Anticipatory postural adjustments in reach-to-grasp: effect of object mass predictability

Identification of movement phenotypes from occupational gesture kinematics: Advancing individual ergonomic exposure classification and personalized training

The identification of personalized preventive strategies plays a major role in contrasting the occurrence of work-related musculoskeletal disorders. This requires the identification of distinct movement patterns within large samples and the attribution of a proper risk level to each identified movement phenotype. We assessed the feasibility of this approach by exploiting wearable inertial measurement units to estimate the whole-body kinematics of 43 healthy participants performing 18 reach-to-manipulate movements, which differed based on the object's position in the space and the type of manipulation required. Through unsupervised clustering, we identified multiple movement phenotypes graded by ergonomic performance. Furthermore, we determined which joints mostly contributed to instantiating the ergonomic differences across clusters, emphasizing the importance of monitoring this aspect during occupational gestures. Overall, our analysis suggests that movement phenotypes can be identified within occupational motor repertoires. Assigning individual performance to specific phenotypes has the potential to inform the development of more effective and tailored interventions.

Anticipatory action planning for stepping onto competing potential targets

The brain plans an anticipatory action for performing tasks successfully and effortlessly even if there are multiple possible options. There is increasing evidence that, when multiple actions are possible, the brain considers two factors when planning an anticipatory action—the probabilistic value and the action cost for each potential action. When the action involves maintaining upright balance, such as standing, stepping, or walking, the action cost for maintaining postural stability could be considered dominantly. We addressed this issue by using a “go-before-you-know” task to step onto a target on the floor. In this task, two potential targets were located on the medial or lateral side of the stepping foot, and the true target was cued only after participants shifted their loads to leave that foot. Participants initiated their stepping actions without knowing which of the potential targets would be the true one. The results showed that, for the majority of participants, lateral displacements of the center of pressure (COP) with two potential targets were similar to those when a single target exists on the individual’s medial side. Given that mediolateral postural stability became more destabilized with stepping onto the medial target than stepping onto the lateral target, they were likely to plan their mediolateral components of the postural adjustments for the worst-case scenario (i.e., falling). Additionally, posterior COP movements with two potential targets became smaller than those with a single target, suggesting an effort to create extra time to determine the true target and to adjust the swing foot. Based on these findings, we concluded that action costs for maintaining postural stability were considered dominantly for planning an anticipatory action to accomplish a stepping task successfully while ensuring upright balance.

Validity and reliability of a smartphone-based assessment for anticipatory and compensatory postural adjustments during predictable perturbations

BACKGROUND

Postural adjustments involve displacements of the center of mass (COM), controlled by the central nervous system (CNS), to maintain equilibrium whilst standing. Postural adjustments can be anticipatory (APAs) or compensatory (CPAs), and are triggered to counteract predictable perturbations.

RESEARCH QUESTION

Is the new smartphone application, Momentum, a valid and reliable tool for the assessment of body balance, by measuring APAs and CPAs using accelerometer readings?

METHODS

20 young adults were exposed to external predictable perturbations induced at the shoulder level, whilst standing. COM linear acceleration was recorded by Momentum (extracting data from a smartphone's accelerometer) and a 3D motion capture system.

RESULTS

The key results demonstrated a very high, significant correlation (r ≥ 0.7, p < 0.05) between the two device settings in the APA parameters_, which obtained r = 0.65, denoting a high correlation. Considering the reliability, variables that are compensatory in nature are presented on a scale of good to excellent in measurement methods, kinematics, and Momentum. However, the anticipatory variables presented excellent reliability only for the kinematics.

SIGNIFICANCE

These experiments show that Momentum is a valid method for measuring COM acceleration under predictable perturbations and is reliable for compensatory events.

Functional Outcomes Associated With Independence in Walking Among People With Hereditary Ataxias: An Exploratory Cross-sectional Study

OBJECTIVE

This study aimed to identify functional outcomes related to independence in walking among people affected by hereditary ataxias.

METHODS

Sixty participants were selected by convenience in a list provided by an organization of people with ataxia. Sociodemographic and clinical data were collected using a semistructured questionnaire. The Assessment and Rating of Ataxia was used to assess and rate cerebellar ataxia. Changes in body structure and function, limitation in activities, and restriction in participation were evaluated with specific outcome measures. Participants were classified as independent in walking if they were able to walk without walking aids or human assistance and as dependent in walking if they have been using walking aids (sticks, crutches, or walkers) for more than 6 months, using a wheelchair for locomotion most of the day, or both. Multivariate logistic regression analyses were conducted hierarchically and in blocks considering upper limbs function, balance systems, sensory functions, postural control, walking, independence, cognition, and perception as independent variables. The prevalence ratio for walking independence was determined.

RESULTS

The final regression model pointed out that gait capacity assessed by the 6-Minute Walk Test and dexterity assessed by the Box and Blocks test were the main markers related to walking independence in individuals with hereditary ataxias.

CONCLUSION

The distance covered in 6 minutes of walking (walking endurance) and upper extremity dexterity can be used to better assess the progression of cerebellar disease related to walking independence in individuals with hereditary ataxias.

IMPACT

This study supports early detection of individuals who are at risk of loss of walking independence and an optimized rehabilitation plan.

Impact of Types of Breathing on Static Balance Ability in Healthy Adults

Recent studies have suggested that breathing type may affect balance ability. However, most of these studies were conducted on the elderly and patients with musculoskeletal or neurological disorders. Therefore, the effect of voluntary breathing, such as thoracic and abdominal breathing, on the balance ability of people in various age groups is not clearly understood. The purpose of this study was to investigate the differences in balance ability according to the type of breathing in healthy young adults. This study included 78 healthy, young adults. All subjects were assessed for balance ability in neutral breathing, thoracic breathing, and abdominal breathing through a crossover design. Balance ability was assessed during static standing using a force plate. Participants were trained in voluntary breathing, evaluated using electromyography. During voluntary breathing, sway velocity, anterior-posterior difference, and anterior-posterior standard deviation increased while anterior-posterior sample entropy decreased compared to neutral breathing (p < 0.05). Compared with thoracic breathing, abdominal breathing increased sway velocity and variability, and reduced complexity (p < 0.05). These findings show that balance ability is affected by breathing, even in healthy young adults.

The Effect of Predictability of the Perturbation Magnitude on Anticipatory and Compensatory Postural Adjustments during a Bimanual Load-Lifting Task

Background: To minimize the potential postural disturbance induced by external or self-initiated perturbations, humans generate anticipatory postural adjustments based on their perceived consequences of the body disturbance. Lifting is a common activity that induces a self-initiated perturbation that can compromise balance control. Aim: To assess anticipatory (APAs) and compensatory (CPAs) postural adjustments generated in response to a self-initiated perturbation induced by lifting objects of uncertain mass. Methods: Ten young adults lifted the tray with either light or heavy object placed in it. Electromyographic activity of eight trunk and leg muscles, and center-of-pressure (COP) displacements were recorded and analyzed during the APAs and CPAs phases. Results: When the object mass changed unpredictably, the participants generated APAs based on the most recent experience of lifting and needed three trials of lifting to generate optimal APAs and CPAs. Conclusions: Young adults were able to predict the perturbation magnitude during self-initiated perturbations induced by lifting objects. The outcome provides a foundation for future studies focusing on the role of predictability of perturbation consequences in postural control of older adults and individuals with balance deficit.

Voluntary control of breathing affects center of pressure complexity during static standing in healthy older adults

Background Physiological/biomechanical systems display high degrees of complexity in their corresponding physiological and/or biomechanical outputs, indicative of normal healthy physiological functioning, though little attention has been paid to potential mechanisms which may affect complexity. Center of pressure (CoP) dynamics also display high degrees of complexity and may be affected via altered respiratory-motor interactions such as during voluntary control of breathing. Purpose The purpose of this study was to investigate the differences in the complexity of CoP dynamics during autonomous vs. voluntary control of breathing and between different voluntarily controlled breathing conditions. Methods Center of pressure recordings were taken from 18 older adults during static standing under three different breathing conditions: 1) neutral breathing, 2) abdominal breathing, and 3) thoracic breathing, the first constituting the autonomous breathing condition and the latter two constituting voluntarily controlled breathing conditions. CoP dynamics were quantified using sample entropy, standard deviation, 95% sway area, and average radial velocity. Repeated measure MANOVAs were used to assess the effect of breathing on CoP dynamics, with top-down application of ANOVAs and pairwise comparison as needed. Results Voluntary control of breathing during both conditions resulted in significantly higher CoP variability and lower sample entropy than during autonomous control of breathing in the mediolateral direction, indicating less complex dynamics and loss of system control. No significant differences between voluntary breathing conditions were observed. Conclusion Voluntary control of breathing significantly affected on CoP dynamics during static standing. The complexity of the postural control system may be affected via alterations in respiratory-motor interactions.

Modelling the structure of object-independent human affordances of approaching to grasp for robotic hands

Grasp affordances in robotics represent different ways to grasp an object involving a variety of factors from vision to hand control. A model of grasp affordances that is able to scale across different objects, features and domains is needed to provide robots with advanced manipulation skills. The existing frameworks, however, can be difficult to extend towards a more general and domain independent approach. This work is the first step towards a modular implementation of grasp affordances that can be separated into two stages: approach to grasp and grasp execution. In this study, human experiments of approaching to grasp are analysed, and object-independent patterns of motion are defined and modelled analytically from the data. Human subjects performed a specific action (hammering) using objects of different geometry, size and weight. Motion capture data relating the hand-object approach distance was used for the analysis. The results showed that approach to grasp can be structured in four distinct phases that are best represented by non-linear models, independent from the objects being handled. This suggests that approaching to grasp patterns are following an intentionally planned control strategy, rather than implementing a reactive execution.

Postural Stabilization Differences in Idiopathic Parkinson's Disease and Progressive Supranuclear Palsy during Self-Triggered Fast Forward Weight Lifting

Progressive supranuclear palsy (PSP) and late-stage idiopathic Parkinson’s disease (IPD) are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Self-triggered, weighted movements appear to provoke falls in IPD, but not in PSP. Repeated self-triggered lifting of a 0.5–1-kg weight (<2% of body weight) with the dominant hand was performed in 17 PSP, 15 IPD with falling history, and 16 controls on a posturography platform. PSP showed excessive force scaling of weight and body motion with high-frequency multiaxial body sway, whereas IPD presented a delayed-onset forward body displacement. Differences in center of mass displacement apparent at very small weights indicate that both syndromes decompensate postural control already within stability limits. PSP may be subject to specific postural system devolution. IPD are susceptible to delayed forward falling. Differential physiotherapy strategies are suggested.

Anticipatory postural adjustments and anticipatory synergy adjustments: preparing to a postural perturbation with predictable and unpredictable direction

We explored two aspects of feed-forward postural control, anticipatory postural adjustments (APAs) and anticipatory synergy adjustments (ASAs) seen prior to self-triggered unloading with known and unknown direction of the perturbation. In particular, we tested two main hypotheses predicting contrasting changes in APAs and ASAs. The first hypothesis predicted no major changes in ASAs. The second hypothesis predicted delayed APAs with predominance of co-contraction patterns when perturbation direction was unknown. Healthy subjects stood on the force plate and held a bar with two loads acting in the forward and backward directions. They pressed a trigger that released one of the loads causing a postural perturbation. In different series, the direction of the perturbation was either known (the same load released in all trials) or unknown (the subjects did not know which of the two loads would be released). Surface electromyograms were recorded and used to quantify APAs, synergies stabilizing center of pressure coordinate (within the uncontrolled manifold hypothesis), and ASA. APAs and ASAs were seen in all conditions. APAs were delayed, and predominance of co-contraction patterns was seen under the conditions with unpredictable direction of perturbation. In contrast, no significant changes in synergies and ASAs were seen. Overall, these results show that feed-forward control of vertical posture has two distinct components, reflected in APAs and ASAs, which show qualitatively different adjustments with changes in predictability of the direction of perturbation. These results are interpreted within the recently proposed hierarchical scheme of the synergic control of motor tasks. The observations underscore the complexity of the feed-forward postural control, which involves separate changes in salient performance variables (such as coordinate of the center of pressure) and in their stability properties.

Quantitative analysis of upright standing in adults with late-onset Pompe disease

Pompe disease is a rare disorder producing muscle weakness and progressive impairments in performing daily motor activities, such as walking and standing. Most studies have focused on dysfunctions at cellular level, restricting the examination of gross motor functions to qualitative or subjective rating scales evaluations. With the aim of providing an instrumented quantification of upright standing in Pompe disease, we used a force platform to measure the center of pressure over three foot positions and with eyes open and closed. Amplitude and variability of body sway were measured to determine the level of postural stability, while power spectrum analysis and nonlinear computations were performed to explore the structure of the postural control. In comparison with healthy participants, patients with Pompe disease showed a reduced level of postural stability, but irrelevant variations in frequency content and spatio-temporal structure of the sway motion were detected. Changes in foot position did not increase the postural instability associated with Pompe disease, but prominent worsening occurred in the patients when they stand with eyes closed, particularly along the anterior-posterior direction. These results provide objective elements to monitor deficiencies of upright standing in Pompe disease, emphasizing the specific contributions of sway direction and sensory deficits.

Specificity of foot configuration during bipedal stance in ballet dancers

BACKGROUND AND AIM

Learning highly specialized upright postures may be of benefit for more common as well as for novel stances. In this study, we asked whether this generalization occurs with foot configurations previously trained or depends on a generic increase in balance difficulty. We also explored the possibility that the benefit may concern not only the level of postural performance but also the structural organization of the upright standing.

METHODS

Ten elite professional ballet dancers were compared to ten untrained subjects, measuring the motion of the center of pressure (COP) across a set of five stances with different foot configurations. The balance stability was measured computing the area, the sway path, and the root mean square of the COP motion, whereas the structure of the postural control was assessed by compute approximate entropy, fractal dimension and the mean power frequency. The foot position included common and challenging stances, with the level of difficulty changed across the configurations. Among these conditions, only one foot configuration was familiar to the dancers.

RESULTS

Statistically significant differences between the two groups, for all the parameters, were observed only for the stance with the foot position familiar to the dancers. Stability and structural parameters exhibited comparable differences.

CONCLUSIONS

We concluded that the benefit from classical ballet is limited to a specific foot configuration, regardless of the level of stance difficulty or the component of postural control.

Effects of predictability of load magnitude on the response of the Flexor Digitorum Superficialis to a sudden fingers extension

Muscle reflexes, evoked by opposing a sudden joint displacement, may be modulated by several factors associated with the features of the mechanical perturbation. We investigated the variations of muscle reflex response in relation to the predictability of load magnitude during a reactive grasping task. Subjects were instructed to flex the fingers 2–5 very quickly after a stretching was exerted by a handle pulled by loads of 750 or 1250 g. Two blocks of trials, one for each load (predictable condition), and one block of trials with a randomized distribution of the loads (unpredictable condition) were performed. Kinematic data were collected by an electrogoniometer attached to the middle phalanx of the digit III while the electromyography of the Flexor Digitorum Superficialis muscle was recorded by surface electrodes. For each trial we measured the kinematics of the finger angular rotation, the latency of muscle response and the level of muscle activation recorded below 50 ms (short-latency reflex), between 50 and 100 ms (long-latency reflex) and between 100 and 140 ms (initial portion of voluntary response) from the movement onset. We found that the latency of the muscle response lengthened from predictable (35.5±1.3 ms for 750 g and 35.5±2.5 ms for 1250 g) to unpredictable condition (43.6±1.3 ms for 750 g and 40.9±2.1 ms for 1250 g) and the level of muscle activation increased with load magnitude. The parallel increasing of muscle activation and load magnitude occurred within the window of the long-latency reflex during the predictable condition, and later, at the earliest portion of the voluntary response, in the unpredictable condition. Therefore, these results indicate that when the amount of an upcoming perturbation is known in advance, the muscle response improves, shortening the latency and modulating the muscle activity in relation to the mechanical demand.

Does postural stability affect grasping?

We examined whether challenging upright stance influences the execution of a grasping task. Participants reached to grasp a small sphere while standing either on a stable surface or on foam. Before reaching for the sphere, participants exhibited more body sway and greater fluctuations in the centre of pressure when standing on foam. While reaching for the sphere, the overall body posture changed less when standing on foam than when standing on the stable surface. The digits' and wrist's movements towards the sphere were no different when standing on foam than when standing on the stable surface. Presumably, the redundancy in the way movements can be performed is exploited to choose the most suitable changes in joint angles to achieve the desired movements of the digits under the prevailing conditions.