Human standing: does the control strategy preprogram a rigid knee?

Abstract

Human standing requires control of multisegmental configuration. Does the postural system normally allow flexible adjustment of configuration, or does it minimize degrees of freedom at the ankle, knee, and hip joints? Gentle, external, unpredictable, sagittal, mechanical perturbations (randomized force, 1-10 N; duration, 0.2-2 s; and leg) were applied to either knee of 24 healthy participants who stood symmetrically for 200 s. The translation of knee perturbation force to ankle, knee, and hip joint rotations in the perturbed and unperturbed legs was studied. We assessed whether consequent joint rotations indicated a stiff configuration-conserving or viscous energy-absorbing relationship to the knee perturbation. Two distinctive response patterns were observed. Twenty-two participants showed limited knee flexion and high ankle stiffness, whereas two participants showed substantial knee flexion, low ankle stiffness, measurable internal rotation of the unperturbed hip (0.4 ± 0.3 vs. 3.0 ± 1°, 5.7 ± 17 vs. 0.5 ± 0.3 N/°, 1.1 ± 0.4°, respectively; mean ± SD), and a viscous relationship between perturbation force and subsequent ankle flexion, knee flexion, and perturbed and unperturbed hip internal rotation. The size of knee-flexion response to knee perturbations was uncorrelated with the extent of unperturbed standing sway. Normal standing conceals a large interindividual range in leg control strategies, indicating adaptive potential to progress with development and skill acquisition and decline with age, disease, injury, and fear. Commonly, leg configuration was maintained stiffly. Less commonly, a bilateral, low-stiffness, energy-absorbing strategy utilizing the available degrees of freedom was shown. We propose that identification of individual coordination strategy has diagnostic and prognostic potential in relation to perceptual-posture-movement-fall interactions.