Human Postural Control Research Articles

Intermittent Feedback-Control Strategy for Stabilizing Inverted Pendulum on Manually Controlled Cart as Analogy to Human Stick Balancing.

The stabilization of an inverted pendulum on a manually controlled cart (cart-inverted-pendulum; CIP) in an upright position, which is analogous to balancing a stick on a fingertip, is considered in order to investigate how the human central nervous system (CNS) stabilizes unstable dynamics due to mechanical instability and time delays in neural feedback control. We explore the possibility that a type of intermittent time-delayed feedback control, which has been proposed for human postural control during quiet standing, is also a promising strategy for the CIP task and stick balancing on a fingertip. Such a strategy hypothesizes that the CNS exploits transient contracting dynamics along a stable manifold of a saddle-type unstable upright equilibrium of the inverted pendulum in the absence of control by inactivating neural feedback control intermittently for compensating delay-induced instability. To this end, the motions of a CIP stabilized by human subjects were experimentally acquired, and computational models of the system were employed to characterize the experimental behaviors. We first confirmed fat-tailed non-Gaussian temporal fluctuation in the acceleration distribution of the pendulum, as well as the power-law distributions of corrective cart movements for skilled subjects, which was previously reported for stick balancing. We then showed that the experimental behaviors could be better described by the models with an intermittent delayed feedback controller than by those with the conventional continuous delayed feedback controller, suggesting that the human CNS stabilizes the upright posture of the pendulum by utilizing the intermittent delayed feedback-control strategy.

Identification of the Unstable Human Postural Control System.

Maintaining upright bipedal posture requires a control system that continually adapts to changing environmental conditions, such as different support surfaces. Behavioral changes associated with different support surfaces, such as the predominance of an ankle or hip strategy, is considered to reflect a change in the control strategy. However, tracing such behavioral changes to a specific component in a closed loop control system is challenging. Here we used the joint input–output (JIO) method of closed-loop system identification to identify the musculoskeletal and neural feedback components of the human postural control loop. The goal was to establish changes in the control loop corresponding to behavioral changes observed on different support surfaces. Subjects were simultaneously perturbed by two independent mechanical and two independent sensory perturbations while standing on a normal or short support surface. The results show a dramatic phase reversal between visual input and body kinematics due to the change in surface condition from trunk leads legs to legs lead trunk with increasing frequency of the visual perturbation. Through decomposition of the control loop, we found that behavioral change is not necessarily due to a change in control strategy, but in the case of different support surfaces, is linked to changes in properties of the plant. The JIO method is an important tool to identify the contribution of specific components within a closed loop control system to overall postural behavior and may be useful to devise better treatment of balance disorders.

Development of a sliding mode control model for quiet upright stance

Human upright stance appears maintained or controlled intermittently, through some combination of passive and active ankle torques, respectively representing intrinsic and contractile contributions of the ankle musculature. Several intermittent postural control models have been proposed, though it has been challenging to accurately represent actual kinematics and kinetics and to separately estimate passive and active ankle torque components. Here, a simplified single-segment, 2D (sagittal plane) sliding mode control model was developed for application to track kinematics and kinetics during upright stance. The model was implemented and evaluated using previous experimental data consisting of whole body angular kinematics and ankle torques. Tracking errors for the whole-body center-of-mass (COM) angle and angular velocity, as well as ankle torque, were all within ∼10% of experimental values, though tracking performance for COM angular acceleration was substantially poorer. The model also enabled separate estimates of the contributions of passive and active ankle torques, with overall contributions estimated here to be 96% and 4% of the total ankle torque, respectively. Such a model may have future utility in understanding human postural control, though additional work is needed, such as expanding the model to multiple segments and to three dimensions.

EEG frequency analysis of cortical brain activities induced by effect of light touch.

In human postural control, touching a fingertip to a stable object with a slight force (<1N) reduces postural sway independent of mechanical support, which is referred to as the effect of light touch (LT effect). The LT effect is achieved by the spatial orientation according to haptic feedback acquired from an external spatial reference. However, the neural mechanism of the LT effect is incompletely understood. Therefore, the purpose of this study was to employ EEG frequency analysis to investigate the cortical brain activity associated with the LT effect when attentional focus was strictly controlled with the eyes closed during standing (i.e., control, fixed-point touch, sway-referenced touch, and only fingertip attention). We used EEG to measure low-alpha (about 8-10Hz) and high-alpha rhythm (about 10-12Hz) task-related power decrease/increase (TRPD/TRPI). The LT effect was apparent only when the subject acquired the stable external spatial reference (i.e., fixed-point touch). Furthermore, the LT-specific effect increased the high-alpha TRPD of two electrodes (C3, P3), which were mainly projected from cortical brain activities of the left primary sensorimotor cortex area and left posterior parietal cortex area. Furthermore, there was a negative correlation between the LT effect and increased TRPD of C3. In contrast, the LT effect correlated positively with increased TRPD of P3. These results suggest that central and parietal high-alpha TRPD of the contralateral hemisphere reflects the sensorimotor information processing and sensory integration for the LT effect. These novel findings reveal a partial contribution of a cortical neural mechanism for the LT effect.

A novel approach to study human posture control: “Principal movements” obtained from a principal component analysis of kinematic marker data

Human upright posture is maintained by postural movements, which can be quantified by “principal movements” (PMs) obtained through a principal component analysis (PCA) of kinematic marker data. The current study expands the concept of “principal movements” in analogy to Newton׳s mechanics by defining “principal position” (PP), “principal velocity” (PV), and “principal acceleration” (PA) and demonstrates that a linear combination of PPs and PAs determines the center of pressure (COP) variance in upright standing. Twenty-one subjects equipped with 27-markers distributed over all body segments stood on a force plate while their postural movements were recorded using a standard motion tracking system. A PCA calculated on normalized and weighted posture vectors yielded the PPs and their time derivatives, the PVs and PAs. COP variance explained by the PPs and PAs was obtained through a regression analysis. The first 15 PMs quantified 99.3% of the postural variance and explained 99.60%±0.22% (mean±SD) of the anterior–posterior and 98.82±0.74% of the lateral COP variance in the 21 subjects. Calculation of the PMs thus provides a data-driven definition of variables that simultaneously quantify the state of the postural system (PPs and PVs) and the activity of the neuro-muscular controller (PAs). Since the definition of PPs and PAs is consistent with Newton׳s mechanics, these variables facilitate studying how mechanical variables, such as the COP motion, are governed by the postural control system.

Multiscale Entropy Analysis of Center-of-Pressure Dynamics in Human Postural Control: Methodological Considerations

Multiscale entropy (MSE) is a widely used metric for characterizing the nonlinear dynamics of physiological processes. Significant variability, however, exists in the methodological approaches to MSE which may ultimately impact results and their interpretations. Using publications focused on balance-related center of pressure (COP) dynamics, we highlight sources of methodological heterogeneity that can impact study findings. Seventeen studies were systematically identified that employed MSE for characterizing COP displacement dynamics. We identified five key methodological procedures that varied significantly between studies: (1) data length; (2) frequencies of the COP dynamics analyzed; (3) sampling rate; (4) point matching tolerance and sequence length; and (5) filtering of displacement changes from drifts, fidgets, and shifts. We discuss strengths and limitations of the various approaches employed and supply flowcharts to assist in the decision making process regarding each of these procedures. Our guidelines are intended to more broadly inform the design and analysis of future studies employing MSE for continuous time series, such as COP.

Postural stability and the influence of concurrent muscle activation – Beneficial effects of jaw and fist clenching

Recent studies reported on the potential benefits of submaximum clenching of the jaw on human postural control in upright unperturbed stance. However, it remained unclear whether these effects might also be observed among active controls. The purpose of the present study, therefore, was to comparatively examine the influence of concurrent muscle activation in terms of submaximum clenching of the jaw and submaximum clenching of the fists on postural stability. Posturographic analyses were conducted with 17 healthy young adults on firm and foam surfaces while either clenching the jaw (JAW) or clenching the fists (FIST), whereas habitual standing served as the control condition (CON). Both submaximum tasks were performed at 25% maximum voluntary contraction, assessed, and visualized in real time by means of electromyography. Statistical analyses revealed that center of pressure (COP) displacements were significantly reduced during JAW and FIST, but with no differences between both concurrent clenching activities. Further, a significant increase in COP displacements was observed for the foam as compared to the firm condition. The results showed that concurrent muscle activation significantly improved postural stability compared with habitual standing, and thus emphasize the beneficial effects of jaw and fist clenching for static postural control. It is suggested that concurrent activities contribute to the facilitation of human motor excitability, finally increasing the neural drive to the distal muscles. Future studies should evaluate whether elderly or patients with compromised postural control might benefit from these physiological responses, e.g., in the form of a reduced risk of falling.

Effects of Uneven Ground Surface on Human Balance

The effect of anteroposteriorly slanted ground surface on human posture control at fully flexed trunk postures was investigated in this study. Custom made wooden apparatus were used to simulate slanted ground surfaces, the slanted were set at -15, 0 and 15 degrees respectively. The flat ground condition was included in the study as a control. Fourteen healthy male subjects were asked to maintain in fully flexed trunk posture while standing on different ground surfaces. The segmental sway motion of C7, T12 and S1 spinal vertebrae in the anteroposterior (AP) and mediolateral (ML) directions were recorded. Results showed that when standing on an anteroposteriorly slanted ground surface and facing downhill (i.e. -15 degree condition) subjects consistently demonstrated the highest sway speeds and reported the highest subjective rating of instability. Therefore, we concluded that, when standing on an anteroposteriorly slanted ground surface in a fully flexed trunk posture facing downhill may result in much higher risk of falling in comparison to facing the opposite direction.

The effect of force-controlled biting on human posture control

Several studies have confirmed the neuromuscular effects of jaw motor activity on the postural stability of humans, but the mechanisms of functional coupling of the craniomandibular system (CMS) with human posture are not yet fully understood. The purpose of our study was, therefore, to investigate whether submaximum biting affects the kinematics of the ankle, knee, and hip joints and the electromyographic (EMG) activity of the leg muscles during bipedal narrow stance and single-leg stance. Twelve healthy young subjects performed force-controlled biting (FB) and non-biting (NB) during bipedal narrow stance and single-leg stance. To investigate the effects of FB on the angles of the hip, knee, and ankle joints, a 3D motion-capture system (Vicon MX) was used. EMG activity was recorded to enable analysis of the coefficient of variation of the muscle co-contraction ratios (CVR) of six pairs of postural muscles. Between FB and NB, no significant differences were found for the mean values of the angles of the ankle, knee, and hip joints, but the standard deviations were significantly reduced during FB. The values of the ranges of motion and the mean angular velocities for the three joints studied revealed significant reduction during FB also. CVR was also significantly reduced during FB for five of the six muscle pairs studied. Although submaximum biting does not change the basic strategy of posture control, it affects neuromuscular co-contraction patterns, resulting in increased kinematic precision.

Intermittent appearances of saddle-type hyperbolic dynamics during human stick balancing on a manually controlled cart.

Stabilization of an inverted pendulum on a manually controlled cart (cart-inverted pendulum; CIP), analogous to human fingertip stick balancing, is considered to get insights of how the human central nervous system stabilizes unstable dynamics. We explore a possibility that a type of intermittent control strategy proposed for human postural control might also be applicable to the CIP task, i.e., whether a transient contracting dynamics along a stable manifold of a saddle-type equilibrium of the non-controlled inverted pendulum is exploited intermittently. To this end, we measured task performances during CIP balancing from several experimental subjects. Intermittent appearances of hyperbolicity as typical characteristics reflecting the intermittent control strategy were examined in the recorded motion data using phase space analysis and wavelet analysis. We show that skilled subjects tend to exhibit those characteristics, suggesting that they stabilize upright posture of the stick by utilizing the intermittent control strategy.

A Correlation-Based Framework for Evaluating Postural Control Stochastic Dynamics.

The inability to maintain balance during varying postural control conditions can lead to falls, a significant cause of mortality and serious injury among older adults. However, our understanding of the underlying dynamical and stochastic processes in human postural control have not been fully explored. To further our understanding of the underlying dynamical processes, we examine a novel conceptual framework for studying human postural control using the center of pressure (COP) velocity autocorrelation function (COP-VAF) and compare its results to Stabilogram Diffusion Analysis (SDA). Eleven healthy young participants were studied under quiet unipedal or bipedal standing conditions with eyes either opened or closed. COP trajectories were analyzed using both the traditional posturographic measure SDA and the proposed COP-VAF. It is shown that the COP-VAF leads to repeatable, physiologically meaningful measures that distinguish postural control differences in unipedal versus bipedal stance trials with and without vision in healthy individuals. More specifically, both a unipedal stance and lack of visual feedback increased initial values of the COP-VAF, magnitude of the first minimum, and diffusion coefficient, particularly in contrast to bipedal stance trials with open eyes. Use of a stochastic postural control model, based on an Ornstein-Uhlenbeck process that accounts for natural weight-shifts, suggests an increase in spring constant and decreased damping coefficient when fitted to experimental data. This work suggests that we can further extend our understanding of the underlying mechanisms behind postural control in quiet stance under varying stance conditions using the COP-VAF and provides a tool for quantifying future neurorehabilitative interventions.

Biomechanical influences on head posture and the respiratory movements of the chest.

The head represents 6% of total body weight, therefore it can significantly affect the biomechanics of human posture control, movements and activities. When set out of vertical body axis, head position interferes with the work of the other links in the kinematic chain. The aim of our study was to evaluate the effect of head posture on the breathing activities of the chest. The research was conducted on a group of 65 patients (51 years ± 9.8 years), including 48 women and 17 men. Head posture and chest movements were assessed using a photogrammetric method. The results confirmed the existence of a negative correlation between head position in the sagittal plane and movements of lower ribs. Forward head posture resulted in lower amplitude of costal arch motion: for the transverse plane Spearman's R = -0.296, for the frontal plane; -0.273, -0.289. Tilting the head in the frontal plane also influenced the change in the biomechanics of breathing and contributed to a reduction of respiratory movements of the lower ribs Spearman's R = -0.260. Changing the position of the head causes disturbances in the three-dimensional shape of the chest and its respiratory movements.

Spinal mechanisms may provide a combination of intermittent and continuous control of human posture: predictions from a biologically based neuromusculoskeletal model.

Several models have been employed to study human postural control during upright quiet stance. Most have adopted an inverted pendulum approximation to the standing human and theoretical models to account for the neural feedback necessary to keep balance. The present study adds to the previous efforts in focusing more closely on modelling the physiological mechanisms of important elements associated with the control of human posture. This paper studies neuromuscular mechanisms behind upright stance control by means of a biologically based large-scale neuromusculoskeletal (NMS) model. It encompasses: i) conductance-based spinal neuron models (motor neurons and interneurons); ii) muscle proprioceptor models (spindle and Golgi tendon organ) providing sensory afferent feedback; iii) Hill-type muscle models of the leg plantar and dorsiflexors; and iv) an inverted pendulum model for the body biomechanics during upright stance. The motor neuron pools are driven by stochastic spike trains. Simulation results showed that the neuromechanical outputs generated by the NMS model resemble experimental data from subjects standing on a stable surface. Interesting findings were that: i) an intermittent pattern of muscle activation emerged from this posture control model for two of the leg muscles (Medial and Lateral Gastrocnemius); and ii) the Soleus muscle was mostly activated in a continuous manner. These results suggest that the spinal cord anatomy and neurophysiology (e.g., motor unit types, synaptic connectivities, ordered recruitment), along with the modulation of afferent activity, may account for the mixture of intermittent and continuous control that has been a subject of debate in recent studies on postural control. Another finding was the occurrence of the so-called “paradoxical” behaviour of muscle fibre lengths as a function of postural sway. The simulations confirmed previous conjectures that reciprocal inhibition is possibly contributing to this effect, but on the other hand showed that this effect may arise without any anticipatory neural control mechanism.

Force-controlled biting alters postural control in bipedal and unipedal stance.

Human posture is characterised by inherent body sway which forces the sensory and motor systems to counter the destabilising oscillations. Although the potential of biting to increase postural stability has recently been reported, the mechanisms by which the craniomandibular system (CMS) and the motor systems for human postural control are functionally coupled are not yet fully understood. The purpose of our study was, therefore, to investigate the effect of submaximum biting on postural stability and on the kinematics of the trunk and head. Twelve healthy young adults performed force-controlled biting (FB) and non-biting (NB) during bipedal narrow stance and single-leg stance. Postural stability was quantified on the basis of centre of pressure (COP) displacements, detected by use of a force platform. Trunk and head kinematics were investigated by biomechanical motion analysis, and bite forces were measured using a hydrostatic system. The results revealed that FB significantly improved postural control in terms of reduced COP displacements, providing additional evidence for the functional coupling of the CMS and human posture. Our study also showed, for the first time, that reductions in the sway of the COP were accompanied by reduced trunk and head oscillations, which might be attributable to enhanced trunk stiffness during FB. This physiological response to isometric activation of the masticatory muscles raises questions about the potential of oral motor activity as a strategy to reduce the risk of falls among the elderly or among patients with compromised postural control.

Complexity of human postural control in subjects with unilateral peripheral vestibular hypofunction

Complexity is a new measure for identifying the adaptability of a complex system to meet possible challenges. For a center of pressure (COP) time series, the complexity measure represents the stability of postural control. In this study, multiscale entropy (MSE) was used to evaluate the complexity of COP time series in six test conditions of sensory organization test (SOT). Complexity index (CI) is defined as the summation of entropies with coarse-graining scales 1–20 by MSE. A total of 51 subjects belonging to 3 groups – healthy-young, healthy-elderly and dizzy – were recruited in this study. The COP signals in both anteroposterior (AP) and mediolateral (ML) directions were analyzed respectively. According to our results, the CI of AP-direction COP time series is significantly correlated to the equilibrium score, which represents the stability of postural control in SOT. The AP-direction sway is significant larger than the ML-direction sway, particularly in the test conditions with sway-surface. In additions, the CI of AP-direction COP for the healthy-elderly and dizzy groups are significantly lower than those for the healthy young group in the test conditions 1–4. The CI of ML-direction COP for the healthy-elderly group is significantly lower than those for the healthy-young and dizzy groups under test conditions 3 and 6. These results show that the complexity loss is a common status of AP-direction COP time series for both healthy-elderly and dizzy groups, and the complexity of ML-direction COP time series for subjects with unilateral vestibular dysfunction is higher than that for the healthy-elderly group specifically under test conditions 3 and 6.

Effects of different unstable sole construction on kinematics and muscle activity of lower limb

Unstable sole construction can change biomechanics of lower extremity as highlighted by some previous studies, which could potentially help developing special training or rehabilitation schemes. In this study, unstable elements are fixed in heel and forefoot zone to exert unstable perturbations, and the position changes (medial, neutral and lateral) of unstable elements in forefoot coronal plane are adjusted to analyze changes of lower extremity kinematics and muscle activities. Twenty-two healthy male subjects participated in the test, walking with control shoes and experimental shoes randomly under self-selected speed. Kinematics and surface electromyography measurements were carried out simultaneously. It is found that experimental shoes can lead to the reduction of knee abduction and internal rotation and hip internal rotation, with p<.05. Ankle inversion and internal rotation amplitude were also reduced, which are associated with significantly increased activation levels of muscles (TA-tibialis anterior, PL-peroneus longus, LG-lateral gastrocnemius) in order to compensate perturbations. It is suggested that a training equipment incorporating unstable elements would enhance postural control by adjusting lower extremity kinematics and reorganizing muscle activity. More research can be conducted to testify the feasibility of unstable shoes construction on human postural control and gait, even guide training regime design, injury prevention and rehabilitation.

The influence of aging on human postural control mechanisms

K. TANIGUCHI, A. TAKANISHI. The influence of aging on human postural control mechanisms. Gerontechnology 2014;13(2):288; doi:10.4017/gt.2014.13.02.123.00 Purpose This study aims to reduce the risk of falls in older people by elucidating the mechanisms of human postural control. Postural balance, which was measured by stabilometer, was suggested as an important risk factor for falls1. It has been proposed that intermittent control provides a framework to explain human postural control2, usually together with continuous control. We suggest that an event trigger for intermittent control is related to behaviour of the Center of Pressure (COP) movement around Root Mean Squared area (RMS). We investigated whether those COP parameters were influenced by aging. Method Subjects were 41 middle and old age (aged 37-85 years, mean=64.5 years (SD=12.6)). The subjects stood on a stabilometer (the Nintendo Wii Balance Board: WBB). The WBB is a portable, inexpensive, and reliable device that has been reported by many to have good validity for assessing standing balance3. The COP sway was recorded (sampling frequency, 50Hz) for 30s. The participants stood with their feet together, eyes open, and hands at their sides. Informed consent was obtained from all participants. The parameters were derived from the COP values (Figure 1). They were evaluated both for intra-RMS (IRMS) and extra-RMS (ERMS). Originally 12 parameters were translated by Principal component analysis (PCA). In this study, we show a comparison with principal component scores for IRMS and ERMS. Results & Discussion Table 1 shows the highest factor loading on each principal component. The SDVEL (x-axis) is significant factor of the COP (factor loading>0.95). To explain the difference in behaviour between IRMS and ERMS, we evaluated the differential value of principal component score. Figure 2 shows the distance of three dimensional coordinates(x=PC1, y=PC2, z=PC3) between IRMS and ERMS versus the age. These results show an age-related increase in the distance of parameters between intra-RMS and extraRMS for the COP. These distance measures are significantly related to postural control. The value of distance may be one of the indicators of fall risk.

Effect of Repeated External Perturbations on the Reflex Control of Human Posture — Influence of Reflex Delay, Duration and Gain

The aim of the study was to assess the effects of muscle responses on the trunk motions during repeated perturbations by external forces. Patients with low back pain have delayed muscle reflex latencies to perturbations compared with healthy controls. The perturbation provoked trunk accelerations were simulated by a model consisting of four rigid bodies and six force elements representing trunk and hip muscles. The influence of the muscle responses were assessed by varying the reflex delays, the reflex durations, and the reflex gains. Trunk accelerations can be reduced by the simulated muscle responses. The optimal solution is not the result of extreme values of the reflex delay and duration range but of intermediate values. The relationship between the trunk accelerations and the reflex delay and duration respectively can be described by asymmetrical u-shape functions. As patients with low back pain showed delayed reflexes, their trunk motions are probably increased compared with healthy subjects.

Sensory reweighting dynamics in human postural control

Healthy humans control balance during stance by using an active feedback mechanism that generates corrective torque based on a combination of movement and orientation cues from visual, vestibular, and proprioceptive systems. Previous studies found that the contribution of each of these sensory systems changes depending on perturbations applied during stance and on environmental conditions. The process of adjusting the sensory contributions to balance control is referred to as sensory reweighting. To investigate the dynamics of reweighting for the sensory modalities of vision and proprioception, 14 healthy young subjects were exposed to six different combinations of continuous visual scene and platform tilt stimuli while sway responses were recorded. Stimuli consisted of two components: 1) a pseudorandom component whose amplitude periodically switched between low and high amplitudes and 2) a low-amplitude sinusoidal component whose amplitude remained constant throughout a trial. These two stimuli were mathematically independent of one another and, thus, permitted separate analyses of sway responses to the two components. For all six stimulus combinations, the sway responses to the constant-amplitude sine were influenced by the changing amplitude of the pseudorandom component in a manner consistent with sensory reweighting. Results show clear evidence of intra- and intermodality reweighting. Reweighting dynamics were asymmetric, with slower reweighting dynamics following a high-to-low transition in the pseudorandom stimulus amplitude compared with low-to-high amplitude shifts, and were also slower for inter- compared with intramodality reweighting.

Functional MR imaging of a simulated balance task

Human postural control, which relies on information from vestibular, visual, and proprioceptive inputs, degrades with aging, and falls are the leading cause of injury in older adults. In the last decade, functional neuroimaging studies have been performed in order to gain a greater understanding of the supraspinal control of balance and walking. It is known that active balancing involves cortical and subcortical structures in the brain, but neuroimaging of the brain during these tasks has been limited. The study of the effect of aging on the functional neuroimaging of posture and gait has only recently been undertaken. In this study, an MRI-compatible force platform was developed to simulate active balance control. Eleven healthy participants (mean age 75±5yr) performed an active balance simulation task by using visual feedback to control anterior–posterior center of pressure movements generated by ankle dorsiflexor (DF) and plantarflexor (PF) movements, in a pattern consistent with upright stance control. An additional ankle DF/PF exertion task was performed. During both the active balance simulation and the ankle DF/PF tasks, the bilateral fusiform gyrus and middle temporal gyrus, right inferior, middle, and superior frontal gyrii were activated. No areas were found to be more active during the ankle DF/PF task when compared with the active balance simulation task. When compared to the ankle DF/PF task, the active balance simulation task elicited greater activation in the middle and superior temporal gyrii, insula, and a large cluster that covered the corpus callosum, superior and medial frontal gyrii, as well as the anterior cingulate and caudate nucleus. This study demonstrates the utility in using a force platform to simulate active balance control during MR imaging that elicits activity in cortical regions consistent with studies of active balance and mental imagery of balance.