Postural Strategies Research Articles

4.70 SENSORIMOTOR INTEGRATION AND ABC-MOVEMENT 2 ASSESSMENT IN ABNORMAL CONNECTIVITY SPECTRUM DISORDERS (ASD, ADHD, TOURETTE’S DISORDER) VERSUS CONTROL SUBJECTS: A CROSS-SECTIONAL STUDY

Multisensory integration deficits in children may affect postural control in static/dynamic conditions. Standing balance requires the ability to integrate sensory inputs form visual, somatosensory, and vestibular systems. Although previous studies have examined balance performances in developmental disorders, sensorimotor integration processes have not been compared in different diagnostic groups. In our study, we intend to perform a cross-sectional analysis of postural strategies under 6 sensory conditions in diagnostic groups (ASD, ADHD, and Tourette’s disorder) compared with control subjects.

Effects of Ankle and Hip Strategy Training on Improving the Center of Pressure Movements and Limits of Stability in Stroke Patients

Background: Stroke patients have leg muscle weakness and impaired balance resulting in compensatory changes. To restore balance in these patients, functional training using postural strategy is needed. Objective: To examine the effects of ankle and hip strategy training on the center of pressure (COP) movement and limits of stability (LOS) in standing posture in stroke patients. Design: The study was an assessor-blinded and randomized-controlled clinical trial. Methods: Thirty patients were randomly assigned to an ankle strategy training group and a ankle/ hip strategy training group. Patients in the ankle strategy training group underwent ankle strategy exercise for 30 min, and those in the ankle/ hip strategy training group underwent 15 min of ankle strategy exercise and 15 min of hip strategy exercise. Both groups underwent training thrice a week for four weeks. Forward, backward, paretic side, and non-paretic side COP movements and LOS were measured using BioRescue. Results: After the intervention, except for the backward area in the ankle strategy training group, the COP movement area and the LOS were significantly improved in both the groups. In addition, these improvements were significantly higher in ankle/ hip strategy training group than that in the ankle strategy training group. Conclusions: Ankle strategy training in addition to hip strategy training improves COP movement (forward-backward, paretic side area, and nonparetic side area) and LOS in stroke patients.

Why do only some people with lumbar disc degeneration have recurrent low back pain? An examination of postural control strategy.

Introduction Patients with recurrent low back pain (LBP) exhibit changes in postural control. Stereotypical muscle activations resulting from external perturbations include anticipatory (APAs) and ...

Postural control in girls with adolescent idiopathic scoliosis while wearing a Chêneau brace or performing active self-correction: a pilot study.

BackgroundIt is known that adolescent idiopathic scoliosis (AIS) is often accompanied by balance deficits. This reciprocal relationship must be taken into account when prescribing new therapeutic modalities because these may differently affect postural control, interacting with therapy and influencing its results.ObjectiveThe purpose was to compare postural control in girls with AIS while wearing the Chêneau brace (BRA) or performing active self-correction (ASC) with their postural control in a quiet comfortable stance.MethodsNine subjects were evaluated on a force plate in three series of two 20-s quiet standing trials with eyes open or closed; three blocks were randomly arranged: normal quiet stance (QST), quiet stance with BRA, and quiet stance with ASC. On the basis of centre-of-pressure (COP) recordings, the spatial and temporal COP parameters were computed.Results and DiscussionPerforming ASC was associated with a significant backward excursion of the COP mean position with eyes open and closed (ES = 0.56 and 0.65, respectively; p < 0.05). This excursion was accompanied by an increase in the COP fractal dimension (ES = 1.05 and 0.98; p < 0.05) and frequency (ES = 0.78; p = 0.10 and ES = 1.14; p < 0.05) in the mediolateral (ML) plane. Finally, both therapeutic modalities decreased COP sample entropy with eyes closed in the anteroposterior (AP) plane. Wearing BRA resulted in ES = 1.45 (p < 0.05) while performing ASC in ES = 0.76 (p = 0.13).ConclusionThe observed changes in the fractal dimension (complexity) and frequency caused by ASC account for better adaptability of patients to environmental demands and for their adequate resources of available postural strategies in the ML plane. These changes in sway structure were accompanied by a significant (around 25 mm) backward excursion of the mean COP position. However, this improvement was achieved at the cost of lower automaticity, i.e. higher attentional involvement in postural control in the AP plane. Wearing BRA may have an undesirable effect on some aspects of body balance.

Single-motor-unit discharge characteristics in lumbar multifidus muscle of acute low back pain patients

Acute low back pain (ALBP) causes rapid deterioration of paraspinal muscle function. The underlying neurophysiology is poorly understood. We therefore carried out this observational study in patients with ALBP to characterize motor unit (MU) activity in deep lumbar multifidus (LM) muscle and compare with our previous findings from pain-free subjects. Nine subjects (1 woman; age 26-59 yr) with ALBP duration of 1-21 days were recruited from outpatient clinics. Fine wire electromyography (EMG) electrodes were implanted bilaterally at the painful spinal level under computer tomography guidance. EMG was recorded during spontaneous sitting and standing, and during voluntary force production. Linear mixed models were utilized to test or control for the effects of a number of predefined variables. Compared with sitting, standing increased total duration of EMG activity, median MU discharge rate, interspike interval variability, and common drive measured as common drive coefficients (CDC) derived from concurrently active MU pairs. Median discharge rate in 73 MUs was 5.5 and 6.6 pulses per second (pps) during spontaneous sitting and standing, and 7.2 pps during voluntary force production. Interspike interval variability was lower during voluntary tasks than during spontaneous force production. Common drive was less pronounced in bilateral vs. unilateral unit pairs, also in spontaneous standing. This difference was not seen in our previous pain-free subjects, suggesting altered bilateral control of the spine in ALBP. The distribution of CDC values was not a homogeneous continuum but could be seen as two partially overlapping populations of CDC distributions.NEW & NOTEWORTHY We implanted fine-wire electrodes in the deepest part of axial postural muscles in patients with acute low back pain and characterized their motor unit activity. We found less pronounced common drive to the two sides of the spine compared with pain-free subjects, suggesting a different postural control strategy in patients with acute low back pain. An unexpected finding was that common drive coefficient values appeared to consist of two partially overlapping populations of normal distributions.

The Amount and Temporal Structure of Center of Pressure Fluctuations During Quiet Standing in Patients With Chronic Low Back Pain.

The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower sample entropy and a higher correlation dimension in the patients with low back pain compared with the healthy subjects. The results of this study demonstrate the greater regularity and higher dimensionality of the center of pressure fluctuations in patients with nonspecific chronic low back pain, which suggests that these patients adopt different postural control strategies to maintain an upright stance.

Haste makes waste: on the trade-off between walking speed and target-stepping accuracy

Previous findings suggest that wearing a lumbar belt may benefit some patients with low back pain; however, the mechanisms of action are not yet fully understood.The effect of wearing two flexible (extensible and non-extensible) lumbar belts on trunk postural control was investigated during an unstable sitting task.Healthy subjects and subjects with LBP sat on a wobbling chair, with and without the lumbar belts. Chair rotation was measured in the sagittal and frontal planes, and 10 linear and nonlinear measures of balance were computed to assess the quantity (3 measures) and quality (7 measures) of the movements.Both lumbar belts induced similar changes in specific measures of trunk postural control, for both subject groups, generally indicative of more instability and less controllability, but with low effect sizes (0.14 and 0.40). Subjects with LBP also showed lower entropy (complexity; effect size 0.93) and higher determinism (predictability; effect size 0.56) than healthy controls, under all test conditions. These findings indicate that the subjects with LBP used a less complex, more predictable trunk postural control strategy, suggestive of impaired adaptability and responsiveness to dynamic trunk postural control demands. The findings also suggest other factors related to dynamic adaptability may be impaired by lumbar belt use.The effects of the lumbar belts on trunk postural control were small, however, their practical implications for the management of LBP remain to be determined in relation to other effects of lumbar belts (e.g. increased mechanical stiffness).

Description of Postural Strategies through a Variable Structure Control.

Human postural strategies in balance maintenance are the results of the complex control action played by the Central Nervous System (CNS). Literature underlined that such strategies become more evident when external perturbations challenge the stance. In this study, a new model of balance maintenance under support base movement perturbation is formulated. A sliding mode approach is employed to simulate the aforementioned strategies in stabilizing a double inverted pendulum, used to describe the mechanics of the bipedal human stance. Control parameters are then optimized in order to reproduce the measured center of mass (COM) displacement in the anterior-posterior direction. Such parameters seem to be useful to distinguish different postural strategies employed by different subjects. Moreover, electromyographic data are employed to effectively support the goodness of the model.

Modeling Perturbed Posture Through An Adaptive Sliding Mode Approach.

Upright stance maintenance under perturbed condition is a complex phenomenon in which the Central Nervous System(CNS) is engaged to regulate the balance preventing subject to fall. Many models of unperturbed stance are present in literature. However, the necessity to model balance maintenance in presence of external disturbance is still an open problem. In this paper, a new model representing the human balance maintenance under perturbed condition is presented. An adaptive sliding mode approach is used to model the action played by the CNS, the control parameters are then optimized in order to match real and simulated data. The trend of optimized parameters seems to reveal the development of different postural strategies throughout the experimental trials.

Abnormal hypersynchronization of body balance control system in children with post-burn foot deformity

Relevance. Treatment of children with post-burn foot deformities is an important task of reconstructive plastic surgery. The scars formed on the back surface of the feet, even with adequate surgical approach, in the acute period of thermal injury, further often lead to deformities of the entire foot, which leads to a derangement of its support function. The importance of the problem lies in the fact that with the growth of the child, secondary abnormal changes develop on the part of the joints of the lower extremities and the spine, leading to impaired locomotor function, including deviations in the body balance control system.&#x0D; Purpose of the study. To study postural stability in children with post-burn foot deformities before and after surgical treatment.&#x0D; Material and methods. The stabilometric study was conducted in 12 patients with post-burn cicatricial foot deformity, the average age of the patients was 9.8 ± 0.93 years old. The control group consisted of 12 children of the same age with no signs of orthopedic abnormality. To assess the results, the methods of descriptive statistics with the inclusion of correlation and regression analysis were used.&#x0D; Results. In patients with post-burn cicatricial deformity of the foot at the pre-treatment stage, a compensatory redistribution of the static load towards the intact lower limb was revealed. Analysis of postural control indicators in patients of the main group showed an abnormal increase in the synchronization of the system of body balance control. After reconstructive operations on the affected foot, symmetry of the distribution of the load and restoration of the support of the limb of the affected side were noted. Correlation analysis revealed a pronounced decrease in abnormal hypersynchronization between stabilometric parameters, which may indicate a trend towards normalization of the postural control strategy in patients after treatment.&#x0D; Conclusion. Elimination of post-burn foot deformity contributed to the restoration of its anatomical shape and was accompanied by pronounced positive dynamics in the state of the system of vertical balance of the patient’s body.

Altered movement strategy of chronic ankle instability individuals with postural instability classified based on Nyquist and Bode analyses

BackgroundThe aim of the current study was to assess movement strategies during a single leg balance in chronic ankle instability individuals with unstable postural control strategy identified by Nyquist and Bode analyses in conjunction with sample entropy. MethodsThirty-three participants with self-reported chronic ankle instability and 22 healthy controls performed single-leg eyes closed static balance trials. The sagittal and frontal plane kinematics in the lower extremity and trunk as well as center of pressure trajectories were recorded during three, 20-second trials. The Nyquist and Bode stability analyses, which classify center of pressure waveforms as stable based on the resulting gain and phase margins, were performed to identify the presence of postural control deficits. Sample entropy was implemented to analyze movement strategies during the task. FindingsBased on the Nyquist and Bode stability analyses, we included 19 out of 33 chronic ankle instability participants with unstable postural control strategy and 16 out of 22 controls with stable postural control strategy in the final analyses. Chronic ankle instability participants demonstrated a significantly lower sample entropy value in sagittal and frontal plane trunk kinematics and sagittal plane hip kinematics compared to the controls. No between-group differences existed in other kinematic measures. InterpretationThe lower sample entropy values in participants with chronic ankle instability indicates that those with postural control deficits may increase reliance on the trunk and hip joint contributions to the maintenance of postural control, reflecting changes in the sensorimotor constraints on movement patterns during the task.

Étude des atteintes posturales chez les patients déficients visuels

IntroductionBalance is an active system allowing the body to maintain individual stability despite external stimuli. It relies on many senses which provide data to compensate for external variations such as visual information. It is thus necessary that the senses be in good condition and transmit accurate data. We wished to study postural adaptations made by visually impaired people. Material and methodsWe performed a prospective study of patients with macular degeneration with visual acuity less than 20/40, glaucoma with a mean visual field defect less 12 decibels, and a control population. All subjects underwent a dynamic equilibrium test on a stabilometric platform with Win-Posturo software. We assessed their postural profile in various situations : eyes open, eyes closed, balance, anteroposterior displacement and lateral displacement. ResultsThe first group consisted of 16 patients with age macular degeneration (AMD), the second of 17 patients with glaucoma and the third of 18 control subjects. In static equilibrium, for the parameter “length vs. surface area,” all groups had an improvement in their performance with eyes open (P=0.05). There was a significant difference between the subject and control groups (P<0.01). In addition, subjects in the group with peripheral visual impairment had significantly greater tendency to lean forward. In dynamic equilibrium, we did not demonstrate any significant difference between the groups. DiscussionIn static equilibrium, patients with poor peripheral vision have better quality somatosensory compensation, but they have a tendency to lean forward, which increases the risk of falling forward. For the three groups, the tests showed that the subjects are vision-dependent, which implies that somatosensory compensation could be developed to limit this dependency. In dynamic equilibrium, the subjects in the disease groups perform significantly worse than the controls. All the visually impaired have a more developed somatosensory mechanism than the controls. The subjects in the first and third groups have the same postural profile, they are vision-dependent. Subjects in the second group have an instability and change in their postural strategy, increasing the risk of falling. Visual acuity has a lesser impact on the risk of falling than the visual field. ConclusionComparing postural responses in these different situations, it appears that postural profiles are modified in the case of visual disability, although the postural profile of the group with central visual loss is similar to that of the controls. Retinal involvement, whether central or peripheral, leads to postural imbalance that may result in falls in certain cases. To limit the prevalence of these falls, it would be interesting to address visually impaired patients by examination and postural rehabilitation to decrease the effects of this visual impairment.

Age related differences in balance approached by a novel dual-task test of anticipatory postural control strategies.

IntroductionAssessment of balance is key to identifying individuals with postural control deficits and an increased fall risk. Subjects may compensate for their deficits by utilizing other strategies; to avoid this, it is recommended to assess postural control using a dual-task test. In most dual-task tests, it is difficult to monitor the performance in the secondary task and the individual’s task prioritisation. This study evaluated a new dual-task testing approach.Materials and methodsA convenience sample of 54 community-dwelling elderly (age 65+ years) and a reference group of 20 young participants were included in the study. They performed a test in which they could utilize cues to improve their baseline performance, provided their level of postural control allowed them residual attention capacity for this cognitive task.ResultsSignificant performance differences were seen between the young and the elderly. The young group improved their performance time by 23.9% (10.7) and 7.1% (14.2) with a cue and a reverse cue, respectively, whereas the elderly failed to improve their performance time. The test was unable to distinguish between individuals within the elderly group due to a floor effect.DiscussionThe test reveals an individual’s capacity to use cues for anticipatory postural control strategies in a dual-task setting and thereby estimates automatization of postural control. While the young subjects were capable of improving their performance during dual-task conditions, the elderly subjects apparently had no residual attentional capacity allowing them to utilize the facilitating cues. Within the elderly group, the dual-task aspects of the test added no value with respect to differentiation in the level of postural control.

Relationship Between Sport Expertise and Postural Skills.

The review addresses the relationship between sport expertise (i.e., sport competition level), postural performance (amount of motion of the center of mass/of pressure of foot or ability to preserve body balance), and postural strategy (geometric organization of different body segments as well as neurobiological involvement of organism). Since the conditions of postural evaluation are likely to influence results, the aim is to compare athletes at different competition levels in ecological postural conditions (specific postural conditions related to the sport practiced) and non-ecological postural conditions (decontextualized postural conditions in relation to the sport practiced). Evidence suggests that the most successful athletes in terms of sport competition level have the best postural performance both in ecological and non-ecological postural conditions. However, in non-ecological conditions, the postural tasks should be preferentially challenging or relatively close to the sport practice stance. Moreover, the most successful athletes also have more elaborate postural strategies compared with athletes at lower competition level. Mechanistic explanations as well as conceptual models are proposed to explain the role of different factors influencing the relationship between sport expertise and postural performance and strategy.

The effect of extensible and non-extensible lumbar belts on trunk postural balance in subjects with low back pain and healthy controls

BackgroundPrevious findings suggest that wearing a lumbar belt may benefit some patients with low back pain; however, the mechanisms of action are not yet fully understood. Research questionThe effect of wearing two flexible (extensible and non-extensible) lumbar belts on trunk postural control was investigated during an unstable sitting task. MethodsHealthy subjects and subjects with LBP sat on a wobbling chair, with and without the lumbar belts. Chair rotation was measured in the sagittal and frontal planes, and 10 linear and nonlinear measures of balance were computed to assess the quantity (3 measures) and quality (7 measures) of the movements. ResultsBoth lumbar belts induced similar changes in specific measures of trunk postural control, for both subject groups, generally indicative of more instability and less controllability, but with low effect sizes (0.14 and 0.40). Subjects with LBP also showed lower entropy (complexity; effect size 0.93) and higher determinism (predictability; effect size 0.56) than healthy controls, under all test conditions. These findings indicate that the subjects with LBP used a less complex, more predictable trunk postural control strategy, suggestive of impaired adaptability and responsiveness to dynamic trunk postural control demands. The findings also suggest other factors related to dynamic adaptability may be impaired by lumbar belt use. SignificanceThe effects of the lumbar belts on trunk postural control were small, however, their practical implications for the management of LBP remain to be determined in relation to other effects of lumbar belts (e.g. increased mechanical stiffness).

Intersegmental strategies in frontal plane in moderately-skilled riders analyzed in ridden and un-mounted situations

The symmetry of the rider is highly relevant, and in the equestrian community it is generally thought that a symmetrical rider has a better possibility to influence the horse in an optimal way. The aim of the study was to analyse and compare frontal plane kinematics of the core body segments in ten riders while riding and while rocking a balance chair from side-to-side. It was hypothesized that the riders were asymmetrical in relation to their intersegmental strategies when comparing between left and right directions and that individual riders would display the same postural strategies when riding and when rocking the balance chair. Ten moderately-skilled riders wore a full-body marker set that was tracked by a motion capture system as they rocked a balance chair from side to side. Inertial measurement units attached to the head, trunk and pelvis were used to measure the segmental movements while riding in left and right directions. Roll rotation data for head, trunk and pelvis were averaged over available strides/cycles. Results from mixed models showed that the riders were asymmetric when comparing riding in left vs right directions, for example the trunk was rotated 19° to the right on the right circle and 14° to the left on the left circle, on average. Riders adopted the same asymmetrical posture whether they were riding in the left or right direction on straight lines, circles or leg yielding. A significant relationship was found between postural asymmetries when riding and when rocking the balance chair, one degree of pelvis or head roll asymmetry on the chair predicted 2.4 (SE 0.9) degrees of asymmetry while riding. Future studies may investigate the value of seated, off-horse postural training for improving rider symmetry and thereby equestrian performance.

I Didn’t Do It: Comparing Denial Posture Crisis Strategies Between Government and Business

Businesses and governments occasionally face crises as a result of being falsely accused of harming their stakeholders. This research seeks to determine how they can most effectively respond using an experiment with 617 participants. Using situational crisis communication theory’s (SCCT) prescribed responses, the study examines unique reputation repair impact of post-crisis response strategies on a government organization compared with a business organization. This study also defines four different types of kategoria as strategies within SCCT’s denial posture and tests their crisis outcomes against other denial posture strategies. Participants were significantly more favorable toward a government organization compared with a business organization. Significant differences were detected in outcomes between different denial posture strategies. Implications for theory and practitioners are discussed.

EFFICACY OF WRIST STRATEGY COACHING ON HANDSTAND PERFORMANCES IN NOVICES: INVERTING EXPLICIT AND IMPLICIT LEARNING OF SKILL-RELATED MOTOR TASKS

In gymnastics, mainstream handstand coaching emphasizes developing an aligned rigid body configuration, frequently leaving wrist-controlled balance work to implicit learning. However, skill-related motor behavioral research suggests the wrists to primarily contribute postural control in handstands. Considering recent research on handstands revealing experience-dependent motor behavior, the present study aimed to examine motor learning effects of explicit wrist usage coaching on handstand performances in skilled and less skilled novices. Therefore, twenty-five volunteering sport students served as participants completing a three-week training intervention which solely and explicitly addressed successful wrist usage during handstand. A video-tutorial introducing participants to the wrist strategy of hand balance preceded five practical training sessions that all neglected providing explicit postural advice. Participants performed three handstands on a plane gymnastics mat prior to (pre-test) and after (post-test) completing the training intervention. Standardized video recordings of each trial allowed retrospective group assignment (skilled and less skilled novices) based on pre-test mean balance times. With this, balance times, expert assessments (postural execution and balance control strategies) and goniometric analyses of shoulder and hip joint angles served to detect practical changes in handstand performances. Enhanced balance times as well as increased scores for postural execution and balance control strategies were revealed for less skilled novices (p &lt; .05), but not for skilled novices (p &gt; .05). Furthermore, in both groups changes in shoulder and hip joint angles failed significance. In conclusion, present findings suggest practitioners to make entirely unexperienced handstand learners explicitly aware of the wrist strategy’s operating principle.

Effects of Ankle Bracing on Postural Sway

Ankle bracing can alter postural control strategies during static and dynamic tasks, theoretically through mechanical constraint of the ankle joint and/or sensorimotor reorganization. While a majority of studies have focused on center of pressure (COP) characteristics or clinical tests of balance to explore this theory, fewer studies have investigated sway characteristics of the center of mass (COM). Additionally, the effects of various styles of ankle braces on postural sway remains inconclusive. Assessing the effects of ankle bracing on postural sway could provide additional insight into potential systemic motor adaptations that occur in response to ankle constraint. PURPOSE: Examine effects of lace-up and semi-rigid bracing on postural sway characteristics during a quiet-standing task. METHODS: Thirty-five adults between the ages of 18-30yrs (height: 1.72 ± 0.1m; mass: 75.49 ± 18kg) participated in the study. Participants performed a single one-minute trial of quiet-standing during each of the following conditions: No brace (NB), lace-up brace (LB), and semi-rigid brace (SRB). A ten-camera motion capture system was utilized to capture lower extremity positon. To assess postural sway, mediolateral (ML) and anteroposterior (AP) lower extremity COM trajectories were extracted, and root-mean-square deviation (RMSx, RMSy) and velocity (RMSvx, RMSvy) of the COM were calculated. Repeated-measures ANOVAs were employed to assess differences in postural sway measures across all conditions. RESULTS: Analysis revealed a significant main effect for RMSy (F = 7.061; p < .01). Pairwise comparisons indicated that RMSy was significantly lower in the SRB condition (1.770±1.698mm) compared to C (2.182 ±1.515mm) (p < .01). CONCLUSION: Results from study indicate that subjects exhibited an altered AP postural sway pattern when a semi-rigid brace is applied. These findings align with previous research reporting reduced AP COP excursions with ankle bracing during quiet-standing. Altered sway patterns with ankle bracing appears to support the presence of sensorimotor reorganization, possibly due to altered proprioceptive and/or haptic feedback stemming from greater mechanical constraint of the ankle joint.

Manipulability Based Hierarchical Control of Perturbed Walking

In this paper, a novel manipulability based three-level hierarchical approach is suggested for control of perturbed bipedal walking. An appropriate postural strategy is selected to restore stability if a perturbation occurs during steady-state human walking. Previous experimental studies on the human walking suggest that the selection of stabilizing strategies can be related to the kinematic manipulability of swing foot. The proposed three-level structure consists of a low, middle, and high levels. The manipulability is at the high-level layer. Therefore, in case of disturbance it determines to lengthen the step (elevating strategy) or shorten the step length (lowering strategy). The middle-level layer determines the optimal desired trajectories for joints. Finally, a low-level controller tracks the desired optimal trajectory to maintain stability. The results show the success of the manipulability based adapted control scheme against pushing perturbation. A comparison between the optimal gait patterns obtained with and without consideration of manipulability is also presented in this study. The results show that the manipulability improves disturbance rejection capability. Positioning the manipulability in the high-level of our proposed method mitigates the possibility of singularity occurrence and configuration limits during postural response.