Load Dependency of Postural Control--Kinematic and Neuromuscular Changes in Response to over and under Load Conditions

Bone deconditioning during partial weight-bearing in rodents - A systematic review and meta-analysis

Space agencies are preparing to send humans to the Moon (16% Earth's gravity) and Mars (38% Earth's gravity), however, there is limited evidence regarding the effects of hypogravity on the skeletal system. A novel rodent partial weight-bearing (PWB) model may provide insight into how human bone responds to hypogravity. The aim of this study was to perform a systematic review investigating the effect of PWB on the structure and function of rodent bone. Five online databases were searched with the following inclusion criteria: population (rodents), intervention (PWB for ≥1-week), control (full weight-bearing), outcomes (bone structure/function), and study design (animal intervention). Of the 2,993 studies identified, eight were included. The main findings were that partial weight-bearing exposure for 21-28 days at 20%, 40%, and 70% of full loading causes: (1) loss of bone mineral density, (2) loss of trabecular bone volume, thickness, number, and increased separation, (3) loss of cortical area and thickness, and 4) reduced bone stiffness and strength. These findings predominately relate the tibia/femur of young/mature female mice, however, their deconditioning response appeared similar, but not identical, to male rats. A dose-response trend was frequently observed between the magnitude of deconditioning and PWB level. The deconditioning patterns in PWB resembled those in rodents and humans exposed to microgravity and microgravity analogs. The present findings suggest that countermeasures against bone deconditioning may be required for humans exploring the Lunar and Martian surfaces.

In vivo measurements of spinal stiffness according to a stepwise increase of axial load

Background

The spine has a complex motor control. Its different stabilization mechanisms through passive, active, and neurological subsystems may result in spinal stiffness. To better understand lumbar spinal motor control, this study aimed to measure the effects of increasing the axial load on spinal stiffness.

Methods

A total of 19 healthy young participants (mean age, 24 ± 2.1 years; 8 males and 11 females) were assessed in an upright standing position. Under different axial loads, the posterior-to-anterior spinal stiffness of the thoracic and lumbar spine was measured. Loads were 0%, 10%, 45%, and 80% of the participant’s body weight.

Results

Data were normally distributed and showed excellent reliability. A repeated-measures analysis of variance with a Greenhouse–Geisser correction showed an effect of the loading condition on the mean spinal stiffness [F (2.6, 744) = 3.456, p < 0.001]. Vertebrae and loading had no interaction [F (2.6, 741) = 0.656, p = 0.559]. Post hoc tests using Bonferroni correction revealed no changes with 10% loading (p = 1.000), and with every additional step of loading, spinal stiffness decreased: 0% or 10–45% loading (p < 0.001), 0% or 10–80% loading (p < 0.001), and 45–80% (p < 0.001).

Conclusion

We conclude that a load of ≥ 45% of the participant’s body weight can lead to changes in the spinal motor control. An axial load of 10% showed no significant changes. Rehabilitation should include high-axial-load exercise if needed in everyday living.

The Influence of Carrying Anterior Load on the Sagittal and Frontal Plane Kinematics of Lower Extremities during Stair Ascending

Background:

Anterior load carriage is a one of the commonly performed activities in some industries. Stair climbing while carrying anterior load significantly alters different biomechanical mechanisms that can potentially affect the musculoskeletal function of the lower extremities.

Objective:

The study aims to assess the effect of carrying an anterior load (20% of body weight) on lower extremity kinematics during the kinematical phases of stairs ascent (weight acceptance, pull up, forward continuance, and swing phase).

Material and Methods:

In this experimental study, data were collected through the use of a custom made wooden staircase and OPtiTrack motion capture system was composed of 12 infrared cameras and a per modeled reflective marker set. Sixteen female college students volunteered to conduct two tasks of ascending stairs with and without an anterior load of approximately 20% of their body weight. The collected frontal and sagittal plane lower extremity joint angles were calculated using MATLAB software (version R2015a). Statistical comparison between the two study tasks was made using IBM SPSS Statistics software (version 25.0; SPSS Inc., Chicago, IL, USA).

Results:

Based on the results, there is significant difference (p-value < 0.05) between the two study tasks during ascending stair phases in all three sagittal plan lower extremity joint angles.

Conclusion:

Anterior load carried during stair ascent causes participants to depend more on the hip joint (higher flexion angles) compared to stair ascent without loads, which may increase the risk of falls and injuries, and the importance of muscle-strengthening activities and highlight the use of appropriate technique during load carriage.

Added body mass alters plantar shear stresses, postural control, and gait kinetics: Implications for obesity

Context

Obesity is a growing global health concern. The increased body mass and altered mass distribution associated with obesity may be related to increases in plantar shear that putatively leads to physical functional deficits. Therefore, measurement of plantar shear may provide unique insights on the effects of body mass and body distribution on physical function or performance.

Purpose

1) To investigate the effects of body mass and distribution on plantar shear. 2) To examine how altered plantar shear influences postural control and gait kinetics.

Hypothesis

1) a weighted vest forward distributed (FV) would shift the center of pressure (CoP) location forward during standing compared with a weighted vest evenly distributed (EV), 2) FV would increase plantar shear spreading forces more than EV during standing, 3) FV would increase postural sway during standing while EV would not, and 4) FV would elicit greater compensatory changes during walking than EV.

Methods

Twenty healthy young males participated in four different tests: 1) static test (for measuring plantar shear and CoP location without acceleration, 2) bilateral-foot standing postural control test, 3) single-foot standing postural test, and 4) walking test. All tests were executed in three different weight conditions: 1) unweighted (NV), 2) EV with 20% added body mass, and 3) FV, also with 20% added body mass. Plantar shear stresses were measured using a pressure/shear device, and several shear and postural control metrics were extracted. Repeated measures ANOVAs with Holms post hoc test were used to compare each metric among the three conditions (α = 0.05).

Results

FV and EV increased both AP and ML plantar shear forces compared to NV. FV shifted CoP forward in single-foot trials. FV and EV showed decreased CoP range and velocity and increased Time-to-Boundary (TTB) during postural control compared to NV. EV and FV showed increased breaking impulse and propulsive impulse compared to NV. In addition, EV showed even greater impulses than FV. While EV increased ML plantar shear spreading force, FV increased AP plantar shear spreading force during walking.

Conclusion

Added body mass increases plantar shear spreading forces. Body mass distribution had greater effects during dynamic tasks. In addition, healthy young individuals seem to quickly adapt to external stimuli to control postural stability. However, as this is a first step study, follow-up studies are necessary to further support the clinical role of plantar shear in other populations such as elderly and individuals with obesity or diabetes.

Impairment of synaptic plasticity and novel object recognition in the hypergravity-exposed rats

The gravity is necessary for living organisms to operate various biological events including hippocampus-related functions of learning and memory. Until now, it remains inconclusive how altered gravity is associated with hippocampal functions. It is mainly due to the difficulties in generating an animal model experiencing altered gravity. Here, we demonstrate the effects of hypergravity on hippocampus-related functions using an animal behavior and electrophysiology with our hypergravity animal model. The hypergravity (4G, 4 weeks) group showed impaired synaptic efficacy and long-term potentiation in CA1 neurons of the hippocampus along with the poor performance of a novel object recognition task. Our studies suggest that altered gravity affects hippocampus-related cognitive functions, presumably through structural and functional adaptation to various conditions of gravity shift.

Characteristics of Standing Postural Control in Women under Additional Load

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

Stumbling reactions in hypo and hyper gravity - muscle synergies are robust across different perturbations of human stance during parabolic flights

The control of bipedal stance and the capacity to regain postural equilibrium after its deterioration in variable gravities are crucial prerequisites for manned space missions. With an emphasize on natural orthograde posture, computational techniques synthesize muscle activation patterns of high complexity to a simple synergy organization. We used nonnegative matrix factorization to identify muscle synergies during postural recovery responses in human and to examine the functional significance of such synergies for hyper-gravity (1.75 g) and hypo-gravity (0.25 g). Electromyographic data were recorded from leg, trunk and arm muscles of five human exposed to five modes of anterior and posterior support surface translations during parabolic flights including transitional g-levels of 0.25, 1 and 1.75 g. Results showed that in 1 g four synergies accounted for 99% of the automatic postural response across all muscles and perturbation directions. Each synergy in 1 g was correlated to the corresponding one in 0.25 and 1.75 g. This study therefore emphasizes the similarity of the synergy organization of postural recovery responses in Earth, hypo- and hyper-gravity conditions, indicating that the muscle synergies and segmental strategies acquired under terrestrial habits are robust and persistent across variable and acute changes in gravity levels.

Stumbling Reactions in Partial Gravity - Neuromechanics of Compensatory Postural Responses and Inter-Limb Coordination During Perturbation of Human Stance

Spontaneous changes in gravity play a significant role in interplanetary space missions. To preserve the astronauts’ capability to execute mission-critical tasks and reduce the risk of injury in transit and on planetary surfaces, a comprehensive understanding of the neuromuscular control of postural responses after balance deterioration in hypo- or hyper-gravity conditions is essential. Therefore, this study aimed to evaluate the effect of acute gravitational variation on postural adjustments in response to perturbations. Gravitational changes were induced using parabolic flight. Postural set was manipulated by randomly providing unilateral left, bilateral or split perturbations which require balance corrections to restore postural stability. In six subjects, postural reactions were recorded after anterior and posterior surface perturbations for progressively increased gravitational conditions spanning from 0.25 to 1.75 g. Ankle and knee joint kinematics and electromyograms (EMG) of eight leg muscles were recorded prior (PRE) and after perturbation onset. Muscle activation onset latencies and amplitudes in the short-, medium-, and long-latency responses (SLR, MLR, LLR) were assessed. Results demonstrate an increased muscle activity (p < 0.05) and co-contraction in the lower extremities (p < 0.05) prior to perturbation in hypo- and hyper-gravity. After perturbation, reduced muscle onset latencies (p < 0.05) and increased muscle activations in the MLR and LLR (p < 0.05), concomitant with an increased co-contraction in the SLR, were manifested with a progressive rise in gravity. Ankle and knee joint deflections remained unaffected, whereas angular velocities increased (p < 0.05) with increasing gravitation. Effects were more pronounced in bi- compared to unilateral or split perturbations (p < 0.05). Neuro-mechanical adaptations to gravity were more distinct and muscle onset latencies were shorter in the displaced compared to the non-displaced leg. In conclusion, the timing and magnitude of postural reflexes involved in stabilization of bipedal stance are gravity-dependent. The approximately linear relationship between gravity and impulse-directed EMG amplitudes or muscle onset latencies after perturbation indicates that the central nervous system correctly predicts the level of gravity. Moreover, it accurately governs contractions in the antigravity musculature to counterbalance the gravitational pull and to regain upright posture after its disturbance. Importantly, unilateral perturbations evoked fast reflex responses in the synergistic muscles of the non-displaced contralateral leg suggesting a synchronized inter-limb coordination mediated by spinal circuitries.

Virtual Balancing for Studying and Training Postural Control

Postural control during free stance has been frequently interpreted in terms of balancing an inverted pendulum. This even holds, if subjects do not balance their own, but an external body weight. We introduce here a virtual balancing apparatus, which produces torque in the ankle joint as a function of ankle angle resembling the gravity and inertial effects of free standing. As a first aim of this study, we systematically modified gravity, damping, and inertia to examine its effect on postural control beyond the physical constraints given in the real world. As a second aim, we compared virtual balancing to free stance to test its suitability for balance training in patients who are not able to balance their full body weight due to certain medical conditions. In a feasibility study, we analyzed postural control during free stance and virtual balancing in 15 healthy subjects. Postural control was characterized by spontaneous sway measures and measures of perturbed stance. During free stance, perturbations were induced by pseudorandom anterior-posterior tilts of the body support surface. In the virtual balancing task, we systematically varied the anterior-posterior position of the foot plate where the balancing forces are zero following a similar pseudorandom stimulus profile. We found that subjects' behavior during virtual balancing resembles free stance on a tilting platform. This specifically holds for the profile of body excursions as a function of stimulus frequencies. Moreover, non-linearity between stimulus and response amplitude is similar in free and virtual balancing. The overall larger stimulus induced body excursions together with an altered phase behavior between stimulus and response could be in part explained by the limited use of vestibular and visual feedback in our experimental setting. Varying gravity or damping significantly affected postural behavior. Inertia as an isolated factor had a mild effect on the response functions. We conclude that virtual balancing may be well suited to simulate conditions which could otherwise only be realized in space experiments or during parabolic flights. Further studies are needed to examine patients' potential benefit of virtual balance training.

Influence of increasing knee flexion angle on knee-ankle varus stress during single-leg jump landing

Objectives

The primary aim of this study was to identify the relationship between the peak knee flexion angle and knee-ankle varus stress in the landing phase of the single-leg jump during running.

Methods

Fifteen male handball players from the first Saudi Arabian handball team were incorporated in this study. Each player performed a single-leg jump-land after running a fixed distance of 450 cm. The data were measured using a 3D motion analysis system. The maximum knee flexion angle, knee varus angle, centre of pressure pathway in the medio-lateral direction, and ankle varus moment were measured.

Results

The Pearson Product Moment Correlation showed that a greater knee flexion angle was related to a greater lateral displacement of the centre of pressure (r = 0.794, P = 0.000), a greater ankle varus moment (r = 0.707, P = 0.003), and a greater knee varus angle (r = 0.753, P = 0.001). In addition, the greater ankle varus moment was related to the greater lateral displacement of the centre of pressure (r = 0.734, P = 0.002).

Conclusions

These findings may help physical therapists and conditioning professionals to understand the impact of increasing knee flexion angle on the lower limb joints. Such findings may help to develop training protocols for enhancing the lateral body reaction during the landing phase of the single-leg jump, which may protect the knee and ankle joints from excessive varus stresses.

Gravity and neuronal adaptation, in vitro and in vivo-from neuronal cells up to neuromuscular responses: a first model

For decades it has been shown that acute changes in gravity have an effect on neuronal systems of human and animals on different levels, from the molecular level to the whole nervous system. The functional properties and gravity-dependent adaptations of these system levels have been investigated with no or barely any interconnection. This review summarizes the gravity-dependent adaptation processes in human and animal organisms from the in vitro cellular level with its biophysical properties to the in vivo motor responses and underlying sensorimotor functions of human subjects. Subsequently, a first model for short-term adaptation of neuronal transmission is presented and discussed for the first time, which integrates the responses of the different levels of organization to changes in gravity.

Plantar Sole Unweighting Alters the Sensory Transmission to the Cortical Areas

It is well established that somatosensory inputs to the cortex undergo an early and a later stage of processing. The later has been shown to be enhanced when the earlier transmission decreased. In this framework, mechanical factors such as the mechanical stress to which sensors are subjected when wearing a loaded vest are associated with a decrease in sensory transmission. This decrease is in turn associated with an increase in the late sensory processes originating from cortical areas. We hypothesized that unweighting the plantar sole should lead to a facilitation of the sensory transmission. To test this hypothesis, we recorded cortical somatosensory evoked potentials (SEPs) of individuals following cutaneous stimulation (by mean of an electrical stimulation of the foot sole) in different conditions of unweighting when standing still with eyes closed. To this end, the effective bodyweight (BW) was reduced from 100% BW to 40% BW. Contrary to what was expected, we found an attenuation of sensory information when the BW was unweighted to 41% which was not compensated by an increase of the late SEP component. Overall these results suggested that the attenuation of sensory transmission observed in 40 BW condition was not solely due to the absence of forces acting on the sole of the feet but rather to the current relevance of the afferent signals related to the balance constraints of the task.

The influence of the aquatic environment on the control of postural sway

Balance training in the aquatic environment is often used in rehabilitation practice to improve static and dynamic balance. Although aquatic therapy is widely used in clinical practice, we still lack evidence on how immersion in water actually impacts postural control. We examined how postural sway measured using centre of pressure and trunk acceleration parameters are influenced by the aquatic environment along with the effects of visual information. Our results suggest that the aquatic environment increases postural instability, measured by the centre of pressure parameters in the time-domain. The mean velocity and area were more significantly affected when individuals stood with eyes closed in the aquatic environment. In addition, a more forward posture was assumed in water with eyes closed in comparison to standing on land. In water, the low frequencies of sway were more dominant compared to standing on dry land. Trunk acceleration differed in water and dry land only for the larger upper trunk acceleration in mediolateral direction during standing in water. This finding shows that the study participants potentially resorted to using their upper trunk to compensate for postural instability in mediolateral direction. Only the lower trunk seemed to change acceleration pattern in anteroposterior and mediolateral directions when the eyes were closed, and it did so depending on the environment conditions. The increased postural instability and the change in postural control strategies that the aquatic environment offers may be a beneficial stimulus for improving balance control.

Kinetics and Muscle Activity Patterns during Unweighting and Reloading Transition Phases in Running

Amongst reduced gravity simulators, the lower body positive pressure (LBPP) treadmill is emerging as an innovative tool for both rehabilitation and fundamental research purposes as it allows running while experiencing reduced vertical ground reaction forces. The appropriate use of such a treadmill requires an improved understanding of the associated neuromechanical changes. This study concentrates on the runner’s adjustments to LBPP-induced unweighting and reloading during running. Nine healthy males performed two running series of nine minutes at natural speed. Each series comprised three sequences of three minutes at: 100% bodyweight (BW), 60 or 80% BW, and 100% BW. The progressive unweighting and reloading transitions lasted 10 to 15 s. The LBPP-induced unweighting level, vertical ground reaction force and center of mass accelerations were analyzed together with surface electromyographic activity from 6 major lower limb muscles. The analyses of stride-to-stride adjustments during each transition established highly linear relationships between the LBPP-induced progressive changes of BW and most mechanical parameters. However, the impact peak force and the loading rate systematically presented an initial 10% increase with unweighting which could result from a passive mechanism of leg retraction. Another major insight lies in the distinct neural adjustments found amongst the recorded lower-limb muscles during the pre- and post-contact phases. The preactivation phase was characterized by an overall EMG stability, the braking phase by decreased quadriceps and soleus muscle activities, and the push-off phase by decreased activities of the shank muscles. These neural changes were mirrored during reloading. These neural adjustments can be attributed in part to the lack of visual cues on the foot touchdown. These findings highlight both the rapidity and the complexity of the neuromechanical changes associated with LBPP-induced unweighting and reloading during running. This in turn emphasizes the need for further investigation of the evolution over time of these neuromechanical changes.

Bouncing on Mars and the Moon—the role of gravity on neuromuscular control: correlation of muscle activity and rate of force development

On our astronomical neighbors Mars and the Moon, bouncing movements are the preferred locomotor techniques. During bouncing, the stretch-shortening cycle describes the muscular activation pattern. This study aimed to identify gravity-dependent changes in kinematic and neuromuscular characteristics in the stretch-shortening cycle. Hence, neuromuscular control of limb muscles as well as correlations between the muscles’ pre-activation, reflex components, and force output were assessed in lunar, Martian, and Earth gravity. During parabolic flights, peak force (Fmax), ground-contact-time, rate of force development (RFD), height, and impulse were measured. Electromyographic (EMG) activities in the m. soleus (SOL) and gastrocnemius medialis (GM) were assessed before (PRE) and during bounces for the reflex phases short-, medium-, and long-latency response (SLR, MLR, LLR). With gradually decreasing gravitation, Fmax, RFD, and impulse were reduced, whereas ground-contact time and height increased. Concomitantly, EMG_GM decreased for PRE, SLR, MLR, and LLR, and in EMG_SOL in SLR, MLR, and LLR. For SLR and MLR, Fmax and RFD were positively correlated to EMG_SOL. For PRE and LLR, RFD and Fmax were positively correlated to EMG_GM. Findings emphasize that biomechanically relevant kinematic adaptations in response to gravity variation were accompanied by muscle- and phase-specific modulations in neural control. Gravitational variation is anticipated and compensated for by gravity-adjusted muscle activities. Importantly, the pre-activation and reflex phases were differently affected: in SLR and MLR, SOL is assumed to contribute to the decline in force output with a decreasing load, and, complementary in PRE and LLR, GM seems to be of major importance for force generation.

Increased calf and plantar muscle fibrotic contents in obese subjects may cause ankle instability

Obesity is strongly associated with musculoskeletal disorders of the lower limb, including ankle instability and resulting gait problems. In the present study, we aimed to examine, using paired comparisons of subjects, whether moderate duration of obesity in patients with mild to moderate elevations of body mass index (BMI), changes the fibrous contents of muscles that support the ankle mortices, namely calf and plantar muscles. We attempted to examine these parameters because this shall provide direct evidence of whether obesity directly impacts myoarchitecture and support of the adjoining joints. MRI image segmentation and pixel correlations by grey level co-occurrence matrix (GLCM) and entropy were used to analyse the changes. The differences in the means between groups (both GLCM and entropy) were significant from control lean populations (P<0.0001, ANOVA) for the parameters examined for both the calf and the plantar muscles. Reduction in weight should thus be a first-line approach in preventing these changes that may significantly affect quality of life due to gait disturbances.

Changes in Balance Strategy and Neuromuscular Control during a Fatiguing Balance Task-A Study in Perturbed Unilateral Stance

Fatigue impairs sensorimotor performance, reduces spinal reflexes and affects the interaction of antagonistic muscles in complex motor tasks. Although there is literature dealing with the interference of fatigue and postural control, the interpretation is confounded by the variety of paradigms used to study it. This study aimed to evaluate the effects of postural fatigue on balance control and strategy, as well as on neuromuscular modulation, in response to postural perturbation (PERT) during a fatiguing balance task. A fatigue protocol consisting of continuous exposure to perturbations until exhaustion was executed in 24 subjects. Number of failed attempts, paths of center of pressure displacement (COP), ankle, knee, and hip joint kinematics, electromyographic activity of the soleus (SOL), tibialis anterior (TA), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus muscles (GM) and spinal excitability of SOL at the peak of the short-latency responses (SLR) were recorded after posterior PERT. The co-contraction index (CCI) was calculated for TA_SOL, VL_BF and RF_GM. (1) The number of failed attempts significantly increased while COP amplitude and velocity, as well as angular excursion at the ankle, knee and hip joints, decreased with fatigue (P < 0.05). (2) Concomitantly, CCI of SOL_TA, VL_BF and RF_GM increased and spinal excitability in SOL declined. (3) Adaptations progressively augmented with progressing exhaustion and occurred in the distal prior to proximal segment. Distinctly deteriorated balance ability was accompanied by a modified neuromuscular control—the increase in co-contraction reflected by simultaneously activated antagonists is accompanied by smaller knee and hip joint excursions, indicating an elevated level of articular stiffness. These changes may be associated with an exaggerated postural rigidity and could have caused the delayed and reduced postural reactions that are reflected in the changes in COP displacement when compensating for sudden PERT. The reduction in spinal excitability may either be caused by fatigue itself or by an increase in reciprocal inhibition due to augmented TA activity.

Reactive Balance Control in Response to Perturbation in Unilateral Stance: Interaction Effects of Direction, Displacement and Velocity on Compensatory Neuromuscular and Kinematic Responses

Unexpected sudden perturbations challenge postural equilibrium and require reactive compensation. This study aimed to assess interaction effects of the direction, displacement and velocity of perturbations on electromyographic (EMG) activity, centre of pressure (COP) displacement and joint kinematics to detect neuromuscular characteristics (phasic and segmental) and kinematic strategies of compensatory reactions in an unilateral balance paradigm. In 20 subjects, COP displacement and velocity, ankle, knee and hip joint excursions and EMG during short (SLR), medium (MLR) and long latency response (LLR) of four shank and five thigh muscles were analysed during random surface translations varying in direction (anterior-posterior (sagittal plane), medial-lateral (frontal plane)), displacement (2 vs. 3 cm) and velocity (0.11 vs. 0.18 m/s) of perturbation when balancing on one leg on a movable platform. Phases: SLR and MLR were scaled to increased velocity (P<0.05); LLR was scaled to increased displacement (P<0.05). Segments: phasic interrelationships were accompanied by segmental distinctions: distal muscles were used for fast compensation in SLR (P<0.05) and proximal muscles to stabilise in LLR (P<0.05). Kinematics: ankle joints compensated for both increasing displacement and velocity in all directions (P<0.05), whereas knee joint deflections were particularly sensitive to increasing displacement in the sagittal (P<0.05) and hip joint deflections to increasing velocity in the frontal plane (P<0.05). COP measures increased with increasing perturbation velocity and displacement (P<0.05). Interaction effects indicate that compensatory responses are based on complex processes, including different postural strategies characterised by phasic and segmental specifications, precisely adjusted to the type of balance disturbance. To regain balance after surface translation, muscles of the distal segment govern the quick regain of equilibrium; the muscles of the proximal limb serve as delayed stabilisers after a balance disturbance. Further, a kinematic distinction regarding the compensation for balance disturbance indicated different plane- and segment-specific sensitivities with respect to the determinants displacement and velocity.