What is the contribution of voluntary and reflex processes to sensorimotor control of balance?

The contribution to balance of spinal and transcortical processes including the long-latency reflex is well known. The control of balance has been modelled previously as a continuous, state feedback controller representing, long-latency reflexes. However, the contribution of slower, variable delay processes has not been quantified. Compared with fixed delay processes (spinal, transcortical), we hypothesize that variable delay processes provide the largest contribution to balance and are sensitive to historical context as well as current states. Twenty-two healthy participants used a myoelectric control signal from their leg muscles to maintain balance of their own body while strapped to an actuated, inverted pendulum. We study the myoelectric control signal (u) in relation to the independent disturbance (d) comprising paired, discrete perturbations of varying inter-stimulus-interval (ISI). We fit the closed loop response, u from d, using one linear and two non-linear non-parametric (many parameter) models. Model M1 (ARX) is a generalized, high-order linear-time-invariant (LTI) process with fixed delay. Model M1 is equivalent to any parametric, closed-loop, continuous, linear-time-invariant (LTI), state feedback model. Model M2, a single non-linear process (fixed delay, time-varying amplitude), adds an optimized response amplitude to each stimulus. Model M3, two non-linear processes (one fixed delay, one variable delay, each of time-varying amplitude), add a second process of optimized delay and optimized response amplitude to each stimulus. At short ISI, the myoelectric control signals deviated systematically both from the fixed delay LTI process (M1), and also from the fixed delay, time-varying amplitude process (M2) and not from the two-process model (M3). Analysis of M3 (all fixed delay and variable delay response amplitudes) showed the variable (compared with fixed) delay process 1) made the largest contribution to the response, 2) exhibited refractoriness (increased delay related to short ISI) and 3) was sensitive to stimulus history (stimulus direction 2 relative to stimulus 1). For this whole-body balance task and for these impulsive stimuli, non-linear processes at variable delay are central to control of balance. Compared with fixed delay processes (spinal, transcortical), variable delay processes provided the largest contribution to balance and were sensitive to historical context as well as current states.

Effects of Hemispheric Stroke Localization on the Reorganization of Arm Movements within Different Mechanical Environments.

This study investigated how stroke's hemispheric localization affects motor performance, spinal maps and muscle synergies while performing planar reaching with and without assistive or resistive forces. A lesion of the right hemisphere affected performance, reducing average speed and smoothness and augmenting lateral deviation in both arms. Instead, a lesion of the left hemisphere affected the aiming error, impairing the feedforward control of the ipsilesional arm. The structure of the muscle synergies had alterations dependent on the lesion side in both arms. The applied force fields reduced the differences in performance and in muscle activations between arms and among populations. These results support the hypotheses of hemispheric specialization in movement control and identify potential significant biomarkers for the design of more effective and personalized rehabilitation protocols.

State-space intermittent feedback stabilization of a dual balancing task.

Balancing the body in upright standing and balancing a stick on the fingertip are two examples of unstable tasks that, in spite of strong motor and sensory differences, appear to share a similar motor control paradigm, namely a state-space intermittent feedback stabilization mechanism. In this study subjects were required to perform the two tasks simultaneously, with the purpose of highlighting both the coordination between the two skills and the underlying interaction between the corresponding controllers. The experimental results reveal, in particular, that upright standing (the less critical task) is modified in an adaptive way, in order to facilitate the more critical task (stick balancing), but keeping the overall spatio-temporal signature well known in regular upright standing. We were then faced with the following question: to which extent the physical/biomechanical interaction between the two independent intermittent controllers is capable to explain the dual task coordination patterns, without the need to introduce an additional, supervisory layer/module? By comparing the experimental data with the output of a simulation study we support the former hypothesis, suggesting that it is made possible by the intrinsic robustness of both state-space intermittent feedback stabilization mechanisms.

Force accuracy rather than high stiffness is associated with faster learning and reduced falls in human balance.

Balance requires the centre of mass to be maintained within the base of support. This can be achieved by minimising position sway (stiffness control: SC) or minimising force error (force accuracy control: FAC). Minimising sway reduces exploration of system properties, whereas minimising force error maximizes accurate mapping of the force vs position. We hypothesise that (i) FAC is associated with faster learning and fewer falls whereas (ii) SC is not. Fifteen participants used myoelectric signals from their legs to maintain balance of an actuated, inverted pendulum, to which they were strapped. Using challenging perturbations, participants were trained to maintain balance without falling within five sessions and tested before (PRE) and after (POST) training. We quantified FAC as 'change (POST-PRE) in correlation of force with position' and SC as 'change in sway'. PRE training, five measures (sway, acceleration, co-contraction, effort, falls) showed no correlation with either FAC or SC. POST training, reduced fall rate, effort and acceleration correlated with FAC metric. SC correlated only with reduced sway. Unlike sway minimisation, development of force accuracy was associated with learning and reduced falls. These results support that accurate force estimation allowing movement is more relevant than stiffness to improve balance and prevent falls.

Tactile and proprioceptive dysfunction differentiates cervical dystonia with and without tremor.

OBJECTIVE: To determine whether different phenotypes of cervical dystonia (CD) express different types and levels of somatosensory impairment. METHODS: We assessed somatosensory function in patients with CD with and without tremor (n = 12 each) and in healthy age-matched controls (n = 22) by measuring tactile temporal discrimination thresholds of the nondystonic forearm and proprioceptive acuity in both the dystonic (head/neck) and nondystonic body segments (forearm/hand) using a joint position-matching task. The head or the wrist was passively displaced along different axes to distinct joint positions by the experimenter or through a robotic exoskeleton. Participants actively reproduced the experienced joint position, and the absolute joint position-matching error between the target and the reproduced positions served as a marker of proprioceptive acuity. RESULTS: Tactile temporal discrimination thresholds were significantly elevated in both CD subgroups compared to controls. Proprioceptive acuity of both the dystonic and nondystonic body segments was elevated in patients with CD and tremor with respect to both healthy controls and patients with CD without tremor. That is, tactile abnormalities were a shared dysfunction of both CD phenotypes, while proprioceptive dysfunction was observed in patients with CD with tremor. CONCLUSIONS: Our findings suggest that the pathophysiology in CD can be characterized by 2 abnormal neural processes: a dysfunctional somatosensory gating mechanism involving the basal ganglia that triggers involuntary muscle spasms and abnormal processing of proprioceptive information within a defective corticocerebellar loop, likely affecting the feedback and feedforward control of head positioning. This dysfunction is expressed mainly in CD with tremor.

Effect of motor and sensory noise in the control of upright standing.

Quiet standing has been modeled many times as an unstable task of controlling an inverted pendulum in a gravity divergent force field. Multiple sensory systems and motor components of the nervous system are involved in postural balancing and the stabilization problem becomes even more complex in presence of perturbations. In the present work, we reveal how humans deal with different sources of perturbations. We asked healthy participants to perform a realistic whole body postural balancing task, controlling a perturbed virtual inverted pendulum through an EMG-interface connected to the ankle muscles, receiving a haptic feedback of the pendulum position. Two sources of perturbations were provided: Motor Noise, applying a gain on the control signal, and Sensory Noise, adding an external disturbance on the system plant. Results show that participants, without a priori knowledge on perturbations and no specific instructions, were able to adapt to perturbations and behaved in different ways in relationship with the different perturbation sources. These findings also suggest that error-enhancing methods (i.e., perturbations) might be suitable for postural stability recovery.

Quiet standing: The Single Inverted Pendulum model is not so bad after all.

In the study of balance and postural control the (Single) Inverted Pendulum model (SIP) has been taken for a long time as an acceptable paradigm, with the implicit assumption that only ankle rotations are relevant for describing and explaining sway movements. However, more recent kinematic analysis of quiet standing revealed that hip motion cannot be neglected at all and that ankle-hip oscillatory patterns are characterized by complex in-phase and anti-phase interactions, suggesting that the SIP model should be substituted by a DIP (Double Inverted Pendulum) model. It was also suggested that DIP control could be characterized as a kind of optimal bi-axial active controller whose goal is minimizing the acceleration of the global CoM (Center of Mass). We propose here an alternative where active feedback control is applied in an intermittent manner only to the ankle joint, whereas the hip joint is stabilized by a passive stiffness mechanism. The active control impulses are delivered to the ankle joint as a function of the delayed state vector (tilt rotation angle + tilt rotational speed) of a Virtual Inverted Pendulum (VIP), namely a pendulum that links the ankle to the CoM, embedded in the real DIP. Simulations of such DIP/VIP model, with the hybrid control mechanism, show that it can reproduce the in-phase/anti-phase interaction patterns of the two joints described by several experimental studies. Moreover, the simulations demonstrate that the DIP/VIP model can also reproduce the measured minimization of the CoM acceleration, as an indirect biomechanical consequence of the dynamic interaction between the active control of the ankle joint and the passive control of the hip joint. We suggest that although the SIP model is literally false, because it ignores the ankle-hip coordination, it is functionally correct and practically acceptable for experimental studies that focus on the postural oscillations of the CoM.

Preliminary results on a dual balancing task.

Balancing a stick on the fingertip while standing upright is a dual balancing task that requires the integration of two independent control systems. This is a completely novel experimental paradigm for attempting to understand how the brain deals with equilibrium in a general way. Preliminary results are presented and interpreted in the framework of an intermittent control policy extended to include a dual balancing task. In particular the study reveals that the upright standing (the less critical task) is modified in an adaptive way, in order to facilitate the more critical task, i.e. stick balancing.

Characterization of compressed earth blocks using low frequency guided acoustic waves.

The objective of this work was to analyze the influence of compaction pressure on the intrinsic acoustic parameters (porosity, tortuosity, air-flow resistivity, viscous, and thermal characteristic lengths) of compressed earth blocks through their identification by solving an inverse acoustic wave transmission problem. A low frequency acoustic pipe (60-6000 Hz of length 22 m, internal diameter 3.4 cm) was used for the experimental characterization of the samples. The parameters were identified by the minimization of the difference between the transmissions coefficients data obtained in the pipe with that from an analytical interaction model in which the compressed earth blocks were considered as having rigid frames. The viscous and thermal effects in the pores were accounted for by employing the Johnson-Champoux-Allard-Lafarge model. The results obtained by inversion for high-density compressed earth blocks showed some discordance between the model and experiment especially for the high frequency limit of the acoustic characteristics studied. This was as a consequence of applying high compaction pressure rendering them very highly resistive therefore degrading the signal-to-noise ratios of the transmitted waves. The results showed that the airflow resistivity was very sensitive to the degree of the applied compaction pressure used to form the blocks.