Abstract

To date, a postural perturbation system capable of generating position-, velocity-, and force-controlled perturbations while being portable and suitable for use during various postural scenarios does not exist. Therefore, the purpose of the present study was to design, develop, and test a portable and automated postural perturbation system (PAPPS) that can be used to measure and train postural reactions during sitting, standing, and treadmill walking. The core component of the PAPPS was a linear actuator that provides horizontal perturbations. The actuator could generate arbitrary displacement, velocity, or force perturbations as a function of time. In addition, the PAPPS was able to measure the actuator’s displacement, velocity, and load, which could be used to study postural perturbation responses. The height at which the PAPPS was delivering the perturbations could be easily adjusted to allow for different subject/patient anthropometrics and a wide range of postural scenarios such as sitting, standing, and treadmill walking. The PAPPS generated a peak displacement of 0.6m, a peak velocity of 0.5ms, and a peak force of 600N, which is more than sufficient to elicit high intensity postural perturbations. Multiple and nested safety circuits have been implemented into the PAPPS to ensure the safety of the subjects/patients during experiments and/or training. To evaluate the accuracy and repeatability of the PAPPS during position-, velocity-, and force-controlled perturbations, experiments were conducted using sinusoidal, impulse, and ramp profiles as a function of time. Highly sensitive displacement and force sensors that were external to the PAPPS were used to determine the accuracy and repeatability of the proposed device. In addition, a case study was performed to demonstrate the performance of the PAPPS during pseudorandom sinusoidal perturbations that were applied to a healthy individual during sitting. The accuracy and repeatability tests suggest that the PAPPS can generate reliable and high-precision displacement, velocity, and force perturbations. Potential applications of this system include, but are not limited to (1) studies of postural response to various perturbation types and profiles in diverse subject populations during sitting, standing, and treadmill walking, and (2) training of postural balance in diverse patient populations during sitting, standing, and treadmill walking.

References

1.
Horak
,
F. B.
, 1987, “
Clinical Measurement of Postural Control in Adults
,”
Phys. Ther.
0031-9023,
67
, pp.
1881
1885
.
2.
Horak
,
F. B.
,
Henry
,
S. M.
, and
Shumway-Cook
,
A.
, 1997, “
Postural Perturbations: New Insights for Treatment of Balance Disorders
,”
Phys. Ther.
0031-9023,
77
, pp.
517
533
.
3.
Maki
,
B. E.
,
Holliday
,
P. J.
, and
Fernie
,
G. R.
, 1990, “
Aging and Postural Control. A Comparison of Spontaneous- and Induced-Sway Balance Tests
,”
J. Am. Geriatr. Soc.
0002-8614,
38
, pp.
1
9
.
4.
Maki
,
B. E.
, and
Ostrovski
,
G.
, 1993, “
Do Postural Responses to Transient and Continuous Perturbations Show Similar Vision and Amplitude Dependence?
,”
J. Biomech.
0021-9290,
26
, pp.
1181
1190
.
5.
Horak
,
F. B.
,
Shupert
,
C. L.
,
Dietz
,
V.
, and
Horstmann
,
G.
, 1994, “
Vestibular and Somatosensory Contributions to Responses to Head and Body Displacements in Stance
,”
Exp. Brain Res.
0014-4819,
100
, pp.
93
106
.
6.
McIlroy
,
W. E.
, and
Maki
,
B. E.
, 1996, “
Age-Related Changes in Compensatory Stepping in Response to Unpredictable Perturbations
,”
J. Gerontol., Ser. A
1079-5006,
51
, pp.
M289
M296
.
7.
Peterka
,
R. J.
, 2002, “
Sensorimotor Integration in Human Postural Control
,”
J. Neurophysiol.
0022-3077,
88
, pp.
1097
1118
.
8.
Forssberg
,
H.
, and
Hirschfeld
,
H.
, 1994, “
Postural Adjustments in Sitting Humans Following External Perturbations: Muscle Activity and Kinematics
,”
Exp. Brain Res.
0014-4819,
97
, pp.
515
527
.
9.
Hirschfeld
,
H.
, and
Forssberg
,
H.
, 1994, “
Epigenetic Development of Postural Responses for Sitting During Infancy
,”
Exp. Brain Res.
0014-4819,
97
, pp.
528
540
.
10.
Zedka
,
M.
,
Kumar
,
S.
, and
Narayan
,
Y.
, 1998, “
Electromyographic Response of the Trunk Muscles to Postural Perturbation in Sitting Subjects
,”
J. Electromyogr Kinesiol
1050-6411,
8
, pp.
3
10
.
11.
Hedberg
,
Å.
,
Forssberg
,
H.
, and
Hadders-Algra
,
M.
, 2004, “
Postural Adjustments due to External Perturbations During Sitting in 1-Month Old Infants: Evidence for the Innate Origin of Direction Specificity
,”
Exp. Brain Res.
0014-4819,
157
, pp.
10
17
.
12.
Carpenter
,
M. G.
,
Allum
,
J. H. J.
, and
Honegger
,
F.
, 1999, “
Directional Sensitivity of Stretch Reflexes and Balance Corrections for Normal Subjects in the Roll and Pitch Planes
,”
Exp. Brain Res.
0014-4819,
129
, pp.
93
113
.
13.
Bloem
,
B. R.
,
Allum
,
J. H. J.
,
Carpenter
,
M. G.
,
Verschuuren
,
J. J. G. M.
, and
Honegger
,
F.
, 2002, “
Triggering of Balance Corrections and Compensatory Strategies in a Patient With Total Leg Proprioceptive Loss
,”
Exp. Brain Res.
0014-4819,
142
, pp.
91
107
.
14.
Henry
,
S. M.
,
Fung
,
J.
, and
Horak
,
F. B.
, 1998, “
Control of Stance During Lateral and Anterior/posterior Surface Translations
,”
IEEE Trans. Rehabil. Eng.
1063-6528,
6
, pp.
32
42
.
15.
Henry
,
S. M.
,
Fung
,
J.
, and
Horak
,
F. B.
, 1998, “
EMG Responses to Maintain Stance During Multidirectional Surface Translations
,”
J. Neurophysiol.
0022-3077,
80
, pp.
1939
1950
.
16.
Torres-Oviedo
,
G.
, and
Ting
,
L. H.
, 2007, “
Muscle Synergies Characterizing Human Postural Responses
,”
J. Neurophysiol.
0022-3077,
98
,
2144
2156
.
17.
Carpenter
,
M. G.
,
Tokuno
,
C. D.
,
Thorstensson
,
A.
, and
Cresswell
,
A. G.
, 2008, “
Differential Control of Abdominal Muscles During Multi-Directional Support-Surface Translations in Man
,”
Exp. Brain Res.
0014-4819,
188
,
445
455
.
18.
Gardner-Morse
,
M. G.
, and
Stokes
,
I. A. F.
, 2001, “
Trunk Stiffness Increases With Steady-State Effort
,”
J. Biomech.
0021-9290,
34
, pp.
457
463
.
19.
Lee
,
P. J.
,
Rogers
,
E. L.
, and
Granata
,
K. P.
, 2006, “
Active Trunk Stiffness Increases With Co-Contraction
,”
J. Electromyogr Kinesiol
1050-6411,
16
, pp.
51
57
.
20.
Fitzpatrick
,
R.
,
Burke
,
D.
, and
Gandevia
,
S. C.
, 1996, “
Loop Gain of Reflexes Controlling Human Standing Measured With the Use of Postural and Vestibular Disturbances
,”
J. Neurophysiol.
0022-3077,
76
, pp.
3994
4008
.
21.
Granata
,
K. P.
,
Slota
,
G. P.
, and
Bennett
,
B. C.
, 2004, “
Paraspinal Muscle Reflex Dynamics
,”
J. Biomech.
0021-9290,
37
, pp.
241
247
.
22.
Moorhouse
,
K. M.
, and
Granata
,
K. P.
, 2007, “
Role of Reflex Dynamics in Spinal Stability: Intrinsic Muscle Stiffness Alone is Insufficient for Stability
,”
J. Biomech.
0021-9290,
40
, pp.
1058
1065
.
23.
Krajcarski
,
S. R.
,
Potvin
,
J. R.
, and
Chiang
,
J.
, 1999, “
The In Vivo Dynamic Response of the Spine to Perturbations Causing Rapid Flexion: Effects of Pre-Load and Step Input Magnitude
,”
Clin. Biomech. (Bristol, Avon)
0268-0033,
14
, pp.
54
62
.
24.
Cholewicki
,
J.
,
Simons
,
A. P. D.
, and
Radebold
,
A.
, 2000, “
Effects of External Trunk Loads on Lumbar Spine Stability
,”
J. Biomech.
0021-9290,
33
, pp.
1377
1385
.
25.
Radebold
,
A.
,
Cholewicki
,
J.
,
Polzhofer
,
G. K.
, and
Greene
,
H. S.
, 2001, “
Impaired Postural Control of the Lumbar Spine is Associated With Delayed Muscle Response Times in Patients With Chronic Idiopathic Low Back Pain
,”
Spine
0362-2436,
26
, pp.
724
730
.
26.
Granata
,
K. P.
,
Slota
,
G. P.
, and
Wilson
,
S. E.
, 2004, “
Influence of Fatigue in Neuromuscular Control of Spinal Stability
,”
Hum. Factors
0018-7208,
46
, pp.
81
91
.
27.
Thomas
,
J. S.
,
Lavender
,
S. A.
,
Corcos
,
D. M.
, and
Andersson
,
G. B. J.
, 1998, “
Trunk Kinematics and Trunk Muscle Activity During a Rapidly Applied Load
,”
J. Electromyogr Kinesiol
1050-6411,
8
, pp.
215
225
.
28.
Stokes
,
I. A. F.
,
Gardner-Morse
,
M.
,
Henry
,
S. M.
, and
Badger
,
G. J.
, 2000, “
Decrease in Trunk Muscular Response to Perturbation With Preactivation of Lumbar Spinal Musculature
,”
Spine
0362-2436,
25
, pp.
1957
1964
.
29.
Radebold
,
A.
,
Cholewicki
,
J.
,
Panjabi
,
M. M.
, and
Patel
,
T. C.
, 2000, “
Muscle Response Pattern to Sudden Trunk Loading in Healthy Individuals and in Patients With Chronic Low Back Pain
,”
Spine
0362-2436,
25
, pp.
947
954
.
30.
Vera-Garcia
,
F. J.
,
Brown
,
S. H. M.
,
Gray
,
J. R.
, and
McGill
,
S. M.
, 2006, “
Effects of Different Levels of Torso Coactivation on Trunk Muscular and Kinematic Responses to Posteriorly Applied Sudden Loads
,”
Clin. Biomech. (Bristol, Avon)
0268-0033,
21
, pp.
443
455
.
31.
Pai
,
Y.-C.
,
Rogers
,
M. W.
,
Patton
,
J.
,
Cain
,
T. D.
, and
Hanke
,
T. A.
, 1998, “
Static Versus Dynamic Predictions of Protective Stepping Following Waist-Pull Perturbations in Young and Older Adults
,”
J. Biomech.
0021-9290,
31
, pp.
1111
1118
.
32.
Patton
,
J. L.
,
Hilliard
,
M. J.
,
Martinez
,
K.
,
Mille
,
M.-L.
, and
Rogers
,
M. W.
, 2006, “
A Simple Model of Stability Limits Applied to Sidestepping in Young, Elderly and Elderly Fallers
,”
Engineering in Medicine and Biology Society, EMBS ’06, 28th Annual International Conference of the IEEE
,
1
, pp.
3305
3308
.
33.
Do
,
M. C.
,
Breniere
,
Y.
, and
Brenguier
,
P.
, 1982, “
A Biomechanical Study of Balance Recovery During the Fall Forward
,”
J. Biomech.
0021-9290,
15
, pp.
933
939
.
34.
Do
,
M. C.
,
Brenière
,
Y.
, and
Bouisset
,
S.
, 1988, “
Compensatory Reactions in Forward Fall: Are They Initiated by Stretch Receptors?
,”
Electroencephalogr. Clin. Neurophysiol.
0013-4694,
69
, pp.
448
452
.
36.
Sin
,
V. W. H.
, 2007, “
Muscle Recruitment Patterns During Sitting
,” M.A.Sc. thesis, University of Toronto, Toronto.
37.
Diener
,
H. C.
,
Horak
,
F. B.
, and
Nashner
,
L. M.
, 1988, “
Influence of Stimulus Parameters on Human Postural Responses
,”
J. Neurophysiol.
0022-3077,
59
, pp.
1888
1905
.
38.
Runge
,
C. F.
,
Shupert
,
C. L.
,
Horak
,
F. B.
, and
Zajac
,
F. E.
, 1999, “
Ankle and Hip Postural Strategies Defined by Joint Torques
,”
Gait and Posture
0966-6362,
10
, pp.
161
170
.
39.
Carpenter
,
M. G.
,
Thorstensson
,
A.
, and
Cresswell
,
A. G.
, 2005, “
Deceleration Affects Anticipatory and Reactive Components of Triggered Postural Responses
,”
Exp. Brain Res.
0014-4819,
167
, pp.
433
445
.
40.
Kuo
,
A. D.
, and
Zajac
,
F. E.
, 1993, “
Human Standing Posture: Multi-Joint Movement Strategies Based on Biomechanical Constraints
,”
Prog. Brain Res.
0079-6123,
97
, pp.
349
358
.
You do not currently have access to this content.