Categorizing and comparing psychophysical detection strategies based on biomechanical responses to short postural perturbations.

BACKGROUND: A fundamental unsolved problem in psychophysical detection experiments is in discriminating guesses from the correct responses. This paper proposes a coherent solution to this problem by presenting a novel classification method that compares biomechanical and psychological responses. METHODS: Subjects (13) stood on a platform that was translated anteriorly 16 mm to find psychophysical detection thresholds through a Adaptive 2-Alternative-Forced-Choice (2AFC) task repeated over 30 separate sequential trials. Anterior-posterior center-of-pressure (APCoP) changes (i.e., the biomechanical response R(B)) were analyzed to determine whether sufficient biomechanical information was available to support a subject's psychophysical selection (R(Ψ)) of interval 1 or 2 as the stimulus interval. A time-series-bitmap approach was used to identify anomalies in interval 1 (a1) and interval 2 (a2) that were present in the resultant APCoP signal. If a1 > a2 then R(B) = Interval 1. If a1 < a2, then R(B)= Interval 2. If a2-a1 < 0.1, R(B) was set to 0 (no significant difference present in the anomaly scores of interval 1 and 2). RESULTS: By considering both biomechanical (R(B)) and psychophysical (R(Ψ)) responses, each trial run could be classified as a: 1) HIT (and True Negative), if R(B) and R(Ψ) both matched the stimulus interval (SI); 2) MISS, if R(B) matched SI but the subject's reported response did not; 3) PSUEDO HIT, if the subject signalled the correct SI, but R(B) was linked to the non-SI; 4) FALSE POSITIVE, if R(B) = R(Ψ), and both associated to non-SI; and 5) GUESS, if R(B) = 0, if insufficient APCoP differences existed to distinguish SI. Ensemble averaging the data for each of the above categories amplified the anomalous behavior of the APCoP response. CONCLUSIONS: The major contributions of this novel classification scheme were to define and verify by logistic models a 'GUESS' category in these psychophysical threshold detection experiments, and to add an additional descriptor, "PSEUDO HIT". This improved classification methodology potentially could be applied to psychophysical detection experiments of other sensory modalities.

The effects of diabetes and/or peripheral neuropathy in detecting short postural perturbations in mature adults.

BACKGROUND: This study explored the effects of diabetes mellitus (DM) and peripheral neuropathy (PN) on the ability to detect near-threshold postural perturbations. METHODS: 83 subjects participated; 32 with type II DM (25 with PN and 7 without PN), 19 with PN without DM, and 32 without DM or PN. Peak acceleration thresholds for detecting anterior platform translations of 1 mm, 4 mm, and 16 mm displacements were determined. A 2(DM) × 2(PN) factorial MANCOVA with weight as a covariate was calculated to compare acceleration detection thresholds among subjects who had DM or did not and who had PN or did not. RESULTS: There was a main effect for DM but not for PN. Post hoc analysis revealed that subjects with DM required higher accelerations to detect a 1 mm and 4 mm displacement. CONCLUSION: Our findings suggest that PN may not be the only cause of impaired balance in people with DM. Clinicians should be aware that diabetes itself might negatively impact the postural control system.

Emergence of Lissajous Patterns as a Function of a Perturbation Frequency in Postural Responses to the Short Sinusoidal Translations of Varying Frequencies.

The existence of in-phase and anti-phase postural responses to sinusoidal perturbations to the base of support is well known. In this study, we investigate if such coordinated postural responses exist at 'near-sway' perturbations where the perturbation amplitudes are kept within the range of normal sway lengths in healthy adults (n=10). The postural responses are analyzed via bursts of anterior-posterior (AP) 2.5 mm horizontal sinusoidal oscillations of the base of support at sequentially varying frequencies (0.25, 0.375, 0.5, 0.625, 0.75, 1 and 1.25 Hz). The parametric plots of the perturbation signal (platform position) and the response profiles (AP Center of Pressure [APCoP]) show the emergence of elliptical Lissajous patterns as the perturbation frequency is increased from 0.25 Hz to 1.25 Hz. The presence of such characteristic pattern shows the 'lock-in' behavior of APCoP with perturbation signal. These elliptical patterns become more apparent at the center frequencies (0.375 to 0.75 Hz). At the higher frequencies (1 and 1.25 Hz), the Lissajous patterns do exist but are dominated by low-frequency drift. The area and orientation of Lissajous patterns and the phase shifts between perturbation and APCoP show a strong nonlinear decreasing trend with increasing perturbation frequency for both, young (n=5) as well as mature (n=5) adults within the study group. This may suggest that such characteristic, frequency-locked, phased shifted response of healthy posture control could be a fundamental property of a healthy posture control's response to 'near-sway' sinusoidal translations in AP direction.

Effect of lateral perturbations on psychophysical acceleration detection thresholds.

BACKGROUND: In understanding how the human body perceives and responds to small slip-like motions, information on how one senses the slip is essential. The effect of aging and plantar sensory loss on detection of a slip can also be studied. Using psychophysical procedures, acceleration detection thresholds of small lateral whole-body perturbations were measured for healthy young adults (HYA), healthy older adults (HOA) and older adults with diabetic neuropathy (DOA). It was hypothesized that young adults would require smaller accelerations than HOA's and DOA's to detect perturbations at a given displacement. METHODS: Acceleration detection thresholds to whole-body lateral perturbations of 1, 2, 4, 8, and 16 mm were measured for HYAs, HOAs, and DOAs using psychophysical procedures including a two-alternative forced choice protocol. Based on the subject's detection of the previous trial, the acceleration magnitude of the subsequent trial was increased or decreased according to the parameter estimation by sequential testing methodology. This stair-stepping procedure allowed acceleration thresholds to be measured for each displacement. RESULTS: Results indicate that for lateral displacements of 1 and 2 mm, HOAs and DOAs have significantly higher acceleration detection thresholds than young adults. At displacements of 8 and 16 mm, no differences in threshold were found among groups or between the two perturbation distances. The relationship between the acceleration threshold and perturbation displacement is of particular interest. Peak acceleration thresholds of approximately 10 mm/s(2) were found at displacements of 2, 4, 8, and 16 mm for HYAs; at displacements of 4, 8, and 16 mm for HOAs; and at displacements of 8 and 16 mm for DOAs. Thus, 2, 4, and 8 mm appear to be critical breakpoints for HYAs, HOAs, and DOAs respectively, where the psychometric curve deviated from a negative power law relationship. These critical breakpoints likely indicate a change in the physiology of the system as it responds to the stimuli. CONCLUSION: As a function of age, the displacement at which the group deviates from a negative power law relationship increases from 2 mm to 4 mm. Additionally, the displacement at which subjects with peripheral sensory deficits deviate from the negative power law relations increases to 8 mm. These increases as a function of age and peripheral sensory loss may help explain the mechanism of falls in the elderly and diabetic populations.

Effects of diabetic neuropathy on body sway and slip perturbation detection in older population.

Postural control is a common mechanism to compensate for unexpected displacements of the body. In the older population, a slip or fall due to a failure of postural control is a common cause of morbidity and mortality. The ability of postural control decreases with aging or neuropathy. In this study, 2 groups, diabetics and non-diabetics in the older population, were compared to determine how patterns of postural sway during quiet standing were related to the detection of perturbation. The SLIP-FALLS system was applied to the measurement of sway and detection of perturbation. In phase 1 of the development of the predictive model, neural network algorithms were applied to find determinant variables for perturbation detection. In phase 2, a fuzzy logic inference system was developed to investigate the relationship between sway and perturbation detection. Results of this study may be applied to the design of floor mats or shoe insoles for preventing fatigue in workplaces.

Using multiple placements of accelerometers to measure cardiovascular pulse transit times.

To measure pulse transit times (PTT) and calculate pulse wave velocities (PWV), tri-axial and uniaxial accelerometers were placed in groups of 2 to 4 over the manubrium, xiphoid process, forehead, wrist and ankle, and/or over the carotid, femoral, and posterior auricular arteries in 11 consented supine subjects. Signals were sampled at 1 kHz and filtered. Radial vectors were calculated from the tri-axial measurements. A 3-lead ECG was simultaneously collected over the same 180 s window, as well as respiratory rate. Ensemble averages (with ±S.D.) and raster plots were generated for each filtered time series from 200 ms before to 800 ms after the peak of each ECG R-wave. Lag times between the R-wave peak (taken as t=0) and one or more prominent peaks (or valleys if appropriate) of the various accelerometer signals were calculated, by using the signal from the axis (or the radial vector) with the best signal to noise ratio. PWV was calculated from the regression of the distance measured versus the PTT between pairs, especially of the clinically-relevant carotid-femoral PTT. A spectral analysis of each ensemble was taken, with the hypothesis that in young adults the measures at the periphery would have less energy at higher frequencies than those of an older adult because of age-related changes in arterial distensibility.

A comparative study of reaction times between type II diabetics and non-diabetics.

BACKGROUND: Aging has been shown to slow reflexes and increase reaction time to varied stimuli. However, the effect of Type II diabetes on these same reaction times has not been reported. Diabetes affects peripheral nerves in the somatosensory and auditory system, slows psychomotor responses, and has cognitive effects on those individuals without proper metabolic control, all of which may affect reaction times. The additional slowing of reaction times may affect every-day tasks such as balance, increasing the probability of a slip or fall. METHODS: Reaction times to a plantar touch, a pure tone auditory stimulus, and rightward whole-body lateral movement of 4 mm at 100 mm/s2 on a platform upon which a subject stood, were measured in 37 adults over 50 yrs old. Thirteen (mean age = 60.6 +/- 6.5 years) had a clinical diagnosis of type II diabetes and 24 (mean age = 59.4 +/- 8.0 years) did not. Group averages were compared to averages obtained from nine healthy younger adult group (mean age = 22.7 +/- 1.2 years). RESULTS: Average reaction times for plantar touch were significantly longer in diabetic adults than the other two groups, while auditory reaction times were not significantly different among groups. Whole body reaction times were significantly different among all three groups with diabetic adults having the longest reaction times, followed by age-matched adults, and then younger adults. CONCLUSION: Whole body reaction time has been shown to be a sensitive indicator of differences between young adults, healthy mature adults, and mature diabetic adults. Additionally, the increased reaction time seen in this modality for subjects with diabetes may be one cause of increased slips and falls in this group.

Treatment of Spasticity in Spinal Cord Injury with Dronabinol, a Tetrahydrocannabinol Derivative.

Spinal-cord-injured patients and the medical literature have increasingly reported anecdotes regarding tetrahydrocannabinol (THC)-induced spasmolysis. These reports motivated this trial of dronabinol, a THC derivative, for the treatment of spasticity in the spinal-cord-injured population. Five made quadriplegic patients were given oral dronabinol in escalating doses from 5 mg BID to 20 mg TID in addition to their current, but ineffective, spasmolytic regime. The pendulum drop test was used to quantify spasticity (stiffness) in the knees. The Weschler Memory Scale (WMS), Profile of Mood States (POMS), and personal interviews were administered by the clinical psychologist to evaluate any changes in the subjects' cognition and/or emotional states. Spasticity was markedly improved in two of the five subjects, unchanged in a third, fluctuated in a fourth and made progressively worse in a fifth. The WMS revealed improvement in memory skills of two subjects and no change in the other. Psychological interviews and the POMS indicated decreased vigor in all subject, but otherwise demonstrated highly individualized emotional changes as indicated by increases and/or decreases in the dysphoric mood scales.

Using fuzzy logic in psychophysical experiments to separate hits, false positives and guesses in posturally perturbed standing subjects.

In a 2-Alternative Forced Choice Interval task (2AFCi), a standing subject is required to press a button once or twice to signal in which of two 4 s sequential intervals that (s)he thought that a short ≤ 16 mm postural perturbation had occurred. The perturbation might or might not result in transient changes of the subject's Anterior-Posterior Center of Pressure (APCOP) or in other measures. This paper used fuzzy inference to explore whether the correctness of a subject's stimulus detection can be gleaned from analyzing changes in one of more metrics related to changes in the APCOP. Also, distinguishing guesses from correct responses is a critical issue in any psychophysical detection paradigm. Biomechanical and psychophysical data are used to design a prediction model based on fuzzy inference that is able to discriminate correct responses from guesses.

Dependence of elbow joint stiffness measurements on speed, angle, and muscle contraction level.

Elbow joint stiffness is critical to positioning the hand. Abnormal elbow joint stiffness may affect a person's ability to participate in activities of daily living. In this work, elbow joint stiffness was measured in ten healthy young adults with a device adapted from one previously used to measure stiffness in other joints. Measurements of elbow stiffness involved applying a constant-velocity rotational movement to the elbow and measuring the resultant displacement, torque, and acceleration. Elbow stiffness was then computed using a previously-established model for joint stiffness. Measurements were made at two unique elbow joint angles, two speeds, and two forearm muscle contraction levels. The results indicate that the elbow joint stiffness is significantly affected by both rotational speed and forearm muscle contraction level.

Psychophysical detection thresholds in anterior horizontal translations of seated and standing blindfolded subjects.

To help separate out the contributions of the somatosensory and vestibular systems to postural and sway control, short (1, 4 and 16 mm) anterior translations of lengths less than the normal sway path length were made of a platform upon which blindfolded young adult test subjects (n=12) stood or sat. Acceleration detection thresholds from these short moves were compared in standing vs seated conditions using a 2-Alternative [Interval] Forced-Choice psychophysical test protocol. A negative power law trading relationship was found between peak acceleration threshold and move length and duration for standing subjects. For these same subjects while seated, acceleration thresholds for all lengths were nearly constant, and showed a weak positive power law trade between threshold and move length or duration. This latter observation is consistent with that of Benson et al '86, who also observed a positive power law trade relationship between acceleration threshold and move duration for seated subjects. Thresholds were higher at 1mm for standing vs. seated tests; while at 16 mm, standing tests had lower thresholds compared to those obtained for the seated tests. These results suggest that the vestibular system provides the principal input for detecting these short translations while seated, but not while standing.

A phase-locked loop model of the response of the postural control system to periodic platform motion.

A phase-locked loop (PLL) model of the response of the postural control system to periodic platform motion is proposed. The PLL model is based on the hypothesis that quiet standing (QS) postural sway can be characterized as a weak sinusoidal oscillation corrupted with noise. Because the signal to noise ratio is quite low, the characteristics of the QS oscillator are not measured directly from the QS sway, instead they are inferred from the response of the oscillator to periodic motion of the platform. When a sinusoidal stimulus is applied, the QS oscillator changes speed as needed until its frequency matches that of the platform, thus achieving phase lock in a manner consistent with a PLL control mechanism. The PLL model is highly effective in representing the frequency, amplitude, and phase shift of the sinusoidal component of the phase-locked response over a range of platform frequencies and amplitudes. Qualitative analysis of the PLL control mechanism indicates that there is a finite range of frequencies over which phase lock is possible, and that the size of this capture range decreases with decreasing platform amplitude. The PLL model was tested experimentally using nine healthy subjects and the results reveal good agreement with a mean phase shift error of 13.7 degrees and a mean amplitude error of 0.8 mm.

A quiet standing index for testing the postural sway of healthy and diabetic adults across a range of ages.

A quiet standing index is developed for tracking the postural sway of healthy and diabetic adults over a range of ages. Several postural sway features are combined into a single composite feature C that increases with age a. Sway features are ranked based on the r(2)-values of their linear regression models, and the composite feature is a weighted sum of selected sway features with optimal weighting coefficients determined using principal component analysis. A performance index based on both reliability and sensitivity is used to determine the optimal number of features. The features used to form C include power and distance metrics. The quiet standing index is a scalar that compares the composite feature C to a linear regression model f(a) using C(')(a) = C/f(a). For a motionless subject, C(') = 0, and when the composite feature exactly matches the healthy control (HC) model, C(') = 1. Values of C(') >> 1 represent excessive postural sway and may indicate impaired postural control. Diabetic neurologically intact subjects, nondiabetic peripheral neuropathy subjects (PN), and diabetic PN subjects (DPN) were evaluated. The quiet standing indexes of the PN and DPN groups showed statistically significant increases over the HC group. Changes in the quiet standing index over time may be useful in identifying people with impaired balance who may be at an increased risk of falling.

Assessing the psychophysics of posture control and its physiological correlates.

Graphical visualization methods are described that enable psychophysical detection data to be quantitatively correlated with underlying physiological data in postural control studies. Stitched, raster and ensemble averaged time-series plots are graphical tools that can guide later quantitative analysis. The examples presented point out the role that early Tibialis Anterior and later Gastrocnemius EMG activation might play in the 2-Alternative Forced Choice psychophysical detection of 16 mm horizontal anterior perturbations of a sliding platform on which a subject stands, and their linkage to AP and ML Center of Pressure changes brought about by a perturbation. These methods also give a preliminary indication that differing or no response patterns were seen at 4 and 1 mm.

Design and characterization of a nano-encapsulated self-referenced fluorescent nitric oxide sensor for wide-field optical imaging.

A nano-encapsulated fluorescence dye DAF-2 sensor that is specifically sensitive to nitric oxide (NO) was fabricated by using an electrostatic layer-by-layer (LbL) self-assembly technique. Fluorescence calibrations of the NO sensor were collected by a wide-field optical imaging system and a fluorescence spectrometer using NO standards generated by the self decomposition of S-nitrosol-acetyl-penicillamine (SNAP). The NO sensor consists of two fluorescence dyes, indicator DAF-2 and a reference R-PE. The two dyes share the same excitation, and have different emission wavelengths. The calibration results show that the indicator fluorescence intensity increases with NO standard solution additions, while the reference fluorescence intensity does not. The encapsulation reduced the NO sensor detection limit, but it is still within physiological level of NO. This sensor design can also achieve ratiometric self referencing with very little leaching effect.

Amplitude demodulation of entrained sway to analyze human postural control.

This paper presents an innovative technique to study postural control. Our translating platform, the Sliding Linear Investigative Platform For Analyzing Lower Limb Stability and Simultaneous Tracking, EMG and Pressure mapping (SLIP-FALLS-STEPm), makes precise, vibration movements under controlled conditions. We look at the psychophysical thresholds to the perception of a sinusoidally induced sway. In the Sine Lock experiments described, an induced sinusoidal perturbation locks the subject's natural sway pattern at the frequency of the perturbation. The input / output system is treated as an Amplitude Shift Key (ASK) modulated signal modulating a carrier frequency (at or about a subject's natural sway frequency). The Position signal (input) and the Anterior-Posterior Center of Pressure (APCOP) signal (output) or the ankle angle are demodulated by mixing them with the pure sine wave carrier at the frequency of underlying oscillation and then low-pass filtering it to detect the amplitude envelope. These detected envelopes elucidate that the square pulse increase in the position sine wave amplitude yields a triangular increase in APCOP demodulated signal.

A biomechanical model of human ankle angle changes arising from short peri-threshold anterior translations of platform on which a subject stands.

This study modeled ankle angle changes during small forward perturbations of a standing platform. A two-dimensional biomechanical inverted pendulum model was developed that uses sway frequencies derived from quiet standing observations on a subject's Anterior Posterior Center of Pressure (APCoP) to track ankle angle changes during a 16 mm anterior displacement perturbation of a platform on which a subject stood. This model used the total torque generated at the ankle joint as one of the inputs, and calculated it assuming a PID controller. This feedback system generated a simulated ankle torque based on the angular position of the center of mass (CoM) with respect to vertical line passing through the ankle joint. This study also assumed that the internal components of the net torque were only a controller torque and a sway-pattern-generating torque. The final inputs to the model were the platform acceleration and anthropometric terms. This model of postural sway dynamics predicted sway angle and the trajectory of the center of mass. Knowing these relationships can advance an understanding of the ankle strategy employed in balance control.

A system for measurement and calibration of nonorthogonal joints and limbs in humans.

Human limbs are a multilinked system in which the revolute joints are not orthogonal to the limb segments or to each other. The standard method for movements of multilinked systems is the Denavit-Hartenberg (DH) representation, which is useful for orthogonal systems. When applied to non-orthogonal systems, the DH representation projects the reference frames outside of the limb segments. Computer graphics techniques move arrays of points in bodies that move about arbitrary revolute joints. This computational model has been modified to calculate both position (X, Y, Z) and orientation (yaw, pitch, and roll) of limbs and their individual segments. This method allows a simplified representation for the kinematics of animal limbs.

Postural control and detection of slip/fall initiation in the elderly population.

One of the common causes of morbidity and mortality in workplaces is related to slips or falls. Reaction to external disturbances, such as slips or falls, requires a process of perturbation detection and control of motion changes. Postural control is a common mechanism to compensate unexpected displacements of the body. The ability of postural control diminishes with ageing or neuropathy. In this study, two controlled groups, diabetics and non-diabetics in the elderly population, were investigated to compare how different postural control mechanisms would relate to the detection of perturbation and regain of balance. The ultra-low-vibration Sliding Linear Investigative Platform for Analyzing Lower Limb Stability SYSTEM was used to measure the biomechanical changes of posture and perturbation detection. In phase 1 of the analysis, static measures during quiet standing were considered to investigate the relationship between postural stability and perturbation detection capability. In phase 2 of the analysis, dynamic measures during an occurrence of perturbation were analysed. Statistical tests and linear logistic regression models were applied to find differences of postural control mechanisms and to build a predictive model for perturbation detection quantitatively. It is anticipated that the results of this study will contribute to more comprehensive understanding of postural control mechanisms and design of slip/fall prevention programmes.

Analyses of rotational singularities in ferret visual cortex.

Activity maps of spatial orientation, obtained by intrinsic optical imaging of the mammalian visual cortex, show the formation of pinwheel-like structures that rotate either clockwise or counterclockwise around zero dimensional points called singularities. Any research that is oriented towards exploring the formation and physiological role of these singularities during an experiment requires an automated tool that can rapidly identify the location of these singularities. In this work we have developed such a tool that looks for the existence of singularities for a certain radius at every pixel location in the angle map. Using data from eleven ferrets, the number of singularities identified was a function of the search radius (0.03325, 0.04665, 0.05985, 0.07315, 0.08645, 0.09975, 0.11305, and 0.12635 mm) and level of image smoothing used. For a given smoothing value, the number of singularities decreased with increasing radius. But the rate of decrease was greater with less smoothing. The more the original image was smoothed, the fewer singularities were identified at a given radius. The trade off between search radius and image smoothing can be partially attributed to spatial sampling resolution.