Should the Minimal Intervention Principle Be Considered When Investigating Dual-Tasking Effects on Postural Control?

Effects of jaw clenching on dynamic reactive balance task performance after 1-week of jaw clenching training

Introduction

Good balance is essential for human daily life as it may help to improve the quality of life and reduce the risk of falls and associated injuries. The influence of jaw clenching on balance control has been shown under static and dynamic conditions. Nevertheless, it has not yet been investigated whether the effects are mainly associated with the dual-task situation or are caused by jaw clenching itself. Therefore, this study investigated the effects of jaw clenching on dynamic reactive balance task performance prior to and after 1 week of jaw clenching training. It was hypothesized that jaw clenching has stabilizing effects resulting in a better dynamic reactive balance performance, and these effects are not related to dual-task benefits.

Methods

A total of 48 physically active and healthy adults (20 women and 28 men) were distributed into three groups, one habitual control group (HAB) and two jaw clenching groups (JAW and INT) that had to clench their jaws during the balance tasks at T1 and T2. One of those two groups, the INT group, additionally practiced the jaw clenching task for 1 week, making it familiar and implicit at T2. The HAB group did not receive any instruction regarding jaw clenching condition. Dynamic reactive balance was assessed using an oscillating platform perturbed in one of four directions in a randomized order. Kinematic and electromyographic (EMG) data were collected using a 3D motion capture system and a wireless EMG system, respectively. Dynamic reactive balance was operationalized by the damping ratio. Furthermore, the range of motion of the center of mass (CoM) in perturbation direction (RoM_{CoM_AP} or RoM_{CoM_ML}), as well as the velocity of CoM (V_CoM) in 3D, were analyzed. The mean activity of the muscles relevant to the perturbation direction was calculated to investigate reflex activities.

Results

The results revealed that jaw clenching had no significant effects on dynamic reactive balance performance or CoM kinematics in any of these three groups, and the automation of jaw clenching in the INT group did not result in a significant change either. However, high learning effects, as revealed by the higher damping ratio values and lower V_CoM at T2, were detected for the dynamic reactive balance task even without any deliberate balance training in the intervention phase. In the case of backward perturbation of the platform, the soleus activity in a short latency response phase increased for the JAW group, whereas it decreased for HAB and INT after the intervention. In the case of forward acceleration of the platform, JAW and INT showed a higher tibialis anterior muscle activity level in the medium latency response phase compared to HAB at T1.

Discussion

Based on these findings, it can be suggested that jaw clenching may lead to some changes in reflex activities. However, the effects are limited to anterior-posterior perturbations of the platform. Nevertheless, high learning effects may have overall overweighed the effects related to jaw clenching. Further studies with balance tasks leading to less learning effects are needed to understand the altered adaptations to a dynamic reactive balance task related to simultaneous jaw clenching. Analysis of muscle coordination (e.g., muscle synergies), instead of individual muscles, as well as other experimental designs in which the information from other sources are reduced (e.g., closed eyes), may also help to reveal jaw clenching effects.

Age and Visual Contribution Effects on Postural Control Assessed by Principal Component Analysis of Kinematic Marker Data

Postural control, the ability to control the body's position in space, is considered a critical aspect of health outcomes. This current study aimed to investigate the effects of age and visual contribution on postural control. To this end, principal component analysis (PCA) was applied to extract movement components/synergies (i.e., principal movements, PMs) from kinematic marker data of bipedal balancing on stable and unstable surfaces with eyes closed and open, pooled from 17 older adults (67.8 ± 6.6 years) and 17 young adults (26.6 ± 3.3 years), one PCA-analysis for each surface condition. Then, three PCA-based variables were computed for each PM: the relative explained variance of PM-position (PP_rVAR) and of PM-acceleration (PA_rVAR) for measuring the composition of postural movements and of postural accelerations, respectively, and the root mean square of PM-acceleration (PA_RMS) for measuring the magnitude of neuromuscular control. The results show the age and visual contribution effects observed in PM₁, resembling the anteroposterior ankle sway in both surface conditions. Specifically, only the greater PA₁_rVAR and PA₁_RMS are observed in older adults (p ≤ 0.004) and in closed-eye conditions (p < 0.001), reflecting their greater need for neuromuscular control of PM₁ than in young adults and in open-eye conditions.

Assessing Walking Stability Based on Whole-Body Movement Derived from a Depth-Sensing Camera

Stability during walking is considered a crucial aspect of assessing gait ability. The current study aimed to assess walking stability by applying principal component analysis (PCA) to decompose three-dimensional (3D) whole-body kinematic data of 104 healthy young adults (21.9 ± 3.5 years, 54 females) derived from a depth-sensing camera into a set of movement components/synergies called "principal movements" (PMs), forming together to achieve the task goal. The effect of sex as the focus area was tested on three PCA-based variables computed for each PM: the relative explained variance (rVAR) as a measure of the composition of movement structures; the largest Lyapunov exponent (LyE) as a measure of variability; and the number of zero-crossings (N) as a measure of the tightness of neuromuscular control. The results show that the sex effects appear in the specific PMs. Specifically, in PM₁, resembling the swing-phase movement, females have greater LyE (p = 0.013) and N (p = 0.017) values than males. Moreover, in PM₃, representing the mid-stance-phase movement, females have smaller rVAR (p = 0.020) but greater N (p = 0.008) values than males. These empirical findings suggest that the inherent sex differences in walking stability should be considered in assessing and training locomotion.

Implications of Optimal Feedback Control Theory for Sport Coaching and Motor Learning: A Systematic Review

Best practice in skill acquisition has been informed by motor control theories. The main aim of this study is to screen existing literature on a relatively novel theory, Optimal Feedback Control Theory (OFCT), and to assess how OFCT concepts can be applied in sports and motor learning research. Based on 51 included studies with on average a high methodological quality, we found that different types of training seem to appeal to different control processes within OFCT. The minimum intervention principle (founded in OFCT) was used in many of the reviewed studies, and further investigation might lead to further improvements in sport skill acquisition. However, considering the homogenous nature of the tasks included in the reviewed studies, these ideas and their generalizability should be tested in future studies.

Activation of the Prefrontal Cortex and Improvement of Cognitive Performance with Standing on One Leg

The prefrontal cortex (PFC) is involved in attention, motor planning, and executive functions. In addition, it is known that postural control and cognitive performance are affected during dual-task paradigms, suggesting that postural control and cognition use common areas of the brain. Although postural control and cognition have been used as interfering dual tasks, the neuronal mechanisms underlying interference are not fully understood. We simultaneously performed postural and cognitive tasks in healthy young adults and evaluated activity in the PFC using near-infrared spectrometry. The displacement of the center of pressure (COP) is reduced by cognitive tasks. Difficult postural tasks increased the relative proportion and amplitude of postural sway in the high-frequency bandwidth, related to the adjustment of postural sway. Although the cognitive tasks did not affect the relative proportion of each frequency bandwidth, the amplitudes were selectively reduced. The postural task-dependent change in PFC activity was correlated with the relative proportion and amplitude of postural sway in the high-frequency bandwidth of the COP movement. Cognitive task-dependent changes in PFC activity were not correlated with postural sway. Cognitive performance was better in unipedal standing than bipedal standing. These findings suggest that postural tasks affect cognitive performance via the activation of the PFC, but cognitive tasks affect postural control through a different mechanism.

Age-Related Changes in Centre of Pressure Trajectories Analysed with a Novel 'Return to Central' Analysis

To evaluate age and fall-risk related changes in balance ability from measures of bipedal quiet stance, this study aims to investigate the characteristics of 'return to central' - Centre of Pressure (COP) trajectories. COP trajectories were extracted from 60-second COP recordings in bipedal stance. In anterior posterior direction, age was associated with a greater number of detected trajectories, increased velocity and more stringent control. No differences related to fall risk were established or to age or fall risk in mediolateral direction. The characteristics 'return to central' COP trajectories provided insight into the working of the postural control system and can be further developed for application if testing balance under challenging conditions is too risky.

Gymnastics Experience Enhances the Development of Bipedal-Stance Multi-Segmental Coordination and Control During Proprioceptive Reweighting

Performance and control of upright bipedal posture requires a constant and dynamic integration of relative contributions of different sensory inputs (i. e., sensory reweighting) to enable effective adaptations as individuals face environmental changes and perturbations. Children with gymnastic experience showed balance performance closer to that of adults during and after proprioceptive alteration than children without gymnastic experience when their center of pressure (COP) was analyzed. However, a particular COP sway can be achieved through performing and coordinating different postural movements. The aim of this study was to assess how children and adults of different gymnastic experience perform and control postural movements while they have to adjust balance during and after bilateral tendon vibration. All participants were equipped with spherical markers attached to their skin and two vibrators strapped over the Achilles tendons. Bipedal stance was performed in three 45-s trials in two visual conditions (eyes open, EO, and eyes closed, EC) ordered randomly in which vibration lasted 10 s. Posture movements were analyzed by a principal component analysis (PCA) calculated on normalized and weighted markers coordinates. The relative standard deviation of each principal movement component (principal position, PP-rSTD) quantified its contribution to the whole postural movements, i.e., quantified the coordinative structure. The first (principal velocities, PV-rSTD) and second (principal accelerations, PA-rSTD) time-derivatives characterized the rate-dependent sensory information associated with and the neuromuscular control of the postural movements, respectively. Children without gymnastic experience showed a different postural coordinative structure and different sensory-motor control characteristics. They used less ankle movements in the anterior-posterior direction but increased ankle movements in medio-lateral direction, presented larger hip and trunk velocities, and exhibited more hip actions. Gymnastic experience during childhood seemed to benefit the development of proprioceptive reweighting processes in children, leading to a more mature form of coordinating and controlling posture similarly to adults.

Principal postural acceleration and myoelectric activity: Interrelationship and relevance for characterizing neuromuscular function in postural control

One approach to investigating sensorimotor control is to assess the accelerations that produce changes in the kinematic state of the system. When assessing complex whole-body movements, structuring the multi-segmental accelerations is important. A useful structuring can be achieved through a principal component analysis (PCA) performed on segment positions followed by double-differentiation to obtain "principal accelerations" (PAs). In past research PAs have proven sensitive to altered motor control strategies, however, the interrelationship between PAs and muscle activation (surface electromyography, sEMG) have never been determined. The purpose of the current study was therefore to assess the relationship between PAs and sEMG signals recorded from muscles controlling the ankle joint during one-leg standing trials. It was hypothesized that medium correlation should be observed when accounting for neurophysiologic latencies (electro-mechanical delay). Unipedal balancing on a level-rigid ground was performed by 25 volunteers. sEMG activities were recorded from the tibialis anterior, peroneus longus, gastrocnemius medialis, and soleus muscles of the stance leg. The first eight PA-time series were determined from kinematic marker data. Then, a cross-correlation analysis was performed between sEMG and PA time series. We found that peak correlation coefficients for many participants aligned at time delays between 0.116 and 0.362 s and were typically in the range small to medium (|r| = 0.1 to 0.6). Thus, the current study confirmed a direct association between many principal accelerations PA(t) and muscle activation signals recorded from four muscles crossing the ankle joint complex. The combined analysis of PA and sEMG signals allowed exploring the neuromuscular function of each muscle in different postural movement components.

Age-Related Changes in Standing Balance in Preschoolers Using Traditional and Nonlinear Methods

Considerable disagreement exists on the linearity of the development of standing balance in children. This study aimed to use different traditional and nonlinear methods to investigate age-related changes in standing balance in preschoolers. A sample of 118 preschoolers took part in this study. A force platform was used to record the center of pressure during standing balance over 15 s in three conditions: eyes open, eyes closed, and/or head extended backward. Detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and traditional measures were used to evaluate standing balance. The main results are as follows: (1) Higher range and SD in the anterior-posterior (AP) direction were observed for 5-year-old than for 4-year-old children, while higher DFA coefficient (at shorter time scales) and higher determinism and laminarity in the AP direction were found for 5-year-old children compared to 3- and 4-year-old children; and (2) as sensory conditions became more challenging, all traditional measures increased and DFA coefficients (at shorter and longer time scales) decreased in the AP and mediolateral directions, while determinism and laminarity significantly declined in the AP direction. In conclusion, although increased postural sway, 5-year-old preschool children's balance performance improved, and their control strategy changed significantly compared with the younger preschoolers. Sensory perturbation (eye closure and/or head extension) changed preschoolers' balance performance and control strategy. Moreover, both traditional and nonlinear methods provided complementary information on the control of standing balance in preschoolers.

Comparison of postural control in older adults under different dual-task conditions: A cross-sectional study

BACKGROUND

and purpose: Performing a cognitive task while maintaining postural stability, known as "dual-task" condition, can increase the cognitive demand and reduce the postural control capacity. The inability to allocate attention to postural control under dual-task conditions may lead to balance impairments, particularly in older adults. The present study aimed to compare the effects of different dual-task conditions of backward counting (BC) and visual attention (VA) on older adults' postural balance performance.

METHODS

Twenty asymptomatic volunteers (mean age: 70.4 ± 4.1 years) were recruited. Participants stood on a foam surface placed over a force plate, and displacement and sway velocity of their center of pressure (COP) in anterior-posterior (AP) and medial-lateral (ML) directions were recorded under three conditions: BC dual-task, VA dual-task (control of center of mass with a laser pointer), and quiet stance as the control task (CT).

RESULTS

Repeated measures ANOVA showed a significant difference in AP and ML sway velocities between conditions with p-values of 0.039 and 0.042, respectively. The LSD post-hoc test revealed that the BC task significantly increased AP sway velocity compared to the CT (p = 0.013), and the VA task significantly increased ML sway velocity compared to the CT (p = 0.034) and the BC tasks (p = 0.026). There were no statistically significant differences between conditions for ML (p = 0.058) and AP (p = 0.350) displacements and total sway velocity (p = 0.051).

CONCLUSION

Older adults' postural stability can be impaired under dual-task conditions and the present study revealed that various dual tasks increase postural sway in different directions.

Analysis of Postural Control Using Principal Component Analysis: The Relevance of Postural Accelerations and of Their Frequency Dependency for Selecting the Number of Movement Components

One criterion when selecting the number of principal components (PCs) to be considered in a principal component analysis (PCA) is the fraction of overall variance that each PC represents. When applying a PCA to kinematic marker data in postural control research, this criterion relates to the amplitude of postural changes, recently often called "principal (postural) positions" (PPs). However, in the assessment of postural control, important aspects are also how fast posture changes and the acceleration of postural changes, i.e., "principal accelerations" (PAs). The current study compared how much of the total position variance each PP explained (PP_rVAR) and how much of the total acceleration variance each PA explained (PA_rVAR). Furthermore, the frequency content of PP and PA signals were evaluated. Postural movements of 26 participants standing on stable ground or balancing on a multiaxial balance board were analyzed by applying a PCA on 90 marker coordinates. For each PC, PP_rVAR, PA_rVAR, and the Fourier transformations of the PP and PA time series were calculated. The PP_rVAR and the PA_rVAR-distributions differed substantially. The PP-frequency domain was observed well below 5 Hz, the PA-frequency domain up to 5 Hz for stable standing and up to 10 Hz on the balance board. These results confirm that small-amplitude but fast movement components can have a higher impact on postural accelerations-and thus on the forces active in the system-than large-amplitude but slow lower-order movement components. Thus, PA variance and its dependence on filter frequencies should be considered in dimensionality reduction decisions.

Adolescent Awkwardness: Alterations in Temporal Control Characteristics of Posture with Maturation and the Relation to Movement Exploration

A phenomenon called adolescent awkwardness is believed to alter motor control, but underlying mechanisms remain largely unclear. Since adolescents undergo neurological and anthropometrical changes during this developmental phase, we hypothesized that adolescents control their movements less tightly and use a different coordinative structure compared to adults. Moreover, we tested if emerging differences were driven by body height alterations between age groups. Using 39 reflective markers, postural movements during tandem stance with eyes open and eyes closed of 12 adolescents (height 168.1 ± 8.8 cm) and 14 adults were measured, in which 9 adults were smaller or equal than 180 cm (177.9 ± 3.0 cm) and 5 taller or equal than 190 cm (192.0 ± 2.5 cm). A principal component analysis (PCA) was used to extract the first nine principal movement components (PMk). The contribution of each PMk to the overall balancing movement was determined according to their relative variance share (rVARk) and tightness of motor control was examined using the number of times that the acceleration of each PMk changed direction (Nk). Results in rVARk did not show significant differences in coordinative structure between adolescents and adults, but Nk revealed that adolescents seem to control their movements less tightly in higher-order PMk, arguably due to slower processing times and missing automatization of postural control or potential increases in exploration. Body height was found to not cause motor control differences between age groups.

Leg Dominance Effects on Postural Control When Performing Challenging Balance Exercises

Leg dominance reflects the preferential use of one leg over another and is typically attributed to asymmetries in the neural circuitry. Detecting leg dominance effects on motor behavior, particularly during balancing exercises, has proven difficult. The current study applied a principal component analysis (PCA) on kinematic data, to assess bilateral asymmetry on the coordinative structure (hypothesis H1) or on the control characteristics of specific movement components (hypothesis H2). Marker-based motion tracking was performed on 26 healthy adults (aged 25.3 ± 4.1 years), who stood unipedally on a multiaxial unstable board, in a randomized order, on their dominant and non-dominant leg. Leg dominance was defined as the kicking leg. PCA was performed to determine patterns of correlated segment movements ("principal movements" PMks). The control of each PMk was characterized by assessing its acceleration (second-time derivative). Results were inconclusive regarding a leg-dominance effect on the coordinative structure of balancing movements (H1 inconclusive); however, different control (p = 0.005) was observed in PM3, representing a diagonal plane movement component (H2 was supported). These findings supported that leg dominance effects should be considered when assessing or training lower-limb neuromuscular control and suggest that specific attention should be given to diagonal plane movements.