Upright stance on a single vs double seesaw: are automatic and voluntary components similarly involved in balance control?

The relevance of seesaw devices in postural evaluation and training is gathering growing evidence due to its sensory-motor specificity. Nonetheless, the physiological specificities resulting from the dissociation or not of the seesaws (single vs double) still need to be investigated, in particular by assessing the respective contribution of automatic and voluntary components in the postural control. A protocol based on attention disturbance through a dual-task paradigm was set to establish this contribution. The general assumption was that the larger the dual-task effects, the larger the voluntary component contribution. Based on the larger postural sway induced by the dissociated seesaws, it is expected that the larger dual-task effect occurs in that latter case. The subjects were required to stand with eyes closed on solid ground (SG), a single (SS) and a double (DS) seesaw device while mentally solving or not a navigation task. The movements of the seesaw, placed on a double force platform, were assessed through a frequency analysis of the resultant center-of-pressure displacements along both mediolateral and anteroposterior axes. A larger contribution (p < 0.05) of the voluntary component was observed when subjects were standing on the DS seesaw, especially along the mediolateral axis. This trend is thought to prepare for a step initiation and would be related to the threat encountered by the subjects. In contrast, performing a dual-task protocol does not affect the antero-posterior sway whatever the support conditions. These data give specific pointers for the relative cognitive demand in the postural strategies induced by the double seesaw device.

Standing on a Double-Seesaw Device is an Easy Way to Modify the Coordination Between the Two Feet for Controlling Upright Stance: Assessment Through Weight-Bearing Asymmetry.

Healthy young subjects were instructed to modify their weight-bearing asymmetry when standing on a double-seesaw device. The results indicated decreased and unchanged amplitudes in the center-of-pressure movements under the unloaded and loaded legs, respectively. In addition, a concomitant increased contribution of the more loaded leg and a decreased contribution of the pressure distribution mechanism along the mediolateral axis were observed in the production of the resultant center of pressure, its amplitude remaining constant. Thus, contrary to what was previously reported for stance control on solid ground, one of the main characteristics of a double-seesaw device, by preventing increased amplitudes on the loaded side during weight-bearing asymmetry, would be to facilitate a greater independency of the feet in the stance control process.

Undisturbed stance on a double seesaw: Interaction between asymmetries of the center-of-pressure patterns under each foot and weight-bearing.

Both center-of-pressure (CP) displacements under each foot and relative body-weight distribution intervene in the production of resultant CP movements. To better understand their respective involvement, a protocol was set up for young healthy individuals consisting in standing on a double seesaw, favoring pitch motions and laying on a dual-force platform. The postural control effects induced by two types of asymmetry, weight-bearing and the CP movement patterns, were investigated. These asymmetries were achieved by associating two seesaws with two different lengths for the radii of the ridges and by requiring specific body-weight distributions. The results indicate that the postural strategies, aimed at controlling anteroposterior sway, are related to the subjects' capacity to minimize the CP displacements under the less stable support, whatever load is applied. In contrast, the degree of involvement of the more stable support must be viewed as a complement used to secure the appropriate motor output, i.e., the resultant CP movements. Within this objective, both the applied load and the CP amplitudes under the more stable support are taken into account. These data provide additional insights into the compensatory mechanisms between the interactions between the two feet, which are used to produce the adequate resultant CP movements and therefore upright stance control. The specificity of the double seesaw that can induce asymmetric CP patterns and/or asymmetric body-weight distribution makes it a legitimate contender to be used as a rehabilitation device for patients with neurological and/or traumatic diseases.