Investigation of the phenomenology, physiology and impact of spiritually transformative experiences - kundalini awakening.

There is a paucity of research examining the phenomenology and energetic effects of spiritually transformative experiences with an energetic component, often referred to as kundalini awakenings (KAs). This limits our ability to understand and support individuals who have these often unexpected and powerful experiences. This study aimed to explore not only the nature of these experiences but also their subsequent behavioral and physiological transformative effects. Methods: An interview questionnaire was used to collect detailed descriptions of both the physical and metaphysical experiences of persons having a spiritually transformative experience (STE) (e.g., spontaneous energetic awakenings, awakenings occurring through near-death experiences, and through spiritual practices). Results: Subjects reported that the entire energetic awakening experience was mystical, involving feelings of expansion (including conscious awareness leaving the body), and a sense of being enveloped in light or love. Of 18 descriptors of experiences of energy, 85% of participants reported unusual flows of energy through or around the body. Principle triggers for these experiences included concentrating on spiritual matters, the presence of a spiritually developed person, and intense meditation or prayer. Transformational changes in participants included, e.g., increased sensory sensitivity, creativity, and changes in beliefs, including a desire to serve others, a sense of unity with all, and the immortality of the spirit. Most participants reported a lack of understanding of the STE phenomenon by healthcare professionals, resulting in their inability to address the needs of experiencers when they came to clinicians for help.

The Seated Postural & Reaching Control Test in Cerebral Palsy: A Validation Study.

Aim: Children with moderate-severe cerebral palsy (CP) show postural control deficits that affect their daily activities, like reaching. The Seated Postural and Reaching Control test (SP&R-co) was developed to address the need for clinical measures that objectively identify dimensions of postural imbalance and corresponding reaching limitations in children with CP.Methods: SP&R-co documentation was designed for test validity and rater training. Rater and internal consistency were examined using Cronbach's α. Reference SP&R-co score sheets of children and rater's scores were used for absolute item-by-item, average inter-rater, and intra-rater reliability. Motor classification systems and performance tests were used for construct and concurrent validity.Results: The SP&R-co scoring showed acceptable-good consistency (α = 0.76-0.84). Interrelatedness of SP&R-co items was good-excellent (α = 0.82-0.97). The raters demonstrated fair, good, and excellent item-by-item reliability (ICC = 0.41-0.92). Inter-rater and intra-rater reliability of SP&R-co dimensions were good-excellent (ICC = 0.68-0.86 and ICC = 0.64-0.95, respectively). Construct and concurrent validity showed moderate-excellent correlations (r = 0.49-0.88).Conclusions: Results provide evidence that the SP&R-co is a reliable and valid test for therapists to objectively examine and quantify seated postural and reaching control in children with CP.

Effect of Biomechanical Constraints on Neural Control of Head Stability in Children With Moderate to Severe Cerebral Palsy.

BACKGROUND: External support has been viewed as an important biomechanical constraint for children with deficits in postural control. Nonlinear analysis of head stability may be helpful to confirm benefits of interaction between external trunk support and level of trunk control. OBJECTIVE: The purpose of this study was to compare the effect of biomechanical constraints (trunk support) on neural control of head stability during development of trunk control. DESIGN: This was a quasi-experimental repeated-measures study. METHODS: Data from 15 children (4-16 years of age) with moderate (Gross Motor Function Classification System [GMFCS] IV; n=8 [4 boys, 4 girls]) or severe (GMFCS V; n=7 [4 boys, 3 girls]) cerebral palsy (CP) were compared with previous longitudinal data from infants with typical development (TD) (3-9 months of age). Kinematic data were used to document head sway with external support at 4 levels (axillae, midrib, waist, and hip). Complexity, predictability, and active degrees of freedom for both anterior-posterior and medial-lateral directions were assessed. RESULTS: Irrespective of level of support, CP groups had lower complexity, increased predictability, and greater degrees of freedom. The effect of support differed based on the child's segmental level of control. The GMFCS V and youngest TD groups demonstrated better head control, with increased complexity and decreased predictability, with higher levels of support. The GMFCS IV group had the opposite effect, showing decreased predictability and increased complexity and degrees of freedom with lower levels of support. LIMITATIONS: Infants with typical development and children with CP were compared based on similar segmental levels of trunk control; however, it is acknowledged that the groups differed for age, cognitive level, and motor experience. CONCLUSIONS: The effect of external support varied depending on the child's level of control and diagnostic status. Children with GMFCS V and young infants with TD had better outcomes with external support, but external support was not enough to completely correct for the influence of CP. Children with GMFCS IV performed worse, with increased predictability and decreased complexity, when support was at the axillae or midribs, suggesting that too much support can interfere with postural sway quality.

Vestibular control of standing balance is enhanced with increased cognitive load.

When cognitive load is elevated during a motor task, cortical inhibition and reaction time are increased; yet, standing balance control is often unchanged. This disconnect is likely explained by compensatory mechanisms within the balance system such as increased sensitivity of the vestibulomotor pathway. This study aimed to determine the effects of increased cognitive load on the vestibular control of standing balance. Participants stood blindfolded on a force plate with their head facing left and arms relaxed at their sides for two trials while exposed to continuous electrical vestibular stimulation (EVS). Participants either stood quietly or executed a cognitive task (double-digit arithmetic). Surface electromyography (EMG) and anterior-posterior ground-body forces (APF) were measured in order to evaluate vestibular-evoked balance responses in the frequency (coherence and gain) and time (cumulant density) domains. Total distance traveled for anterior-posterior center of pressure (COP) was assessed as a metric of balance variability. Despite similar distances traveled for COP, EVS-medial gastrocnemius (MG) EMG and EVS-APF coherence and EVS-TA EMG and EVS-MG EMG gain were elevated for multiple frequencies when standing with increased cognitive load. For the time domain, medium-latency peak amplitudes increased by 13-54% for EVS-APF and EVS-EMG relationships with the cognitive task compared to without. Peak short-latency amplitudes were unchanged. These results indicate that reliance on vestibular control of balance is enhanced when cognitive load is elevated. This augmented neural strategy may act to supplement divided cortical processing resources within the balance system and compensate for the acute neuromuscular modifications associated with increased cognitive demand.

Electrocortical Sources Related to Whole-Body Surface Translations during a Single- and Dual-Task Paradigm.

Appropriate reactive motor responses are essential in maintaining upright balance. However, little is known regarding the potential location of cortical sources that are related to the onset of a perturbation during single- and dual-task paradigms. The purpose of this study was to estimate the location of cortical sources in response to a whole-body surface translation and whether diverted attention decreases the N1 event-related potential (ERP) amplitude related to a postural perturbation. This study utilized high-resolution electroencephalography in conjunction with measure projection analysis from ERPs time-locked to backwards surface translation onsets to determine which cortical sources were related to whole-body postural perturbations. Subjects (n = 15) either reacted to whole-body surface translations with (dual task) or without (single task) performing a visual working memory task. For the single task, four domains were identified that were mainly localized within the frontal and parietal lobes and included sources from the prefrontal, premotor, primary and supplementary motor, somatosensory and anterior cingulate cortex. Five domains were estimated for the dual task and also included sources within the frontal and parietal lobes, but the sources also shifted to other locations that included areas within the temporal and occipital lobes. Additionally, mean absolute N1 ERP amplitudes representing the activity from similar locations in both tasks were greater for the single than dual task. The present localization results highlight the importance of frontal, parietal and anterior cingulate cortical areas in reactive postural control and suggest a re-allocation or shift of cortical sources related to reactive balance control in the presence of a secondary task. Thus, this study provides novel insight into the underlying neurophysiology and contribution of cortical sources in relation to the neural control of reactive balance.

Corrigendum: The development of trunk control and its relation to reaching in infancy: a longitudinal study.

[This corrects the article on p. 94 in vol. 9, PMID: 25759646.].

The development of trunk control and its relation to reaching in infancy: a longitudinal study.

The development of reaching is crucially dependent on the progressive control of the trunk, yet their interrelation has not been addressed in detail. Previous studies on seated reaching evaluated infants during fully supported or unsupported conditions; however, trunk control is progressively developed, starting from the cervical/thoracic followed by the lumbar/pelvic regions for the acquisition of independent sitting. Providing external trunk support at different levels to test the effects of controlling the upper and lower regions of the trunk on reaching provides insight into the mechanisms by which trunk control impacts reaching in infants. Ten healthy infants were recruited at 2.5 months of age and tested longitudinally, until 8 months. During the reaching test, infants were placed in an upright seated position and an adjustable support device provided trunk fixation at pelvic and thoracic levels. Kinematic and electromyographic data were collected. Results showed that prior to independent sitting, postural instability was higher when infants were provided with pelvic compared to thoracic support. Associated reaches were more circuitous, less smooth and less efficient. In response to the instability, there was increased postural muscle activity and arm muscle co-activation. Differences between levels of support were not observed once infants acquired independent sitting. These results suggest that trunk control is acquired in a segmental sequence across the development of upright sitting, and it is tightly correlated with reaching performance.

Segmental Contributions to Trunk Control in Children With Moderate-to-Severe Cerebral Palsy.

OBJECTIVE: To examine postural constraints in children with moderate-to-severe cerebral palsy (CP) using a segmental approach. DESIGN: Quasi-experimental repeated-measures study; case series. SETTING: Motor control research laboratory. PARTICIPANTS: Children (N=15; age range, 4-16y) with moderate (Gross Motor Function Classification System [GMFCS] IV; n=8; 4 boys) or severe (GMFCS V) (n=7; 4 boys) CP. INTERVENTIONS: Each child participated in 3 data collection sessions. During each session, we evaluated postural control for sitting using kinematics and clinical assessments. MAIN OUTCOME MEASURES: Kinematic data were used to document head alignment and stabilization with external support at 4 levels (axillae, midrib, waist, hip). Two clinical assessments, the Segmental Assessment of Trunk Control and behavioral assessment for stage of trunk control, were also used to compare results for children with CP to previous longitudinal data from typically developing (TD) infants (3-9mo of age). RESULTS: Children with GMFCS V had difficulty aligning and stabilizing their head along the medial-lateral and anterior-posterior axes. External support improved postural control for children with GMFCS V but not for those classified as GMFCS IV, who had opposite responses to support compared with TD infants. CONCLUSIONS: Children with GMFCS V have limited trunk control but respond to support similarly to young TD infants, suggesting delayed postural control. Response to external support for children with GMFCS IV suggests a unique strategy for trunk control not observed in typical infants. Overall a segmental approach offers new insights into development of trunk control in children with moderate-to-severe CP.

Tai Chi and meditation-plus-exercise benefit neural substrates of executive function: a cross-sectional, controlled study.

BACKGROUND: We report the first controlled study of Tai Chi effects on the P300 event-related potential, a neuroelectric index of human executive function. Tai Chi is a form of exercise and moving meditation. Exercise and meditation have been associated with enhanced executive function. This cross-sectional, controlled study utilized the P300 event-related potential (ERP) to compare executive network neural function between self-selected long-term Tai Chi, meditation, aerobic fitness, and sedentary groups. We hypothesized that because Tai Chi requires moderate aerobic and mental exertion, this group would show similar or better executive neural function compared to meditation and aerobic exercise groups. We predicted all health training groups would outperform sedentary controls. METHODS: Fifty-four volunteers (Tai Chi, n=10; meditation, n=16; aerobic exercise, n=16; sedentary, n=12) were tested with the Rockport 1-mile walk (estimated VO2 Max), a well-validated measure of aerobic capacity, and an ecologically valid visuo-spatial, randomized, alternating runs Task Switch test during dense-array electroencephalographic (EEG) recording. RESULTS: Only Tai Chi and meditation plus exercise groups demonstrated larger P3b ERP switch trial amplitudes compared to sedentary controls. CONCLUSIONS: Our results suggest long-term Tai Chi practice, and meditation plus exercise may benefit the neural substrates of executive function.

Cross-sectional comparison of executive attention function in normally aging long-term T'ai chi, meditation, and aerobic fitness practitioners versus sedentary adults.

This cross-sectional field study documented the effect of long-term t'ai chi, meditation, or aerobic exercise training versus a sedentary lifestyle on executive function. It was predicted that long-term training in t'ai chi and meditation plus exercise would produce greater benefits to executive function than aerobic exercise. T'ai chi and meditation plus exercise include mental and physical training. Fifty-four volunteers were tested: t'ai chi (n=10); meditation+exercise (n=16); aerobic exercisers (n=16); and sedentary controls (n=12). A one-factor (group), one-covariate (age) multivariate analysis of covariance was performed. Significant main effects of group and age were found (group, 67.9%, p<0.001; age, 76.3%, p=0.001). T'ai chi and meditation practitioners but not aerobic exercisers outperformed sedentary controls on percent switch costs (p=0.001 and p=0.006, respectively), suggesting that there may be differential effects of training type on executive function.

Segmental trunk control acquisition and reaching in typically developing infants.

This study explored the influence of an external support at the thoracic and pelvic level of the trunk on the success of reaching, postural stability and reaching kinematics while infants reached for a toy. Seventeen infants (4-6 months) were clustered into two groups according to their trunk control assessed with the Segmental Assessment of Trunk Control. Major differences were seen between groups with pelvic support, whereas with thoracic support, all infants showed similar quality reaching behaviors. With the external pelvic support, infants who had acquired trunk control in the lumbar region were more accurate in their reaching movements (less movement time, improved straightness of reach, less movement units and increased path length per movement unit) and were more stable (decreased trunk and head displacement) during a reach than infants who had only acquired trunk control in the thoracic region. These results support the hypothesis that trunk control influences the quality of reaching behavior.

Ankle dorsiflexor strength relates to the ability to restore balance during a backward support surface translation.

Functional base of support (FBOS), the effective area for center of pressure (COP) movement, decreases with aging, which would reduce one's ability to restore balance during perturbed stance. We investigated the relationship between ankle muscle strength and FBOS as well as the threshold perturbation acceleration that required a heel-rise (HR) or step (STEP) to maintain balance. Standing posture of 16 young and 16 elderly adults was perturbed with a backward support surface translation with the speed ranging from 15 to 70 cm/s. Dorsiflexor (DF) strength was found to significantly correlate with FBOS measures and threshold acceleration for HR. Significant correlations were also found between FBOS measures and threshold accelerations for HR and STEP, except for the backward FBOS and threshold acceleration for STEP. Elderly subjects demonstrated significantly smaller DF strength and FBOS measures than young subjects, but no significant group difference was detected in plantarflexor (PF) strength. Most elderly subjects took a step once they raised their heels, while most young subjects were able to restore balance after heel-rise. These findings, taken together, imply that weakness in ankle dorsiflexors could limit the ability of elderly adults to restore balance while standing on their toes. FBOS measures and ankle dorsiflexor strength could be sensitive measures to detect individuals with declined balance control.

Learning about gravity: segmental assessment of upright control as infants develop independent sitting.

The question of how infants attain upright sitting is at the core of understanding the development of most functional abilities. Our simple, practical method of securing the hips and different trunk segments while evaluating the infant's ability to vertically align and stabilize the trunk in space contributes a useful method and new insights into the development of upright control. Previous studies have considered the trunk to develop as a single segment. The goal of the present study was to examine how postural control changes across multiple trunk segments during typical development (TD) of sitting balance. For this purpose, electromyography (EMG) and kinematic data were collected at four levels of trunk support (axillae, midribs, waist, hips), in a longitudinal study of eight TD infants (3-9 mo of age). We found that developmental changes in stability were specific to the region of the trunk being investigated, changes in antagonistic muscle activity differed for the anterior-posterior versus the medial-lateral axis, and the relationship between muscle activation and movement changed from erratic attempts to gain upright position to anticipatory graded responses as infants developed upright control through a four-stage behavioral process. This information can be used by researchers to further refine hypotheses regarding this developmental process and by clinicians who wish to develop and test more specific treatment programs for children with postural dysfunction.

Why does older adults' balance become less stable when walking and performing a secondary task? Examination of attentional switching abilities.

Previous research using dual-task paradigms indicates balance-impaired older adults (BIOAs) are less able to flexibly shift attentional focus between a cognitive and motor task than healthy older adults (HOA). Shifting attention is a component of executive function. Task switch tests assess executive attention function. This multivariate study asked if BIOAs demonstrate greater task switching deficits than HOAs. A group of 39 HOA (65-80 years) and BIOA (65-87 years) subjects performed a visuo-spatial task switch. A sub-group of subjects performed a dual-task obstacle avoidance paradigm. All participants completed the Berg Balance Scale (BBS) and Timed Up and Go (TUG). We assessed differences by group for: (1) visuo-spatial task switch reaction times (switch/no-switch), and performance on the BBS and TUG. Our balance groups differed significantly on BBS score (p<.001) and switch reaction time (p=.032), but not the TUG. This confirmed our hypothesis that neuromuscular and executive attention function differs between these two groups. For our BIOA sub-group, gait velocity correlated negatively with performance on the switch condition (p=.036). This suggests that BIOA efficiency of attentional allocation in dual task settings should be further explored.

Development of postural control during gait in typically developing children: the effects of dual-task conditions.

The purpose of this study was to investigate the typical development of postural control in younger (5-6 yrs) and older (7-16 yrs) children (YTD and OTD) during two gait tasks, including level walking and obstacle-crossing, using a dual-task paradigm, and to compare the results of the children's performance with that of healthy young adults (HYA). Our findings revealed that gait control in typical children requires attentional resources to maintain stability. Moreover, dual-task interference was less in HYA compared to YTD and OTD. Gait performance decrements in the dual-task context were greater in YTD compared to OTD, whereas cognitive performance decrements in YTD and OTD were similar. In addition, dual-tasking affected cognitive performance more in YTD when gait task difficulty was increased. Results suggest a developmental trend in attentional resources used to control gait in typical children. Postural control during gait under dual-task conditions was improved when children were more mature, as attentional resources increased with age.

Community walking in people with Parkinson's disease.

People with Parkinson's disease often have walking difficulty, and this is likely to be exacerbated while walking in places in the community, where people are likely to face greater and more varied challenges. This study aims to understand the facilitators and the barriers to walking in the community perceived by people with Parkinson's disease. This qualitative study involved 5 focus groups (n = 34) of people with Parkinson's disease and their partners residing in metropolitan and rural regions in Queensland, Australia. Results found that people with PD reported to use internal personal strategies as facilitators to community walking, but identified primarily external factors, particularly the environmental factors as barriers. The adoption of strategies or the use of facilitators allows people with Parkinson's disease to cope so that participants often did not report disability.

Single and dual task gait training in people with Parkinson's disease: a protocol for a randomised controlled trial.

BACKGROUND: Difficulty performing more than one task at a time (dual tasking) is a common and disabling problem experienced by people with Parkinson disease (PD). If asked to perform another task when walking, people with PD often take shorter steps or walk more slowly. Currently there is uncertainty about whether clinicians should teach people with PD to avoid dual tasking or whether they should encourage them to practice dual tasking with the hope that practice will lead to enhanced performance. This study will address this issue by comparing single to dual task gait training. METHODS AND DESIGN: A prospective randomised clinical trial is being conducted. Sixty participants with idiopathic PD will be recruited, provided they score I-IV on the modified Hoehn and Yahr (1967) scale, and fulfil other inclusion criteria. Participants will be randomly allocated to either a single or dual task gait training group. Both groups will receive 12 hours of walking training over 4 weeks. The single task group will undertake gait training with cueing strategies to increase step length. The dual task group will train to improve step length when walking and performing a variety of added tasks. Both groups will receive a tailored home program for 6 months. Blinded assessors will conduct four assessments: two baseline assessments, one post intervention and one at 6 months follow-up. The primary outcome measure will be step length when dual tasking over 8 m. Secondary outcome measures include: spatiotemporal gait parameters when walking under single and dual task conditions, measures of executive function, the timed up and go test, measures of community mobility, and quality of life. All analyses will be based on intention to treat principle. DISCUSSION: This trial will examine the immediate and longer term effect of dual task walking training as compared to single task training in people with idiopathic PD, at the impairment, activity, and participation levels. It has the potential to identify a new intervention that may improve and maintain walking beyond the laboratory. The results of this trial will provide guidance for clinicians in the development of walking training programs for people with PD. TRIAL REGISTRATION: ACTRN12609000791235.

Neuromuscular responses to platform perturbations in power- versus endurance-trained athletes.

The purpose was to assess differences in postural response characteristics between two groups of elite athletes having power or endurance training. Participants were all men and included power- (M age = 21 yr., SD = 3, n = 12) and endurance-trained (M age = 22, SD = 3, n = 12) athletes. Muscle response characteristics and center of pressure measures were recorded during recovery from Fast (10 cm at 80 cm/sec.) and Slow (10 cm at 20 cm/sec.) horizontal platform perturbations. In response to Fast perturbations, power-trained athletes responded with significantly shorter times to stabilize the center of pressure, shorter muscle-contraction onset times, and larger muscle response amplitudes than endurance-trained athletes. This suggests power-trained athletes are more effective than endurance-trained athletes in responding to balance threats such as slips and trips in daily life and that power training should be studied to improve balance control of balance-impaired populations.

Refinement, reliability, and validity of the segmental assessment of trunk control.

PURPOSE: The Segmental Assessment of Trunk Control (SATCo) provides a systematic method of assessing discrete levels of trunk control in children with motor disabilities. This study refined the assessment method and examined reliability and validity of the SATCo. METHODS: After refining guidelines, 102 video recordings of the SATCo were made of 8 infants with typical development followed longitudinally from 3 to 9 months of age and 24 children with neuromotor disability with a mean age of 10 years 4 months. Eight researchers independently scored recordings. RESULTS: Intraclass correlation coefficient values for interrater reliability were more than 0.84 and 0.98 across all data sets and all aspects of control. Tests of concurrent validity with the Alberta Infant Motor Scales resulted in coefficients ranging from 0.86 to 0.88. CONCLUSION: The SATCo is a reliable and valid measure allowing clinicians greater specificity in assessing trunk control.

Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial.

OBJECTIVE: To compare the effect of 3 different approaches to balance training on dual-task balance performance in older adults with balance impairment. DESIGN: A double-blind, randomized controlled trial. SETTING: University research laboratory. PARTICIPANTS: Older adults (N=23) with balance impairment (mean age, 74.8y). They scored 52 or less on the Berg Balance Scale (BBS) and/or walked with a self-selected gait speed of 1.1m/s or less. INTERVENTIONS: Participants were randomly assigned to 1 of 3 interventions: single-task training, dual-task training with fixed-priority instructions, and dual-task training with variable-priority instructions. Participants received 45-minute individualized training sessions, 3 times a week for 4 weeks. MAIN OUTCOME MEASURES: Gait speed under single-task and dual-task conditions was obtained at baseline, the second week, the end of training, and the twelfth week after the end of training. Other measures, including the BBS and the Activities-specific Balance Confidence (ABC) Scale, were collected at baseline and after training. RESULTS: Participants in all groups improved on the BBS (P<.001; effect size [ES]=.72), and walked significantly faster after training (P=.02; ES=.27). When a cognitive task was added, however, only participants who received dual-task training with fixed-priority instructions and dual-task training with variable-priority instructions exhibited significant improvements in gait speed (P<.001, ES=.57; and P<.001, ES=.46, respectively). In addition, only the dual-task training with variable-priority instructions group demonstrated a dual-task training effect at the second week of training and maintained the training effect at the 12-week follow-up. Only the single-task training group showed a significant increase on the ABC after training (P<.001; ES=.61). CONCLUSIONS: Dual-task training is effective in improving gait speed under dual-task conditions in elderly participants with balance impairment. Training balance under single-task conditions may not generalize to balance control during dual-task contexts. Explicit instruction regarding attentional focus is an important factor contributing to the rate of learning and the retention of the dual-task training effect.