J. Massion

Postural control system

The postural control system has two main functions: first, to build up posture against gravity and ensure that balance is maintained; and second, to fix the orientation and position of the segments that serve as a reference frame for perception and action with respect to the external world. This dual function of postural control is based on four components: reference values, such as orientation of body segments and position of the center of gravity (an internal representation of the body or postural body scheme); multisensory inputs regulating orientation and stabilization of body segments; and flexible postural reactions or anticipations for balance recovery after disturbance, or postural stabilization during voluntary movement. The recent data related to the organization of this system will be discussed in normal subjects (during ontogenesis), the elderly and in patients with relevant deficits.

Forward and backward axial synergies in man

Summary1. Upper trunk and head forward and backward movements were analyzed in human subjects standing on a force platform. EMG of several flexor and extensor muscles was recorded together with the kinematics of the movement (EL.I.TE. system). 2. It was found that upper trunk movements are accompanied by movements of hip and knees in the opposite direction, resulting in a slight displacement of the center of gravity projection on the ground. 3. In fast movements, all the body segments were displaced at the same time, which suggests a feedforward control, whereas in slow movements, onset of displacement of the body segments was found to take place sequentially in a cranio-caudal direction. 4. EMG analysis during fast movements revealed two different types of control, utilized in forward and backward movements. With forward bending movements the action of two sets of muscles could be recognized: the prime mover (R. Abd.), the activation of which was not correlated with that of the other muscles and preceded the onset of movement with a fairly constant lead, and a group of postural muscles, the activation (VM, TA) and inhibition (Sol) of which were closely correlated. By contrast, with backward movements, the prime mover (Er.S.) and the postural leg muscles (Hamstrings, Sol) were activated simultaneously. In both cases, a feedforward type of control is evident. 5. Performance of the fast forward movements was accompanied by an initial forward displacement of the knee. The function of this phenomenon is discussed in term of a destabilizing action favouring the forward bending of the body or a prestretching of the knee extensor muscles increasing the strength of their subsequent contraction.

Postural control systems in developmental perspective.

How can the adult postural organisation be elucidated using an ontogenetic approach, and what questions can be raised about ontogenesis starting from the organisation of adult posture? These questions will be addressed taking three aspects of postural organisation. The first is the internal representation of erect posture, including the role played by the various sensory inputs in this representation. The second aspect relates to the variables which are controlled during erect posture: is it the body orientation with respect to the vertical or the localisation of the centre of gravity with respect to the feet which is controlled? The third aspect concerns the coordination between posture, equilibrium and movement, focusing on the role played by an internal representation of the external world and its interactions with the body segments in organising the anticipatory postural adjustments. The central organisation of coordinated control will also be considered. Each of these aspects will be discussed in relation to ontogenetic considerations.

Coordination between posture and movement in a bimanual load lifting task: putative role of a medial frontal region including the supplementary motor area

SummaryThe aim of the present experimental series was to investigate the role of the medial frontal region including the supplementary motor area in the coordination between posture and movement in a bimanual load lifting task. The seated subject was instructed to maintain in a horizontal position one forearm (postural arm) which was loaded with a 1 kg weight. The unloading was performed either by the experimenter (imposed unloading) or by a voluntary movement of the other arm (voluntary unloading). In normal individuals, with the voluntary unloading, the movement control was accompanied by an anticipatory adjustment of the postural forearm flexor activity, which resulted in the maintenance of the forearm position despite the unloading. The anticipatory postural adjustments were impaired in 4 out of 5 patients with unilateral lesion of the SMA region; the defect was observed mainly when the postural forearm was contralateral to the lesion. No change in the anticipatory postural adjustment was observed in one patient with complete callosal section. This finding indicates that the coordination between the posture and movement in this task is not organized through callosal fibers linking the cortices on both sides but rather at a subcortical level. The anticipatory postural adjustments were abolished in two patients with spastic hemiparesis when the postural forearm was the spastic arm. It is suggested that the SMA region contralateral to the postural forearm, together with other premotor or motor areas, may select the circuits responsible for the phasic postural adjustments which are necessary to ensure postural maintenance, whereas the motor cortex contralateral to the voluntary movement controls both the movement and, via collaterals, the preselected circuits responsible for the associated postural adjustments.

Axial synergies during human upper trunk bending

Abstract Upper trunk bending movements were accompanied by opposite movements of the lower body segments. These axial kinematic synergies maintained equilibrium during the movement performance by stabilizing the center of gravity (CG), which shifted on average across all the subjects by 1±4 cm in the anteroposterior direction and thus always remained within the support area. The aim of the present investigation was to provide an insight into the central control responsible for the performance of these synergies. The kinematic analysis was performed by the method of principal components (PC) analysis applied to the covariation between ankle, knee and hip joint angles and compared with CG shifts during upper trunk bending. Subjects were asked to perform backward or forward upper trunk bending in response to a tone. They were instructed to move as fast as possible or slowly (2 s), with high or low movement amplitudes. PC analysis showed a strong correlation between hip, knee and ankle joint changes. The first principal component (PC1) representing a multijoint movement with fixed ratios between joint angular changes, accounted, on average, for 99.7%±0.2% of the total angular variance in the forward trunk movements and for 98.4%±1.4% in the backward movements. The instructed voluntary regulation of the amplitude and velocity of the movement was achieved by adapting the bell-shaped profile of the velocity time course without changes in interjoint angular relations. Fixed ratios between changes in joint angles, represented by PC1, ensured localization of the CG within the support area during trunk bending. The ratios given by PC1 showed highly significant dependence on subjects, suggesting the adaptability of the central control to each subject’s biomechanical peculiarities. Subject’s intertrial variability of PC1 ratios was small, suggesting a stereotyped automatic interjoint coordination. When changing velocity and amplitude of the movement, the ratios remained the same in about half the subjects while in others slight variations were observed. A weak second principal component (PC2) was shown only for fast movements. In forward movements PC2 reflected the early knee flexion that seems related to the disturbances caused by the passive interaction between body segments, rather than to the effect of a central command. In fast backward movements, PC2 reflected the delay in hip extension relative to the movement onset in the ankle and knee that mirrors intersubject differences in the initiation process of the axial synergy. The results suggest that PC1 reflects the centrally controlled multijoint movement, defining the time course and amplitude of the movement and fixing the ratios between changes in joint angles. They support the hypothesis that the axial kinematic synergies result from a central automatic control that stabilizes the CG shift in the anteroposterior direction while performing the upper trunk bending.

Postural forearm changes induced by predictable in time or voluntary triggered unloading in man

SummaryHuman subjects sitting in a chair were asked to maintain their right forearm in a horizontal position in half supination. The forearm was loaded with a constant weight of one kilogram. Vertical force at the wrist level, angular position of the elbow and EMG activity of biceps, brachio-radialis and triceps muscles were recorded. Unloading was tested under four different conditions, the first two having been used in a previous study (Hugon et al. 1982): (A) Voluntary unloading by the subjects other hand. An “anticipatory” deactivation of the load bearing forearm flexors is observed preventing the elbow rotation of that arm. (B) Unpredictable passive unloading. This results in an upward forearm rotation which provokes the classical “unloading reflex”. Two new conditions were tested in the present paradigm: (C) Imposed unloading predictable in time (tone signal preceding unloading by a fixed interval). (D) Unloading being actively triggered when the subject presses a key. Under the two latter conditions, no anticipatory deactivation of the flexor supporting muscles preceding the onset of unloading as in situation A was observed. During the first 120 ms after the onset of unloading, the forearm rotation was the same as in situation B (unpredictable passive unloading). Thereafter, the rotation was smaller in some subjects, apparently due to an ameliorated reflex action. It is concluded that temporal information concerning the precise time of the unloading or the triggering of the load release by a voluntary movement (key press) was not by itself able to induce the anticipatory deactivation of the forearm flexors that was seen with a coordinated voluntary release of the load by the contralateral arm.

Why and how are posture and movement coordinated

In most motor acts, posture and movement must be coordinated in order to achieve the goal of the task. The focus of this chapter is on why and how this coordination takes place. First, the nature of posture is discussed. Two of its general functions are recognized; an antigravity role, and a role in interfacing the body with its environment such that perception and action can ensue. Next addressed is how posture is controlled centrally. Two models are presented and evaluated; a genetic and a hierarchical one. The latter has two levels; internal representation and execution. Finally, we consider how central control processes might achieve an effective coordination between posture and movement. Is a single central control process responsible for both movement and its associated posture? Alternatively, is there a dual coordinated control system: one for movement, and the other for posture? We provide evidence for the latter, in the form of a biomechanical analysis that features the use of eigenmovement approach.

Biomechanical analysis of movement strategies in human forward trunk bending. I. Modeling

Abstract. Two behavioral goals are achieved simultaneously during forward trunk bending in humans: the bending movement per se and equilibrium maintenance. The objective of the present study was to understand how the two goals are achieved by using a biomechanical model of this task. Since keeping the center of pressure inside the support area is a crucial condition for equilibrium maintenance during the movement, we decided to model an extreme case, called “optimal bending”, in which the movement is performed without any center of pressure displacement at all, as if standing on an extremely narrow support. The “optimal bending” is used as a reference in the analysis of experimental data in a companion paper. The study is based on a three-joint (ankle, knee, and hip) model of the human body and is performed in terms of “eigenmovements”, i.e., the movements along eigenvectors of the motion equation. They are termed “ankle”, “hip”, and “knee” eigenmovements according to the dominant joint that provides the largest contribution to the corresponding eigenmovement. The advantage of the eigenmovement approach is the presentation of the coupled system of dynamic equations in the form of three independent motion equations. Each of these equations is equivalent to the motion equation for an inverted pendulum. Optimal bending is constructed as a superposition of two (hip and ankle) eigenmovements. The hip eigenmovement contributes the most to the movement kinematics, whereas the contributions of both eigenmovements into the movement dynamics are comparable. The ankle eigenmovement moves the center of gravity forward and compensates for the backward center of gravity shift that is provoked by trunk bending as a result of dynamic interactions between body segments. An important characteristic of the optimal bending is the timing of the onset of each eigenmovement: the ankle eigenmovement onset precedes that of the hip eigenmovement. Without an earlier onset of the ankle eigenmovement, forward bending on the extremely narrow support results in falling backward. This modeling approach suggests that during trunk bending, two motion units – the hip and ankle eigenmovements – are responsible for the movement and for equilibrium maintenance, respectively.

Impairment of posturo-kinetic co-ordination during initiation of forward oriented stepping movements in parkinsonian patients

In order to differentiate between a specific impairment affecting gait initiation and a non-specific deficit in the postural adjustment which occurs prior to any forward oriented stepping movement, 3 forward oriented movements (FOMs), performed by a group of parkinsonian patients and a group of healthy age-matched subjects, were compared in the present study. These FOMs all consisted of initiating 1 step, but differed in their respective planning characteristics. The first consisted of initiating normal walking. The second consisted of initiating a single step, while the third was a visually guided task, consisting of placing the foot just behind a mark on the ground. In all 3 FOMs, the postural phase, i.e., the time elapsing between the initial shift of the center of pressure (CP) and the onset of the first step, was significantly longer in the patients than in the healthy subjects, whereas the duration of the subsequent movement phase, i.e., that of the first step, was within the same range in both groups. The horizontal reaction forces that led to a forward center of gravity (CG) acceleration during the postural phase were markedly reduced in the patients in all 3 FOMs, and the maximal velocity of the iliac crest marker, which corresponds approximately to that of the CG, decreased significantly in the patients. In addition, the length of the first step was significantly shorter in the patients than in the healthy subjects, in all 3 FOMs. The EMG pattern differed significantly between the patients and the healthy subjects; the amplitudes of the early tibialis anterior (TA) and vastus lateralis (VL) activations often decreased and were unilateral rather than bilateral. In addition, the gastrocnemius medialis (GM) burst associated with foot lift-off at the end of the postural phase was either absent or greatly reduced, thus suggesting that the co-ordination between the preparatory postural adjustment of the whole body and the actual stepping movement was impaired. The present results suggested that the lengthening of the postural phase is a common deficit in all FOM tasks in parkinsonian patients and is due to the impaired production of the requisite propulsive forces providing the forward acceleration of the CG. Consequently, a shortening of the first step length occurs. However, the step length is reduced less in the FOM tasks which provide some information about the goal of the first step (single step, visually guided step) than in a normal walking task, during which such information is missing. This suggests that although the stepping movement can be improved with the aid of any sensory cue about the end of the step in patients with Parkinsons disease, the postural phase will always be prolonged whichever FOM task they perform.

Acquisition of anticipatory postural adjustments in a bimanual load-lifting task: normal and pathological aspects.

Abstract Anticipatory adjustments of forearm posture are associated with a voluntary load-lifting movement in bimanual load-lifting tasks. Three aspects of these adjustments are analyzed: their goal, their central organization, and their acquisition. The goal of the anticipatory adjustment in this task is to minimize the perturbation of forearm posture that occurs during unloading. The central organization is based on two parallel controls responsible, respectively, for the lifting movement of the moving forearm and the anticipatory postural adjustment of the postural forearm, their coordination depending on a central timing signal. The acquisition of the anticipatory postural adjustment was tested using a paradigm where the voluntary movement performed by one hand triggered, via an electronic switch, the load release of the postural forearm. It was achieved after 40–60 trials and was not graded as a function of the voluntary movement parameters, but of the disturbance of the postural arm about to occur. The learned anticipation was not transferred when, after a first acquisition session with one forearm as the postural forearm, a second learning session was performed with the other forearm as the postural forearm. The acquisition was tested in Parkinsonian and in hemiparetic patients with capsular lesion. The highest acquisition deficit was observed in hemiparetic patients, when the contralateral forearm was the postural forearm; the deficit was less important when the ipsilateral arm was postural. Surprisingly, the anticipatory postural adjustments in hemiparetic patients were rather well preserved when the natural load-lifting task was tested. These results suggest that the basal-ganglia SMA circuit and M1 premotor areas are important in the acquisition process.