Vestibular input modulates stepping balance reactions early in the pre-step phase through to post-recovery.

Compensatory stepping reactions to recover balance are frequently performed, however, the role of sensory feedback in regulating these responses is not fully understood. Specifically, it is unknown whether vestibular input influences compensatory stepping. Here, we aimed to assess whether step responses utilize vestibular input by combining medio-lateral galvanic vestibular stimulation (GVS) with step-inducing balance perturbations via unpredictable anterior-posterior platform translations.

The Influence of Countermovements on Inter-Segmental Coordination and Mechanical Energy Transfer during Vertical Jumping.

Inter-segmental coordination patterns and mechanical energy transfer were compared between vertical jumping tasks which possess different countermovement characteristics. Thirteen participants completed squat (SJ), countermovement (CMJ) and drop (DVJ) vertical jumps. Inter-segmental coordination patterns became more out-of-phase with increases in countermovement velocity (DVJ > CMJ > SJ), at the ankle, hip and lumbar spine (all  < 0.

Altered Arm-Body Coordination with Triggered Pointing Responses as Influenced by Task Predictability.

Reaching movements generate reaction forces that affect postural stability, requiring sophisticated coordination between body and arm movement to maintain balance. In voluntary movement, this coordination involves feedforward shifts of posture, and such anticipatory postural muscle activity also accompanies the rapid modulation of an ongoing point to suddenly a shifting target (double-step). However, it is unknown if this early postural activity depends on target-shift predictability and whether arm and body motion are similar coordinated to voluntary movement.

Older adults exhibit altered motor coordination during an upper limb object transport task requiring a lateral change in support.

Investigating an ecologically relevant upper limb task, such as manually transporting an object with a concurrent lateral change in support (sidestepping alongside a kitchen counter), may provide greater insight into potential deficits in postural stability, variability and motor coordination in older adults. Nine healthy young and eleven older, community dwelling adults executed an upper limb object transport task requiring a lateral change in support in two directions at two self-selected speeds, self-paced and fast-paced. Dynamic postural stability and movement variability was quantified via whole-body center of mass motion.

Stepping Responses in Young and Older Adults Following a Perturbation to the Support Surface During Gait.

The objective of this work was to investigate the influence perturbation direction has on postural responses during overground gait, and whether these responses are age related. Differences in stepping patterns following perturbations of the support surface were examined in the frontal and sagittal planes during forward walking. Eleven young and 10 older adults completed Mini BESTest, hip strength tests, and 45 perturbed walking trials, triggered on heel contact.

Effect of aging on dynamic postural stability and variability during a multi-directional lean and reach object transportation task.

A "reach and transport object" task that represents common activities of daily living may provide improved insight into dynamic postural stability and movement variability deficits in older adults compared to previous lean to reach and functional reach tests. Healthy young and older, community dwelling adults performed three same elevation object transport tasks and two multiple elevation object transport tasks under two self-selected speeds, self-paced and fast-paced. Dynamic postural stability and movement variability was quantified by whole-body center of mass motion.

Simultaneous Turn and Step Task for Investigating Control Strategies in Healthy Young and Community Dwelling Older Adults.

A simultaneous turn and step motion is a vital component of many complex movements and may provide insight into age related balance and stability deficits during a weight transfer task. In this study, nine young adults and ten healthy, community dwelling older adults performed a simultaneous "turn and step" task from a quiet standing position under two self-selected speeds, self-paced and as quickly and efficiently as possible. Whole-body center of mass was estimated to investigate stability, segmental coordination, and variability.

Effects of temporal and spatial cueing on anticipatory postural control in a rapid interceptive task.

Balance disruptions induced by voluntary focal arm actions are accommodated via anticipatory postural adjustments, but how this coordinated control is organized by the central nervous system remains unclear: either as combined or separate streams of postural-focal motor commands. For example, a focal arm task that dictates extremely tight temporal constraints may induce a focal response in absence of an anticipatory postural adjustment, providing evidence for separate focal-postural control streams. This study sought to probe the organization of focal-postural control via an interceptive task with very little available response time, and to determine whether focal-postural coordination depends on temporal and/or spatial foreknowledge of the task.

Experimentally induced central sensitization in the cervical spine evokes postural stiffening strategies in healthy young adults.

Dysequilibrium of cervicogenic origin can result from pain and injury to cervical paraspinal tissues post-whiplash; however, the specific physiological mechanisms still remain unclear. Central sensitization is a neuradaptive process which has been clinically associated with conditions of chronic pain and hypersensitivity. Strong links have been demonstrated between pain hypersensitivity and postural deficits post-whiplash; however, the precise mechanisms are still poorly understood.

Determinants and consequences for standing balance of spontaneous weight-bearing on the paretic side among individuals with chronic stroke.

Hemiparetic stroke patients commonly bear more weight on the non-paretic side which seems intuitively linked to unilateral control deficits. However, there is evidence that some post-stroke favour weighting the paretic side, which may be problematic given altered capacity of the paretic limb to contribute to the control of upright posture. This study explores the prevalence and clinical determinants of stance asymmetry, and the relationship between stance asymmetry and postural control among chronic stroke patients.

Reducing fall risk by improving balance control: development, evaluation and knowledge-translation of new approaches.

Problem: Falling is a leading cause of serious injury, loss of independence, and nursing-home admission in older adults. Impaired balance control is a major contributing factor.

Methods: Results from our balance-control studies have been applied in the development of new and improved interventions and assessment tools.

Effect of competing attentional demands on perturbation-evoked stepping reactions and associated gaze behavior in young and older adults.

Background: Rapid stepping reactions are a prevalent response to sudden loss of balance and are thought to play a crucial role in preventing falls. Previous dual-task studies, involving concurrent performance of step reactions and a visuomotor tracking task, indicated that online visual attention was not required to guide the step, even when nearby objects increased demands for accurate foot movement. However, the planning and execution of the step apparently required attentional resources initially allotted to the tracking task.

Gaze behavior of older adults during rapid balance-recovery reactions.

Background: Rapid stepping reactions are a prevalent response to sudden loss of balance and play a crucial role in preventing falls. A previous study indicated that young adults are able to guide these stepping reactions amid challenging environmental constraints using "stored" visuospatial information. This study addressed whether healthy older adults also use "stored" visuospatial information in this manner, or are more dependent on "online" visual control.

Stepping to recover balance in complex environments: is online visual control of the foot motion necessary or sufficient?

Rapid step reactions evoked by balance perturbation must accommodate constraints on limb motion imposed by obstacles and other environmental features. Recent results suggest that the required visuospatial information (VSI) is acquired and stored "proactively", prior to perturbation onset (PO); however, the extent to which "online" (post-PO) visual feedback can contribute is not known. To study this, we used large unpredictable platform perturbations to evoke rapid step reactions, while subjects wore liquid crystal goggles that occluded vision: (1) prior to PO (forcing use of online-VSI), (2) after PO (forcing use of stored-VSI), or (3) not at all (normal-VSI).

Gaze behavior governing balance recovery in an unfamiliar and complex environment.

Visuospatial information regarding obstacles and other environmental constraints on limb movement is essential for the successful planning and execution of stepping movements. Visuospatial control strategies used during gait and volitional stepping have been studied extensively; however, the visuospatial strategies that are used when stepping rapidly to recover balance in response to sudden postural perturbation are not well established. To study this, rapid forward stepping reactions were evoked by unpredictable support-surface acceleration while subjects stood amid multiple obstacles that moved intermittently and unpredictably prior to perturbation onset (PO).

Redirection of gaze and switching of attention during rapid stepping reactions evoked by unpredictable postural perturbation.

In many situations successful execution of a balance-recovery reaction requires visual information about the environment. In particular, reactions that involve rapid limb movements, such as stepping, must be controlled to avoid obstacles and accommodate other constraints on limb trajectory. However, it is unknown whether the central nervous system can acquire the necessary visuospatial information prior to perturbation onset or must, instead, redirect gaze at the floor during the execution of the stepping reaction.

Environmental constraints on foot trajectory reveal the capacity for modulation of anticipatory postural adjustments during rapid triggered stepping reactions.

This study used environmental restrictions on foot movement to challenge the capacity of the central nervous system (CNS) to counter the lateral instability that arises after foot-lift during rapid triggered stepping reactions evoked by unpredictable postural perturbation. The objective was to determine the extent to which lateral stability could be regulated via modulation of the mediolateral (m-l) anticipatory postural adjustment (APA) that precedes foot-lift. A high frontal obstacle was used to double the required swing duration, and thereby increase the potential for the center of mass (COM) to fall laterally toward the unsupported side, during forward-step reactions.

Can stabilizing features of rapid triggered stepping reactions be modulated to meet environmental constraints?

This study examined whether the stabilizing features of rapid triggered compensatory stepping reactions can be modulated to accommodate an environmental constraint, in the form of an obstacle placed in front of the subject. The compensatory stepping reactions were evoked, in 11 healthy young adults, by unpredictable multidirectional platform translation; the forward-step reactions evoked by large backward translations were analyzed. Clearance of the obstacle required a doubling of the usual (no obstacle) swing duration and therein presented significant challenges to both anteroposterior (a-p) and lateral stability, yet the central nervous system (CNS) was able to decelerate and stabilize the body's center of mass (COM) without taking additional steps.