Long-term effects of mTBIs includes a higher dependency on visual inputs to control vertical posture.

This study investigated the hypothesis that individuals living with long-term effects of mild traumatic brain injury (mTBI) develop an increased dependency on visual inputs to control upright posture. To test this hypothesis, we quantified visuo-postural dependency indices (VPDIs) calculated for multiple postural behavioral markers extracted from the body's center of pressure coordinates signals. These signals were recorded during the execution of a quiet bipedal stance under Vision and No-Vision experimental conditions. VPDIs were calculated as the normalized pair-wise subtraction of recordings obtained under Vision and No-Vision. A total of one hundred and twenty-nine volunteers were organized into two groups: mTBI group (n = 50) and neurotypical control group (n = 79). Consistent with our hypothesis, the results reveal that balance behavior of participants with mTBI deteriorate more abruptly in the absence of visual inputs when compared to neurotypical controls. These impairments might increase the likelihood of recurrent injuries and falls when time-constrained reactions are needed in daily activities, sports practice, or military operations. Additionally, the methodology used in this study shows to be potentially useful to aid future investigations of neural circuitry impaired by mTBI. It also provides indices of recovery for future clinical trials testing mTBI-related clinical interventions.

The effects of aging on the distribution and strength of correlated neural inputs to postural muscles during unperturbed bipedal stance.

The present study investigated the effects of aging on the distribution of common descending neural drives to main postural muscles acting on the ankle, knee, hip, and lower trunk. The presence, distribution, and strength of these drives were assessed using intermuscular coherence estimations at a low-frequency band (0-55 Hz). Ten healthy older adults (68.7 ± 3.5 years) with no recent history of falls and ten healthy younger adults (26.8 ± 2.7 years) performed bipedal stances with eyes either opened or closed. Electromyographic (EMG) signals of six postural muscles were recorded. Estimations of intermuscular coherence were obtained from fifteen muscle pairs and four muscle groups. In general, single-pair and pooled coherence analyzes revealed significant levels of signal synchronization within 1-10 Hz. Significant common drives to anterior, posterior, and antagonist muscle groups were observed for both cohorts of participants. However, older participants showed significantly stronger EMG-EMG synchronization in the frequency domain compared to younger participants. It seems that age-related sarcopenia, visual-vestibular-proprioceptive decline, cortical activation increase, presynaptic inhibition modulation decrease, and co-contraction increase had a major impact on strengthening the common drives to the aforementioned muscle groups. Differently from young adults, the absence of visual inputs did not reduce the magnitude of signal synchronization in older adults. These results suggest that the aging central nervous system seems to organize similar arrangements of common drives to postural antagonist muscles at different joints, and to postural muscles pushing the body either forward or backward when visual information is not available.

The effects of mild traumatic brain injury on postural control.

PRIMARY OBJECTIVE: The purpose of this study was to investigate the effects of mild traumatic brain injury (mTBI) on multiple postural indices that characterize body sway behaviour. METHODS AND PROCEDURES: The body's centre of pressure (COP) displacement was recorded from 11 individuals with a history of mTBI (29.4 ± 6.7 years old) and 11 healthy controls (26.8 ± 3.7 years old) performing bipedal stance on a force platform for 120 seconds. Spatio-temporal (area, amplitude and mean velocity of the COP displacement) and frequency characteristics (frequency containing 80% of the power spectral density) of the body oscillation, as well as its dynamic characteristics (sample entropy estimate of the COP displacement) were extracted from COP signals. MAIN OUTCOMES AND RESULTS: All postural indices studied were significantly affected by mTBI (p < 0.010). Participants with a history of mTBI presented a larger, slower, and more random body oscillation compared to controls. CONCLUSION: The results suggest that (a) balance deficits can be recognized as an effect of mTBI; (b) balance deficits induced by mTBI are multi-dimensional, affecting all three domains included in this study; and

The influence of visual information on multi-muscle control during quiet stance: a spectral analysis approach.

Standing upright requires the coordination of neural drives to a large set of muscles involved in controlling human bipedal stance (i.e., postural muscles). The coordination may deteriorate in situations where standing is performed under more challenging circumstances, such as standing on a smaller base of support or not having adequate visual information. The present study investigates the role of common neural inputs in the organization of multi-muscle synergies and the effects of visual input disruption to this mechanism of control. We analyzed the strength and distribution of correlated neural inputs (measured by intermuscular coherence) to six postural muscles previously recognized as components of synergistic groups involved in the maintenance of the body's vertical positioning. Two experimental conditions were studied: quiet bipedal stance performed with opened eyes (OEs) and closed eyes (CEs). Nine participants stood quietly for 30 s while the activity of the soleus, biceps femoris, lumbar erector spinae, tibialis anterior, rectus femoris, and rectus abdominis muscles were recorded using surface electrodes. Intermuscular (EMG-EMG) coherence was estimated for 12 muscle pairs formed by these muscles, including pairs formed solely by either posterior, anterior, or mixed (one posterior and one anterior) muscles. Intermuscular coherence was only found to be significant for muscle pairs formed solely by either posterior or anterior muscles, and no significant coherence was found for mixed muscle pairs. Significant intermuscular coherence was only found within a distinct frequency interval bounded between 1 and 10 Hz when visual input was available (OEs trials). The strength of correlated neural inputs was similar across muscle pairs located in different joints but executing a similar function (pushing body either backward or forward) suggesting that synergistic postural groups are likely formed based on their functional role instead of their anatomical location. Absence of visual information caused a significant decrease in intermuscular coherence. These findings are consistent with the hypothesis that correlated neural inputs are a mechanism used by the CNS to assemble synergistic muscle groups. Further, this mechanism is affected by interruption of visual input.

Multi-muscle control during bipedal stance: an EMG-EMG analysis approach.

Posture and postural reactions to mechanical perturbations require the harmonic modulation of the activity of multiple muscles. This precision can become suboptimal in the presence of neuromuscular disorders and result in higher fall risk and associated levels of comorbidity. This study was designed to investigate neurophysiological principles related to the generation and distribution of inputs to skeletal muscles previously recognized as a synergistic group. Specifically, we investigated the current hypothesis that correlated neural inputs, as measured by intermuscular coherence, are the mechanism used by the central nervous system to coordinate the formation of postural muscle synergies. This hypothesis was investigated by analyzing the strength and distribution of correlated neural inputs to postural muscles during the execution of a quiet stance task. Nine participants, 4 females and 5 males, mean age 29.2 years old (±6.1 SD), performed the task of standing while holding a 5-kg barbell in front of their bodies at chest level. Subjects were asked to maintain a standing position for 10 s while the activity of three postural muscles was recorded by surface electrodes: soleus (SOL), biceps femoris (BF), and lumbar erector spinae (ERE). EMG-EMG coherence was estimated for three muscle pairs (SOL/BF, SOL/ERE, and BF/ERE). Our choice of studying these muscles was made based on the fact that they have been reported as components of a functional (synergistic) muscle group that emerges during the execution of bipedal stance. In addition, an isometric contraction can be easily induced in this muscle group by simply adding a weight to the body's anterior aspect. The experimental condition elicited a significant increase in muscle activation levels for all three muscles (p < 0.01 for all muscles). EMG-EMG coherence analysis revealed significant coherence within two distinct frequency bands, 0-5 and 5-20 Hz. Significant coherence within the later frequency band was also found to be significantly uniformly distributed across the three muscle pairs. These findings are interpreted as corroborative with the idea of a hierarchic system of control where the controller may use the generation of common neural inputs to reduce the number of variables it manipulates.

Feature Importance Analysis and Machine Learning for Alzheimer's Disease Early Detection: Feature Fusion of the Hippocampus, Entorhinal Cortex, and Standardized Uptake Value Ratio.

Introduction: Alzheimer's disease (AD) is a progressive neurological disorder characterized by mild memory loss and ranks as a leading cause of mortality in the USA, accounting for approximately 120,000 deaths per year. It is also the primary form of dementia. Early detection is critical for timely intervention as the neurodegenerative process often starts 15-20 years before cognitive symptoms manifest. This study focuses on determining feature importance in AD classification using fused texture features from 3D magnetic resonance imaging hippocampal and entorhinal cortex and standardized uptake value ratio (SUVR) derived from positron emission tomography (PET) images. Methods: To achieve this objective, we employed four distinct classifiers (Linear Support Vector Classification, Linear Discriminant Analysis, Logistic Regression, and Logistic Regression Classifier with Stochastic Gradient Descent Learning). These classifiers were used to derive both average and top-ranked importance scores for each feature based on their outputs. Our framework is designed to distinguish between two classes, AD-negative (or mild cognitive impairment stable [MCIs]) and AD-positive (or MCI conversion [MCIc]), using a probabilistic neural network classifier and the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Results: The findings from the feature importance highlight the crucial role of the GLCM texture features extracted from the hippocampus and entorhinal cortex, demonstrating their superior performance compared to the volume and SUVR. GLCM texture AD classification achieved approximately 90% sensitivity in identifying MCIc cases while maintaining low false positives (below 30%) when fused with other features. Moreover, the receiver operating characteristic curves validate the GLCMs' superior performance in distinguishing between MCIs and MCIc. Additionally, fusing different types of features improved classification performance compared to relying solely on any single feature category. Conclusion: Our study emphasizes the pivotal role of GLCM texture features in early Alzheimer's detection.

Are menstrual symptoms associated with central sensitization inventory? A cross-sectional study.

BACKGROUND: Dysmenorrhoea is a prevalent pain condition that affects women of reproductive age, who are monthly exposed to this pain, usually until they reach adult age, or even after that, which can predispose them to Central Sensitization. The present study aimed to observe the association between menstrual characteristics and central sensitivity symptoms in women. METHODS: Cross-sectional study. Brazilian women (n = 10,402) answered an online form comprised of questions regarding their gynaecological history, the Numerical Rating Scale for pain and the Central Sensitization Inventory, part A. For the analysis, we separated women into two groups: the Central Sensitivity Symptoms group (n = 5200) and the no Central Sensitivity Symptoms group (n = 5202). We performed a binary logistic regression with the backward insertion method for the variables with p < 0.05 in the bivariate analysis between groups. The significance level was set at 5%. RESULTS: Prevalence of dysmenorrhoea was 67.3%, and 32.2% of women in the Central Sensitivity Symptoms group reported pain >8 during their menstrual period. The logistic regression showed that greater levels of menstrual pain (odds ratio 1.12), gynaecological diseases (odds ratio 1.51), presence of dysmenorrhoea since adolescence (odds ratio 1.20) and irregular menstrual cycles (odds ratio 1.47) increased the likelihood of women presenting with Central Sensitivity Symptoms (p < 0.05 for all comparisons). CONCLUSIONS: The present study shows that Central Sensitivity Symptoms are present in about 50% of women and are associated with menstrual characteristics such as dysmenorrhoea-related pain intensity, cycle regularity, presence of dysmenorrhoea since adolescence accompanied by gynaecological diseases. SIGNIFICANCE: Central sensitivity symptoms occur in 50% of women and are more present in women with dysmenorrhoea. They are associated with cycle regularity, presence of dysmenorrhoea since adolescence and gynaecological diseases. LIMITATIONS: Women that suffer from dysmenorrhoea and are of higher socio-economic and educational levels may have been more propense to respond to the invitation; as such, the findings of the present study should be carefully interpreted.

Visuo-postural dependency index (VPDI) in human postural control.

BACKGROUND: Computerized stabilometry has been utilized to investigate the effect of vision on the neuromechanisms of human postural control. However, this approach lacks operational methods to quantify visual dependency during upright stance. This study had three goals: (1) To introduce the concept of visuo-postural dependency indices (VPDI) representing balance sway characteristics in multiple analytical domains (spatial, temporal, frequency, and structural), (2) To investigate the age and gender effects on VPDIs, and (3) To investigate the degree of relationships between VPDI and both subjective visual vertical and horizontal perception (SVV and SVH, respectively). METHODS: 102 participants (16 to 80 years old) performed bipedal stances on a force platform with eyes open and closed. Response variables included the VPDIs computed for each postural index. In addition, 29 participants also performed SVV and SVH assessments. RESULTS: Fifteen VPDIs showed to be robust indicators of visual input modulation, and the variation across their magnitudes of modulation revealed a non-homogeneous response to changes in visual stimuli. Gender and age were not found to be a significant factor to VPDI modulation. CONCLUSIONS: VPDIs revealed to be potential measures capable to quantitatively assess visuo-postural dependency and aid the assessment of fall risks and balance impairments.

Force-independent distribution of correlated neural inputs to hand muscles during three-digit grasping.

The ability to modulate digit forces during grasping relies on the coordination of multiple hand muscles. Because many muscles innervate each digit, the CNS can potentially choose from a large number of muscle coordination patterns to generate a given digit force. Studies of single-digit force production tasks have revealed that the electromyographic (EMG) activity scales uniformly across all muscles as a function of digit force. However, the extent to which this finding applies to the coordination of forces across multiple digits is unknown. We addressed this question by asking subjects (n = 8) to exert isometric forces using a three-digit grip (thumb, index, and middle fingers) that allowed for the quantification of hand muscle coordination within and across digits as a function of grasp force (5, 20, 40, 60, and 80% maximal voluntary force). We recorded EMG from 12 muscles (6 extrinsic and 6 intrinsic) of the three digits. Hand muscle coordination patterns were quantified in the amplitude and frequency domains (EMG-EMG coherence). EMG amplitude scaled uniformly across all hand muscles as a function of grasp force (muscle x force interaction: P = 0.997; cosines of angle between muscle activation pattern vector pairs: 0.897-0.997). Similarly, EMG-EMG coherence was not significantly affected by force (P = 0.324). However, coherence was stronger across extrinsic than that across intrinsic muscle pairs (P = 0.0039). These findings indicate that the distribution of neural drive to multiple hand muscles is force independent and may reflect the anatomical properties or functional roles of hand muscle groups.

Influence of fatigue on hand muscle coordination and EMG-EMG coherence during three-digit grasping.

Fingertip force control requires fine coordination of multiple hand muscles within and across the digits. While the modulation of neural drive to hand muscles as a function of force has been extensively studied, much less is known about the effects of fatigue on the coordination of simultaneously active hand muscles. We asked eight subjects to perform a fatiguing contraction by gripping a manipulandum with thumb, index, and middle fingers while matching an isometric target force (40% maximal voluntary force) for as long as possible. The coordination of 12 hand muscles was quantified as electromyographic (EMG) muscle activation pattern (MAP) vector and EMG-EMG coherence. We hypothesized that muscle fatigue would cause uniform changes in EMG amplitude across all muscles and an increase in EMG-EMG coherence in the higher frequency bands but with an invariant heterogeneous distribution across muscles. Muscle fatigue caused a 12.5% drop in the maximum voluntary contraction force (P < 0.05) at task failure and an increase in the SD of force (P < 0.01). Although EMG amplitude of all muscles increased during the fatiguing contraction (P < 0.001), the MAP vector orientation did not change, indicating that a similar muscle coordination pattern was used throughout the fatiguing contraction. Last, EMG-EMG coherence (0-35 Hz) was significantly greater at the end than at the beginning of the fatiguing contraction (P < 0.01) but was heterogeneously distributed across hand muscles. These findings suggest that similar mechanisms are involved for modulating and sustaining digit forces in nonfatiguing and fatiguing contractions, respectively.

Multi-muscle synergies in a dual postural task: evidence for the principle of superposition.

We used the framework of the uncontrolled manifold hypothesis to quantify multi-muscle synergies stabilizing the moment of force about the frontal axis (M(Y)) and the shear force in the anterior-posterior direction (F(X)) during voluntary body sway performed by standing subjects. We tested a hypothesis whether the controller could stabilize both M(Y) and F(X) at the same time when the task and the visual feedback was provided only on one of the variables (M(Y)). Healthy young subjects performed voluntary body sway in the anterior-posterior direction while different loads were attached at the ankle level producing horizontal forces acting forward or backwards. Principal component analysis was used to identify three M-modes within the space of integrated indices of muscle activation. Variance in the M-mode space across sway cycles was partitioned into two components, one that did not affect a selected performance variable (M(Y) or F(X)) and the other that did. Under all loading conditions and for each performance variable, a higher value for the former variance component was found. We interpret these results as reflections of two multi-M-mode synergies stabilizing both F(X) and M(Y). The indices of synergies were modulated within the sway cycle; both performance variables were better stabilized when the body moved forward than when it moved backward. The results show that the controller can use a set of three elemental variables (M-modes) to stabilize two performance variables at the same time. No negative interference was seen between the synergy indices computed for the two performance variables supporting the principle of superposition with respect to multi-muscle postural control.

Postural Behavior in Medicated Parkinson Disease Patients: A Preliminary Study Searching for Indicators to Track Progress.

PURPOSE: The establishment of early diagnostic methods for Parkinson disease (PD) is one of the key features to clinically control the rate of PD progression. This study aimed to give a first step toward recognizing the efficacy of multiple postural indices of balance control in differentiating medicated PD patients from health participants. METHODS: Nine individuals with PD (Hoehn and Yahr Stage up to 2), 9 staged 2.5 and up, and 9 healthy age-matched Controls performed bipedal stances for 120 seconds with eyes either open or closed on a stable force platform. All participants with PD were under anti-Parkinsonian medication. Non-parametric tests investigated the effects of PD and visual input on postural indices extracted from the center of pressure coordinates. RESULTS: Independent of the stage of the disease, individuals with PD presented faster and shakier body sway compared with Controls. Advanced stages of PD also revealed increased body sway length and variability. In addition, medio-lateral postural instability was more pronounced in all stages of PD when visual inputs were not allowed. CONCLUSION AND SIGNIFICANCE: Body sway velocity, jerkiness, length, and its variability revealed to be potential markers for subclinical signs of adjustments in the neuromechanisms of balance control and postural instability even at early stages of disease and under anti-Parkinsonian medication. Results produced here will direct future studies aiming to investigate the efficacy of these same indices on recognizing subclinical development of PD as well as those individuals susceptible to faster rates of progression.

Postural control during upper body locomotor-like movements: similar synergies based on dissimilar muscle modes.

We studied the organization of leg and trunk muscles into groups (M-modes) and co-variation of M-mode involvement (M-mode synergies) during whole-body tasks associated with large variations of the moment of force about the vertical body axis. Our major questions were: (1) can muscle activation patterns during such tasks be described with a few M-modes common across tasks and subjects? (2) do these modes form the basis for synergies stabilizing M(z) time pattern? (3) will this organization differ between an explicit body-rotation task and a task associated with locomotor-like alternating arm movements? Healthy subjects stood barefoot on the force platform and performed two motor tasks while paced by the metronome at 0.7, 1.0, and 1.4 Hz: cyclic rotation of the upper body about the vertical body axis (body-rotation task), and alternating rhythmic arm movements imitating those during running or quick walking (arm-movement task). Principal component analysis was used to identify three M-modes within the space of integrated indices of muscle activity. The M-mode vectors showed clustering neither across subjects nor across frequencies. Variance in the M-mode space across sway cycles was partitioned into two components, one that did not affect the average value of M(z) shift ("good variance") and the other that did. An index was computed reflecting the relative amount of the "good variance"; positive values of this index have been interpreted as reflecting a multi-M-mode synergy stabilizing the M(z) trajectory. On average, the index was positive for both tasks and across all frequencies studied. However, the magnitude of the index was smaller for the intermediate frequency (1 Hz). The results show that the organization of muscles into groups during relatively complex whole-body tasks can differ significantly across both task variations and subjects. Nevertheless, the central nervous system seems to be able to build M(z) stabilizing synergies based on different sets of M-modes, within the approach accepted in this study. The drop in the synergy index at the frequency of 1 Hz, which was close to the preferred movement frequency, may be interpreted as corroborating the neural origin of the M-mode co-variation.

Flexible muscle modes and synergies in challenging whole-body tasks.

We used the idea of hierarchical control to study multi-muscle synergies during a whole-body sway task performed by a standing person. Within this view, at the lower level of the hierarchy, muscles are united into groups (M-modes). At the higher level, gains at the M-modes are co-varied by the controller in a task-specific way to ensure low variability of important physical variables. In particular, we hypothesized that (1) the composition of M-modes could adjust and (2) an index of M-mode co-variation would become weaker in more challenging conditions. Subjects were required to perform a whole-body sway at 0.5 Hz paced by a metronome. They performed the task with eyes open and closed, while standing on both feet or on one foot only, with and without vibration applied to the Achilles tendons. Integrated indices of muscle activation were subjected to principal component analysis to identify M-modes. An increase in the task complexity led to an increase in the number of principal components that contained significantly loaded indices of muscle activation from 3 to 5. Hence, in more challenging tasks, the controller manipulated a larger number of variables. Multiple regression analysis was used to define the Jacobian of the system mapping small changes in M-mode gains onto shifts of the center of pressure (COP) in the anterior-posterior direction. Further, the variance in the M-mode space across sway cycles was partitioned into two components, one that did not affect an average across cycles COP coordinate and the other that did (good and bad variance, respectively). Under all conditions, the subjects showed substantially more good variance than bad variance interpreted as a multi-M-mode synergy stabilizing the COP trajectory. An index of the strength of the synergy was comparable across all conditions, and there was no modulation of this index over the sway cycle. Hence, our first hypothesis that the composition of M-modes could adjust under challenging conditions has been confirmed while the second hypothesis stating that the index of M-mode co-variation would become weaker in more challenging conditions has been falsified. We interpret the observations as suggesting that adjustments at the lower level of the hierarchy-in the M-mode composition-allowed the subjects to maintain a comparable level of stabilization of the COP trajectory in more challenging tasks. The findings support the (at least) two-level hierarchical control scheme of whole-body movements.

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.

Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli.

Understanding the long-term effects of concussive events remains a challenge for the development of modern medical practices and the prevention of recurrent traumas. In this study, we utilized indices of oculomotor performance and the ability to react to simple environmental stimuli to assess the long-term motor effects of traumatic brain injury in its mildest form (mTBI). We performed analysis of eye movement accuracy, investigated the presence of abnormal eye movements, and quantified time to react to simple environmental stimuli on long-term mTBI survivors. Results indicated the presence of impairments to basic neural functions used to explore and respond to environmental demands long after the occurrence of mTBIs. Specifically, the result revealed the presence of abnormal saccadic eye movements while performing horizontal smooth pursuit, diminished accuracy of primary saccadic horizontal eye movement, and a widespread slower reaction to both visual and auditory stimuli. The methodology used in this study indicated to be potentially useful in aiding future investigations of neural circuitry impaired by mTBI and provide indices of recovery in future clinical trials testing mTBI-related clinical interventions.

Author Correction: Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

Upright balance control strategies during pregnancy.

BACKGROUND: Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of falling. A clear understanding of these mechanisms is important to improve pre-natal care and reduce the fall risk in this population. OBJECTIVES: This study focused on investigating how pregnancy affects postural control in each trimester of pregnancy by analyzing pelvic inclination and body sway behavior. Our main hypothesis was that balance control and posture would change during pregnancy. More specifically, pregnancy would increase sway amplitude, anterior pelvic tilt, and body sway regularity in time. STUDY DESIGN: Forty women formed four groups: non-pregnant women (NP) and women at their first, second, and third trimester of pregnancy (P1, P2, and P3, respectively). All participants performed (1) postural evaluation of the pelvic inclination using a digital system of postural analysis and (2) instrumented posturography using a force platform to collect the coordinates of the body's center of pressure (COP) during quiet bipedal stance for 120 s. Kruskal-Wallis H test and post-hoc Mann-Whitney U tests were used to investigate the effects of pregnancy (NP, P1, P2, and P3) on pelvic inclination angle and postural indices computed from the COP signals. RESULTS: Results revealed significant larger body sway accompanied by a more regular medial-lateral pattern of oscillation and a more synchronized anterior-posterior and medial-lateral sway already at the first trimester of pregnancy. The averaged COP migrated posteriorly at third trimester of pregnancy and the anterior pelvic tilt increased at second and third trimesters. CONCLUSIONS: Our results indicate the existence of changes in posture and balance metrics even at early stages of pregnancy. We suggest the use of posturography as one of screening tools for postural instability and fall risk during pregnancy.

Anticipatory control of head posture.

OBJECTIVE: We tested a hypothesis on two patterns of anticipatory postural adjustments (APAs) in neck muscles, reciprocal and co-activation, that may be used in a task-specific way. We also explored possible relation of APAs in leg and trunk muscles to head stabilization. METHODS: Load perturbations (loading and unloading) were applied to the head, trunk, and head and trunk simultaneously using similar hand actions by standing persons. Electromyographic signals (EMGs) from 10 muscles were recorded. Shifts of the center of pressure and EMG indices were computed over typical time intervals for APA. RESULTS: Time-shifted (reciprocal) activation of neck flexor and extensor muscles during APAs was seen when perturbations were applied directly to the head. Simultaneous activation dominated when the perturbations were applied to the trunk. Minimal APAs were seen in the leg/trunk muscles during head perturbation tests. APAs during trunk perturbation were not different from those during trunk and head perturbation. CONCLUSIONS: The results confirm the existence of two different patterns of APAs in neck muscles. A time-shifted (reciprocal) pattern is more likely to be used in anticipation of a perturbation acting directly on the head. A simultaneous activation (co-activation) pattern is used when direction of head perturbation cannot be predicted with certainty. Leg/trunk APAs are unlikely to help stabilize head posture. SIGNIFICANCE: These results are important for better understanding of feed-forward mechanisms of the control of head posture with possible implications for neurological patients who suffer from impaired feed-forward postural control.

The use of intermuscular coherence analysis as a novel approach to detect age-related changes on postural muscle synergy.

The overall goal of this study was to investigate potential adaptations brought about by the natural processes of aging on the coordination of postural muscles. Considering the progressive and non-homogeneous deterioration of sensorimotor and neuromuscular systems as the individual grows older, it was hypothesized that aging is associated with a reorganization of synergistic mechanisms controlling postural muscles. Therefore, the presence, distribution, and strength of correlated neural inputs to three posterior postural muscles were measured by intermuscular coherence estimations at a low frequency band (0-55Hz). Nine healthy young adults and thirteen healthy older adults performed ten trials of a perturbed task: bipedal stance while holding a five kg load for fifteen seconds. Estimates of intermuscular coherence for each pair of electromyographic signals (soleus and biceps femoris, soleus and erector spinae, and biceps femoris and erector spinae) were computed. Results revealed significantly stronger levels of synchronization of posterior muscles within 0-10Hz in seniors compared to young adults. In addition, seniors presented similar spectra of intermuscular coherence within 0-55Hz for all three muscle pairs analyzed. These findings provide valuable information regarding compensatory mechanisms adopted by older adults to control balance. The age-related reorganization of neural drive controlling posterior postural muscles revealing a stronger synchronization within 0-10Hz might be related to the faster body sway and muscle co-activation patterns usually observed in this population. Finally, this study supports the use of Intermuscular Coherence Analysis as a sensitive method to detect age-related changes in multi-muscle control.