Payas A, Kurtoğlu E, Kepenek Varol B, Batın S, Karartı C, Koç A, Uçar İ. The Role of Conscious and Unconscious Proprioceptive Sensation in Unstable Postural Balance: A Cross-Sectional Study. J Clin Pract Res 2024;46(3):242–250. (original) (raw)
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Some methods and parameters of body sway quantification and their neurological applications
Archiv f�r Psychiatrie und Nervenkrankheiten, 1980
Methods and parameters are described to quantify body sway as measured by a force-transducing platform. Analogue data representing the coordinates of the body's center of force (COF) are fed into a digital computer. The following parameters are then calculated and tested for their diagnostic significance: sway path (SP), mean amplitude of sway (MA), mean sway frequency (MF), their lateral and sagittal components, and the quotients sagittal/lateral of these as well as the sway area (SA) circumscribed by the COF. Quotients of eyes open/eyes closed for all these parameters determine the visual stabilization of posture. Sway position and sway direction histograms allow for a more detailed analysis of MA and SP. Despite considerable interand intraindividual variance of these parameters (in 28 normals), some of them seem of clinical significance not only for documentation and follow-up studies but also for differential diagnosis. In patients with cerebellar lesions (n = 12), SP and MA were up to 10 times larger with a marked antero-posterior instability, MF being above normal. Patients with labyrinthine lesions (n = 10) showed significant instability only with eyes closed, MF being slightly below normal.
Movement Disorders, 1996
We studied the effects of altered sensory information on standing balance in 25 patients with cortical cerebellar atrophy (CCA), nine patients with olivopontocerebellar atrophy (OPCA), and 10 normal subjects. The total sway path and its components, the antroposterior (AP) sway path and the lateral sway path, were measured under six conditions: (1) standing on a fixed platform with the eyes open and visual surroundings fixed, (2) standing on a fixed platform with the eyes closed, (3) standing on a fixed platform with the eyes open and visual surroundings AP sway referenced, (4) standing on an AP sway-referenced platform with the eyes open and visual surroundings fixed, (5) standing on an AP sway-referenced platform with the eyes closed, and (6) standing on an AP sway-referenced platform with the eyes open and visual surroundings AP sway referenced. Patients swayed more than normal subjects during normal stance (condition 1), when the visual information was absent (condition 2) or distorted (condition 3), and when the proprioceptive information from the ankles was distorted (condition 4). Patients swayed much more than normal, and most fell, when two sensory modalities were affected under condition 5 (proprioceptive information distorted and visual information absent) and condition 6 (both proprioceptive information and visual information distorted). When the patients' sway was normalized to that of the first condition, however, only their lateral sway was greater than the sway in normal subjects. Unlike in normal subjects, the patients' lateral sway varied with the AP sway to approximately the same degree in each condition for conditions 1–5. Clinical ratings of gait and balance were highly correlated with the sway measures. Quantitative testing of standing balance with altered sensory information has better sensitivity than normal stance testing.
Gait & Posture, 2008
Maintaining erect human posture depends on graviceptive information. This can come from at least of three origins: vestibular, visual and somaesthetic. We hypothesize here that subject's use proprioception rather than visual or vestibular cues for their control of upright body posture and this even when subjects stand on a tilting body support surface. In order to find experimental evidence for this hypothesis, we exclude in our experiments visual cues (eyes close) and by keeping frequency and amplitude of the tilt stimulus so low that it would be below the detection threshold for vestibular semi-circular canal stimuli. The orientations of body segments were analysed during various phases of the perturbation cycle. Segmental stabilisations were defined in terms of both the global anchoring index calculated during the whole perturbation cycle and an appropriate sequential anchoring index calculated during various phases in the perturbation cycle. We show that subjects tend to align their bodies with the space vertical and do so better for their heads than for their upper bodies and lower bodies. A further finding is that stabilisation is related to the tilt stimulus in the form that it is minimal at the turning points of the tilt, where peak tilt velocity is minimal with the sinusoidal stimulus used.
2020
ABSTRACT: Adequate integration of sensory information from different modalities is essential for standing balance. Inadequate and/or incongruent information inputs cause sensory conflict which endangers equilibrium. That is even more expressed during dynamic suprapostural tasks, such as functional reach (FR). Our aim was to study the influence of sensory conflict on FR performance and dynamic standing balance steadiness. Ten healthy right-handed adults performed FR standing on a pedobarographic platform in four sensory conditions: eyes-open (EO), eyes-closed (EC), head in maximal extension and eyes open or closed (EO-HE/EC-HE), adding conflict of vestibular origin. Data were analyzed by Two-Way RM Anova and paired t-test. Factor vision was significant, while only a tendency for head position was found for FR, which shortens in EC, EO-HE and especially EC-HE. For center of pressure (COP) sway path both vision and head position were significant factors. Sway path increased in both EC ...
Proprioceptive control of posture: a review of new concepts
Gait & Posture, 1998
The assumption that proprioceptive inputs from the lower legs are used to trigger balance and gait movements is questioned in this review (an outgrowth of discussions initiated during the Neural Control of Movement Satellite meeting held in Cozumel, Mexico, April 1997). Recent findings presented here suggest that trunk or hip inputs may be more important in triggering human balance corrections and that proprioceptive input from the lower legs mainly helps with the final shaping and intermuscular coordination of postural and gait movements. Three major questions were considered. First, what role, if any, do lower-leg proprioceptive inputs play in the triggering of normal balance corrections? If this role is negligible, which alternative proprioceptive inputs then trigger balance corrections? Second, what is the effect of proprioceptive loss on the triggering of postural and gait movements? Third, how does proprioceptive loss affect the output of central pattern generators in providing the final shaping of postural movements? The authors conclude that postural and gait movements are centrally organized at two levels. The first level involves the generation of the basic directionally-specific response pattern based primarily on hip or trunk proprioceptive input and secondarily on vestibular inputs. This pattern specifies the spatial characteristics of muscle activation, that is which muscles are primarily activated, as well as intermuscular timing, or the sequence in which muscles are activated. The second level is involved in the shaping of centrally set activation patterns on the basis of multi-sensorial afferent input (including proprioceptive input from all body segments and vestibular sensors) in order that movements can adapt to different task conditions.
Changes in postural sway and its fractions in conditions of postural instability
2006
We investigated changes in postural sway and its fractions associated with manipulations of the dimensions of the support area. Nine healthy adults stood as quietly as possible, with their eyes open, on a force plate as well as on 5 boards with reduced support area. The center of pressure (COP) trajectory was computed and decomposed into rambling (Rm) and trembling (Tr) trajectories. Sway components were quantifi ed using RMS (root mean square) value, average velocity, and sway area. During standing on the force plate, the RMS was larger for the anterior-posterior (AP) sway components than for the mediolateral (ML) components. During standing on boards with reduced support area, sway increased in both directions. The increase was more pronounced when standing on boards with a smaller support area. Changes in the larger dimension of the support area also affected sway, but not as much as changes in the smaller dimension. ML instability had larger effects on indices of sway compared to AP instability. The average velocity of Rm was larger while the average velocity of Tr was smaller in the AP direction vs. the ML direction. The fi ndings can be interpreted within the hypothesis of an active search function of postural sway. During standing on boards with reduced support area, increased sway may by itself lead to loss of balance. The fi ndings also corroborate the hypothesis of Duarte and Zatsiorsky that Rm and Tr reveal different postural control mechanisms.
Age and Ageing, 2006
Postural control is no longer considered simply a summation of static reflexes but, rather, a complex skill based on the interaction of dynamic sensorimotor processes. The two main functional goals of postural behaviour are postural orientation and postural equilibrium. Postural orientation involves the active alignment of the trunk and head with respect to gravity, support surfaces, the visual surround and internal references. Sensory information from somatosensory, vestibular and visual systems is integrated, and the relative weights placed on each of these inputs are dependent on the goals of the movement task and the environmental context. Postural equilibrium involves the coordination of movement strategies to stabilise the centre of body mass during both self-initiated and externally triggered disturbances of stability. The specific response strategy selected depends not only on the characteristics of the external postural displacement but also on the individual's expectations, goals and prior experience. Anticipatory postural adjustments, prior to voluntary limb movement, serve to maintain postural stability by compensating for destabilising forces associated with moving a limb. The amount of cognitive processing required for postural control depends both on the complexity of the postural task and on the capability of the subject's postural control system. The control of posture involves many different underlying physiological systems that can be affected by pathology or sub-clinical constraints. Damage to any of the underlying systems will result in different, context-specific instabilities. The effective rehabilitation of balance to improve mobility and to prevent falls requires a better understanding of the multiple mechanisms underlying postural control.
Technology and Health Care, 2021
BACKGROUND: Balance control is a leading component of human motor activities and its impairment is associated with an increased risk of falling, lower back pain due to impaired motor control mechanism. Prolonged sitting position at workplace is one of the risk factors of reduced postural control and lower back pain. OBJECTIVE: To evaluate theta and alpha waves cortical activity, trunk muscles activity and kinematics in static sitting, dynamic sitting on different platforms: simple wobble board (WB) and wobble board on bearing surface (WBB). METHODS: The kinematics of body segments, electromyography of five trunk muscles, electroencephalography of 32 scalp electrodes were measured during balance tasks in sitting position for 17 subjects with continuous seated position at workplace. RESULTS: Cortical power on WBB1 increase in fronto – central (p< 0.05) region while on WBB2 increase in centro – parietal region (p< 0.05). WBB2 increase more muscles compared with WB2. The amplitude...