Alexander S. Aruin

Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements

Healthy subjects performed bilateral fast shoulder movements in different directions while standing on a force platform. Anticipatory postural adjustments were seen as changes in the electrical activity of postural muscles as well as displacements of the center of pressure and center of gravity. Postural muscle pairs of agonist-antagonist commonly demonstrated triphasic patterns starting prior to the first electromyographic (EMG) burst in the prime-mover muscle. Proximal postural muscles demonstrated the largest anticipatory increase in the background activity during movements in one of the two opposite directions (forward or backwards). These changes progressively decreased when movements deviated from the preferred direction and frequently disappeared during movements in the opposite direction. The patterns in distal muscles varied across subjects and could demonstrate larger anticipatory changes during movements forward and backwards as compared to movements in intermediate directions. Bilateral addition of inertial loads to the wrists did not change the general anticipatory patterns, while making some of their features more pronounced. Anticipatory postural adjustments were followed by later changes in the activity of postural muscles, also reflected in the mechanical variables. Changes in leg joint angles revealed a „hip-ankle strategy” during shoulder flexions and an „ankle strategy” during shoulder extensions. The study demonstrates different behaviors of proximal and distal muscles during anticipatory postural adjustments in preparation for fast arm movements. We suggest that the proximal muscles produce a general pattern of postural adjustments, while distal muscles take care of fine adjustments that are more likely to vary across subjects.

The role of motor action in anticipatory postural adjustments studied with self-induced and externally triggered perturbations

This study investigated the relation between the magnitude of a motor action triggering a postural perturbation and the magnitude of anticipatory postural adjustments. Subjects stood on a force platform and held, in extended arms, a balloon with a 2.2-kg load suspended on a rigid cord. In different series, unloadings were induced by fast bilateral shoulder abduction movements, by popping the balloon with a tack taped to the subjects right middle finger, or by the experimenter popping the balloon. Anticipatory postural adjustments were seen during all self-initiated unloadings as changes in the level of activation of postural muscles and in displacements of the center of pressure. However, absolute values of these changes were significantly smaller in the series with balloon popping as compared to the series with shoulder abductions. Such reactions were absent when the unloading was triggered by the experimenter. We conclude that a self-triggered perturbation is always associated with anticipatory postural adjustments, while the magnitude of the adjustments may be scaled with respect to the magnitude of a motor action used to induce the perturbation.

Anticipatory postural adjustments in conditions of postural instability

OBJECTIVES The purpose of this study was to investigate anticipatory postural adjustments (APAs) in standing subjects who performed a standard motor action triggering a standard postural perturbation (releasing a 2.2 kg load from extended arms) in conditions of different stability requirements. METHODS The degree of stability was varied either by balancing on special boards with long and narrow support beams or by instructions to the subjects. In the first series of experiments 13 subjects stood on the board facing either perpendicular to the beam (instability in a sagittal plane) or along the beam (instability in frontal plane); different widths of the beam were used to vary the degree of instability. During the second series of experiments (6 subjects) inclined and one-legged postures were used to induce instability in sagittal and frontal planes respectively. EMG activity of rectus abdominis, erector spinae, rectus femoris, biceps femoris, tibialis anterior, and soleus muscles were recorded. Statistical methods included repeated measures analysis of variance (ANOVA) with direction of instability and level of instability being major factors, descriptive statistics, and post hoc Students t tests. RESULTS The integral measure of changes in the background electromyographic activity of postural muscles during APAs depended on two factors related to the postural task: (1) standing on a platform with a narrow support area led to an attenuation of the APAs; and (2) these effects were stronger when instability was in a sagittal rather than in the frontal plane. The anticipatory component in the displacement of the center of pressure did not show a clear attenuation that would depend on the direction of instability. CONCLUSIONS We suggest a hypothesis that, in conditions of high stability demands, the central nervous system may suppress APAs as a protection against their possible destabilizing effects. These effects are more pronounced when the direction of an expected perturbation is in the plane of instability.

Anticipatory postural adjustments during self inflicted and predictable perturbations in Parkinson's disease.

This study investigated the relation between impaired anticipatory postural adjustments and bradykinesia in Parkinsons disease. Patients with Parkinsons disease and age matched controls stood on a platform. In one series of experiments, they performed fast, discrete shoulder flexion or extension movements. In another series, they were required to press a trigger with the right thumb and thus to release a load that was suspended from a bar which they were holding in front of them in extended arms. One more series included catching a load on the same bar. Anticipatory changes in the activity of postural muscles before fast voluntary movements occurred in patients and controls although the patients showed higher variability of anticipatory patterns. During load dropping and catching, control subjects had reproducible, although smaller, anticipatory changes in postural muscle activity. Such changes were absent in all but one patient. Two sources of these postural perturbations were analysed. The anticipatory postural adjustments in different muscle groups may counteract perturbations of different origin. The distal to proximal sequencing of joint involvement in postural reactions may be related to different reference points and working points associated with these tasks compared with reaching limb movements. The deficit in anticipatory postural adjustments in Parkinsons disease is likely to be unrelated to bradykinesia and is more likely to reflect the deficits in the basic processes of preparation and initiation of a motor act.

The role of anticipatory postural adjustments in compensatory control of posture: 1. Electromyographic analysis

Anticipatory (APAs) and compensatory (CPAs) postural adjustments are the two principal mechanisms that the central nervous system uses to maintain equilibrium while standing. We studied the role of APAs in compensatory postural adjustments. Eight subjects were exposed to external predictable and unpredictable perturbations induced at the shoulder level, while standing with eyes open and closed. Electrical activity of leg and trunk muscles was recorded and analyzed during four epochs representing the time duration typical for anticipatory and compensatory postural control. No anticipatory activity of the trunk and leg muscles was seen in the case of unpredictable perturbations; instead, significant compensatory activation of muscles was observed. When the perturbations were predictable, strong anticipatory activation was seen in all the muscles: such APAs were associated with significantly smaller compensatory activity of muscles and COP displacements after the perturbations. The outcome of the study highlights the importance of APAs in control of posture and points out the existence of a relationship between the anticipatory and the compensatory components of postural control. It also suggests a possibility to enhance balance control by improving the APAs responses during external perturbations.

Teager–Kaiser Energy Operation of Surface EMG Improves Muscle Activity Onset Detection

This study presents a novel method for detection of the onset time of muscle activity using surface electromyogram (EMG) signals. The method takes advantage of the nonlinear properties of the Teager–Kaiser energy (TKE) operator, which simultaneously considers the amplitude and instantaneous frequency of the surface EMG, and therefore increases the prospects of muscle activity detection. To detect the onset time of muscle activity, the surface EMG signal was first processed by the TKE operator to highlight motor unit activities of the muscle. Then a robust threshold-based algorithm was developed in the TKE domain to locate the onset of muscle activity. The validity of the proposed method was illustrated using various surface EMG simulations as well as experimental surface EMG recordings.

Anticipatory postural adjustments during self-initiated perturbations of different magnitude triggered by a standard motor action

The purpose of the study was to define whether anticipatory postural adjustments scale with the magnitude of a self-triggered postural perturbation when a standard motor action triggers the perturbation. Standing subjects generated vertical forces of different magnitude with their extended arms against a bar connected through a rigid cord to the floor. They released the bar with a standard bilateral shoulder abduction. Anticipatory postural adjustments were seen as changes in the level and/or timing of the background activation of postural muscles. Muscles of the dorsal part of the legs and of the trunk demonstrated an anticipatory decrease in the level of activation, commonly leading to its complete disappearance. There was no relation between the magnitude of the unloading and the timing of the changes in the background activity of these muscles. Muscles of the frontal part of the legs and of the trunk demonstrated an anticipatory increase in their activity whose timing and amplitude correlated positively with the magnitude of the perturbation. We conclude that anticipatory postural adjustments can be scaled with respect to the magnitude of a self-triggered perturbation.

The role of anticipatory postural adjustments in compensatory control of posture: 2. Biomechanical analysis.

The central nervous system (CNS) utilizes anticipatory (APAs) and compensatory (CPAs) postural adjustments to maintain equilibrium while standing. It is known that these postural adjustments involve displacements of the center of mass (COM) and center of pressure (COP). The purpose of the study was to investigate the relationship between APAs and CPAs from a kinetic and kinematic perspective. Eight subjects were exposed to external predictable and unpredictable perturbations induced at the shoulder level while standing. Kinematic and kinetic data were recorded and analyzed during the time duration typical for anticipatory and compensatory postural adjustments. When the perturbations were unpredictable, the COM and COP displacements were larger compared to predictable conditions with APAs. Thus, the peak of COM displacement, after the pendulum impact, in the posterior direction reached 28+/-9.6mm in the unpredictable conditions with no APAs whereas it was 1.6 times smaller, reaching 17+/-5.5mm during predictable perturbations. Similarly, after the impact, the peak of COP displacement in the posterior direction was 60+/-14 mm for unpredictable conditions and 28+/-3.6mm for predictable conditions. Finally, the times of the peak COM and COP displacements were similar in the predictable and unpredictable conditions. This outcome provides additional knowledge about how body balance is controlled in presence and in absence of information about the forthcoming perturbation. Moreover, it suggests that control of posture could be enhanced by better utilization of APAs and such an approach could be considered as a valuable modality in the rehabilitation of individuals with balance impairment.

Anticipatory postural adjustments during standing in below-the-knee amputees

OBJECTIVE: We studied the role of adaptive changes within the central nervous system in anticipatory postural adjustments seen in unilateral below-the-knee amputees. DESIGN: Changes in electromyographic and mechanical variables were compared during standardized tasks performed by standing subjects. BACKGROUND: Anticipatory postural adjustments represent an important mechanism of postural control which was expected to be changed in amputees because of both mechanical and secondary, neurological reasons. METHODS: Six patients after a below-the-knee amputation and six control subjects stood on a force platform and performed fast bilateral shoulder movements and also dropped or caught a load from (into) extended hands. Anticipatory changes in the background activity of postural muscles were analysed. RESULTS: In amputees, there were cases of marked asymmetry in anticipatory changes of the background muscle activity which were larger on the intact side of the body but were commonly small or absent on the side of the amputation. This asymmetry could lead to larger mediolateral forces and displacements of the centre of pressure. CONCLUSIONS: We suggest that asymmetrical patterns of anticipatory postural adjustments reflect central adaptive changes secondary to the amputation. Rehabilitation approaches would benefit from understanding and taking advantage of the adaptive changes within the central nervous system. RELEVANCE: We demonstrated asymmetries in patterns of anticipatory postural adjustments during voluntary arm movements and load manipulations by standing unilateral amputees. This finding is of potential importance for rehabilitation of amputees and their prosthetic training.

Task-specific modulation of anticipatory postural adjustments in individuals with hemiparesis

OBJECTIVES To study adaptation of anticipatory postural adjustments (APAs) in paretic and non-paretic muscles of individuals with hemiparesis to changes in the direction of the self-initiated perturbation and additional manual support. METHODS Electrical activity of leg and trunk muscles on both sides of the body and ground reaction forces were recorded in 10 patients with hemiparesis and a group of matched control subjects. Subjects released a standard load, held in the hand of the extended relatively unimpaired arm. The load was released either in front of the body or to the side, with or without the impaired arm touching an external stable surface. RESULTS APAs were reduced in individuals with hemiparesis, especially on the paretic side. In paretic muscles, the modulation of APAs with the direction of the perturbation was decreased or showed atypical patterns. Also the effects of touch were decreased in patients. Center of pressure displacements shortly after load release were similar in control subjects and patients. CONCLUSIONS The results suggest that the ability of individuals with hemiparesis to prepare for a self-initiated predictable perturbation is reduced and that they may use alternative strategies of postural stabilization.