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.     

Contribution of ankle, knee, and hip joints to the perception threshold for support surface rotation.

The purpose of the present experiment was to investigate the extent to which subjects can perceive, at very slow velocities, an angular rotation of the support surface about the medio-lateral axis of the ankle, knee, hip, or neck joint when visual cues are not available. Subjects were passively displaced on a slowly rotating platform at .01, .03, and .05 deg/sec. The subjects' task was to detect movements of the platform in four different postural conditions allowing body oscillations about the ankle, knee, hip, or neck joint. In Experiment 1, subjects had to detect backward and forward rotation (pitching). In Experiment 2, they had to detect left and right rotations of the platform (rolling). In Experiment 3, subjects had to detect both backward/forward and left/right rotations of the platform, with the body fixed and the head either fixed or free to move. Overall, when the body was free to oscillate about the ankle, knee, or hip joints, a similar threshold for movement perception was observed. This threshold was lower for rolling than for pitching. Interestingly, in these postural conditions, an unconscious compensation in the direction opposite to the platform rotation was observed on most trials. The threshold for movement perception was much higher when the head was the only segment free to oscillate about the neck joint. These results suggest that, in static conditions, the otoliths are poor detectors of the direction of gravity forces. They also suggest that accurate perception of body orientation is improved when proprioceptive information can be dynamically integrated.     

Contribution of ankle, knee, and hip joints to the perception threshold for support surface rotation

The purpose of the present experiment was to investigate the extent to which subjects can perceive, at very slow velocities, an angular rotation of the support surface about the medio-lateral axis of the ankle, knee, hip, or neck joint when visual cues are not available. Subjects were passively displaced on a slowly rotating platform at .01, .03, and .05 deg/sec. The subjects’ task was to detect movements of the platform in four different postural conditions allowing body oscillations about the ankle, knee, hip, or neck joint. In Experiment 1, subjects had to detect backward and forward rotation (pitching). In Experiment 2, they had to detect left and right rotations of the platform (rolling). In Experiment 3, subjects had to detect both backward/forward and left/right rotations of the platform, with the body fixed and the head either fixed or free to move. Overall, when the body was free to oscillate about the ankle, knee, or hip joints, a similar threshold for movement perception was observed. This threshold was lower for rolling than for pitching. Interestingly, in these postural conditions, an unconscious compensation in the direction opposite to the platform rotation was observed on most trials. The threshold for movement perception was much higher when the head was the only segment free to oscillate about the neck joint. These results suggest that, in static conditions, the otoliths are poor detectors of the direction of gravity forces. They also suggest that accurate perception of body orientation is improved when proprioceptive information can be dynamically integrated.     

Postural Stability in Children with High Sacral Level Spina Bifida: Deviations from a Control Group

Abstract

Objective: To assess static and dynamic postural stability changes in children with high sacral level spina bifida.

Methods: Thirty-five children with high sacral level spina bifida and 35 age-matched healthy controls were enrolled. Their lower extremity muscle strengths and static and dynamic postural stability parameters were measured with the use of a dynamometer and the NeuroCom Balance Master^® device, respectively. Functional gait and balance were evaluated using the five times sit-to-stand test (5STS) and the 6-minute walk test (6MWT). Spinal, hip, and ankle deformities of the patient group were measured by radiologic evaluation.

Results: In comparison with controls, patients were found to have lower ankle dorsiflexion and plantar-flexion strength, increased 5STS duration, and decreased 6MWT distance while both static and dynamic postural stability parameters were significantly different. Bilateral ankle muscle strengths were found to be negatively correlated with postural stability parameters. The presence of hydrocephalus or meningomyelocele in the patient group was found to have negative effects on static postural stability.

Conclusion: Static and dynamic postural stability is affected even in children with high sacral level spina bifida who are expected to have best condition in this patient population. The ankle muscle strength is the main factor influencing these changes.     

Strategies used for unconstrained direction change during walking

Full functional mobility requires adaptations, such as turning, to the basic straight locomotor pattern. The aim was to assess the mechanics of completing a complex turning manoeuvre. A full 3-dimensional kinematic and kinetic analysis of the ipsilateral limb was carried out during both straight gait and unconstrained turning through 90 degrees. 10 healthy university students participated. Analysis indicated that two distinctive substrategies of the spin turn-ipsilateral pivot and ipsilateral crossover-were employed. The ipsilateral pivot was the more dynamic turn and required two additional power phases at the ankle and hip to facilitate the pivot phase. The ipsilateral crossover uses a fall into the new direction. The spin turn is a more complex action than previously indicated.     

Higher order balance control: Distinct effects between cognitive task and manual steadiness constraint on automatic postural responses

In the present experiment, we aimed to evaluate the interactive effect of performing a cognitive task simultaneously with a manual task requiring either high or low steadiness on APRs. Young volunteers performed the task of recovering upright balance following a mechanical perturbation provoked by unanticipatedly releasing a load pulling the participant’s body backwards. The postural task was performed while holding a cylinder steadily on a tray. One group performed that task under high (cylinder’ round side down) and another one under low (cylinder’ flat side down) manual steadiness constraint. Those tasks were evaluated in the conditions of performing concurrently a cognitive numeric subtraction task and under no cognitive task. Analysis showed that performance of the cognitive task led to increased body and tray displacement, associated with higher displacement at the hip and upper trunk, and lower magnitude of activation of the GM muscle in response to the perturbation. Conversely, high manual steadiness constraint led to reduced tray velocity in association with lower values of trunk displacement, and decreased rotation amplitude at the ankle and hip joints. We found no interactions between the effects of the cognitive and manual tasks on APRs, suggesting that they were processed in parallel in the generation of responses for balance recovery. Modulation of postural responses from the manual and cognitive tasks indicates participation of higher order neural structures in the generation of APRs, with postural responses being affected by multiple mental processes occurring in parallel.     

Inter-joint coordination patterns differ between younger and older runners

Older runners are at greater risk of certain running-related injuries. Previous work demonstrated that aging influences running biomechanics, and suggest a compensatory relation between changes in the proximal and distal joints. Previous comparisons of interjoint coordination strategies between young and older runners could potentially have missed relevant differences by averaging coordination measures across time.ObjectiveTo compare coordination strategies between male runners under the age of 30 to those over the age of 60.MethodsTwelve young (22 ± 3 yrs, 1.80 ± 0.07 m, 78.0 ± 12.1 kg) and 12 older (63 ± 3 yrs, 1.78 ± 0.06 m, 73.2 ± 15.8 kg) male runners ran at 3.35 m/s on an instrumented treadmill. Ankle frontal plane, tibial transverse plane, knee sagittal plane, and hip frontal plane motion were measured. Inter-joint coordination was calculated using a modified vector coding technique. Coordination patterns and variability time series were compared between groups throughout stance using ANOVA for circular data.ResultsAt the ankle, older runners use in-phase propulsion (inversion, tibia external rotation) pattern following midstance (46–47% stance) while young runners are still in an in-phase collapse pattern (eversion, tibia external rotation). In coordination of the knee and hip, older runners maintained an in-phase collapse pattern (knee flexion, hip adduction) approaching midstance (35–37% stance), while younger runners use an out of phase strategy (knee extension, hip adduction). In coordination of the ankle and hip in the frontal plane, older runners again maintained an in phase collapse pattern up to midstance (34–39% stance), while younger runners used an out of phase strategy (ankle inversion, hip adduction). Variability was similar between age groups.ConclusionOlder runners appear to display altered coordination patterns during mid-stance, which may indicate protective biomechanical adaptations. These changes may also have implications for performance in older runners.     

Human hip–ankle coordination emerging from multisensory feedback control

Human sensorimotor control involves inter-segmental coordination to cope with the complexity of a multi-segment system. The combined activation of hip and ankle muscles during upright stance represents the hip–ankle coordination. This study postulates that the coordination emerges from interactions on the sensory levels in the feedback control. The hypothesis was tested in a model-based approach that compared human experimental data with model simulations. Seven subjects were standing with eyes closed on an anterior–posterior tilting motion platform. Postural responses in terms of angular excursions of trunk and legs with respect to vertical were measured and characterized using spectral analysis. The presented control model consists of separate feedback modules for the hip and ankle joints, which exchange sensory information with each other. The feedback modules utilize sensor-derived disturbance estimates rather than ‘raw’ sensory signals. The comparison of the human data with the simulation data revealed close correspondence, suggesting that the model captures important aspects of the human sensory feedback control. For verification, the model was re-embodied in a humanoid robot that was tested in the human laboratory. The findings show that the hip–ankle coordination can be explained by interactions between the feedback control modules of the hip and ankle joints.     

The effects of obesity on balance recovery using an ankle strategy

Obesity is associated with an increased risk of falls. The purpose of this study was to investigate the effects of obesity on balance recovery using an ankle strategy. In addition, computer simulations to understand how increased inertia and weight associated with obesity independently influence balance recovery. Ten normal weight (BMI: 22.7 ± 0.6 kg/m²) and ten obese (BMI: 32.2 ± 2.2 kg/m²) adult male subjects participated in the study. Subjects recovered balance using an ankle strategy after three types of postural perturbations: an initial angular displacement, an initial angular velocity from the natural stance, and an initial angular velocity from a prescribed position. Balance recovery was quantified by the largest initial angular displacement or angular velocity from which balance could be recovered. Obesity impaired balance recovery from perturbations involving an initial angular velocity, but not from an initial angular displacement. Similarly, computer simulations determined that increased inertia is beneficial to balance recovery when there is little to no initial angular velocity. These findings indicate that the effects of obesity on balance recovery are dependent on the type of perturbation, and that increased inertia associated with obesity can be beneficial for perturbations that involve little to no initial angular velocity.     

Visual flow is interpreted relative to multisegment postural control

To control upright stance, the human nervous system must estimate the movements of multiple body segments based on multisensory information. To investigate how visual information contributes to such multisegmental estimation, participants were exposed to 3 types of visual-scene movement: translation in the anteroposterior direction, rotation about the ankle joint, and rotation about the hip joint. Trunk and leg responses were larger for rotational than for translational movements, but only at lower stimulus frequencies. Based on a feedback-control theoretical framework, these results indicated that visual inputs distinguish between translation and rotation of the head. Also, visual condition effects were similar for the leg and trunk segments, suggesting a control strategy with a single control signal that determines the activation of all muscles.     

The effect of exercise intensity on joint power and dynamics in ergometer double-poling performed by cross-country skiers

The purpose of this study was to examine the effect of increasing exercise intensity on the role of joint powers in ergometer double poling (DP), while taking specific dynamic constraints into account. One main question was whether lower-body power contribution increased or decreased with increasing intensity. Nine male Norwegian national-level cross-country skiers performed ergometer DP at low, moderate, high and maximal intensity. Kinematics, and ground (GRF) and poling (F_poling) reaction forces were recorded and used in link segment modeling to obtain joint and whole-body dynamics. Joint powers were averaged over the cycle, the poling (PP) and recovery (RP) phases. The contribution of these average powers was their ratios to cycle average poling power. At all intensities, the shoulder (in PP) and hip (mostly in RP) generated most power. Averaged over the cycle, lower-body contribution (sum of ankle, knee and hip power) increased from ∼37% at low to ∼54% at maximal intensity (p < .001), originating mostly from increased hip contribution within PP, not RP. The generation of larger F_poling at higher intensities demanded a reversal of hip and knee moment. This was necessary to appropriately direct the GRF vector as required to balance the moment about center of mass generated by F_poling (control of angular momentum). This was reflected in that the hip changed from mostly absorbing to generating power in PP at lower and higher intensities, respectively. Our data indicate that power-transfer rather than stretch-shortening mechanisms may occur in/between the shoulder and elbow during PP. For the lower extremities, stretch-shortening mechanisms may occur in hip, knee and trunk extensors, ensuring energy conservation or force potentiation during the countermovement-like transition from body lowering to heightening. In DP locomotion, increasing intensity and power output is achieved by increased lower-body contribution. This is, at least in ergometer DP, partly due to changes in joint dynamics in how to handle dynamic constraints at different intensities.     

Weighted vest effects on impact forces and joint work during vertical jump landings in men and women

Weighted vest (WV) use during vertical jump landings (VJL) does not appear to alter peak vertical ground reaction forces (GRF) or peak joint torques. However, WV effects on joint work and sex differences during VJL are not well understood. This study assessed WV effects on vertical GRF and sagittal joint work during VJL in men and women. Twelve men and 12 women performed VJL wearing a WV with zero added mass (unloaded) and with 10% body mass (loaded) while GRF and kinematic data were obtained. Mixed-model analyses of variance (α = 0.05) and effect sizes (ES) were used to assess differences between sexes and/or load conditions. Regardless of sex, greater landing height (p < 0.001; ES = 0.37) and peak vertical GRF (p = 0.001; ES 0.51) occurred when unloaded, while greater landing time (p = 0.001; ES = 0.46) and negative lower extremity work (p < 0.001; ES = 0.41) occurred when loaded through greater negative work about the hip (p = 0.001; ES = 0.27) and ankle (p = 0.020; ES = 0.27). No differences in hip (p = 0.753; ES = 0.03), knee (p = 0.588; ES = 0.07), or ankle (p = 0.580; ES = 0.09) joint displacement were detected between loaded and unloaded conditions. Men exhibited greater landing heights (p < 0.001; ES = 2.49) and greater peak vertical GRF than women (p = 0.007; ES = 1.18), though women exhibited greater negative lower extremity work (p < 0.001; ES = 1.98) than men through greater negative knee (p < 0.001; ES = 1.98) and ankle (p = 0.032; ES = 0.94) work. No sex differences were detected for joint angular displacement about the hip (p = 0.475; ES = 0.30), knee (p = 0.666; ES = 0.18), or ankle (p = 0.084; ES = 0.71). These data revealed a unique load accommodation strategy during VJL with a WV characterized by greater lower extremity joint work performed via increased joint torque despite lesser landing height and peak vertical GRF. Women appear to perform greater lower extremity joint work than men during VJL despite lesser landing height and peak vertical GRF. Current and prospective WV users should be aware of their load accommodation strategy during VJL with an external load. Women may consider developing more refined load accommodation strategies for VJL regardless of whether external loading is applied to avoid performing excessive amounts of lower extremity work.     

Effects of back loading on the biomechanics of sit-to-stand motion in healthy children

The goal of the present study was to determine the thus far unstudied effects of back loading on the kinematics and kinetics of sit-to-stand (STS) motion in healthy children. Fifteen children (8 boys, 7 girls, mean age 9.6 years, SD 1.2 years) were tested with no back load and with a back load of 10% and 20% of body weight, respectively. A motion analysis system was used with six infrared cameras and two force plates. Total STS duration did not change; however, differential effects were shown for the durations of its phases. Back loading increased ankle dorsiflexion yielding a greater maximal dorsiflexion angle. Effects on the knee angle were limited except for a significant decrease in final knee flexion. Initial and maximal hip flexion increased but final hip angle did not change. Initial backward pelvic tilt decreased and a shift to forward pelvic tilt occurred at an earlier stage of STS motion. Back loading affected trunk motion: maximal and final forward shoulder tilt increased. Maximal ankle and knee moments and powers increased; however, hip joint kinetics was not affected significantly. Therefore, while maintaining the general pattern of STS motion, participants showed selectively significant adjustments to back loading during its different phases. The main kinematic adjustments were increased trunk flexion and greater ankle dorsiflexion, while the major kinetic adjustment was increased knee extension moment. Increased back loading yielded more pronounced effects, primarily in the ankle. In sum, back loading substantially affected the biomechanics of STS motion even for the lower load level studied. This finding may be of clinical relevance for musculoskeletal disorders, but this needs to be examined.     

Effects of plantar cutaneo-muscular and tendon vibration on posture and balance during quiet and perturbed stance

Modulation of lower limb somatosensory information by tendon or plantar vibration produces directionally specific, vibration-induced falling reactions that depend on the tendon or the region of the sole that is vibrated. This study characterized the effects of different patterns of plantar cutaneo-muscular vibration and bilateral Achilles tendon vibration (ATV) on the postural strategies observed during quiet and perturbed stance. Twelve healthy young participants stood barefooted, with their vision blocked, on two sets of plantar vibrators placed on two AMTI force plates embedded in a moveable support surface. Two other vibrators were positioned over the Achilles tendons. Participants were randomly exposed to different patterns of plantar cutaneo-muscular and ATV. Tilts of the support surface in the toes-up (TU) and toes-down (TD) directions were given 5-8 s after the beginning of vibration. Body kinematics in 3D and ground reaction forces were recorded. Bilateral ATV applied with or without rearfoot vibration (RFV) during quiet stance resulted in a whole-body backward leaning accompanied by an increase in trunk extension and hip and knee flexion. RFV alone produced a forward whole-body tilt with increased flexion in trunk, hip, and ankle. When stance was perturbed by TU tilts, the center of mass (CoM) and center of pressure (CoP) displacements were larger in the presence of RFV or ATV and associated with increased peak trunk flexion. TD tilts with or without ATV resulted in no significant difference in CoM and CoP displacements, while larger trunk extension and smaller distal angular displacements were observed during ATV. RFV altered the magnitude of the balance reactions, as observed by an increase in CoP displacements and variable response in trunk displacement. Significant interactions between ATV and RFV were obtained for the peak angular excursions for both directions of perturbations, where ATV either enhanced (for TU tilts) or attenuated (for TD tilts) the influence of RFV. Manipulating somatosensory information from the plantar cutaneo-muscular and muscle spindle Ia afferents thus results in altered and widespread postural responses, as shown by profound changes in body kinematics and CoM and CoP displacements. This suggests that the CNS uses plantar cutaneo-muscular and ankle spindle afferent inputs to build an appropriate reference of verticality that influences the control of equilibrium during quiet and perturbed stance.     

An investigation of lower extremity energy dissipation strategies during single-leg and double-leg landing based on sagittal and frontal plane biomechanics

There is limited understanding of the differences in lower extremity energy dissipation strategies between single-leg and double-leg landing maneuvers. This study sought to investigate these differences in sagittal and frontal planes, and explain the differences using kinematics and kinetics. We hypothesized that single-leg and double-leg landing maneuvers involve different lower extremity energy dissipation strategies in both planes. Ten recreational athletes were recruited and instructed to perform double-leg and single-leg landing from 0.60-m height. Force-plates and motion-capture system were used to obtain kinetics and kinematics data respectively. Joint power was taken as product of joint moment and angular velocity. Joint work was computed as integral of joint power over time, whereby negative work represented energy dissipation. In the sagittal plane, the hip and knee showed major contributions to energy dissipation during double-leg landing; the hip and ankle were the dominant energy dissipaters during single-leg landing. In the frontal plane, the hip acted as the key energy dissipater during double-leg landing; the knee contributed the most energy dissipation during single-leg landing. The knee also exhibited greater frontal plane joint ROM, moment and energy dissipation during single-leg landing than double-leg landing. Our findings indicated that different energy dissipation strategies were adopted for double-leg and single-leg landing in sagittal and frontal planes. Considering the prominent frontal plane biomechanics exhibited by the knee during single-leg landing, we expect that this maneuver may have greater likelihood of leading to traumatic knee injuries, particularly non-contact ACL injuries, compared to the double-leg landing maneuver.     

Common and specific gait patterns in people with varying anatomical levels of lower limb amputation and different prosthetic components

The present study’s aim was to identify the kinematic and kinetic gait patterns and to measure the energy consumption in people with amputation according to both the anatomical level of amputation and the type of prosthetic components in comparison with a control group matched for the gait speed. Fifteen subjects with unilateral transtibial amputation (TTA), forty with unilateral transfemoral amputation (TFA) (9 with mechanical, 17 with CLeg and 14 with Genium prosthesis) and forty healthy subjects were recruited. We computed the time-distance gait parameters; the range of angular motion (RoM) at hip, knee and ankle joints, and at the trunk and pelvis; the values of the 2 peaks of vertical force curve; the full width at half maximum (FWHM) and center of activity (CoA) of vertical force; the mechanical behavior in terms of energy recovery (R-step) and energy consumption. The main results were: i) both TTA and TFA show a common gait pattern characterized by a symmetric increase of step length, step width, double support duration, pelvic obliquity, trunk lateral bending and trunk rotation RoMs compared to control groups. They show also an asymmetric increase of stance duration and of Peak1 in non-amputated side and a decrease of ankle RoM in amputated side; ii) only TFA show a specific gait pattern, depending on the level of amputation, characterized by a symmetric reduction of R-step and an asymmetric decrease of stance duration, CoA and FWHM and an increase of Peak1 in the amputated side and of hip and knee RoM, CoA and FWHM in the non-amputated side; iii) people with amputation with Genium prosthesis show a longer step length and increased hip and knee RoMs compared to people with amputation with mechanical prosthesis who conversely show an increased pelvic obliquity: these are specific gait patterns depending of the type of prosthesis. In conclusion, we identified both common and specific gait patterns in people with amputation, either regardless of, or according to their level of amputation and the type of prosthetic component.     

Source of improvement in balance control after a training program for ankle proprioception

Previous research on healthy individuals reported improvements in balance control following a purported ankle proprioception-training program. The training may have resulted in a general rather than a specific enhancement of ankle proprioception. To test this hypothesis, subjects were constrained at the hips and trunk with a custom-made thoracolumbosacral orthosis and performed a one-leg standing test with eyes closed and head tilted back, so that they had to rely primarily on their ankle musculature to keep their balance. Subjects were retested after training on the BAPS three times a week for 4 weeks, following the training recommendations of the manual. Subjects' bodies were not constrained during the training. Analysis showed that subjects made improvements during training in performing more difficult tasks on the board. On the one-leg test, however, there were no improvements in sway velocity, number of touchdowns, or falls relative to pretest scores. Improvements observed during training likely resulted from diffuse enhancement of proprioception in other body segments such as the knees, hips, spine, and upper extremities. A training program in control of general balance does not specifically target ankle proprioception.     

Sit-to-stand: Functional relationship between upper body and lower limb segments

The behaviour of linked body segments during sit-to-stand was the subject of this study which investigated the relationship between the trunk and lower limb segments by varying the initial position of the trunk. Six subjects were videotaped as they stood up with feet on a forceplate from three initial positions: erect sitting, trunk flexed forward 30 deg, and 60 deg. When subjects actively flexed the trunk in the pre-extension phase, the order in which lower limb joints extended was knee, hip, ankle. However, when there was no active flexion, the order of onsets changed, the hip extending first followed by the knee and ankle. An extensor support moment (SM), a summation of extensor moments at hip, knee and ankle, occurred throughout the extension phase. The mean peak value of SM remained invariant in all three conditions despite variability in individual hip, knee and ankle moments. When active trunk flexion was absent, the duration of the extension phase was longer and a high value of SM was sustained for a longer proportion of the phase, indicating that more muscle force was required. The findings support the view that biomechanical characteristics emerge naturally from a functional coupling between segments, according to the demands of the action.     

Aging-related cocontraction effects during ankle strategy balance recovery following tether release in women

Increased antagonistic muscle activation during balance recovery has been documented during proprioceptive reliant responses in older adults. The authors examined ankle muscle cocontraction levels in young and older adults during balance recovery from a tether-release-induced, vestibular-input-reliant perturbation. Nine healthy young adult and 9 older women without history of falls performed maximum isometric plantar flexion and dorsiflexion trials followed by balance recovery trials using the ankle strategy. Surface electromyography data normalized to isometric conditions were analyzed during the 100 ms prior to release, the 50 ms immediately after release, and the 100-ms epochs from 100-400 ms following release. No differences existed in gastrocnemius and soleus activity levels (p > .05), though antagonistic tibialis anterior activity was greater in the older adults during the 300-400 ms epoch (young: 23.5 ± 5.8%, older: 38.7 ± 9.4%; p = .001). Vestibular-dominated perturbations may increase antagonistic activity during the recovery phase in older adults, inhibiting efficient balance recovery during proprioceptive and vestibular reliant perturbations.     

Perceptual-Motor Contributions to Static and Dynamic Balance Control in Children

The authors addressed balance control in children from the perspective of skill development and examined the relationship between specific perceptual and motor skills and static and dynamic balance performance. Fifty 11- to 13-year-old children performed a series of 1-legged balance tasks while standing on a force platform. Postural control was reflected in the maximum displacement of the center of mass in anterior-posterior and mediolateral directions. Simple visual, discrimination, and choice reaction times; sustained attention; visuomotor coordination; kinesthesis; and depth perception were also assessed in a series of perceptual and motor tests. The correlation analysis revealed that balancing under static conditions was strongly associated with the ability to perceive and process visual information, which is important for feedback-based control of balance. On the other hand, when greater task demands were imposed on the system under dynamic balancing conditions, the ability to respond to the destabilizing hip abductions-adductions in order to maintain equilibrium was associated with motor response speed, suggesting the use of a descending, feedforward control strategy. Therefore, like adults, 11- to 13-year-old children have the ability to select varying balance strategies (feedback, feedforward, or both), depending on the constraints of a particular task.