Changes In Anticipatory Postural Adjustments Research Articles

Relationship between improvements in motor performance and changes in anticipatory postural adjustments during whole-body reaching training

Anticipatory postural adjustments (APAs) provide postural stability and play an important role in ensuring appropriate motor performance. APAs also change in various situations. However, it is unknown whether changes in APAs during repetitive movement training contribute to improvement in motor performance. This study aimed to investigate the relationship between improvement in motor performance and changes in APAs during repeated reaching training, as well as the learning effects on APA changes. Sixteen healthy subjects (23±2years of age) stood barefoot on a force platform and reached as quickly and accurately as possible to a target placed at their maximum reach distance immediately following a beep signal in a reaction time condition. Whole-body reaching training with the right arm was repeated 100 times for three consecutive days. Motor performance and APAs were evaluated on the first day, after discontinuation of training for one day, and again at three months. In addition, reaching with the left arm (untrained limb) was tested on the first and the fifth training day. Body position segments were measured using three-dimensional motion analysis. Surface electromyography of eight postural muscles in both lower limbs was recorded. Kinetics data were recorded using the force platform. Whole-body reaching training induced not only improvements in motor performance (e.g., increased peak hand velocity), but also changes in APAs (e.g., earlier APA onset and increased amplitude). These changes were strongly correlated with and occurred earlier than improvements in motor performance. The learning effects on APAs were retained after the discontinuation of training and were generalized to the untrained limb. These results suggest that change in APAs contributes to improvement in motor performance; that is, the central nervous system may be able to adapt APAs for improvement in motor performance.

Effect of dual tasking on postural responses to rapid lower limb movement while seated on an exercise ball

Postural adjustments are used by the central nervous system to pre-empt and correct perturbations in balance during voluntary body movements. Alteration in these responses is associated with a number of neuromuscular/musculoskeletal conditions. Attention has been identified as important in this system; performing a concurrent cognitive task has been suggested to reduce the efficacy of this postural control. The aim of this study was to examine the effect of concurrent cognitive tasking on anticipatory postural adjustments while sitting on an exercise ball with a view to help inform future rehabilitation programmes.Bilateral EMG activity was recorded from the external and internal obliques, rectus abdominis, erector spinae and the right rectus femoris of 20 healthy subjects (9 males) with mean (SD) age of 21.88 (0.86) years (range 21–24 years). A rapid hip flexion protocol was carried out under three conditions: no concurrent task, counting out loud up from one and completing a serial sevens task.The addition of the cognitive task delayed and reduced the EMG in the prime mover muscle but had little impact on the responses of the trunk muscles within the time frame of the anticipatory responses; suggestive of a decoupling of voluntary and postural control mechanisms.The results of this study suggest that perhaps the clinical effects of dual task may not be largely due to changes in anticipatory postural adjustments. However, it would be important to compare these results to those seen in older and functionally impaired individuals as this would be more representative of the typical population undertaking such rehabilitation programmes.

Additional weight load increases freezing of gait episodes in Parkinson’s disease; an experimental study

Freezing of gait is an episodic gait disorder,characterized by the inability to generate effective forward stepping movements. The pathophysiology underlying freezing of gait remains insufficiently understood, and this hampers the development of better treatment strategies.Preliminary evidence suggests that impaired force control during walking may contribute to freezing episodes, with difficulty to unload the swing leg and initiate the swing phase. Here, we used external loading to manipulate force control and to investigate its influence on freezing of gait.Twelve Parkinson's disease patients with freezing of gait performed three contrasting tasks: (1) loaded gait while wearing a belt fortified with lead weights; (2) weight supported gait using a parachute harness connected to a rigid metal cable running above the gait trajectory; and (3)normal gait. Gait tasks were used to provoke freezing episodes, including rapid 360° turns. Freezing episodes were quantified using blinded, videotaped clinical assessment. Furthermore, ground reaction forces and body kinematics were recorded. Loading significantly increased the mean number of freezing episodes per trial compared to the normal gait condition (P<0.05), but the effect of weight support was not consistent. Loading particularly increased the number of freezing episodes during rapid short steps. Step length was significantly smaller during loaded gait compared to normal gait (P<0.05), but changes in anticipatory postural adjustments were not different.Our results may point to impaired force control playing a key role in freezing of gait. Future studies should further investigate the mechanism, i.e., the contribution of deficient load feedback, and evaluate which forms of weight support might offer treatment opportunities.

Specific Trunk and General Exercise Elicit Similar Changes in Anticipatory Postural Adjustments in Patients With Chronic Low Back Pain

A randomized controlled trial. To compare changes in self-rated disability, pain, and anticipatory postural adjustments between specific trunk exercise and general exercise in patients with chronic low back pain. Chronic low back pain is associated with altered motor control of the trunk muscles. The best exercise to address altered motor control is unclear. Sixty-four patients with chronic low back pain were randomly assigned to a specific trunk exercise group (SEG) that included skilled cognitive activation of the trunk muscles in addition to a number of other best practice exercises, whereas the general exercise group performed only seated cycling exercise. The training program lasted for 8 weeks. Self-rated disability and pain scores were collected before and after the training period. Electromyographic activity of various trunk muscles was recorded during performance of a rapid shoulder flexion task before and after training. Muscle onsets were calculated, and the latency time (in ms) between the onset of each trunk muscle and the anterior deltoid formed the basis of the motor control analysis. After training, disability was significantly lower in the SEG (d = 0.62, P = 0.018). Pain was reduced in both groups after training (P < 0.05), but was lower for the SEG (P < 0.05). Despite the general exercise group performing no specific trunk exercise, similar changes in trunk muscle onsets were observed in both groups after training. SEG elicited significant reductions in self-rated disability and pain, whereas similar between-group changes in trunk muscle onsets were observed. The motor control adaptation seems to reflect a strategy of improved coordination between the trunk muscles with the unilateral shoulder movement. Trunk muscle onsets during rapid limb movement do not seem to be a valid mechanism of action for specific trunk exercise rehabilitation programs.

Adaptive Changes in Anticipatory Postural Adjustments With Novel and Familiar Postural Supports

Anticipatory postural adjustments (APAs) serve to stabilize posture prior to initiation of voluntary movement. This study examined the effects of changes in postural support on APAs using novel and familiar support paradigms. We also investigated whether postural strategies were refined with practice and how the CNS responded when multiple supports were available. Twelve healthy subjects stood on dual force platforms and performed 20 randomized left and right rapid leg-lift tasks in response to a visual cue under four conditions: unsupported, bilateral handgrip, bite plate, and a combined handgrip and bite plate condition. Vertical ground reaction forces, electromyography of limb, trunk and jaw muscles, and forces exerted on the support apparatus were recorded. Shift in center-of-pressure amplitude and duration were reduced with increased support. Muscles were recruited in advance of the focal movement when able to contribute to stability, and activity was modulated based on the amount of support available. The CNS adapted anticipatory postural strategies immediately with changes in condition regardless of familiarity with the support; however, adaptation was only complete at the first repetition in conditions that involved familiar support strategies. Tasks that involved a novel bite strategy continued to adapt with practice. In the multiple support condition, both hand and bite strategies were immediately incorporated; however, the contribution of each was not identical to conditions where supports were provided individually. This study emphasizes the flexibility of the CNS to organize postural strategies to meet the demands of postural stability in both familiar and novel situations.

Elderly show decreased adjustments of motor synergies in preparation to action.

Aging is associated with decreased manual dexterity. Recent findings have identified changes in multi-finger synergies in elderly individuals. The purpose of current work was to study age-related changes in adjustments of multi-finger synergies in preparation to a quick targeted force pulse production task. Right-handed elderly and young subjects produced quick force pulses by pressing on individual force sensors with the four fingers of the right hand. Prior to the force pulse, the subjects produced a constant low level of the total force. An index of multi-finger synergies was computed across trials for each time sample for each subject and each condition. During steady-state force production, subjects showed co-variation of commands to fingers that stabilized the total force. An index of this co-variation started to decrease prior to the initiation of the force pulse (anticipatory synergy adjustment). Anticipatory synergy adjustments in young subjects started earlier and were larger than in elderly subjects. In particular, young and elderly subjects showed significant anticipatory synergy adjustments starting about 150ms and about 50ms prior to the force pulse initiation, respectively. There were no significant differences between the two groups in other indices of performance such as reaction time, time to peak force, and magnitude of the peak force. We conclude that healthy aging is associated with decreased feed-forward adjustments of multi-finger synergies in preparation to action. This may contribute to the age-related decline in the hand function. Based on similarities in age-related changes in anticipatory postural adjustments and anticipatory synergy adjustments we suggest a hypothesis that the two phenomena may share common mechanisms.