Regulation Of Postural Control Research Articles

The effect of hemispheric lesion location on trunk control.

Trunk control is the basic component of postural control, and achieving trunk control is a complex process that can be achieved by dynamically building and maintaining neuromuscular function. Lateropulsion, which is also defined as the body falling to one side, is considered an important condition that is frequently encountered after stroke and affects trunk control. It is known that there are differences in the regulation of postural control and trunk control according to hemispheric localization. We had a very specific group of patients and tried to find out the outcomes prospectively in this study. The patients were divided into 2 groups those with right hemisphere lesions (Group 1) and those with left hemisphere lesions (Group 2). Comorbidity and cognitive function were evaluated using the Charlson Comorbidity Index (CMI) and Standardized Mini-Mental State Test (SMMSE). Activities of daily living were evaluated using the Turkish version of the Modified Barthel Index (MBI). The Stroke Rehabilitation Assessment of Movement Instrument (STREAM) test was used to assess trunk control and the Brunnstrom (BS) test was used to assess motor functions. There was a significant difference between Groups 1 and 2 in terms of STREAM in lower extremity scores were higher in Group 2 (P < .05). The number of patients in BS lower extremity Stages IV-VI was higher in Group 1 and Group 2 (P < .05). It was determined that upper extremity, lower extremity and Total STREAM scores and BS Hand stage in Group 2 were significantly higher than Group 1 in patients with total middle cerebral artery (MCA) affected(P < .05). It was determined that trunk control was more affected in patients with right hemispheric lesions. Additionally, trunk control is significantly affected in patients with total MCA lesions.

Facilitating or disturbing? An investigation about the effects of auditory frequencies on prefrontal cortex activation and postural sway.

Auditory stimulation activates brain areas associated with higher cognitive processes, like the prefrontal cortex (PFC), and plays a role in postural control regulation. However, the effects of specific frequency stimuli on upright posture maintenance and PFC activation patterns remain unknown. Therefore, the study aims at filling this gap. Twenty healthy adults performed static double- and single-leg stance tasks of 60s each under four auditory conditions: 500, 1000, 1500, and 2000 Hz, binaurally delivered through headphones, and in quiet condition. Functional near-infrared spectroscopy was used to measure PFC activation through changes in oxygenated hemoglobin concentration, while an inertial sensor (sealed at the L5 vertebra level) quantified postural sway parameters. Perceived discomfort and pleasantness were rated through a 0-100 visual analogue scale (VAS). Results showed that in both motor tasks, different PFC activation patterns were displayed at the different auditory frequencies and the postural performance worsened with auditory stimuli, compared to quiet conditions. VAS results showed that higher frequencies were considered more discomfortable than lower ones. Present data prove that specific sound frequencies play a significant role in cognitive resources recruitment and in the regulation of postural control. Furthermore, it supports the importance of exploring the relationship among tones, cortical activity, and posture, also considering possible applications with neurological populations and people with hearing dysfunctions.

Morphological and functional criteria for the effectiveness of recreational activities in children

Objective. The study aimed to perform a comprehensive morphofunctional assessment of the effectiveness of recreational activities in children aged 9–12 years in the summer of 2019.Materials and methods. The study was conducted by the “Problem scientific laboratory of physical methods of diagnosis and treatment” of RostGMU in the children’s health and recreation camp “Mir” (Krasnyi Desant village, Gulf of Taganrog). Procedures and time of the study: somatometry, bioimpedance analysis, сardiointervalography, stabilometrics on the 2nd day of stay and 2.5 weeks after. Two groups were formed: Group I included overweight children (OW), n = 15 (boys, n = 9; girls, n = 6); Group II included children with normal physical development (NPD), n = 37 (boys, n = 17; girls, n = 20). The children received a non-drug complex of camp resource provision for 3 weeks.Results. Health measures did not lead to significant changes in the somatometric parameters. According to the results of the сardiointerval recording, an authentic increase in the variational range and vegetative rhythm index was found in children with NPD, which indicates an increase in the parasympathetic activity of regulation. The stress index decreased by 30% in the case of NPD, and by 6% in the case of OW. Data from the stabilometric “Balls” simulator showed that after the recovery, the regulation of postural control was optimized, and decision-making processes were accelerated, especially in children with NPD.Conclusion. The study showed that in order to assess the effectiveness of recreational activities, along with “mandatory” methods, it is advisable to use functional methods such as cardiointervalography and stabilometrics, which can be recommended for use in health and rehabilitation institutions to assess the adaptive capabilities of the organism.

Basic Motor Skills of Children With Down Syndrome: Creating a Motor Growth Curve.

To create a motor growth curve based on the Test of Basic Motor Skills for Children with Down Syndrome (BMS) and estimate the age of achieving BMS milestones. A multilevel exponential model was applied to create a motor growth curve based on BMS data from 119 children with Down syndrome (DS) aged 2 months to 5 years. Logistic regression was applied to estimate the 50% probability of achieving BMS milestones. The BMS growth curve had the largest increase during infancy with smaller increases as children approached the predicted maximum score. The age at which children with DS have a 50% probability of achieving the milestone sitting was 22 months, for crawling 25 months, and for walking 38 months. The creation of a BMS growth curve provides a standardization of the gross motor development of children with DS. Physical therapists then may monitor a child's individual progress and improve clinical decisions.

Balance task difficulty affects postural sway and cortical activity in healthy adolescents

Electroencephalographic (EEG) research indicates changes in adults’ low frequency bands of frontoparietal brain areas executing different balance tasks with increasing postural demands. However, this issue is unsolved for adolescents when performing the same balance task with increasing difficulty. Therefore, we examined the effects of a progressively increasing balance task difficulty on balance performance and brain activity in adolescents. Thirteen healthy adolescents aged 16–17 year performed tests in bipedal upright stance on a balance board with six progressively increasing levels of task difficulty. Postural sway and cortical activity were recorded simultaneously using a pressure sensitive measuring system and EEG. The power spectrum was analyzed for theta (4–7 Hz) and alpha-2 (10–12 Hz) frequency bands in pre-defined frontal, central, and parietal clusters of electrocortical sources. Repeated measures analysis of variance (rmANOVA) showed a significant main effect of task difficulty for postural sway (p < 0.001; d = 6.36). Concomitantly, the power spectrum changed in frontal, bilateral central, and bilateral parietal clusters. RmANOVAs revealed significant main effects of task difficulty for theta band power in the frontal (p < 0.001, d = 1.80) and both central clusters (left: p < 0.001, d = 1.49; right: p < 0.001, d = 1.42) as well as for alpha-2 band power in both parietal clusters (left: p < 0.001, d = 1.39; right: p < 0.001, d = 1.05) and in the central right cluster (p = 0.005, d = 0.92). Increases in theta band power (frontal, central) and decreases in alpha-2 power (central, parietal) with increasing balance task difficulty may reflect increased attentional processes and/or error monitoring as well as increased sensory information processing due to increasing postural demands. In general, our findings are mostly in agreement with studies conducted in adults. Similar to adult studies, our data with adolescents indicated the involvement of frontoparietal brain areas in the regulation of postural control. In addition, we detected that activity of selected brain areas (e.g., bilateral central) changed with increasing postural demands.

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Background: Stroke is a leading cause of disability in elderly people. Lesion location and size, and trunk control early after stroke have been found predictive of functional outcome. Trunk control is an important aspect of postural control, and commonly found to be impaired. A hemispheric difference in the regulation of postural control has been suggested, but limited knowledge of a relationship between specific lesions and trunk control exists. Objective: To explore the relationship between middle cerebral artery (MCA) lesion locations and trunk control post stroke, and compare trunk control between patients with lesions in single and multiple locations, and between left and right hemispheres. Methods: A cross-sectional design was used. Patients were recruited from a hospital stroke unit. Assessment tools: Trunk Impairment Scale–modified Norwegian version and Alberta Stroke Program Early CT Score (ASPECTS). Statistics: Descriptive, Independent t-test, Mann-Whitney’s U-test, Chi-Square test. Results:109 patients with first time middle cerebral artery lesions were included, 71 with multiple and 38 with single ASPECT locations. Trunk control was poorer in multiple (median 8.0) than in single (median 11.0) lesion locations, P=0.011. The most common single lesion locationswereM5 (50%) and internal capsule (18.4%). M5 is situated in the anterior parts of the MCA territory and hypothesized to represent sensory and motor areas of the cortex. Patients with lesions of M5 locations in the right hemisphere achieved poorer scores on trunk control than patients with left sided locations, P=0.030. Conclusions: The results indicate that patients with lesions in multiple ASPECT locations have poorer trunk control than patients with single locations, and that trunk control is poorer after single right M5 lesions as compared to left. We recommend therapists to have specific attention towards trunk control in rehabilitation of patients with MCA lesions and especially with a right M5 location early post stroke.

Frequency analysis approach to study balance control in individuals with multiple sclerosis

BackgroundThe ability to control balance is often compromised in people with multiple sclerosis (MS) and is considered to be a strong contributing factor toward their increased risk of falls. New methodThe aim of the study was to demonstrate that frequency analysis of postural sway could be used to investigate postural control in people with MS. Ten individuals with MS and ten age-and-gender matched healthy subjects stood on the force platform with eyes open or closed. The displacements of center of pressure (COP) were used to calculate power spectrum using fast Fourier transform. Power spectrum was analyzed for anterior-posterior (AP) and medial-lateral (ML) directions using three frequency bands: 0–0.3Hz, 0.3–1Hz, and 1–3Hz reflecting contributions from the visual, vestibular/somatosensory, and proprioceptive systems, respectively. ResultsThe mean COP velocity in the eyes closed condition was significantly larger for the MS than the healthy control group. Additionally, the MS group showed a significant decrease in the magnitude of COP power spectrum in the low frequency band and a pattern of increase in the medium and high frequency bands in the medial–lateral direction. ConclusionThe observed redistribution of the COP power spectrum when vision is absent indicates that people with MS relied more on the vestibular/somatosensory and proprioceptive systems. However, such a strategy change was ineffective in maintaining postural stability, thus highlighting the impaired ability of the somatosensory system in regulation of postural control in people with MS. The outcome of the study suggests that the COP frequency analysis could be used in identifying the possible sources of balance impairment in people with MS.

Physical activity after retirement enhances vestibulo-ocular reflex in elderly humans

Vestibular information decreases in sensitivity with ageing, and its role becomes less important in the regulation of postural control. In addition, the practice of physical activity (PA) helps to improve vestibular sensitivity. This study aimed to evaluate PA-related benefit on vestibular function in 36 subjects split into four groups according to the period of practice. Caloric and rotatory vestibular testings showed that the performance of subjects who had begun practising PA recently were close to those of subjects active for a long time, whereas those of subjects who had stopped practising at an early age were close to those of inactive subjects. Although starting to practise PA has immediate beneficial effects on the vestibule, in terms of vestibular stimulation mechanisms these effects soon disappear if this activity is stopped.

The contribution of vision in dynamic spontaneous sways of male classical dancers according to student or professional level

We investigated the involvement of vision in the regulation of dynamic equilibrium in male children and young adults performing a physical activity requiring a high level of spatial skill: self-induced body sways of ballet dancers on a free unstable platform, 45 professional male dancers (Paris Opera) participated in the study. They included two student groups (beginners and confirmed) and two performer groups (adolescent and adult). They maintained their equilibrium on the platform under different visual and position conditions. The displacements of the seesaw platform were calculated from accelerometer measures. Fast Fourier transform processing of stabilograms allowed spectral frequency analysis. The total spectrum energy and the energies of the three frequency bands (0–0.5 Hz, 0.5–2 Hz, 2–20 Hz) were determined. For all groups, ANOVA indicated that values were higher for eyes-closed than for eyes-open conditions. The visual dependence differed according to age: for 14-year-old students the postural control for dynamic equilibrium was less visually dependent than for 11-year-old students. The 18-year-old dancers, although professional, were more dependent on vision than 14-year-old student dancers. These 18-year-old dancers were still adolescent because they had recently undergone growth acceleration which could disturb their proprioceptive references and internal body representations. Thus, visual input may dominate over the other sensory inputs in the regulation of postural control.

Effect of physical training on head-hip co-ordinated movements during unperturbed stance.

A cross-correlation analysis between head and hip lateral accelerations has been used to analyse the effects of sport training (in experts in judo or classical dance as compared to controls) on postural strategies during unperturbed stance. Subjects were standing in the sharpened Romberg position on either a hard or foam rubber support. The main results were: (1) several non-visual and ankle-like strategies (head-hip movements in the same sense) were used by both groups on both supports; (2) two types of lateral hip strategies (head-hip movements in opposite sense) were seen in controls on soft support only, and were mainly modulated by vision. Training appears to result in a shift from a visual to a proprioceptive dominance in the regulation of postural control in unperturbed stance.