Ajitkumar P. Mulavara

Changes in walking strategies after spaceflight

Over the last several years, our laboratory has investigated postflight astronaut locomotion with the aim of better understanding how adaptive changes in underlying sensorimotor mechanisms contribute to postflight gait dysfunction. One of the first questions we asked focused on the effects of spaceflight on head movement control during postflight locomotion. We hypothesized that adaptive modification in multiple sensorimotor systems caused by exposure to the microgravity conditions of spaceflight would lead to disruption in head-trunk coordination during postflight walking. These changes in head-trunk coordination strategies would then disrupt gaze control and alter the organization of terrestrial locomotor control strategies. The data presented indicate that some behavior observed after spaceflight may represent an adaptive reorganization of motor responses targeted at restoring functional mobility but in a novel way that is not observed or required during preflight walking. This observation has implications for the interpretation of all tests of postflight sensorimotor function.

Critical features of training that facilitate adaptive generalization of over ground locomotion

When subjects learn motor tasks under novel visuomotor conditions variations in sensory input during training facilitate adaptive generalization. We tested the hypotheses that training with multiple sensory input variations is more effective than a single or no variation and that training must include critical features of the criterion task. Normal adults were pre- and post-tested on an obstacle avoidance task while wearing visual distortion lenses after treadmill walking (Experiment 1), or balance training (Experiment 2). Subjects were randomized to training groups in which they wore either: (1) three different visual distortion lenses, (2) a single pair of visual distortion lenses, or (3) sham lenses. Post-tests were done while wearing novel lenses. In Experiment 1 subjects who trained with multiple lenses adapted better than single or sham lens groups. The single lens-training group with magnifying lenses adapted better than the other single lens groups. In Experiment 2, training for dynamic balance, alone, did not increase training efficacy. Thus, training for an obstacle avoidance task in a novel visual environment required a critical feature of the criterion task: locomotion. Constant practice with a single lens was successful only if the best lens was selected, but the best lens could not be known ahead of time. Therefore variable practice with multiple lenses on a task that included a critical feature of the criterion task was the best training strategy to enhance adaptive generalization.

Effects of Stochastic Vestibular Galvanic Stimulation and LDOPA on Balance and Motor Symptoms in Patients With Parkinson's Disease

BACKGROUND Balance problems contribute to reduced quality of life in Parkinsons disease (PD) and available treatments are often insufficient for treating axial and postural motor symptoms. OBJECTIVE To investigate the safety of use and possible effects of stochastic vestibular stimulation (SVS) alone and combined with LDOPA in patients with PD. METHODS SVS or sham stimulation was administered to 10 PD patients in a double-blind placebo controlled cross-over pilot study. Motor symptoms and balance were evaluated in a defined off-medication state and after a 200 mg test dose of LDOPA, using UPDRS-III, Posturo-Locomotor-Manual (PLM) movement times (MT), static posturography and force plate measurements of the correcting response to a balance perturbation. RESULTS Patients did not detect when SVS was active, but SVS increased nausea after LDOPA in two patients. Mixed model analysis demonstrated that SVS improved balance corrections after a backward perturbation and shortened the postural response time. In static posturography there was significant interaction between effects of SVS, medication and proprioceptive input (standing on foam vs. on hard support) and SVS decreased the total sway-path with eyes closed and off medication. As expected, LDOPA improved the UPDRS-III scores and MT. There was an interaction between the effect of SVS and LDOPA on UPDRS-III partly because of reduced UPDRS-III scores with SVS in the off-medication state. CONCLUSIONS Short term use of SVS is safe, improves corrective postural responses and may have a small positive effect on motor symptoms in PD patients off treatment.

Adaptation of neuromuscular activation patterns during treadmill walking after long-duration space flight

The precise neuromuscular control needed for optimal locomotion, particularly around heel strike and toe off, is known to he compromised after short duration (8- to 15-day) space flight. We hypothesized here that longer exposure to weightlessness would result in maladaptive neuromuscular activation during postflight treadmill walking. We also hypothesized that space flight would affect the ability of the sensory-motor control system to generate adaptive neuromuscular activation patterns in response to changes in visual target distance during postflight treadmill walking. Seven crewmembers, who completed 3- to 6-month missions, walked on a motorized treadmill while visually fixating on a target placed 30 cm (NEAR) or 2 m (FAR) from the subjects eyes. Electronic foot switch data and surface electromyography were collected from selected muscles of the right lower limb. Results indicate that the phasic features of neuromuscular activation were moderately affected and the relative amplitude of activity in the tibialis anterior and rectus femoris around toe off changed after space flight. Changes also were evident after space flight in how these muscles adapted to the shift in visual target distance.

The use of in-flight foot pressure as a countermeasure to neuromuscular degradation.

The purpose of this study was to determine whether applying foot pressure to unrestrained subjects during space flight could enhance the neuromuscular activation associated with rapid arm movements. Four men performed unilateral arm raises while wearing--or not wearing--specially designed boots during a 81- or 115-day space flight. Arm acceleration and surface EMG were obtained from selected lower limb and trunk muscles. Pearson r coefficients were used to evaluate similarity in phasic patterns between the two in-flight conditions. In-flight data also were magnitude normalized to the mean voltage value of the muscle activation waveforms obtained during the no-foot-pressure condition to facilitate comparison of activation amplitude between the two in-flight conditions. Foot pressure enhanced neuromuscular activation and somewhat modified the phasic features of the neuromuscular activation during the arm raises.

Vestibular-somatosensory convergence in head movement control during locomotion after long-duration space flight.

Space flight causes astronauts to be exposed to adaptation in both the vestibular and body load-sensing somatosensory systems. The goal of these studies was to examine the contributions of vestibular and body load-sensing somatosensory influences on vestibular mediated head movement control during locomotion after long-duration space flight. Subjects walked on a motor driven treadmill while performing a gaze stabilization task. Data were collected from three independent subject groups that included bilateral labyrinthine deficient (LD) patients, normal subjects before and after 30 minutes of 40% bodyweight unloaded treadmill walking, and astronauts before and after long-duration space flight. Motion data from the head and trunk segments were used to calculate the amplitude of angular head pitch and trunk vertical translation movement while subjects performed a gaze stabilization task, to estimate the contributions of vestibular reflexive mechanisms in head pitch movements. Exposure to unloaded locomotion caused a significant increase in head pitch movements in normal subjects, whereas the head pitch movements of LD patients were significantly decreased. This is the first evidence of adaptation of vestibular mediated head movement responses to unloaded treadmill walking. Astronaut subjects showed a heterogeneous response of both increases and decreases in the amplitude of head pitch movement. We infer that body load-sensing somatosensory input centrally modulates vestibular input and can adaptively modify vestibularly mediated head-movement control during locomotion. Thus, space flight may cause central adaptation of the converging vestibular and body load-sensing somatosensory systems leading to alterations in head movement control.

Using Low Levels of Stochastic Vestibular Stimulation to Improve Balance Function

Low-level stochastic vestibular stimulation (SVS) has been associated with improved postural responses in the medio-lateral (ML) direction, but its effect in improving balance function in both the ML and anterior-posterior (AP) directions has not been studied. In this series of studies, the efficacy of applying low amplitude SVS in 0–30 Hz range between the mastoids in the ML direction on improving cross-planar balance function was investigated. Forty-five (45) subjects stood on a compliant surface with their eyes closed and were instructed to maintain a stable upright stance. Measures of stability of the head, trunk, and whole body were quantified in ML, AP and combined APML directions. Results show that binaural bipolar SVS given in the ML direction significantly improved balance performance with the peak of optimal stimulus amplitude predominantly in the range of 100–500 μA for all the three directions, exhibiting stochastic resonance (SR) phenomenon. Objective perceptual and body motion thresholds as estimates of internal noise while subjects sat on a chair with their eyes closed and were given 1 Hz bipolar binaural sinusoidal electrical stimuli were also measured. In general, there was no significant difference between estimates of perceptual and body motion thresholds. The average optimal SVS amplitude that improved balance performance (peak SVS amplitude normalized to perceptual threshold) was estimated to be 46% in ML, 53% in AP, and 50% in APML directions. A miniature patch-type SVS device may be useful to improve balance function in people with disabilities due to aging, Parkinson’s disease or in astronauts returning from long-duration space flight.

Exercise as potential countermeasure for the effects of 70 days of bed rest on cognitive and sensorimotor performance

Background: Spaceflight has been associated with changes in gait and balance; it is unclear whether it affects cognition. Head down tilt bed rest (HDBR) is a microgravity analog that mimics cephalad fluid shifts and body unloading. In consideration of astronaut’s health and mission success, we investigated the effects of HDBR on cognition and sensorimotor function. Furthermore, we investigated if exercise mitigates any cognitive and sensorimotor sequelae of spaceflight. Method: We conducted a 70-day six-degree HDBR study in 10 male subjects who were randomly assigned to a HDBR supine exercise or a HDBR control group. Cognitive measures (i.e., processing speed, manual dexterity, psychomotor speed, visual dependency, and 2D and 3D mental rotation) and sensorimotor performance (functional mobility (FMT) and balance performance) were collected at 12 and 8 days pre-HDBR, at 7, 50, and 70 days in HDBR, and at 8 and 12 days post-HDBR. Exercise comprised resistance training, and continuous and high-intensity interval aerobic exercise. We also repeatedly assessed an outside-of-bed rest control group to examine metric stability. Results: Small practice effects were observed in the control group for some tasks; these were taken into account when analyzing effects of HDBR. No significant effects of HDBR on cognition were observed, although visual dependency during HDBR remained stable in HDBR controls whereas it decreased in HDBR exercise subjects. Furthermore, HDBR was associated with loss of FMT and standing balance performance, which were almost fully recovered 12 days post-HDBR. Aerobic and resistance exercise partially mitigated the effects of HDBR on FMT and accelerated the recovery time course post-HDBR. Discussion: HDBR did not significantly affect cognitive performance but did adversely affect FMT and standing balance performance. Exercise had some protective effects on the deterioration and recovery of FMT.

Obstacle avoidance in novel visual environments improved by variable practice training.

Motor performance on simple tasks improves after training in variable practice. We asked if locomotor skill during an obstacle-avoidance task in a novel sensorimotor environment improved through training in variable practice on other complex tasks. 40 normal adults practiced gross motor skills while wearing either sham lenses, one of several visual distortion lens (constant practice), or three different visual distortion lenses (variable practice). Posttests on obstacle avoidance with novel lenses showed significantly better scores with variable practice and one of the constant groups vs sham lenses. Constant and variable practice groups did not differ. Thus, performance in a novel environment improves after training on similar type novelty, even when practice and test conditions differ. Constant practice was effective only if the subjects used the lens efficacious in training. Variable practice increases the likelihood of efficacious training when adaptive performance is required in a novel environment.

Postural stability during treadmill locomotion as a function of the visual polarity and rotation of a three-dimensional virtual environment

Visual inputs provide us with important cues for orientation and self-movement perception during locomotion. The purpose of the present study was to better understand and quantify the effects of visual scene variables: visual polarity and visual scene rotation on postural stability during treadmill locomotion. During 60 s trials, subjects walked at 4.0 km/h while viewing a monoscopic, passive-immersive, 3D virtual room environment that contained either polarized or nonpolarized content and was back-projected onto a screen 1.5 m in front of them, one at a time. Scenes remained static for the first 30 s, then rotated about the roll, pitch, or yaw axis of the room at a constant rate of 30/s for the remaining 30 s. Each subject saw each combination of visual polarity (polarized, nonpolarized) and scene rotation direction (roll, pitch, yaw) for three separate trials. There was a main effect of visual polarity on variability in torso linear X (foreaft) position and torso roll and pitch angular orientations with polarized scenes causing more variability than nonpolarized scenes. For the polarized scenes only, variability in torso roll, pitch, and yaw angular orientations was increased for corresponding scene rotation directions, respectively. In general, rotating visual scenes caused increased variability in torso motion compared to static scenes. Visual polarity is an important consideration when designing virtual environment motion simulations.