Sensory information affords exploration of posture in newly walking infants and toddlers

The development of posture and locomotion provides a valuable window for understanding the ontogeny of perception-action relations. In this study, 13 infants were examined cross-sectionally while standing quietly either hands-free or while lightly touching a contact surface. Mean sway amplitude results indicate that infants use light touch for sway attenuation (≈28–40%) as has been seen previously with adults (Jeka & Lackner, 1994). Additionally, while using the contact surface, movement patterns of the head and trunk show reduced temporal coordination (≈25–40%), as well as increased temporal variability, as compared to no touch conditions. These findings are discussed with regard to the ontogeny of perception-action relations, with the overall conclusion that infants use somatosensory information in an exploratory manner to aid in the development of an accurate internal model of upright postural control.     

Posture control and complex arm coordination: analysis of multijoint coordinative movements and stability of stance

The authors addressed the interactions between control of bimanual multijoint coordination tasks and posture. Participants (N = 6) performed 8 coordination patterns that differed in degree of complexity by using their bilateral elbows and wrists under 3 scaled motion speeds while standing on 2 force plates. Results indicated that producing complex bimanual multijoint coordinative tasks affected postural sway, thus resulting in an increase of sway activity. Behavioral as well as mechanical factors accounted for the increased disturbance in postural sway. Those findings suggest that performing complex coordination tasks disrupts postural control in normal young adults.     

Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn’t affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn’t result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD.     

Two steps forward and one back: Learning to walk affects infants' sitting posture

The transition from sitting to walking is a major motor milestone for the developing postural system. This study examined whether this transition to walking impacts the previously established posture (i.e., sitting). Nine infants were examined monthly from sitting onset until 9 months post-walking. Infants sat on a saddle-shape chair either independently or with their right hand touching a stationary contact surface. Postural sway was measured by sway amplitude, variability, area, and velocity of the center of pressure trajectory. The results showed that for all the postural measures in the no-touch condition, a peak before or at walk onset was observed in all the infants. At the transition age, when peak sway occurred, infants' postural sway measures were significantly greater than at any other age. Further, infants' postural sway was attenuated by touch only at this transition. We suggest that this transient disruption in sitting posture results from a process involving re-calibration of an internal model for the sensorimotor control of posture so as to accommodate the newly emerging bipedal behavior of independent walking.     

The Influence of Motor Imagery on Postural Sway: Differential Effects of Type of Body Movement and Person Perspective

The present study examined the differential effects of kinesthetic imagery (first person perspective) and visual imagery (third person perspective) on postural sway during quiet standing. Based on an embodied cognition perspective, the authors predicted that kinesthetic imagery would lead to activations in movement-relevant motor systems to a greater degree than visual imagery. This prediction was tested among 30 participants who imagined various motor activities from different visual perspectives while standing on a strain gauge plate. The results showed that kinesthetic imagery of lower body movements, but not of upper body movements, had clear effects on postural parameters (sway path length and frequency contents of sway). Visual imagery, in contrast, had no reliable effects on postural activity. We also found that postural effects were not affected by the vividness of imagery. The results suggest that during kinesthetic motor imagery participants partially simulated (re-activated) the imagined movements, leading to unintentional postural adjustments. These findings are consistent with an embodied cognition perspective on motor imagery.     

Individuals with chronic ankle instability compensate for their ankle deficits using proximal musculature to maintain reduced postural sway while kicking a ball

The aim of this study was to investigate anticipatory (APA), simultaneous (SPA) and compensatory (CPA) postural adjustments in individuals with and without chronic ankle instability (CAI) as they kicked a ball while standing in a single-leg stance on a stable and unstable surface. Electromyographic activity (EMG) of postural muscles and center of pressure (COP) displacements were calculated and their magnitudes analyzed during the postural adjustment intervals. Additionally, the COP area of sway was calculated over the duration of the whole task. The activities of postural muscles were also studied using principal component analysis (PCA) to identify between-group differences in patterns of muscle activation. The individuals with CAI showed reduced magnitude of EMG at the muscles around the ankle while around the hip the activity was increased. These were associated with a reduction in balance sway across the entire task, as compared with the control group. The PCA revealed that CAI participants assemble different sets of muscle activation to compensate for their ankle instability, primarily activating hip/spine muscles. These results set up potential investigations to examine whether balance control interventions enhance these adaptations or revert them to a normal pattern as well as if any of these changes proactively address recurrent ankle sprain conditions.     

Effect of magnetic insoles on postural sway measures in men and women during a static balance test

Numerous anecdotal reports have suggested a growing public enthusiasm for magnetic devices for treatment of pain and various motor and sensory dysfunctions. Although the principles behind magnetic therapy are well documented, a complete technical explanation of whether static magnet application is effective is lacking due to a paucity of scientific research. In this study the effectiveness of magnetic insoles on postural sway measures during a single application were investigated. Twenty-eight adults (14 old, 14 young) were assessed on postural sway measures while performing a static two-legged stance test on a Kistler force platform under two treatment conditions (magnetic insoles, nonmagnetic insoles). Significant reductions in total sway area and lateral sway scores were obtained by the older adults while standing on the magnetic insoles. These preliminary results indicate that treatment of postural instability using magnetic insoles may be a viable alternative for older adults.     

Postural stabilization for the control of touching

We attempted to distinguish between task-related (supra-postural) and perceptual influences on postural motions. Two groups of participants had to make very light tactile contact with an adjacent pliable surface while standing with their eyes closed. In the absence of vision, such light touching with a finger is known to reduce sway. For one group, tactile contact with the surface was merely the result of extending the right forearm. For the other group, variability in the point of tactile contact had to be kept to a minimum. Touching reduced postural sway relative to non-touching only for participants in the latter group. The present results, in combination with others addressing similar task differences, question the assumption that information detected haptically and/or visually is used solely to reduce postural fluctuations. It seems that postural fluctuations are modulated to facilitate performance of tasks over and above the task of standing upright and still.     

Not just standing there: the use of postural coordination to aid visual tasks

Postural control is an integral part of all physical behavior. Recent research has indicated that postural control functions in a manner that facilitates other higher order (suprapostural) tasks. These studies, while showing that postural sway is modulated in a task specific manner, have not examined the form of postural coordination that allows for the achievement of these higher behavioral goals. The current study examined the relation between visual task constraints (viewing distance), environmental constraints (changes in the surface of support), and the postural coordination employed to complete the task. Thirty-one participants were asked to perform a reading task while standing on various surfaces. Postural motion was recorded from the head, cervico-thoracic spine, sacrum (hip), and ankle. It was found that body segment coordination changed as a function of surface characteristics and task constraints. Additionally, the overall pattern of postural sway (head motion) replicated that which was found by Stoffregen et al. [J. Exp. Psychol. Human Percep. Perform. 25 (6) (1999) 1641]. These findings suggest that postural adaptation involves more than basic reduction or increase of motion; it involves the functional coordination of body segments to achieve a particular goal. The data further suggest that there is a need to examine postural control in the absence of external perturbations.     

Static balance in children with developmental coordination disorder

The purpose of this study was to compare the postural sway profiles of 9/10-year-old children with developmental coordination disorder and balance problems (DCD-BP, n=64) with those of non-DCD children (n=71). We measured center of pressure excursions in conditions with and without vision for 30s while standing still on the dominant leg, the non-dominant leg, or both legs. Sway area, total path length, and Romberg's quotient were analyzed. Most measures differed significantly between groups, except sway area when the children stood with vision on either the dominant leg or both legs. When standing on the dominant leg or both legs, DCD-BP children demonstrated greater total path length in all conditions and a greater sway area in without-vision conditions. DCD-BP children showed more difficulty standing on the non-dominant leg with eyes both open and closed. While boys showed results similar to the total group, the girls with DCD-BP only exhibited significant differences in three conditions with eyes closed, but not with eyes open. Analysis of Romberg's coefficient also indicated that children with DCD-BP did not over-rely on visual information.     

Transitions in Visual Proprioception: A Cross-Sectional Developmental Study of the Effect of Visual Flow on Postural Control

In the present study, a moving room paradigm was used that characterized the developmental progression of the effects of visual perturbations on stance control in subjects (N = 39) from 5 months to 10 years of age. Kinematic (probability of recording sway, magnitude of sway response) and electromyographic (probability and patterns of muscle activation, muscle onset latencies) data were found that suggested that visual flow simulating sway activates organized postural muscle responses and results in subsequent sway in standing infants as young as 5 months of age, well before they are able to stand independently. In new walkers, there was an increase in the magnitude of the effect of the visual perturbation, suggesting a possible increase in reliance on visual information. The magnitude of sway decreased to very low levels in older children and adults. The large-amplitude responses observed in the youngest age groups may indicate an inability to switch from an unreliable to a reliable source of perceptual information or an inability to modulate the responses produced following the perturbations. With increasing age and experience, the ability to resolve the conflict increased, with adult subjects demonstrating little sway response.     

Haptic cues for orientation and postural control

Haptic cues from fingertip contact with a stable surface attenuate body sway in subjects even when the contact forces are too small to provide physical support of the body. We investigated how haptic cues derived from contact of a cane with a stationary surface at low force levels aids postural control in sighted and congenitally blind individuals. Five sighted (eyes closed) and five congenitally blind subjects maintained a tandem Romberg stance in five conditions: (1) no cane; (2, 3) touch contact (<2 N of applied force) while holding the cane in a vertical or slanted orientation; and (4, 5) force contact (as much force as desired) in the vertical and slanted orientations. Touch contact of a cane at force levels below those necessary to provide significant physical stabilization was as effective as force contact in reducing postural sway in all subjects, compared to the no-cane condition. A slanted cane was far more effective in reducing postural sway than was a perpendicular cane. Cane use also decreased head displacement of sighted subjects far more than that of blind subjects. These results suggest that head movement control is linked to postural control through gaze stabilization reflexes in sighted subjects; such reflexes are absent in congenitally blind individuals and may account for their higher levels of head displacement.     

Responses to Optical Looming in the Retinal Center and Periphery

Stoffregen (1985, 1986) found that the periphery of the retina is insensitive to radially structured optic flow specifying postural sway. This raised the issue of whether the retinal periphery is sensitive to radially structured flow per se, that is, to radial flow specifying events other than postural sway. In the experiment discussed herein we addressed this question in the context of optical looming. Computer-generated optical displays were presented to the retinal center or periphery of standing participants, who were required to dodge out of the path of the depicted object at the last moment before impact. Depicted trajectories were slightly eccentric, requiring participants to employ a directional response. Results showed that the trajectory and time-to-contact of the simulated object strongly influenced responses for peripheral as well as central looms. In general, responses to peripheral looms closely matched those to central looms. These findings indicate that the periphery of the retina is sensitive to optically specified time-to-contact, despite the fact that such information is carried in radially structured flow patterns. We argue that impending collision and postural sway can be distin- guished on the basis of dynamics that are characteristic of each event.     

Approximate entropy used to assess sitting postural sway of infants with developmental delay

Infant sitting postural sway provides a window into motor development at an early age. The approximate entropy, a measure of randomness, in the postural sway was used to assess developmental delay, as occurs in cerebral palsy. Parameters used for the calculation of approximate entropy were investigated, and approximate entropy of postural sway in early sitting was found to be lower for infants with developmental delay in the anterior-posterior axis, but not in the medial-lateral axis. Spectral analysis showed higher frequency features in the postural sway of early sitting of infants with typical development, suggesting a faster control mechanism is active in infants with typical development as compared to infants with delayed development, perhaps activated by near-fall events.     

Personality traits and individual differences predict threat-induced changes in postural control

This study explored whether specific personality traits and individual differences could predict changes in postural control when presented with a height-induced postural threat. Eighty-two healthy young adults completed questionnaires to assess trait anxiety, trait movement reinvestment (conscious motor processing, movement self-consciousness), physical risk-taking, and previous experience with height-related activities. Tests of static (quiet standing) and anticipatory (rise to toes) postural control were completed under low and high postural threat conditions. Personality traits and individual differences significantly predicted height-induced changes in static, but not anticipatory postural control. Individuals less prone to taking physical risks were more likely to lean further away from the platform edge and sway at higher frequencies and smaller amplitudes. Individuals more prone to conscious motor processing were more likely to lean further away from the platform edge and sway at larger amplitudes. Individuals more self-conscious about their movement appearance were more likely to sway at smaller amplitudes. Evidence is also provided that relationships between physical risk-taking and changes in static postural control are mediated through changes in fear of falling and physiological arousal. Results from this study may have indirect implications for balance assessment and treatment; however, further work exploring these factors in patient populations is necessary.     

Embodied prosthetic arm stabilizes body posture,while unembodied one perturbs it

Senses of ownership (this arm belongs to me) and agency (I am controlling this arm) originate from sensorimotor system. External objects can be integrated into the sensorimotor system following long-term use, and recognized as one’s own body. We examined how an (un)embodied prosthetic arm modulates whole-body control, and assessed the components of prosthetic embodiment. Nine unilateral upper-limb amputees participated. Four frequently used their prosthetic arm, while the others rarely did. Their postural sway was measured during quiet standing with or without their prosthesis. The frequent users showed greater sway when they removed the prosthesis, while the rare users showed greater sway when they fitted the prosthesis. Frequent users reported greater everyday feelings of postural stabilization by prosthesis and a larger sense of agency over the prosthesis. We suggest that a prosthetic arm maintains or perturbs postural control, depending on the prosthetic embodiment, which involves sense of agency rather than ownership.     

Is voluntary control of natural postural sway possible?

The authors explored whether standing human participants could voluntarily decrease the amplitude of their natural postural sway when presented with explicit visual feedback and a target. Participants (N = 9) stood quietly, without any feedback and with feedback on the center of pressure coordinate or the head orientation. They were unable to decrease sway amplitude when presented with visual feedback and a target. Decreasing target size led to contrasting effects on the 2 fractions of sway: rambling and trembling. The smaller target was associated with a decrease in rambling and an increase in trembling. Those observations suggest that sway represents a superposition of at least 2 independent processes. They also suggest that providing visual feedback on a variable tied to body sway may not be an effective way to decrease postural sway in young healthy people.     

Measures of postural control and mobility during dual-tasking as candidate markers of instability in Huntington's disease

BackgroundIndividuals with Huntington's disease (HD) have impairments in performing dual-tasks, however, there is limited information about the effects of changing postural and cognitive demands as well as which measures are best suited as markers of underlying motor-cognitive interference.MethodsForty-three individuals with HD and 15 healthy controls (HC) completed single tasks of walking (Timed Up & Go (TUG), 7 m walk), standing (feet together, feet apart and foam surface) and seated cognitive performance (Stroop, Symbol Digit Modalities Test (SDMT), Delis-Kaplan Executive Function System (DKEFS) Sorting test) and dual cognitive-motor tasks while standing (+ Stroop) and walking (+ DKEFS, TUG cognitive). APDM Opal sensors recorded measures of postural sway and time to complete motor tasks.ResultsIndividuals with HD had a greater increase in standing postural sway compared to HC from single to dual-tasks and with changes to support surface. Both groups demonstrated a decrease in gait performance during the TUG cognitive, however, this difference was greater in people with HD compared to HC. While those with HD showed a greater dual-task motor cost compared to HC, both groups behaved similarly as condition complexity increased.ConclusionsStanding postural sway is a more sensitive marker of instability than change in standard gait speed, particularly under dual-task conditions. The more complex TUG cognitive is a sensitive measure of walking dual-task performance. The results of this study provide insights about the nature of motor-cognitive impairments in HD and provide support for a distinction between static and dynamic postural control mechanisms during performance of dual-tasks.     

Postural sway and joint kinematics during quiet standing are affected by lumbar extensor fatigue

The purpose of this study was to investigate changes in postural sway and strategy elicited by lumbar extensor muscle fatigue. Specifically, changes in center of mass (COM), center of pressure (COP), and joint kinematics during quiet standing were determined, as well as selected cross correlations between these variables that are indicative of movement strategy. Twelve healthy male participants stood quietly both before and after exercises that fatigued the lumbar extensors. Whole-body movement and ground reaction force data were recorded and used to calculate mean body posture and variability of COM, COP, and joint kinematics during quiet standing. Three main findings emerged. First, participants adopted a slight forward lean post-fatigue as evidenced by an anterior shift of the COM and COP. Second, post-fatigue increases in joint angle variability were observed at multiple joints including joints distal to the fatigued musculature. Despite these increases, anterior-posterior (AP) ankle angle correlated well with AP COM position, suggesting the body still behaved similar to an inverted pendulum. Third, global measures of sway based on COM and COP were not necessarily indicative of changes in individual joint kinematics. Thus, in trying to advance our understanding of how localized fatigue affects movement patterns and the postural control system, it appears that joint kinematics and/or multivariate measures of postural sway are necessary.     

Interacting Constraints and the Emergence of Postural Behavior in ACL-Deficient Subjects

In this study, the authors examined how task, informational, and sensorimotor system constraints influence postural control. Postural behavior of subjects with (n = 15) and without (n = 15) a key sensorimotor system constraint, anterior cruciate ligaments (ACLs) in 1 knee, was examined during 1- and 2-legged stance with and without vision. Postural control was assessed on a commonly used postural sway meter and on a dynamic stabilometer. Data on postural sway characteristics were obtained for 30 s under 6 different conditions: standing, with eyes open and closed, on both legs, on the injured leg, and on the noninjured leg. The interaction of task, informational, and sensorimotor constraints was observed only on the dynamic stabilometer and not the postural sway meter. Vision was the most important informational constraint on postural control for subjects on the dynamic stabilometer, particularly for the ACL-deficient group standing on the injured leg. Under more static task constraints, ACL deficiency did not prove a significant disadvantage, because vision was confirmed as a significant source of exproprioceptive information. The results support the functionality of using dynamic tasks such as a stabilometer in assessing postural behavior of subjects with sensorimotor system constraints.