Increased co-contraction reaction during a surface perturbation is associated with unsuccessful postural control among older adults.

BACKGROUND: As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening. METHODS: A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable. RESULTS: Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables. CONCLUSIONS: When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research.

What Explains Successful or Unsuccessful Postural Adaptations to Repeated Surface Perturbations among Older Adults?

As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group "Non-fallers" whereas those that fell during all perturbations were assigned to the group "Fallers". The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures- the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers' postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation.

Modelling the dynamic margins of stability for use in evaluations of balance following a support-surface perturbation.

The dynamic margin of stability provides a method that captures the center of mass (CoM) state (position-velocity) in relation to the base of support (BoS). However, the model upon which this concept was derived does not consider how the inertial characteristics of forced support-surface perturbations would influence balance control. Within the current article, the inverted pendulum model was restructured to account for fixed, piecewise accelerations of the BoS. From this logic, two variations of the adjusted margin of stability, each maintaining a similar definition of extrapolated CoM, are proposed; one ignoring horizontal ground contact and inertial forces applied to the BoS, the other incorporating these forces. Unique within the proposed models is the time-variant BoS boundaries that depend on the perturbation applied. Verification of the solution for each model is provided, along with a comparison of obtained values to previous methods of defining CoM position-velocity stability metrics using a computational model and optimal control. For the simpler model variation (ignoring forces), we also assessed how CoM position and perturbation parameter selection over/underestimate the predicted maximal permissible velocity. The results of these analyses suggest that factors which increase the acceleration impulse decrease the difference between the two models; the opposite was observed for factors increasing displacements between the CoM and BoS boundary. Lastly, use of the proposed adjusted margin of stability within an experimental data set highlights the ability of our model to predict instability (stepping strategies; negative margin of stability) relative to the use of the extrapolated CoM alone.

Compensation for inertial and gravity effects in a moving force platform.

Force plates for human movement analysis provide accurate measurements when mounted rigidly on an inertial reference frame. Large measurement errors occur, however, when the force plate is accelerated, or tilted relative to gravity. This prohibits the use of force plates in human perturbation studies with controlled surface movements, or in conditions where the foundation is moving or not sufficiently rigid. Here we present a linear model to predict the inertial and gravitational artifacts using accelerometer signals. The model is first calibrated with data collected from random movements of the unloaded system and then used to compensate for the errors in another trial. The method was tested experimentally on an instrumented force treadmill capable of dynamic mediolateral translation and sagittal pitch. The compensation was evaluated in five experimental conditions, including platform motions induced by actuators, by motor vibration, and by human ground reaction forces. In the test that included all sources of platform motion, the root-mean-square (RMS) errors were 39.0 N and 15.3 N m in force and moment, before compensation, and 1.6 N and 1.1 N m, after compensation. A sensitivity analysis was performed to determine the effect on estimating joint moments during human gait. Joint moment errors in hip, knee, and ankle were initially 53.80 N m, 32.69 N m, and 19.10 N m, and reduced to 1.67 N m, 1.37 N m, and 1.13 N m with our method. It was concluded that the compensation method can reduce the inertial and gravitational artifacts to an acceptable level for human gait analysis.

Inertial compensation for belt acceleration in an instrumented treadmill.

Instrumented treadmills provide a convenient means for applying horizontal perturbations during gait or standing. However, varying the treadmill belt speed introduces inertial artifacts in the sagittal plane moment component of the ground reaction force. Here we present a compensation method based on a second-order dynamic model that predicts inertial pitch moment from belt acceleration. The method was tested experimentally on an unloaded treadmill at a slow belt speed with small random variations (1.20±0.10m/s) and at a faster belt speed with large random variations (2.00±0.50m/s). Inertial artifacts of up to 12Nm (root-mean-square, RMS) and 30Nm (peak) were observed. Coefficients of the model were calibrated on one trial and then used to predict and compensate the pitch moment of another trial with different random variations. Coefficients of determination (R(2)) were 72.08% and 96.75% for the slow and fast conditions, respectively. After compensation, the root-mean-square (RMS) of the inertial artifact was reduced by 47.37% for the slow speed and 81.98% for fast speed, leaving only 1.5Nm and 2.1Nm of artifact uncorrected, respectively. It was concluded that the compensation technique reduced inertial errors substantially, thereby improving the accuracy in joint moment calculations on an instrumented treadmill with varying belt speed.