correlation between consecutive center of pressure displacements observed for long time intervals, likely due to higher amplitude of plantar flexors torque. Aging itself does not result in major changes of postural stability, but reflects a small increase in plantar flexion torque amplitude and frequency of torque adjustments, probably to compensate for the lower stiffness of calf muscle tendon in aged subjects.

Postural responses evoked by platform pertubations are dominated by continuous feedback

Is human balance control dominated by time invariant continuous feedback mechanisms or do noncontinuous mechanisms play a significant role like intermittent control? The goal of this paper is to quantify how much of the postural responses evoked by pseudorandom external periodic perturbations can be explained by continuous time invariant feedback control. Nine healthy subjects participated in this study. Center of mass and ankle torque responses were elicited by periodic platform perturbations in forward-backward directions containing energy in the 0.06- to 4.5-Hz frequency band. Subjects had their eyes open (EO) or eyes closed (EC). Responses were decomposed into a periodic component and a remnant (stochastic) component using spectral analysis. It is concluded that periodic responses can explain most of the evoked responses, although the remnant power spectral densities (PSDs) were significant especially for slow responses (<0.2 Hz) and largest for EC. The found remnant PSD did depend on the sensory condition but not on the platform perturbation amplitude. The ratio of the body sway and ankle torque remnant PSD reflects the body dynamics. Both findings are consistent with the idea that estimation of body orientation is part of a continuous feedback loop and that (stochastic) estimation errors increase when one source of sensory information is removed. The findings are not consistent with the idea that discrete or discontinuous intermittent feedback mechanisms significantly shape postural responses.

The frequency of human, manual adjustments in balancing an inverted pendulum is constrained by intrinsic physiological factors

While standing naturally and when manually or pedally balancing an equivalent inverted pendulum, the load sways slowly (characteristic unidirectional duration approximately 1 s) and the controller, calf muscles or hand, makes more frequent adjustments (characteristic unidirectional duration 400 ms). Here we test the hypothesis that these durations reflect load properties rather than some intrinsic property of the human neuromuscular system. Using a specialized set-up mechanically analogous to real standing, subjects manually balanced inverted pendulums with different moments of inertia through a compliant spring representing the Achilles tendon. The spring bias was controlled by a sensitive joystick via a servo motor and accurate visual feedback was provided on an oscilloscope. As moment of inertia decreased, inverted pendulum sway size increased and it became difficult to sustain successful balance. The mean duration of unidirectional balance adjustments did not change. Moreover, the mean duration of unidirectional inverted pendulum sway reduced only slightly, remaining around 1 s. The simplest explanation is that balance was maintained by a process of manual adjustments intrinsically limited to a mean frequency of two to three unidirectional adjustments per second corresponding to intermittent control observed in manual tracking experiments. Consequently the inverted pendulum sway duration, mechanically related to the bias duration, reflects an intrinsic constraint of the neuromuscular control system. Given the similar durations of sway and muscle adjustments observed in real standing, we postulate that the characteristic duration of unidirectional standing sway reflects intrinsic intermittent control rather than the inertial properties of the body.