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Fino PC, Raffegeau TE, Parrington L, Peterka RJ, King LA. Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury. J Biomech 2020; 112:110045. [PMID: 33011672 DOI: 10.1016/j.jbiomech.2020.110045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 01/28/2023]
Abstract
Increased postural sway is often observed in people with mild traumatic brain injury (mTBI), but our understanding of how individuals with mTBI control their head during stance is limited. The purpose of this study was to determine if people with mTBI exhibit increased sway at the head compared with healthy controls. People with persisting symptoms after mTBI (n = 59, 41 women) and control participants (n = 63, 38 women) stood quietly for one minute in four conditions: eyes open on a firm surface (EO-firm), eyes closed on a firm surface (EC-firm), eyes open on a foam pad (EO-foam), and eyes closed on foam (EC-foam). Inertial sensors at the head, sternum, and lumbar region collected tri-axial accelerations. Root-mean-square (RMS) accelerations in anteroposterior (AP) and mediolateral (ML) directions and sway ratios between the head and sternum, head and lumbar, and sternum and lumbar region were compared between groups. Temporal coupling of anti-phase motion between the upper and lower body angular accelerations was assessed with magnitude squared coherence and cross-spectral phase angles. People with mTBI demonstrated greater sway than controls across conditions and directions. During foam-surface conditions, the control group, but not the mTBI group, reduced ML sway at their head and trunk relative to their lumbar by increasing the expression of an anti-phase hip strategy within the frontal plane. These results are consistent with suggestions of inflexible or inappropriate postural control in people with mTBI.
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Affiliation(s)
- Peter C Fino
- University of Utah, Department of Health and Kinesiology, Salt Lake City, UT, USA.
| | - Tiphanie E Raffegeau
- University of Utah, Department of Health and Kinesiology, Salt Lake City, UT, USA
| | - Lucy Parrington
- Oregon Health Sciences University, Department of Neurology, Portland, OR, USA
| | - Robert J Peterka
- Oregon Health Sciences University, Department of Neurology, Portland, OR, USA; National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR, USA
| | - Laurie A King
- Oregon Health Sciences University, Department of Neurology, Portland, OR, USA; National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR, USA
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Sozzi S, Nardone A, Schieppati M. Adaptation of balancing behaviour during continuous perturbations of stance. Supra-postural visual tasks and platform translation frequency modulate adaptation rate. PLoS One 2020; 15:e0236702. [PMID: 32735602 PMCID: PMC7394407 DOI: 10.1371/journal.pone.0236702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 07/13/2020] [Indexed: 01/01/2023] Open
Abstract
When humans are administered continuous and predictable perturbations of stance, an adaptation period precedes the steady state of balancing behaviour. Little information is available on the modulation of adaptation by vision and perturbation frequency. Moreover, performance of supra-postural tasks may modulate adaptation in as yet unidentified ways. Our purpose was to identify differences in adaptation associated to distinct visual tasks and perturbation frequencies. Twenty non-disabled adult volunteers stood on a platform translating 10 cm in antero-posterior (AP) direction at low (LF, 0.18 Hz) and high frequency (HF, 0.56 Hz) with eyes open (EO) and closed (EC). Additional conditions were reading a text fixed to platform (EO-TP) and reading a text stationary on ground (EO-TG). Peak-to-peak (PP) displacement amplitude and AP position of head and pelvis markers were computed for each of 27 continuous perturbation cycles. The time constant and extent of head and pelvis adaptation and the cross-correlation coefficients between head and pelvis were compared across visual conditions and frequencies. Head and pelvis mean positions in space varied little across conditions and perturbation cycles but the mean head PP displacements changed over time. On average, at LF, the PP displacement of the head and pelvis increased progressively. Adaptation was rapid or ineffective with EO, but slower with EO-TG, EO-TP, EC. At HF, the head PP displacement amplitude decreased progressively with fast adaptation rates, while the pelvis adaptation was not apparent. The results show that visual tasks can modulate the adaptation rate, highlight the effect of the perturbation frequency on adaptation and provide evidence of priority assigned to pelvis stabilization over visual tasks at HF. The effects of perturbation frequency and optic flow and their interaction with other sensory inputs and cognitive tasks on the adaptation strategies should be investigated in impaired individuals and considered in the design of rehabilitation protocols.
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Affiliation(s)
- Stefania Sozzi
- Centro Studi Attività Motorie, ICS Maugeri SPA SB, IRCCS, Institute of Pavia, Pavia, Italy
| | - Antonio Nardone
- Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Neurorehabilitation and Spinal Units, ICS Maugeri SPA SB, IRCCS Institute of Pavia, Pavia, Italy
- * E-mail:
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Benallegue M, Laumond JP, Berthoz A. On the mechanical contribution of head stabilization to passive dynamics of anthropometric walkers. Int J Rob Res 2019. [DOI: 10.1177/0278364919894387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
During the steady gait, humans stabilize their head around the vertical orientation. Although there are sensori-cognitive explanations for this phenomenon, its mechanical effect on the body dynamics remains unexplored. In this study, we take profit from the similarities that human steady gait shares with the locomotion of passive-dynamics robots. We introduce a simplified anthropometric 2D model to reproduce a broad walking dynamics. In a previous study, we showed heuristically that the presence of a stabilized head–neck system has a significant influence on the dynamics of walking. This article gives new insights that lead to understanding this mechanical effect. In particular, we introduce an original cart upper-body model that allows to better understand the mechanical interest of head stabilization when walking, and we study how this effect is sensitive to the choice of control parameters.
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Affiliation(s)
- Mehdi Benallegue
- National Institute of Advanced Industrial Science and Technology, Japan
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Colebatch JG, Rosengren SM. Investigating short latency subcortical vestibular projections in humans: what have we learned? J Neurophysiol 2019; 122:2000-2015. [PMID: 31596627 DOI: 10.1152/jn.00157.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Vestibular evoked myogenic potentials (VEMPs) are now widely used for the noninvasive assessment of vestibular function and diagnosis in humans. This review focuses on the origin, properties, and mechanisms of cervical VEMPs and ocular VEMPs; how these reflexes relate to reports of vestibular projections to brain stem and cervical targets; and the physiological role of (otolithic) cervical and ocular reflexes. The evidence suggests that both VEMPs are likely to represent the effects of excitation of irregularly firing otolith afferents. While the air-conducted cervical VEMP appears to mainly arise from excitation of saccular receptors, the ocular VEMP evoked by bone-conducted stimulation, including impulsive bone-conducted stimuli, mainly arises from utricular afferents. The surface responses are generated by brief changes in motor unit firing. The effects that have been demonstrated are likely to represent otolith-dependent vestibulocollic and vestibulo-ocular reflexes, both linear and torsional. These observations add to previous reports of short latency otolith projections to the target muscles in the neck (sternocleidomastoid and splenius) and extraocular muscles (the inferior oblique). New insights have been provided by the investigation and application of these techniques.
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Affiliation(s)
- James G Colebatch
- Prince of Wales Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | - Sally M Rosengren
- Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
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Sozzi S, Nardone A, Schieppati M. Vision Does Not Necessarily Stabilize the Head in Space During Continuous Postural Perturbations. Front Neurol 2019; 10:748. [PMID: 31354614 PMCID: PMC6635830 DOI: 10.3389/fneur.2019.00748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 06/26/2019] [Indexed: 12/17/2022] Open
Abstract
Vision favors head stabilization in space during perturbations of standing balance. This is particularly obvious under conditions of continuous predictable perturbations as during sinusoidal antero-posterior (A-P) translations of the supporting platform. We tested here the hypothesis that under this condition the head can instead undergo large A-P oscillations, when a precision visual task is concurrently performed. We compared the head oscillations across four conditions while standing on a continuously translating platform. Eyes open (EO, no visual task), EO while reading a text fixed to the moving platform (EO-TP), EO while reading a text fixed to earth-ground (EO-TG), eyes-closed (EC). The platform translated at 0.2 and 0.6 Hz. Participants were young adult subjects, who received no particular instruction except reading the text aloud when required. Markers fixed on head, platform and text-sheet were captured by an optoelectronic device. We found that head oscillations were larger with EC than under all EO conditions. The oscillations were the least with EO and EO-TG, and intermediate with EO-TP. This was true under both low and high translation frequency, in spite of broadly smaller head oscillations at high frequency, common to all visual conditions. The distance between the head and the text was quite constant with EO-TP but fluctuated with EO-TG. The basic whole-body coordination features were moderately similar under all conditions, as assessed by the head-platform correlation coefficients and time lags. It appears that vision does not produce head stabilization in space when a concurrent visual task requiring focusing on a reading-text moving with the platform is performed. Contrary to traditional views centered on the stabilizing effect of vision under both static and dynamic conditions, the results show that head stabilization, normally ensuring a reference for inertial guidance for body balance, can be revoked by the CNS to allow performance of a non-postural task. This novel paradigm can shift long-standing views on the effect of vision on equilibrium control and be considered a potential exercise treatment for enhancing the multisensory integration process in people with balance problems.
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Affiliation(s)
- Stefania Sozzi
- Centro Studi Attività Motorie, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonio Nardone
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Marco Schieppati
- Centro Studi Attività Motorie, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Farkhatdinov I, Michalska H, Berthoz A, Hayward V. Idiothetic Verticality Estimation Through Head Stabilization Strategy. IEEE Robot Autom Lett 2019. [DOI: 10.1109/lra.2019.2913790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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