Postural control adaptation during galvanic vestibular and vibratory proprioceptive stimulation

The objective for this study was to investigate whether the adaptation of postural control was similar during galvanic vestibular stimulation and during vibratory proprioceptive stimulation of the calf muscles. Healthy subjects were tested during erect stance with eyes open or closed. An analysis method designed to consider the adaptive adjustments was used to evaluate the motion dynamics and the evoked changes of posture and stimulation response. Galvanic vestibular stimulation induced primarily lateral body movements and vibratory proprioceptive stimulation induced anteroposterior movements. The lateral body sway generated by the galvanic stimulation was proportionally smaller and contained more high-frequency movements (> 0.1 Hz) than the anteroposterior body sway induced by the vibratory stimulation. The adaptive adjustments of the body sway to the stimulation had similar time course and magnitude during galvanic and vibratory stimulation. The perturbations induced by stimulation were gradually reduced within the same time range (15-20 s) and both kinds of stimulation induced a body leaning whose direction was dependent on stimulus. The similarities in the adjustment patterns suggest that postural control operates in the same way independent of the receptor systems affected by the disturbance and irrespective of whether the motion responses were induced in a lateral or anteroposterior direction.     

Identification of human postural dynamics

Human postural dynamics was investigated for six healthy subjects using a force platform recording body sway induced by vibrators attached to the calf muscles. The model of body mechanics adopted was that of an inverted pendulum, the dynamics of postural control being assumed to be reflected in the stabilizing forces exerted on the platform by the feet as a result of complex muscular activity subject to state feedback of body sway and position. The approach to signal processing has been that of parametric identification of a transfer function representing the stabilized inverted pendulum. Posture control was quantified in three variables: swiftness, stiffness, and damping. It is shown that the identification fulfils ordinary statistical validation criteria, and it is conjectured that the state feedback parameters identified are suitable for use in assessing ability to maintain posture     

The application of time-frequency methods to the analysis ofpostural sway

We apply time-frequency (TF) spectral analysis techniques, namely evolutionary spectral estimators, to postural sway data gathered during quiet standing and in response to external visual stimuli. These techniques provide insight into the time-varying properties of the human balance control systems during standing. We demonstrate by means of individual and group examples that the results of the TF methods can be used to characterize the behavior of the balance system for groups of patients and controls. Specifically we show that, for healthy control subjects, sway at a visual stimulus frequency toward and away from the subject shows an amplitude which decays in time. On the other hand, patients display a response whose amplitude at the stimulus frequency increases with time. Thus TF analysis yields insights into the time-varying nature of the postural control system     

Early recognition of postural disorders in multiple sclerosisthrough movement analysis: a modeling study

In the present study, spontaneous postural behavior has been analyzed in freely standing multiple sclerosis (MS) patients, exhibiting no clinically assessable abnormalities of postural control. This population has been compared with two other groups, healthy people and hemiparetic patients. This latter group represents a situation where the central nervous system (CNS) lesion is precisely localized in one anatomical site and no signal-conduction disorders are present; i.e., it has an opposite anatomical character with respect to the MS at a preclinical stage. The hypothesis underlying the modeling study is the presence of a controller block working in a feedback posture control system. This controller block receives the body sway as input, and produces the corresponding ankle torque stabilizing the body, the latter being modeled as an inverted pendulum. The CNS damage, caused by MS, is supposed to be reflected in some detectable change in the structure of the controller of the posture control system. The identification of the controller has been performed by means of a parametric estimation procedure which employed as input sequences, data recorded by means of a movement-analysis (MA) system. Reported findings show a structural change of the model of the controller block in the posture control system. This result may suggest the presence of an MS-specific reorganization of the posture control system. Some speculation is finally made on the black-box approach in comparison with traditional posturography, to arrive at hypothesizing a progression path for postural disorders     

Stiffness and Damping in Postural Control Increase With Age

Upright balance is believed to be maintained through active and passive mechanisms, both of which have been shown to be impacted by aging. A compensatory balance response often observed in older adults is increased co-contraction, which is generally assumed to enhance stability by increasing joint stiffness. We investigated the effect of aging on standing balance by fitting body sway data to a previously developed postural control model that includes active and passive stiffness and damping parameters. Ten young (24 $pm$ 3 years) and seven older (75 $pm$ 5 years) adults were exposed during eyes-closed stance to perturbations consisting of lateral pseudorandom floor tilts. A least-square fit of the measured body sway data to the postural control model found significantly larger active stiffness and damping model parameters in the older adults. These differences remained significant even after normalizing to account for different body sizes between the young and older adult groups. An age effect was also found for the normalized passive stiffness, but not for the normalized passive damping parameter. This concurrent increase in active stiffness and damping was shown to be more stabilizing than an increase in stiffness alone, as assessed by oscillations in the postural control model impulse response.      

Analysis of the posture control system under fixed andsway-referenced support conditions

To delineate the relative roles of each of the feedback sensors in the posture control system such as the visual, vestibular, and proprioceptive sensors, an identification technique was applied to measurements of antero-posterior sway angles of the body and ankle moments under the following conditions: standing on a fixed support with eyes open (ox), standing on a fixed support with eyes closed (cx), standing on a sway-referenced support with eyes open (os), and standing on a sway-referenced support with eyes closed (cs). Frequency response functions from the sway angle to the ankle moment were calculated. Gain and phase characteristics for conditions (os) and (cs) were similar to those of Nashner's (1972) vestibular model in the high-frequency range, which shows that the vestibular system may be dominant. The gain was higher under condition (cx) than under (ox). Judging from the phase characteristics, this was probably due to increased weighting of the proprioceptive sensor over the vestibular sensor. There was a tendency for gain to increase as balance tasks became more demanding     

Postural stability and stereo-ambiguity in man-designed visualenvironments

Our modern rectilinear visual environment contains visual stimuli for which evolution has not had time to optimally shape visual processing. One such stimulus, periodic stripes, is known to lead to visual depth ambiguity. In this paper we show that postural instability, as measured by the variance of fore and aft sway, is increased by viewing such stimuli. This instability may be the precursor of falls. Designers must evaluate the visual impressions conveyed by their systems in order to avoid postural instability due to visual ambiguity.     

Application of cross time-frequency analysis to postural sway behavior: the effects of aging and visual systems

In this paper, the effects of visual feedback and aging on postural sway systems and signals are investigated by analyzing the transient phase difference between "input" and "output" which correspond to center of pressure (COP) and center of mass (COM), respectively. In order to analyze the transient phase difference characteristics of COP and COM, a relatively new cross time-frequency analysis technique that provides time- and frequency-localized phase difference information is utilized. The feedback control process in the postural sway is interpreted in terms of a feedback compensator which is characterized in terms of a phase difference. Using the experimental results of the transient phase difference obtained from the cross time-frequency distribution, it is demonstrated that the postural control of young persons are more stable and rely more on visual sensory feedback to stabilize postural control compared to that of the elderly persons.     

A recursive free-body approach to computer simulation of human postural dynamics

A recursive, free-body approach to the estimation of joint torques associated with observed motion in linkage mechanisms has recently been shown to be computationally more efficient than any other known approach to this problem. This paper applies this method to the analysis of human postural dynamics and shows how it can also be used to compute accelerations for specified joint torques. The latter calculation, referred to here as the direct dynamics problem, has until now involved symbolic complexity to such an extent as to generally limit computer simulation studies of postural control to very simple models. The model presented in this paper is both straightforward and general, and removes this obstacle to the investigation of possible neural control mechanisms by means of computer simulation. A computationally oriented linearization procedure for the direct dynamics problem is also included in the paper. Finally, example simulation results and corresponding measured body motions for human subjects are presented to validate the method.     

A Quiet Standing Index for Testing the Postural Sway of Healthy and Diabetic Adults Across a Range of Ages

A quiet standing index is developed for tracking the postural sway of healthy and diabetic adults over a range of ages. Several postural sway features are combined into a single composite feature C that increases with age a. Sway features are ranked based on the r ²-values of their linear regression models, and the composite feature is a weighted sum of selected sway features with optimal weighting coefficients determined using principal component analysis. A performance index based on both reliability and sensitivity is used to determine the optimal number of features. The features used to form C include power and distance metrics. The quiet standing index is a scalar that compares the composite feature C to a linear regression model f(a) using C ^'(a) = C/f(a). For a motionless subject, C ^' = 0, and when the composite feature exactly matches the healthy control (HC) model, C ^' = 1. Values of C ^' >> 1 represent excessive postural sway and may indicate impaired postural control. Diabetic neurologically intact subjects, nondiabetic peripheral neuropathy subjects (PN), and diabetic PN subjects (DPN) were evaluated. The quiet standing indexes of the PN and DPN groups showed statistically significant increases over the HC group. Changes in the quiet standing index over time may be useful in identifying people with impaired balance who may be at an increased risk of falling.     

Invariant density analysis: modeling and analysis of the postural control system using Markov chains

In this paper, a novel analysis technique, invariant density analysis (IDA), is introduced. IDA quantifies steady-state behavior of the postural control system using center of pressure (COP) data collected during quiet standing. IDA relies on the analysis of a reduced-order finite Markov model to characterize stochastic behavior observed during postural sway. Five IDA parameters characterize the model and offer physiological insight into the long-term dynamical behavior of the postural control system. Two studies were performed to demonstrate the efficacy of IDA. Study 1 showed that multiple short trials can be concatenated to create a dataset suitable for IDA. Study 2 demonstrated that IDA was effective at distinguishing age-related differences in postural control behavior between young, middle-aged, and older adults. These results suggest that the postural control system of young adults converges more quickly to their steady-state behavior while maintaining COP nearer an overall centroid than either the middle-aged or older adults. Additionally, larger entropy values for older adults indicate that their COP follows a more stochastic path, while smaller entropy values for young adults indicate a more deterministic path. These results illustrate the potential of IDA as a quantitative tool for the assessment of the quiet-standing postural control system.     

Paraplegic standing controlled by functional neuromuscularstimulation. I. Computer model and control-system design

We have developed a planar computer model to investigate paraplegic standing induced by functional neuromuscular stimulation. The model consists of nonlinear musculotendon dynamics (pulse train activation dynamics and musculotendon actuator dynamics), nonlinear body-segmental dynamics, and a linear output-feedback control law. The model of activation dynamics is an analytic expression that characterizes the relation between the stimulus parameters (pulse width and interpulse interval) and the muscle activation. Hill's classic two-element muscle model was modified into a musculotendon actuator model in order to account for the effects of submaximal activation and tendon elasticity on development of force by the actuator. The three body-segmental, multijoint model accounts for the anterior-posterior movements of the head and trunk, the thigh, and the shank. We modeled arm movement as an external disturbance and imposed the disturbance to the body-segmental dynamics by means of a quasistatic analysis. Linearization, and at times linear approximation of the computer model, enabled us to compute a constant, linear feedback-gain matrix, whose output is the net activation needed by a dynamical joint-torque actuator. Motivated by an assumption that minimization of energy expenditure lessens muscle fatigue, we developed an algorithm that then computes how to distribute the net activation among all the muscles crossing the joint. In part II, the combined feedback control strategy is applied to the nonlinear model of musculotendon and body-segmental dynamics to study how well the body ought to maintain balance should the feedback control strategy be employed.     

Balance prosthesis based on micromechanical sensors using vibrotactile feedback of tilt

A prototype balance prosthesis has been made using miniature, high-performance inertial sensors to measure lateral head tilt and vibrotactile elements mounted on the body to display head tilt to the user. The device has been used to study the feasibility of providing artificial feedback of head tilt to reduce postural sway during quiet standing using six healthy subjects. Two vibrotactile display schemes were used: one in which the individual vibrating elements, called tactors, were placed on the shoulders (shoulder tactors); another in which columns of tactors were placed on the right and left sides of the trunk (side tactors). Root-mean-square head-tilt angle (Tilt) and center of pressure displacement (Sway) were measured for normal subjects standing in a semi-tandem Romberg position with eyes closed, under four conditions: no balance aids; shoulder tactors; side tactors; and light touch. Compared with no balance aids, the side tactors significantly reduced Tilt (35%) and Sway (33%). Shoulder tactors also significantly reduced Tilt (44%) and Sway (17%). Compared with tactors, light touch resulted in less Sway, but more Tilt. The results suggest that healthy normal subjects can reduce their lateral postural sway using head tilt information as provided by a vibrotactile display. Thus, further testing with balance-impaired subjects is now warranted.     

Instrumented Force Platform for Postural Sway Studies

A force platform has been developed, which is capable of measuring postural sway in humans in two orthogonal directions. For each direction, output data consist of total average sway in two frequency bands centered on 0.57 and 2.9 Hz. The device is suitable for use in research or in a clinical setting.     

Maximum Likelihood Identification of a Posture Control System

To identify characteristics of a sensory feedback path of a posture control system without external disturbances, the maximum likelihood identification method was applied to data of an antero-posterior sway during quiet stance. A subject stood on a force plate and the sway angle of a body (input) was measured by a position sensor camera and the ankle joint moment (output) was measured by the force plate. Using data of 500 input-output pairs sampled every 0.1 s, parameters of the sensory feedback path were estimated and frequency response functions were calculated. These showed derivative characteristics that are necessary for stabilization of the posture control system. Gain characteristics under the closed eyes condition tended to be greater than those under the open eyes condition.     

Measures of postural steadiness: differences between healthy youngand elderly adults

Measures of postural steadiness are used to characterize the dynamics of the postural control system associated with maintaining balance during quiet standing. The objective of this study was to evaluate the relative sensitivity of center-of-pressure (COP)-based measures to changes in postural steadiness related to age. A variety of time and frequency domain measures of postural steadiness were compared between a group of twenty healthy young adults (21-35 years) and a group of twenty healthy elderly adults (66-70 years) under both eyes-open and eyes-closed conditions. The measures that identified differences between the eyes-open and eyes-closed conditions in the young adult group were different than those that identified differences between the eye conditions in the elderly adult group. Mean velocity of the COP was the only measure that identified age-related changes in both eye conditions, and differences between eye conditions in both age groups. The results of this study will be useful to researchers and clinicians using COP-based measures to evaluate postural steadiness     

New Foot Pressure Activated Sensory Compensation System for Posture-Control Enhancement in Amputees

A computerized foot pressure activated sensory compensation system using subsensory electrical stimulation combined with visual-auditory biofeedback was developed. The proposed system was used for enhancing standing balance and gait performance for amputees. In this pilot study, we hypothesized that the static balance with single limb support and gait performance during treadmill walking could be improved by providing proprioceptive neuromuscular facilitation using subsensory stimulation and visual-auditory biofeedback in amputee, respectively. To test this hypothesis, five unilateral transtibial amputees who consecutively wore prosthetics over two years were recruited. Experimental results show a reduction in all of the postural sway indexes and increase in single-leg support time index during single-leg quiet standing by applying subsensory stimulation. With visual-auditory biofeedback for providing clue for heel contact and toe push-off condition during treadmill ambulation, an improvement in all four dynamic gait performance indexes in amputees was verified. These findings suggest that the proposed system with subsensory electrical stimulation and visual-auditory biofeedback mechanisms may be effective in compensating sensory loss and improving posture control for amputees.     

Adaptive coupling control for overhead crane systems

Due to the requirements of high positioning accuracy, small swing angle, short transportation time, and high safety, both motion and stabilization control for an overhead crane system becomes an interesting issue in the field of control technology development. Since the overhead crane system is subject to underactuation with respect to the load sway dynamics, it is very hard to manipulate the crane system in a desired manner, namely, gantry position tracking and sway angle stabilization. Hence, in this paper, a nonlinear control scheme incorporating parameter adaptive mechanism is devised to ensure the overall closed-loop system stability. By applying the designed controller, the position error will be driven to zero while the sway angle is rapidly damped to achieve swing stabilization. Stability proof of the overall system is given in terms of Lyapunov concept. To demonstrate the effectiveness of the proposed controller, results for both computer simulation and experiments are also shown.     

Simple rotary crane dynamics modeling and open-loop control for residual load sway suppression by only horizontal boom motion

To suppress two-dimensional load sway caused by the horizontal boom motion of a rotary crane, both horizontal and vertical boom motions are generally used. However, it would be more energy efficient and safer if a control scheme using only horizontal boom motion could be developed, eliminating the need for any boom vertical motion. In addition, if we can suppress load sway without the need to measure it, cost reduction of sensors can be achieved. Furthermore, the use of simple velocity trajectory patterns such as a trapezoidal velocity pattern and an S-curve acceleration/deceleration pattern, which are widely used in industrial automation systems, may provide cost-effective implementation of controllers. This paper presents a simple model of rotary crane dynamics that includes only significant centrifugal and Coriolis force terms. This simple model allows analytical solutions of the differential equations of the model to be derived. Thus, S-curve trajectory that considers residual vibration suppression without sensing it, using only horizontal boom motion, can be generated by solving only algebraic equations numerically. The effectiveness of the proposed method is demonstrated by numerical simulations and experimental results.