Jean Louis Honeine

Leg muscle activity during tandem stance and the control of body balance in the frontal plane

OBJECTIVES We investigated the pattern of activity of the tibialis anterior (TA), soleus (SOL) and peroneus longus (PER) muscles of both legs during tandem stance, in order to highlight their respective role in maintaining balance. METHODS Twelve young healthy subjects were asked to stand with feet in line for successive 15s-epochs, on a dynamometric platform with (EO) and without (EC) vision. EMG was recorded from the six muscles simultaneously. Collected signals were displacement of the centre of feet pressure (CoP) and EMG. Variables calculated for each recorded epoch were mean level, variability and distribution between legs of EMG, and cross-correlation between EMG and CoP traces and between EMG of homonymous muscles. RESULTS CoP motion was larger along the medio-lateral (M-L) than antero-posterior (A-P) axis, and larger with EC than EO particularly in the M-L axis. Muscle activity was larger in the rear than in the front leg, as expected, except for PER. Activity increased with the increase in M-L CoP oscillations, except for SOL, which was tonically active, both legs, regardless of the amplitude of the oscillations. Manipulating vision had no effect on the variability of the EMG for equal mean levels of activity, for any muscle. Cross-correlation between EMG of rear leg muscles and M-L CoP sway gave higher coefficients for TA and PER than SOL, and appropriate time-delays between TA or PER and CoP motion, indicating a role of these muscles in the control of M-L sway. Except for the tonically active SOL, the homonymous muscles of the two legs were active out-of-phase, indicating a mutual push-pull action of the pairs. This was confirmed by the reciprocal activation of TA and PER of the same leg. CONCLUSIONS Overall, in spite of a large inter-trial and inter-subject variability, the neural command to the leg muscles during tandem stance implies a task-sharing rule, whereby SOL keeps the body upright while the reciprocal PER and TA activities produce the alternate impulses necessary for body stabilization in the frontal plane. SIGNIFICANCE Knowledge of the normal mode of control of balance in frontal plane can foster new investigation in both posture and gait control, in addition to offering tools for understanding balance problems of elderly persons and patients at risk of fall.

Processing time of addition or withdrawal of single or combined balance-stabilizing haptic and visual information

We investigated the integration time of haptic and visual input and their interaction during stance stabilization. Eleven subjects performed four tandem-stance conditions (60 trials each). Vision, touch, and both vision and touch were added and withdrawn. Furthermore, vision was replaced with touch and vice versa. Body sway, tibialis anterior, and peroneus longus activity were measured. Following addition or withdrawal of vision or touch, an integration time period elapsed before the earliest changes in sway were observed. Thereafter, sway varied exponentially to a new steady-state while reweighting occurred. Latencies of sway changes on sensory addition ranged from 0.6 to 1.5 s across subjects, consistently longer for touch than vision, and were regularly preceded by changes in muscle activity. Addition of vision and touch simultaneously shortened the latencies with respect to vision or touch separately, suggesting cooperation between sensory modalities. Latencies following withdrawal of vision or touch or both simultaneously were shorter than following addition. When vision was replaced with touch or vice versa, adding one modality did not interfere with the effect of withdrawal of the other, suggesting that integration of withdrawal and addition were performed in parallel. The time course of the reweighting process to reach the new steady-state was also shorter on withdrawal than addition. The effects of different sensory inputs on posture stabilization illustrate the operation of a time-consuming, possibly supraspinal process that integrates and fuses modalities for accurate balance control. This study also shows the facilitatory interaction of visual and haptic inputs in integration and reweighting of stance-stabilizing inputs.

The Neuro-Mechanical Processes That Underlie Goal-Directed Medio-Lateral APA during Gait Initiation.

Gait initiation (GI) involves passing from bipedal to unipedal stance. It requires a rapid movement of the center of foot pressure (CoP) towards the future swing foot and of the center of mass (CoM) in the direction of the stance foot prior to the incoming step. This anticipatory postural adjustment (APA) allows disengaging the swing leg from the ground and establishing favorable conditions for stepping. This study aimed to describe the neuro-mechanical process that underlies the goal-directed medio-lateral (ML) APA. We hypothesized that controlled knee flexion of the stance leg contributes to the initial ML displacement of the CoP and to the calibration of the first step. Fourteen subjects initiated gait starting from three different initial stance widths of 15 cm (Small), 30 cm (Medium), and 45 cm (Large). Optoelectronic, force platform and electromyogram (EMG) measurements were performed. During APA, soleus activity diminished bilaterally, while tibialis anterior (TA) activity increased, more so in the stance leg than in the swing leg, and to a larger extent with increasing initial stance width. Knee flexion of the stance leg was observed during APA and correlated with the ML CoP displacement towards the swing leg. ML CoP and CoM displacements during APA increased with increasing stance width. The activity of stance-leg TA was correlated with the degree of knee flexion. Swing-leg tensor fasciae latae (TFL) was also active during APA. Across subjects, when stance-leg tibialis activity was low, TFL activity was large and vice versa. The modulation of the ML CoP position during APA allowed the gravity-driven torque to place the CoM just lateral to the stance foot during step execution. Accordingly, the gravity-driven torque, the ML CoM velocity during step execution, and the step width at foot contact (FC) were lower in the Small and greater in the Large condition. Consequently, the position of the stepping foot at FC remained close to the sagittal plane in all three conditions. Conclusively, coordinated activation of hip abductors and ankle dorsiflexors during APA displaces the CoP towards the swing leg, and sets the contact position for the swing foot.

Time-interval for integration of stabilizing haptic and visual information in subjects balancing under static and dynamic conditions

Maintaining equilibrium is basically a sensorimotor integration task. The central nervous system (CNS) continually and selectively weights and rapidly integrates sensory inputs from multiple sources, and coordinates multiple outputs. The weighting process is based on the availability and accuracy of afferent signals at a given instant, on the time-period required to process each input, and possibly on the plasticity of the relevant pathways. The likelihood that sensory inflow changes while balancing under static or dynamic conditions is high, because subjects can pass from a dark to a well-lit environment or from a tactile-guided stabilization to loss of haptic inflow. This review article presents recent data on the temporal events accompanying sensory transition, on which basic information is fragmentary. The processing time from sensory shift to reaching a new steady state includes the time to (a) subtract or integrate sensory inputs; (b) move from allocentric to egocentric reference or vice versa; and (c) adjust the calibration of motor activity in time and amplitude to the new sensory set. We present examples of processes of integration of posture-stabilizing information, and of the respective sensorimotor time-intervals while allowing or occluding vision or adding or subtracting tactile information. These intervals are short, in the order of 1–2 s for different postural conditions, modalities and deliberate or passive shift. They are just longer for haptic than visual shift, just shorter on withdrawal than on addition of stabilizing input, and on deliberate than unexpected mode. The delays are the shortest (for haptic shift) in blind subjects. Since automatic balance stabilization may be vulnerable to sensory-integration delays and to interference from concurrent cognitive tasks in patients with sensorimotor problems, insight into the processing time for balance control represents a critical step in the design of new balance- and locomotion training devices.