Sandra Maria Sbeghen Ferreira de Freitas

EFFECTS OF JOINT IMMOBILIZATION ON STANDING BALANCE

We investigated the effect of joint immobilization on the postural sway during quiet standing. We hypothesized that the center of pressure (COP), rambling, and trembling trajectories would be affected by joint immobilization. Ten young adults stood on a force plate during 60 s without and with immobilized joints (only knees constrained, CK; knees and hips, CH; and knees, hips, and trunk, CT), with their eyes open (OE) or closed (CE). The root mean square deviation (RMS, the standard deviation from the mean) and mean speed of COP, rambling, and trembling trajectories in the anterior-posterior and medial-lateral directions were analyzed. Similar effects of vision were observed for both directions: larger amplitudes for all variables were observed in the CE condition. In the anterior-posterior direction, postural sway increased only when the knees, hips, and trunk were immobilized. For the medial-lateral direction, the RMS and the mean speed of the COP, rambling, and trembling displacements decreased after immobilization of knees and hips and knees, hips, and trunk. These findings indicate that the single inverted pendulum model is unable to completely explain the processes involved in the control of the quiet upright stance in the anterior-posterior and medial-lateral directions.

Effect of light touch on postural sway in individuals with balance problems: a systematic review.

The aim of the present review was to examine the experimental, case-control studies that investigated the effect of light touch on postural sway in individuals with balance problems due to aging, brain lesion or other motor or sensory deficits. Articles published before the end of March of 2013 were searched in PubMed, Scielo and Lilacs databases using terms related to postural control and sensory information. Twelve studies that assessed the postural sway of individuals with balance problems during quiet standing with the light touch using a force plate were reviewed. Two reviewers rated all selected articles as having good quality. The effect of light touch on postural control was reported by all eligible studies regardless of the cause of the balance problem of the participants. Such effect was more evident when the applied vertical force was greater than 1N, but if individuals with poor balance took more advantage of the light touch than healthy ones it depended on the source of their balance problems and not the amount of the applied force. These findings suggested that the maintenance of the fingertip lightly touching an external surface could provide additional somatosensory information for individuals with poor balance and then it could be used as a strategy to improve the control of upright standing during intervention programs.

Joint coordination in young and older adults during quiet stance: Effect of visual feedback of the center of pressure

How aging affects body sway and joint coordination during quiet standing was investigated under two visual feedback conditions provided on a monitor screen: fixed and moving cursor representing the center of pressure (COP) position measured by a platform. The across-time joint motion variance of ankle, knee, hip, mid-trunk, and cervical spine leading to COP displacement was analyzed using the uncontrolled manifold approach. The body sway was assessed by the COP displacement. Young and older adults showed greater ankle joint contribution to COP displacement than the other joints. However, older adults showed larger variability of knee and mid-trunk joint motions than young adults. During the moving condition, the ankle joint contribution decreased and hip joint contribution increased for both groups, but the COP displacement increased only for the older adults. We conclude that joint coordination and body sway during quiet standing can be modified by providing COP visual feedback and that joint coordination is affected by aging.

Individuals with post-stroke hemiparesis are able to use additional sensory information to reduce postural sway

The present study aimed to investigate whether stroke survivals are able to use the additional somatosensory information provided by the light touch to reduce their postural sway during the upright stance. Eight individuals, naturally right-handed pre-stroke, and eight healthy age-matched adults stood as quiet as possible on a force plate during 35s. Participants performed two trials for each visual condition (eyes open and closed) and somatosensory condition (with and without the right or left index fingertip touching an instrumented rigid and fixed bar). When participants touched the bar, they were asked to apply less than 1N of vertical force. The postural sway was assessed by the center of pressure (COP) displacement area, mean amplitude and velocity. In addition, the mean and standard deviation of the force vertically applied on the bar during the trials with touch were assessed. The averaged values of COP area, amplitude and velocity were greater for stroke individuals compared to healthy adults during all visual and somatosensory conditions. For both groups, the values of all variables increased when participants stood with eyes closed and reduced when they touched the bar regardless of the side of the touch. Overall, the results suggested that, as healthy individuals, persons with post-stroke hemiparesis are able to use the additional somatosensory information provided by the light touch to reduce the postural sway.

Does hand dominance affect the use of motor abundance when reaching to uncertain targets

This study investigated hemispheric differences in utilizing motor abundance to achieve flexible patterns of joint coordination when reaching to uncertain target locations. Right-handed participants reached with each arm to the same central target when its final location was certain or when there was a 66% probability that its location could change after movement initiation. Use of greater motor abundance was observed when participants reached to the central target under target location uncertainty regardless of the arm used to reach. Joint variance associated with variability of movement direction was larger when reaching with the left, non-dominant arm. This arm also exhibited higher hand path variability compared to the dominant arm. These arm differences were not found when the final (central) target location was known in advance. The results provide preliminary evidence for a greater ability of the dominant (right) arm/left hemisphere to decouple directions in joint space. That is, to increase the use of motor abundance without simultaneously inducing unwanted hand path variability requires that joint variations be restricted to a limited subspace of joint space. Hemispheric differences in motor planning did not appear to account for arm differences related to the use of motor abundance.

A comparison of methods for identifying the Jacobian for uncontrolled manifold variance analysis

Uncontrolled Manifold (UCM) analysis has been used to identify a component of joint variance leading to pointer-tip position variability and a component representing motor abundant joint combinations corresponding to an equivalent pointer-tip position. A Jacobian is required for UCM analysis, typically derived from an analytic model relating joint postures to pointer-tip position. Derivation of the Jacobian is often non-trivial, however, because of the complexity of the system being studied. In this article, we compared the effect of different methods of deriving the Jacobian on results of UCM analyses during reaching. Jacobian matrices were determined at each percentage of the reach across trials using one of three methods: (M1) partial derivatives of the geometric model relating ten joint postures, segment lengths and pointer length to the position of a hand-mounted pointer tip; or (M2-M3) as the coefficients of linear regression between the ten joint postures and either (M2) the pointer tip position measured directly from motion capture or (M3) the pointer-tip position estimated from the geometric model. For all methods, motor abundant joint variance (V(UCM)) was larger than joint variance leading to a variable pointer-tip position (V(ORT)). Results did not differ among methods prior to the time of peak velocity. Thereafter, M2 yielded lower V(ORT) and slightly higher V(UCM) compared to M1. Method M3 was used to disambiguate the possible effect of estimating model parameters for the geometric model on the M1-M2 comparison. The advantages of the use of linear regression method in the UCM approach are discussed.

TIMING VARIABILITY OF REACH TRAJECTORIES IN LEFT VERSUS RIGHT HEMISPHERE STROKE

This study investigated trajectory timing variability in right and left stroke survivors and healthy controls when reaching to a centrally located target under a fixed target condition or when the target could suddenly change position after reach onset. Trajectory timing variability was investigated with a novel method based on dynamic programming that identifies the steps required to time warp one trials acceleration time series to match that of a reference trial. Greater trajectory timing variability of both hand and joint motions was found for the paretic arm of stroke survivors compared to their non-paretic arm or either arm of controls. Overall, the non-paretic left arm of the LCVA group and the left arm of controls had higher timing variability than the non-paretic right arm of the RCVA group and right arm of controls. The shoulder and elbow joint warping costs were consistent predictors of the hands warping cost for both left and right arms only in the LCVA group, whereas the relationship between joint and hand warping costs was relatively weak in control subjects and less consistent across arms in the RCVA group. These results suggest that the left hemisphere may be more involved in trajectory timing, although the results may be confounded by skill differences between the arms in these right hand dominant participants. On the other hand, arm differences did not appear to be related to differences in targeting error. The paretic left arm of the RCVA exhibited greater trajectory timing variability than the paretic right arm of the LCVA group. This difference was highly correlated with the level of impairment of the arms. Generally, the effect of target uncertainty resulted in slightly greater trajectory timing variability for all participants. The results are discussed in light of previous studies of hemispheric differences in the control of reaching, in particular, left hemisphere specialization for temporal control of reaching movements.

Gait characteristics of younger-old and older-old adults walking overground and on a compliant surface

BACKGROUND Walking across unstable surfaces disturbs normal stability and efficient strategies must be used to avoid falls. This study identified age-related changes in gait during unstable surface walking. METHOD Eight healthy younger-old adults (YOG, mean age, 68.6 years) and eight healthy older-old adults (OOG, mean age, 82.1 years) were assessed. Both groups performed the Timed Up and Go Test (TUG) and walked on a rigid and on a compliant surface while kinematic data were obtained. RESULTS The OOG needed more time to complete the TUG test compared to YOG (F1,14=5.18; p=0.04). The gait speed, stride length and vertical displacement of the foot were similar for both groups, but they were slower (F1,14=5.64; p=0.03) when walking on the compliant surface. The knee and hip range of motion on the sagittal plane (F1,14=191.9; p<0.001 and F1,14=36.4, p<0,001, respectively) increased on the complaint surface but no group effect was found. The displacement of upper trunk on the frontal plane was similar between groups (F1,14=2.43; p=0.14) and conditions (F1,14=1.15; p=0.3). The OOG had greater displacement of the pelvic segment on the frontal plane than the YOG (F1,14=4.9; p=0.04) mainly for the complaint surface. CONCLUSIONS Older-old individuals have slower TUG test and greater displacement of the pelvic segment on a compliant surface. More challenging tasks and/or environment should be used for gait assessment and intervention of older adults with risk of falls.

Ipsilesional Arm Motor Sequence Performance After Right and Left Hemisphere Damage

ABSTRACT Aiming movements are part of daily activities but the brain hemispheres’ role in targeted aiming sequential movements is not fully clear. Start and execution of discrete and sequential tasks toward targets were analyzed in 10 individuals with left-hemisphere damage, 10 right-hemisphere–damaged, and 10 healthy ones. Arm movements were performed over a digitizing tablet, following stimuli on a monitor, from initial position toward right and left-positioned targets. Poststroke individuals used their ipsilesional arm and healthy individuals, both arms. Right-hemisphere–damaged individuals showed higher reaction time and left-hemisphere–damaged individuals, lower smoothness. Due to spatial demand of tasks, the right hemisphere played a major role in movement planning, while the left, in movement execution.

Uso da informação somatossensorial adicional no controle postural: efeito da dominância manual

In this study we investigated the effect of handedness and vision on the use of additional somatosensory information provided by the light touch in postural control. Fifteen right-handed, young adults quietly stood on a force plate with a) eyes open or closed and b) arms hanging along the body or with the right or left index finger in contact with a rigid bar. We assessed the center of pressure (CP) area and CP mean sway amplitude and velocity in anterior-posterior and medial-lateral directions. The results revealed a reduction of these measures in the touch conditions and increase with the eyes closed, except when the touch was performed with right index fingertip. The grip strength was greater for the right hand, while the cutaneous sensitivity and the forces applied on the bar were similar between the two sides of the body. These results suggested an effect of the handedness and vision in the use of additional somatosensory information on the postural control.