Two mechanisms can be used to accelerate the center of mass (CoM) to control the CoM in relation to the base of support during standing. The first is applying ankle moments to shift the center of pressure (CoP), which has been coined the “CoP mechanism”. The second is changing the angular momentum around the CoM to change the direction of the ground reaction force, i.e., the “counter-rotation mechanism”. At both the beginning and the end of the lifespan, problems with postural control are common. In this study, we asessed anteroposterior balance performance and the related use of these postural control mechanisms in children, younger adults, and older adults. Sixteen pre-pubertal children (6-9y), 17 younger adults (18-24y) and eight older adults (65-80y) performed bipedal upright standing trials of 16 seconds on a rigid surface and on three balance boards that could freely move in the sagittal plane, varying in height (15-19 cm) of the board above the point of contact with the floor. Full body kinematics were measured. Performance related outcome measures, i.e., the number of trials with balance loss and the Root Mean Square (RMS) of the time series of the CoM acceleration were calculated. Additionally, the RMS of the time series of the CoM acceleration due to the CoP and counter-rotation mechanism and the contributions of the CoP and the counter-rotation mechanism to the CoM acceleration (in %) in the sagittal plane were calculated. Furthermore, selected kinematic measures, i.e., the orientation of the board and the head and the Mean Power Frequency of balance board orientation and of CoM acceleration were calculated. Compared to younger adults, children and older adults showed a poorer balance performance, reflected by a greater RMS of CoM accelerations and more balance loss in older adults. Across age groups and conditions, the contribution of the CoP mechanism to the total CoM acceleration was dominant, i.e., 95%-108%. The contribution of the counter-rotation mechanism ranged between 19%-31% (with totals higher than 100% indicating opposite effects of both mechanisms). We suggest that the contribution of the counter-rotation mechanism is limited, since the counter-rotation mechanism would conflict with stabilizing the orientation of the head in space. Furthermore, children did use the counter-rotation mechanism relatively more to accelerate the CoM compared to younger adults. Possibly this reflects that they are still learning to limit the contribution of the counter-rotation mechanism to the same extent as adults.

Limited effects of age on the use of the ankle and counter-rotation mechanism in the sagittal plane

During standing, posture can be controlled by accelerating the Center of Mass (CoM) through shifting the center of pressure (CoP) within the base of support by applying ankle moments (9CoP mechanism9), or through the 9counter-rotation mechanism9, i.e., changing the angular momentum of segments around the CoM to change the direction of the ground reaction force. Postural control develops over the lifespan; at both the beginning and the end of the lifespan adequate postural control appears more challenging. In this study, we aimed to assess mediolateral balance performance and the related use of the postural control mechanisms in children, older adults and young adults when standing on different (unstable) surfaces. Sixteen pre-pubertal children (6-9y), 17 young adults (18-24y) and eight older adults (65-80y) performed bipedal upright standing trials of 16 seconds on a rigid surface and on three balance boards that could freely move in the frontal plane, varying in height (15-19 cm) of the surface of the board above the point of contact with the floor. Full body kinematics (16 segments, 48 markers, using SIMI 3D-motion analysis system (GmbH) and DeepLabCut and Anipose) were retrieved. Performance related outcome measures, i.e., the number of trials with balance loss and the Root Mean Square (RMS) of the time series of the CoM acceleration, the contributions of the CoP mechanism and the counter-rotation mechanism to the CoM acceleration in the frontal plane and selected kinematic measures, i.e. the orientation of the board and the head and the Mean Power Frequency (MPF) of the balance board orientation and the CoM acceleration were determined. Balance loss only occurred when standing on the highest balance board, twice in one older adult once in one young adult. In children and older adults, the RMS of the CoM accelerations were larger, corresponding to poorer balance performance. Across age groups and conditions, the contribution of the CoP mechanism to the total CoM acceleration was much larger than that of the counter-rotation mechanisms, ranging from 94%-113% vs 23%-38% (with totals higher than 100% indicating opposite effects of both mechanisms). Deviations in head orientation were small compared to deviations in balance board orientation. We hypothesize that the CoP mechanism is dominant, since the counter rotation mechanism would conflict with stabilizing the orientation of the head in space.

https://www.biorxiv.org/content/biorxiv/early/2021/09/09/2021.09.08.459390.2.full.pdf

Effects of age and surface instability on the control of the center of mass

Vestibular information modulates muscle activity during gait, presumably to contribute stability, because noisy electrical vestibular stimulation perturbs gait stability. An important mechanism to stabilize gait in the mediolateral direction is to coordinate foot placement based on a sensory estimate of the trunk center of mass state, to which vestibular information appears to contribute. We, therefore expected that noisy vestibular stimulation would decrease the correlation between foot placement and trunk center of mass state. Moreover, as vestibular modulation of muscle activity during gait depends on step width, we expected stronger effects for narrow-base than normal walking, and smaller effects for wide-base walking. In eleven healthy subjects we measured the kinematics of the trunk (as a proxy of the center of mass), and feet, while they walked on a treadmill in six conditions, including three different step widths: control (preferred step width), narrow-base (steps smaller than hip width), and wide-base (with steps greater than hip width). The three conditions were conducted with and without a bipolar electrical stimulus, applied behind the ears (5 mA). Walking with EVS reduced gait stability but increased the foot placement to center of mass correlation in different step width conditions. The narrow-base walking was the most stable condition and showed a stronger correlation between foot placement and center of mass state. We argue that EVS destabilized gait, but that this was partially compensated for by tightened control over foot placement, which would require successful use of other than vestibular sensory inputs, to estimate center of mass movement.

https://biorxiv.org/content/10.1101/2021.09.09.459650v1.full.pdf

Effects of vestibular stimulation on gait stability and variability

11 Bicycles are more difficult to control at low speeds due to the vehicle’s unstable low-speed dynamics. This issue might be exacerbated by factors such as aging, disturbances, and multi-tasking. To address this issue, we developed a second prototype ’balance assist system’ with Royal Dutch Gazelle and Bosch eBike Systems at Delft University of Technology, which includes an electric motor capable of providing additional steering torque to that of the rider. We conducted a study with 18 older and 14 younger cyclists to first examine the effect of aging, disturbances, and multi-tasking on cycling at lower forward speeds, and evaluate the effectiveness of the system in improving the self-stability of the rider-bicycle system while facing these challenges.

Bicycle balance assist system reduces roll 1 and steering motion for young and older 2 bicyclists during real-life safety challenges

Previous studies have estimated the energy cost required for the control of medio-lateral stability in human walking by means of external lateral stabilization. Results were inconsistent, possibly due to differences in task constraints or stabilization devices. To better understand the effects of lateral stabilization on energy cost, we conducted a systematic review with meta-analysis of studies, which directly assessed effects of lateral stabilization on energy cost in healthy young adult participants (18-41 years old). We obtained individual participant data on net energy cost (J kg-1 m-1) from previously published studies. Across all studies reviewed, the net energy cost reduction during stabilized walking at preferred and zero step widths equaled to 0.05 {+/-} 0.35 (~2-3% reduction) and 0.25 {+/-} 0.29 J kg-1 m-1 (mean {+/-} s.d.) (~8-9% reduction), respectively. The effect of external lateral stabilization was significant only for walking at zero step width and without arm swing. Lateral stabilization devices with short rope length increased energy cost reduction. However, spring stiffness and habituation time did not influence energy cost reduction. We provide recommendations for improvement of lateral stabilization devices to avoid some of the confounding effects. External lateral stabilization reduces energy cost during walking by a small amount. It can be concluded that a small proportion of total energy cost is required to control medio-lateral stability; this proportion is larger when walking with narrow steps and without arm swing.

https://biorxiv.org/content/10.1101/2021.09.07.459220v1.full.pdf

The effect of external lateral stabilization on energy cost of walking - A systematic review and meta-analysis

Recovering balance after perturbations becomes challenging with aging, but an effective balance training could reduce such challenges. In this study, we examined the effect of balance training on feedback control after unpredictable perturbations by investigating balance performance, recovery strategy, and muscle synergies. We assessed the effect of balance training on unipedal perturbed balance in twenty older adults (>65 years) after short-term (one session) and long-term (3-weeks) training. Participants were exposed to random medial and lateral perturbations consisting of 8-degree rotations of a robot-controlled balance platform. We measured full-body 3D kinematics and activation of 9 muscles (8 stance leg muscles, one trunk muscle) during 2.5 s after the onset of perturbation. The perturbation was divided into 3 phases: phase1 from the onset to maximum rotation of the platform, phase 2 from the maximum rotation angle to the 0-degree angle and phase 3 after platform movement. Balance performance improved after long-term training as evidenced by decreased amplitudes of center of mass acceleration and rate of change of body angular momentum. The rate of change of angular momentum did not directly contribute to return of the center of mass within the base of support, but it reoriented the body to an aligned and vertical position. The improved performance coincided with altered activation of synergies depending on the direction and phase of the perturbation. We concluded that balance training improves control of perturbed balance, and reorganizes feedback responses, by changing temporal patterns of muscle activation. These effects were more pronounced after long-term than short-term training.

/pdf/balance-training-improves-feedback-control-of-perturbed-2ds2mvmx2w.pdf

Balance training improves feedback control of perturbed balance in older adults

During steady-state walking mediolateral gait stability can be maintained by controlling the center of pressure (CoP) The CoP modulates the moment of the ground reaction force, which brakes and reverses movement of the center of mass (CoM) towards the lateral border of the base of support In addition to foot placement, ankle moments serve to control the CoP We hypothesized that, during steady-state walking, single stance ankle moments establish a CoP shift to correct for errors in foot placement We expected ankle muscle activity to be associated with this complementary CoP shift During treadmill walking, full-body kinematics, ground reaction forces and electromyography were recorded in thirty healthy participants We found a negative relationship between preceding foot placement error and CoP displacement during single stance Too medial steps were compensated for by a lateral CoP shift and vice versa, too lateral steps were compensated for by a medial CoP shift Peroneus longus, soleus and tibialis anterior activity correlated with these CoP shifts As such, we identified an (active) ankle strategy during steady-state walking As expected, absolute explained CoP variance by foot placement error decreased when walking with shoes constraining ankle moments Yet, contrary to our expectations that ankle moment control would compensate for constrained foot placement, the absolute explained CoP variance by foot placement error did not increase when foot placement was constrained We argue that this lack of compensation reflects the interdependent nature of ankle moment and foot placement control We suggest that single stance ankle moments do not only compensate for preceding foot placement errors, but also assist control of the subsequent foot placement Foot placement and ankle moment control are caught in a circular relationship, in which constraints imposed on one will also influence the other

https://biorxiv.org/content/10.1101/2021.03.31.437904v1.full.pdf

van Dieen Jh

Papers

Balance training improves feedback control of perturbed balance in older adults

Ankle muscles activate: mediolateral center of pressure control ensures stable gait