Acute alcohol intoxication impairs segmental body alignment in upright standing.

Balance control when standing upright is a complex process requiring input from several partly independent mechanisms such as coordination, feedback and feedforward control, and adaptation. Acute alcohol intoxication from ethanol is recognized as a major contributor to accidental falls requiring medical care. This study aimed to investigate if intoxication at 0.06 and 0.10% blood alcohol concentration affected body alignment. Mean angular positions of the head, shoulder, hip, and knee were measured with 3D-motion analysis and compared with the ankle position in 25 healthy adults during standing with or without perturbations, and with eyes open or closed. Alcohol intoxication had significant effects on body alignment during perturbed and unperturbed stance, and on adaptation to perturbations. It induced a significantly more posterior alignment of the knees and shoulders, and a tendency for a more posterior and left deviated head alignment in perturbed stance than when sober. The impact of alcohol intoxication was most apparent on the knee alignment, where availability of visual information deteriorated the adaptation to perturbations. Thus, acute alcohol intoxication resulted in inadequate balance control strategies with increased postural rigidity and impaired adaptation to perturbations. These factors probably contribute to the increased risk of falling when intoxicated with alcohol.

Effectuation of adaptive stability and postural alignment strategies are decreased by alcohol intoxication.

Human stability control is a complex process comprising contributions from several partly independent mechanisms such as coordination, feedback and feed-forward control, and adaptation. Acute alcohol intoxication impairs these functions and is recognized as a major contributor to fall traumas. The study aimed to investigate how alcohol intoxication at .06% and .10% blood alcohol concentration (BAC) affected the movement spans and control of posture alignment. The angular positions of the head, shoulder, hip and knees relative to the ankles were measured with a 3D motion analysis system in 25 healthy adults during standing with eyes open or closed and with or without vibratory balance perturbations. Alcohol intoxication significantly increased the movement spans of the head, shoulders, hip and knees in anteroposterior and lateral directions during quiet stance (p < or = .047 and p < or = .003) and balance perturbations (p<.001, both directions). Alcohol intoxication also decreased the ability to reduce the movement spans through adaptation in both anteroposterior (p < or = .011) and lateral (p < or = .004) directions. When sober and submitted to balance perturbations, the subjects aligned the head, shoulders, hip and knees more forward relative to the ankle joint (p < .001), hence adopting a more resilient posture increasing the safety margin for backward falls. Alcohol intoxication significantly delayed this forward realignment (p < or = .022). Alcohol intoxication did not cause any significant posture realignment in the lateral direction. Thus, initiation of adaptive posture realignments to alcohol or other disruptions might be context dependent and associated with reaching a certain level of stability threats.

Study I: effects of 0.06% and 0.10% blood alcohol concentration on human postural control.

Alcohol intoxication causes many accidental falls presented at emergency departments, with the injury severity often related to level of blood alcohol concentration (BAC). One way to evaluate the decline in postural control and the fall risk is to assess standing stability when challenged. The study objective was to comprehensively investigate alcohol-related impairments on postural control and adaptive motor learning at specific BAC levels. Effects of alcohol intoxication at 0.06% and 0.10% BAC were examined with posturography when unperturbed or perturbed by calf vibration. Twenty-five participants (mean age 25.1 years) were investigated standing with either eyes open or closed. Our results revealed several significant findings: (1) stability declined much faster from alcohol intoxication between 0.06% and 0.10% BAC (60-140%) compared with between 0.0% and 0.06% BAC (30%); (2) sustained exposure to repeated balance perturbations augmented the alcohol-related destabilization; (3) there were stronger effects of alcohol intoxication on stability in lateral direction than in anteroposterior direction; and (4) there was a gradual degradation of postural control particularly in lateral direction when the balance perturbations were repeated at 0.06% and 0.10% BAC, indicating adaptation deficits when intoxicated. To summarize, alcohol has profound deteriorating effects on human postural control, which are dose dependent, time dependent and direction specific. The maximal effects of alcohol intoxication on physiological performance might not be evident initially, but may be revealed first when under sustained sensory-motor challenges.

Study II: mechanoreceptive sensation is of increased importance for human postural control under alcohol intoxication.

Standing postural stability relies on input from visual, vestibular, proprioceptive and mechanoreceptive sensors. When the information from any of these sensors is unavailable or disrupted, the central nervous system maintains postural stability by relying more on the contribution from the reliable sensors, termed sensory re-weighting. Alcohol intoxication is known to affect the integrity of the vestibular and visual systems. The aim was to assess how mechanoreceptive sensory information contributed to postural stability at 0.00% (i.e. sober), 0.06% and 0.10% blood alcohol concentration (BAC) in 25 healthy subjects (mean age 25.1 years). The subjects were assessed with eyes closed and eyes open under quiet standing and while standing was perturbed by repeated, random-length, vibratory stimulation of the calf muscles. Plantar cutaneous mechanoreceptive sensation was assessed for both receptor types: slowly adapting (tactile sensitivity) and rapidly adapting (vibration perception). The correlation between recorded torque variance and the sensation from both mechanoreceptor types was calculated. The recorded stability during alcohol intoxication was significantly influenced by both the tactile sensation and vibration perception of the subjects. Moreover, the study revealed a fluctuating association between the subjects' vibration perception and torque variance during balance perturbations, which was significantly influenced by the level of alcohol intoxication, vision and adaptation. Hence, one's ability to handle balance perturbations under the influence of alcohol is strongly dependent on accurate mechanoreceptive sensation and efficient sensory re-weighting.

Foam posturography: standing on foam is not equivalent to standing with decreased rapidly adapting mechanoreceptive sensation.

Standing on a foam surface is believed to exaggerate balance deficits by decreasing the reliability of somatosensory information from cutaneous mechanoreceptors on the plantar soles (i.e. base of feet) and by altering the effectiveness of ankle torque. The aim was to further document the nature of foam posturography testing by comparing between standing on foam and standing with decreased Rapidly Adapting Mechanoreceptive Sensation (RAMS). Sixteen healthy adults (mean age 20.8 years) were tested with posturography, standing with eyes open and closed on a solid surface and on foam, with and without decreased plantar RAMS. Standing balance was measured as torque variance and further analyzed by being divided into three spectral categories. Plantar cutaneous hypothermic anesthesia by ice-cooling was used to decrease RAMS. Plantar mechanoreceptive sensation was precisely determined with tactile sensitivity and vibration perception tests. Vibration perception was significantly decreased by hypothermic anesthesia, but tactile sensitivity was not. The anterior-posterior torque variance was significantly larger for frequencies less than 0.1 Hz under eyes closed conditions when standing on a solid surface with decreased RAMS compared to normal sensation. No effect of decreased RAMS was seen with eyes open on a solid surface, nor on foam with eyes open or closed. Decreased RAMS produced body sway responses on a solid surface that were different in spectral composition, amplitude, direction and that responded differently to vision compared with standing on foam. Hence, this study showed that RAMS contributes to postural control but reduction in RAMS does not produce a similar challenge as standing on foam.

Effects of dyslexia on postural control in adults.

Dyslexia has been shown to affect postural control. The aim of the present study was to investigate the difference in postural stability measured as torque variance in an adult dyslexic group (n=14, determined using the Adult Dyslexia Checklist (ADCL) and nonsense word repetition test) and an adult non-dyslexic group (n=39) on a firm surface and on a foam block and with eyes open and eyes closed. Another aim was to investigate the correlation between ADCL scores and postural stability. Findings showed that ADCL scores correlated with torque variance in the anteroposterior direction on foam with eyes closed (p=0.001) and in the lateral direction on the foam surface with eyes closed (p=0.040) and open (p=0.010). General Linear Model analysis showed that high dyslexia scores were associated with increased torque variance (p<0.001). However, we found no significant difference between dyslexics and non-dyslexics, though there were indications of larger torque variance in the dyslexics. The findings suggest that adults with high dyslexic ADCL scores may experience sub-clinical balance deficits. Hence, assessing motor ability and postural control in those with high ADCL scores is motivated.

Alcohol intoxication at 0.06 and 0.10% blood alcohol concentration changes segmental body movement coordination.

Alcohol intoxication is the cause of many falls requiring emergency care. The control of upright standing balance is complex and comprises contributions from several partly independent mechanisms like coordination, feedback and feedforward control and adaptation. Analysis of the segmental body movement coordination offers one option to detect the severity of balance problems. The study aims were (1) to investigate whether alcohol intoxication at 0.06 and 0.10% blood alcohol concentration (BAC) affected the segmental movement pattern under unperturbed and perturbed standing; (2) whether alcohol affected the ability for movement pattern adaptation; (3) whether one's own subjective feeling of drunkenness correlated to the movement pattern used. Twenty-five participants (13 women and 12 men, mean age 25.1 years) performed tests involving alcohol intoxication. Body movements were recorded at five locations (ankle, knee, hip, shoulder and head) during quiet standing and pseudorandom pulses of calf muscle vibration for 200 s with eyes closed or open. There was no significant effect of alcohol on the general movement pattern in unperturbed stance or on adaptation. However, when balance was repeatedly perturbed, knee movements became significantly less correlated to other body movements over time at 0.10% BAC and when visual information was unavailable, suggesting that the normal movement pattern could not be maintained for a longer period of time while under 0.10% BAC intoxication. Subjective feelings of drunkenness correlated often with a changed upper body movement pattern but less so with changed knee movements. Thus, an inability to relate drunkenness with changed knee movements may be a contributing factor to falls in addition to the direct effect of alcohol intoxication.

Change of body movement coordination during cervical proprioceptive disturbances with increased age.

BACKGROUND: To date, there are very few studies on postural stability in older adults using body movement recordings to capture the postural movement pattern. Moreover, the importance of proprioception at key areas such as the calf or neck on the postural movement pattern in older adults has rarely been investigated. OBJECTIVE: To investigate whether the body movement coordination strategy to calf or neck vibration was affected by aging. METHODS: Body movement measurements were taken at five locations (ankle, knee, hip, shoulder and head) from 18 younger (mean age 29.1 years) and 16 older (mean age 71.5 years) adult subjects using a 3D movement measuring system while subjected to 50 s of pseudo-random calf or neck vibratory stimulation pulses with eyes open or closed. The positions from the knee, hip, shoulder and head markers were correlated against one another to give an indication of the body coordination. RESULTS: During quiet standing, older adults had greater correlation between the head and trunk than the young. There was an age effect in the body movement coordination strategy. Older adults had a different movement pattern with neck vibration involving mainly more independent knee movements, indicating balance difficulty. CONCLUSIONS: Neck vibration affects the movement pattern in older adults more compared with younger adults and calf vibration, suggesting that, the regulation of body orientation in older adults is more difficult, especially during cervical proprioceptive disturbances.

Vestibular PREHAB and gentamicin before schwannoma surgery may improve long-term postural function.

BACKGROUND: Unilateral vestibular deafferentation (uVD), as performed in vestibular schwannoma surgery, results in a chronic vestibular deficit, though most of the insufficiency can be compensated by other sensory input. By vestibular training (prehabituation) performed before surgery, motor adaptation processes can be instigated before the actual lesion. The adaptation processes of the altered sensory input could be affected if the vestibular ablation and surgery were separated in time, by pretreating patients who have remaining vestibular function with gentamicin. OBJECTIVE: To determine whether presurgical deafferentation would affect postsurgery postural control also in a long-term perspective (6 months). METHOD: 41 patients subjected to trans-labyrinthine schwannoma surgery were divided into four groups depending on the vestibular activity before surgery (with no clinical significant remaining function n = 17; with remaining function n = 8), whether signs of central lesions were present (n = 10), and if patients with remaining vestibular activity were treated with gentamicin with the aim to produce uVD before surgery (n = 6). The vibratory posturography recordings before surgery and at the follow-up 6 months after surgery were compared. RESULTS: The subjects pretreated with gentamicin had significantly less postural sway at the follow-up, both compared with the preoperative recordings and compared with the other groups. CONCLUSION: The results indicate that by both careful sensory training and separating the surgical trauma and the effects of uVD in time, adaptive processes can develop more efficiently to resolve sensory conflicts, resulting in a reduction of symptoms not only directly after surgery but also perhaps up to 6 months afterwards.

Differences between body movement adaptation to calf and neck muscle vibratory proprioceptive stimulation.

Adaptation is essential in maintaining stability during balance-challenging situations. We studied, in standing subjects with eyes open and closed, adaptive responses of the anteroposterior head, shoulder, hip and knee movements; gastrocnemius and tibialis anterior EMG activity and anteroposterior body posture when proprioceptive information from the neck or calf muscles underwent vibratory perturbations. After 30s of quiet stance, vibratory stimuli were applied repeatedly for 200s, and adaption to stimulation was analyzed in four successive 50s periods. Repeated neck and calf vibration significantly increased linear body movement variance at all recorded sites (p<0.001, except neck stimulation with eyes closed, EC-neck), increased tibialis anterior (p<0.001, except EC-neck) and gastrocnemious muscle activity (p<0.001). Most body movement variances and tibialis anterior EMG activity decreased significantly over time (most p-values<0.01 or lower) and overall, the body leaning forward increased from 5.5 degrees to 6.5 degrees (p<0.01). The characteristics of the responses were influenced by vision and site of vibration, e.g., neck vibration affected body posture more rapidly than calf vibration. Our findings support the notion that proprioceptive perturbations have different effects in terms of nature, degree and adaptive response depending on site of vibratory proprioceptive stimulation, a factor that needs consideration in clinical investigations and design of rehabilitation programs.

Adaptation and vision change the relationship between muscle activity of the lower limbs and body movement during human balance perturbations.

OBJECTIVE: Investigate the relationship between changes in lower limb EMG root mean square (RMS) activity and changes in body movement during perturbed standing. Specifically, linear movement variance, torque variance and body posture were correlated against tibialis anterior and gastrocnemius RMS EMG activity during perturbed standing by vibration of the calf muscles. METHODS: Eighteen healthy participants (mean age 29.1 years) stood quietly for 30s before vibration pulses were randomly applied to the calf muscles over a period of 200 s with eyes open or closed. Movement variance, torque variance and RMS EMG activity were separated into five periods, thereby allowing us to explore any time-varying changes of the relationships. RESULTS: Changes of tibialis anterior muscles EMG activity were positively correlated with changes in linear movement variance and torque variance throughout most of the trials, and negatively correlated with some mean angular position changes during the last 2 min of the trials. Moreover, the initial changes in Gastrocnemius EMG activity were associated with initial changes of mean angular position. Additionally, both tibialis anterior and gastrocnemius muscle activities were more involved in the initial control of stability with eyes closed than with eyes open. CONCLUSIONS: Visual information and adaptation change the association between muscle activity and movement when standing is perturbed by calf muscle vibration. SIGNIFICANCE: Access to visual information changes the standing strategy to calf muscle vibrations. Training evoking adaptation could benefit those susceptible to falls by optimising the association between muscle activities and stabilising body movement.

Effects of ageing on adaptation during vibratory stimulation of the calf and neck muscles.

BACKGROUND: The ability to adapt and habituate based on prior experiences is important for human movement control, fall prevention and for the ability to enhance performance during various human activities. However, little is known about the ability for the elderly to adapt to balance perturbations in the lateral direction. OBJECTIVE: To determine whether adaptation, i.e., the ability to adjust postural control to handle balance perturbations better over time, differed in the elderly subjects compared with young subjects in the anteroposterior and lateral directions, and whether the site of the balance perturbation or the presence or absence of vision affected the response. METHODS: Postural stability was measured as anteroposterior and lateral torque variance in a young group (n = 18 (9 female and 9 male), average age = 29.1 years) and an elderly group (n = 16 (5 female and 11 male), average age = 71.5 years) with eyes open and closed during balance perturbations from calf and neck vibrations. After a 30-s period of quiet stance, these vibrations were repeated over a period of 200 s, so the adaptive responses could be analyzed by splitting the data into 50-s periods. RESULTS: The adaptive responses in the anteroposterior and lateral directions were different. Adaptation in the anteroposterior direction occurred to an almost equal extent in the elderly and young, whereas adaptation in the lateral direction was markedly larger in the elderly in all tests except for neck vibration with eyes closed. Age, vision and vibration site were all influential factors for recorded body movements, but no significant combined effects were found. CONCLUSION: Balance perturbation instigates an adaptive response in the elderly in both the anteroposterior and lateral directions. However, during perturbation, age and vision are both very influential factors for the stability, thus associating the previously documented age-related decline in visual functioning with a higher risk of falls in this age range.

The effects of foam surface properties on standing body movement.

CONCLUSION: The properties of a foam surface significantly affect body movement variance. Therefore, studies where different kinds of foam have been used may not provide congruent results. OBJECTIVES: To investigate whether different properties of foam affect body movement variance (32 subjects, mean age 22.5 years) in terms of linear head, shoulder, hip and knee movements. Subjects repeated tests with eyes open and closed, to also determine the effect of vision on the different surfaces. SUBJECTS AND METHODS: Body movement was captured on three different foam surfaces and on a control solid surface over 2 min using a Zebris ultrasound measuring system. The foam surfaces were categorized by their firmness as firm foam, medium foam and soft foam. RESULTS: Body movement variance increased significantly when standing on all foam surfaces compared with the solid surface. However, movement variance was larger when standing on the firm foam compared with the softer foams, except in the anteroposterior total and low frequency ranges. We also found that the body movement pattern differed when standing on foam and firm surfaces, with greater reliance on movements at the knee to give postural stability on foam than on the solid surface. Vision clearly reduced all body movement variances, but particularly within the high frequency range.

The effect of foam surface properties on postural stability assessment while standing.

A common assessment of postural control often involves subjects standing on a compliant surface, such as a foam block, to make balance tests more challenging. However, the physical properties of the foam block used by different researchers can vary considerably. The objective of this study was to provide an initial approach for investigating whether two of the foam properties, i.e. density and elastic modulus, influenced recorded anteroposterior and lateral torque variance with eyes open and eyes closed. Thirty healthy adults (mean age 22.5 years) were assessed with posturography using three different types of foam block placed on a force platform. These blocks were categorised: firm foam, medium foam and soft foam by their elastic modulus. To investigate the spectral characteristics of recorded body movements, variance values were calculated for total movements, movements <0.1Hz and movements >0.1Hz. Results showed that anteroposterior and lateral torque variances >0.1Hz were larger when standing on the firm foam compared with medium and soft foam and in turn were larger on the medium foam compared with the soft foam with eyes closed. Moreover, GLM and correlation analysis demonstrated that the properties of the foam blocks affected anteroposterior torque variance >0.1Hz and lateral torque variance in all frequency ranges. In addition, the stabilising effect of vision in the anteroposterior direction had a greater influence when the subjects' stability was increasingly challenged by the support surface, as illustrated by the higher torque variance values. In conclusion, caution should be taken when analysing balance deficits with foam test setups, because the foam properties may influence the recorded body movements.

Effects of proprioceptive vibratory stimulation on body movement at 24 and 36h of sleep deprivation.

OBJECTIVE: To investigate whether postural stability and adaptation differed after a normal night of sleep, after 24h (24 SDep) and 36h (36 SDep) of sleep deprivation while subjected to repeated balance perturbations. Also, to determine whether there was any correlation between subjective alertness scores and objective posturographic measurements. Lastly, to investigate the effects of vision on the stability during sleep deprivation. METHODS: Body movements at five locations were recorded in 18 subjects (mean age 23.8years) using a 3D movement measurement system while subjected with eyes open and closed to vibratory proprioceptive calf stimulation after a normal night of sleep, 24 and 36 SDep. RESULTS: The clearest sleep deprivation effect was reduced ability to adapt head, shoulder and hip movements, both with eyes open and eyes closed. Additionally, several near falls occurred after being subjected to balance perturbations for 2-3min while sleep deprived. Unexpectedly, postural performance did not continue to deteriorate between 24 and 36h of sleep deprivation, but showed some signs of improvement. Subjective scores of sleepiness correlated poorly with actual changes in postural control performance. CONCLUSIONS: Sleep deprivation might affect postural stability through reduced adaptation ability and lapses in attention. Subjective alertness might not be an accurate indicator of the physiological effects of sleep deprivation. SIGNIFICANCE: Sleep deprivation could increase the risk of accidents in attention demanding tasks. There is a need for objective evaluation methods to determine actual performance capacity during sleep deprivation.

Effects of 24-h and 36-h sleep deprivation on human postural control and adaptation.

This study investigated whether human postural stability and adaptation were affected by sleep deprivation and the relationship between motor performance and subjective scores of sleepiness (visuo-anlogue sleepiness scores, VAS). Postural stability and subjective sleepiness were examined in 18 healthy subjects (mean age 23.8 years) following 24 and 36 h of continued wakefulness, ensured by portable EEG recordings, and compared to a control test where the assessments were made after a normal night of sleep. The responses were assessed using posturography with eyes open and closed, and vibratory proprioceptive stimulations were used to challenge postural control. Postural control was significantly affected after 24 h of sleep deprivation both in anteroposterior and in lateral directions, but less so after 36 h. Subjective VAS scores showed poor correlation with indicators of postural control performance. The clearest evidence that sleep deprivation decreased postural control was the reduction of adaptation. Also several near falls after 2-3 min during the posturographic tests showed that sleep deprivation might affect stability through momentary lapses of attention. Access to vision, somewhat, but not entirely reduced the effect of sleep deprivation. In conclusion, sleep deprivation can be a contributing factor to decreased postural control and falls.

Effects of 24-hour and 36-hour sleep deprivation on smooth pursuit and saccadic eye movements.

Sleep restrictions and sleep deprivation have become common in modern society, as many people report daily sleep below the recommended 8 hours per night. This study aimed to examine the effects of sleep deprivation on oculomotor performance by recording smooth pursuit and saccadic eye movements after 24 and 36 hours of sleep deprivation. Another objective was to determine whether detected changes in oculomotor performance followed fluctuations according to a circadian rhythm and/or subjective Visuo-Analogue sleepiness Scale scores. Oculomotor responses were recorded from 18 subjects using electronystagmography, and comprised measurements of accuracy (i.e., the percentage of time the eye movement velocity was within the target velocity boundaries), velocity and latency. Continuous EEG recordings were used to validate that subjects had remained awake throughout the 36-hour period. Our findings showed that sleep deprivation deteriorated smooth pursuit gain, smooth pursuit accuracy and saccade velocity. Additionally, the ratio between saccade velocity and saccade amplitude was significantly decreased by sleep deprivation. However, as the length of sleep deprivation increased, only smooth pursuit gain deteriorated further, whereas there were signs of improvement in smooth pursuit accuracy measurements. The latter observation suggests that smooth pursuit accuracy might be affected by the circadian rhythm of alertness. Surprisingly, high subjective scores of sleepiness correlated in most cases with better saccade performance, especially after 36 hours of sleep deprivation, suggesting that awareness of sleepiness might make subjects perform better during saccade assessments. To conclude, oculomotor function clearly decreased after sleep deprivation, but the performance deteriorations were complex and not necessarily correlated with subjectively felt sleepiness.

Changes in multi-segmented body movements and EMG activity while standing on firm and foam support surfaces.

Postural control ensures stability during both static posture and locomotion by initiating corrective adjustments in body movement. This is particularly important when the conditions of the support surface change. We investigated the effects of standing on a compliant foam surface using 12 normal subjects (mean age 26 years) in terms of: linear movements at the head, shoulder, hip and knee; EMG activity of the tibialis anterior and gastrocnemius muscles and torques towards the support surface. As subjects repeated the trials with eyes open or closed, we were also able to determine the effects of vision on multi-segmented body movements during standing upon different support surface conditions. As expected, EMG activity, torque variance values and body movements at all measured positions increased significantly when standing on foam compared with the firm surface. Linear knee and hip movements increased more, relative to shoulder and head movements while standing on foam. Vision stabilized the head and shoulder movements more than hip and knee movements while standing on foam support surface. Moreover, vision significantly reduced the tibialis anterior EMG activity and torque variance during the trials involving foam. In conclusion, the foam support surface increased corrective muscle and torque activity, and changed the firm-surface multi-segmented body movement pattern. Vision improved the ability of postural control to handle compliant surface conditions. Several essential features of postural control have been found from recording movements from multiple points on the body, synchronized with recording torque and EMG.

Cervical muscle afferents play a dominant role over vestibular afferents during bilateral vibration of neck muscles.

A previous study showed that vibratory stimulation of neck muscles in humans induced short-latency electromyographic (EMG) activation of lower leg muscles, producing postural reactions at the feet. These findings indicated that cervical proprioception contributes to stabilization of stance through rapidly integrated pathways. However, as vibration may excite both proprioceptive and vestibular afferents, and because of the proximity of neck muscles to the vestibular apparatus, neck muscle vibration could also have activated the vestibular system thereby contributing to the effect observed. To investigate any possible contribution of vestibular stimulation, vibratory stimuli were applied bilaterally and separately to the splenius muscles of the neck and the planum mastoideum overlying the vestibular organs. Ten normal subjects, with eyes closed, were exposed to vibratory stimulation of two different amplitudes and frequencies. Responses were assessed by EMG activity recorded from tibialis anterior and gastrocnemius muscles of both legs and by changes in center of pressure as measured by a force platform. Results indicated that vibration induced reproducible EMG and postural responses in the anteroposterior direction, particularly on cessation of vibration. EMG and postural responses were considerably lower and less consistent with mastoid vibration compared with neck muscles vibration. Previous reports suggest that vibratory stimulation could propagate to the vestibular organs and generate a vestibular-induced postural activation. However, our findings indicate that cervical muscles afferents play a dominant role over vestibular afferents when vibration is directed towards the neck muscles.

Improved postural control through repetition and consolidation.

Research regarding the optimal frequency of training in postural control rehabilitation has been sparse. Posturography with vibratory proprioceptive stimulation was performed with eyes open and closed on 36 healthy subjects divided into 3 groups. Each group was tested 5 times, though with different time-intervals; 20 minutes, 3 hours and 24 hours respectively. Two different adaptive processes seems to be involved in the formation of a new movement pattern when exposed to a postural disturbance, one fast adaptation active during each test occasion and a second adaptation active between the consecutive tests. As the same adaptation pattern was found regardless the repetition time interval, the results imply either that the consolidation process of the new motor memory is time-independent or that the stimulus was sufficiently strong to induce fast consolidation thus leaving the time-interval unimportant. The findings suggest that it is primarily the number of repetitions in the exercises that governs the outcome of training, whereas the time interval between the exercises is of less importance.