Differential integration of visual and kinaesthetic signals to upright stance

The present experiment was designed to assess the effect of active (deliberate) maintenance of a small forward (FL) or backward body lean (BL) (about 2° ankle flexion) with respect to the spontaneous direction of balance (or neutral posture, N) on postural balance. We questioned whether BL and FL stances, which impose a volitional proprioceptive control of the body-on-support angle, could efficiently reduce mediolateral displacements of the centre of pressure (CoP) induced by the visual motion of a room and darkness. Subjects (n = 15) were asked to stand upright quietly feet together while confronted to a large visual scene rolling to 10° on either side in peripheral vision (and surrounding vertical visual references in central vision) at 0.05 Hz. CoP displacements were recorded using a force platform. Analysis of medio-lateral CoP root-mean square showed that the effect of the moving room depends on the subject’s postural stability performance in the eyes open N stance condition. Two significant postural behaviours emerged. (1) The most stable subjects (G1) were not affected by the conditions of altered vision, but swayed more in BL stance than in the N stance. (2) The unstable subjects (G2) exhibited (i) larger CoP displacements in altered visual conditions and a greater coupling of the CoP with the motion of the visual scene, (ii) enhanced visual dependency with postural leaning, and (iii) decreased CoP displacements when leaning forward in the eyes open motionless scene. Interestingly, the visual quotient positively correlated with the proprioceptive quotient, indicating that the more the subjects relied heavily on the visual frame of reference (FOR) the more they were influenced by body leaning. This result suggested hence a lesser ability to use efficiently body-ground proprioceptive cues. On the whole, the present findings indicate that body leaning could provide a useful mean to assess the subject’s ability to use body-ground proprioceptive cues not only to improve postural stability during eyes opening (especially during forward leaning), but also as a mean to disclose subjects’ visual dependency and their associated difficulties to shift from visual to proprioceptive-based FOR.     

Sensorimotor integration in human postural control

It is generally accepted that human bipedal upright stance is achieved by feedback mechanisms that generate an appropriate corrective torque based on body-sway motion detected primarily by visual, vestibular, and proprioceptive sensory systems. Because orientation information from the various senses is not always available (eyes closed) or accurate (compliant support surface), the postural control system must somehow adjust to maintain stance in a wide variety of environmental conditions. This is the sensorimotor integration problem that we investigated by evoking anterior-posterior (AP) body sway using pseudorandom rotation of the visual surround and/or support surface (amplitudes 0.5-8 degrees ) in both normal subjects and subjects with severe bilateral vestibular loss (VL). AP rotation of body center-of-mass (COM) was measured in response to six conditions offering different combinations of available sensory information. Stimulus-response data were analyzed using spectral analysis to compute transfer functions and coherence functions over a frequency range from 0.017 to 2.23 Hz. Stimulus-response data were quite linear for any given condition and amplitude. However, overall behavior in normal subjects was nonlinear because gain decreased and phase functions sometimes changed with increasing stimulus amplitude. "Sensory channel reweighting" could account for this nonlinear behavior with subjects showing increasing reliance on vestibular cues as stimulus amplitudes increased. VL subjects could not perform this reweighting, and their stimulus-response behavior remained quite linear. Transfer function curve fits based on a simple feedback control model provided estimates of postural stiffness, damping, and feedback time delay. There were only small changes in these parameters with increasing visual stimulus amplitude. However, stiffness increased as much as 60% with increasing support surface amplitude. To maintain postural stability and avoid resonant behavior, an increase in stiffness should be accompanied by a corresponding increase in damping. Increased damping was achieved primarily by decreasing the apparent time delay of feedback control rather than by changing the damping coefficient (i.e., corrective torque related to body-sway velocity). In normal subjects, stiffness and damping were highly correlated with body mass and moment of inertia, with stiffness always about 1/3 larger than necessary to resist the destabilizing torque due to gravity. The stiffness parameter in some VL subjects was larger compared with normal subjects, suggesting that they may use increased stiffness to help compensate for their loss. Overall results show that the simple act of standing quietly depends on a remarkably complex sensorimotor control system.     

Differential approach to strategies of segmental stabilisation in postural control

The present paper attempts to clarify the between-subjects variability exhibited in both segmental stabilisation strategies and their subordinated or associated sensory contribution. Previous data have emphasised close relationships between the interindividual variability in both the visual control of posture and the spatial visual perception. In this study, we focused on the possible relationships that might link perceptual visual field dependence–independence and the visual contribution to segmental stabilisation strategies. Visual field dependent (FD) and field independent (FI) subjects were selected on the basis of their extreme score in a static rod and frame test where an estimation of the subjective vertical was required. In the postural test, the subjects stood in the sharpened Romberg position in darkness or under normal or stroboscopic illumination, in front of either a vertical or a tilted frame. Strategies of segmental stabilisation of the head, shoulders and hip in the roll plane were analysed by means of their anchoring index (AI). Our hypothesis was that FD subjects might use mainly visual cues for calibrating not only their spatial perception but also their strategies of segmental stabilisation. In the case of visual cue disturbances, a greater visual dependency to the strategies of segmental stabilisation in FD subjects should be validated by observing more systematic "en bloc" functioning (i.e. negative AI) between two adjacent segments. The main results are the following:1.Strategies of segmental stabilisation differed between both groups and differences were amplified with the deprivation of either total vision and/or static visual cues.2.In the absence of total vision and/or static visual cues, FD subjects have shown an increased efficiency of the hip stabilisation in space strategy and an "en bloc" operation of the shoulder–hip unit (whole trunk). The last "en bloc" operation was extended to the whole head–trunk unit in darkness, associated with a hip stabilisation in space.3.The FI subjects have adopted neither a strategy of segmental stabilisation in space nor on the underlying segment, whatever the body segment considered and the visual condition. Thus, in this group, head, shoulder and hip moved independently from each other during stance control, roughly without taking into account the visual condition.The results, emphasising a differential weighting of sensory input involved in both perceptual and postural control, are discussed in terms of the differential choice and/or ability to select the adequate frame of reference common to both cognitive and motor spatial activities. We assumed that a motor-somesthetics "neglect" or a lack of mastering of these inputs/outputs rather than a mere visual dependence in FD subjects would generate these interindividual differences in both spatial perception and postural balance. This proprioceptive "neglect" is assumed to lead FD subjects to sensory reweighting, whereas proprioceptive dominance would lead FI subjects to a greater ability in selecting the adequate frame of reference in the case of intersensory disturbances. Finally, this study also provides evidence for a new interpretation of the visual field dependence–independence dimension in both spatial perception and postural control. Electronic Publication     

Dynamic regulation of sensorimotor integration in human postural control

Upright stance in humans is inherently unstable, requiring corrective action based on spatial-orientation information from sensory systems. One might logically predict that environments providing access to accurate orientation information from multiple sensory systems would facilitate postural stability. However, we show that, after a period in which access to accurate sensory information was reduced, the restoration of accurate information disrupted postural stability. In eyes-closed trials, proprioceptive information was altered by rotating the support surface in proportion to body sway (support surface "sway-referencing"). When the support surface returned to a level orientation, most subjects developed a transient 1-Hz body sway oscillation that differed significantly from the low-amplitude body sway typically observed during quiet stance. Additional experiments showed further enhancement of the 1-Hz oscillation when the surface transitioned from a sway-referenced to a reverse sway-referenced motion. Oscillatory behavior declined with repetition of trials, suggesting a learning effect. A simple negative feedback-control model of the postural control system predicted the occurrence of this 1-Hz oscillation in conditions where too much corrective torque is generated in proportion to body sway. Model simulations were used to distinguish between two alternative explanations for the excessive corrective torque generation. Simulation results favor an explanation based on the dynamic reweighting of sensory contributions to postural control rather than a load-compensation mechanism that scales torque in proportion to a fixed combination of sensory-orientation information.     

A model-based approach to attention and sensory integration in postural control of older adults

We conducted a dual-task experiment that involved information processing (IP) tasks concurrent with postural perturbations to explore the interaction between attention and sensory integration in postural control in young and older adults. A postural control model incorporating sensory integration and the influence of attention was fit to the data, from which parameters were then obtained to quantify the interference of attention on postural control. The model hypothesizes that the cognitive processing and integration of sensory inputs for balance requires time, and that attention influences this processing time, as well as sensory selection by facilitating specific sensory channels. Performing a concurrent IP task had an overall effect on the time delay. Differences in the time delay of the postural control model were found for the older adults. The results suggest enhanced vulnerability of balance processes in older adults to interference from concurrent cognitive IP tasks.     

Impaired vertical postural control and proprioceptive integration deficits in Parkinson's disease

The aim of the present study was to investigate how the orientation and stabilization components of postural control may be affected as the result of the impaired proprioceptive integration possibly occurring in Parkinson's disease. To determine the proprioceptive contribution to postural control, parkinsonian patients and control subjects were asked to maintain vertical stance while very slow sinusoidal oscillations were being applied in the lateral and antero-posterior planes to the platform on which they were standing. The amplitude and frequency of their movements were kept below the semicircular canal perception threshold. Data were collected with the ELITE automatic motion analyzer and the two postural components (orientation and segmental stabilization) were analyzed at head and trunk levels while the subjects were performing the task with their eyes open and closed. The results show that 1) the parkinsonian groups' performances were affected in terms of both the postural orientation and stabilization components in comparison with the control group, 2) the use of vision improved the parkinsonian patients' postural performances, and 3) both parkinsonian patients and control subjects achieved better postural performances when antero-posterior perturbations rather than lateral perturbations were applied to the foot support. These results suggest that Parkinson's disease is associated with proprioceptive impairment, which may be an important factor contributing to these patients' postural deficits. On the basis of these results, the visual dependence observed in parkinsonian patients is re-defined as an adaptive strategy partly compensating for the impaired proprioception.     

Adaptation of postural control to weightlessness

Summary Adaptation of motor control to weightlessness was studied during a 7-day spaceflight. The maintenance of control of upright posture was examined during a voluntary raising movement of the arm and during the voluntary raising on tiptoe. In order to evaluate the contribution of visual cues, three types of visual situations were examined: normal vision, central vision, and without vision. On the basis of cinematographic and mechanographic data, the postural perturbations consecutive to the movement of a body part in conditions of weightlessness were found to be similar to those observed on earth. However, in weightlessness, in contrast to the ground-based situation, erectness of posture was maintained primarily due to the predominant contraction of the ankle flexor muscles. The sequences of postural leg muscle activity associated with the arm or foot movement were well structured and varied slightly in the course of the flight. In addition, the initial posture, that is the erect posture before the movement was executed, changed throughout the flight from an exaggerated oblique position to a terrestrial standing position. Visual information was preponderant at the beginning of the space mission for the recalibration of other sensory cues affected by weightlessness. The findings are indicative of two types of adaptation of the central program of posture regulation to weightlessness: fast, short-term adaptation, characterized by a quasi-instantaneous redistribution of motor commands between ankle flexors and extensors (an operative process) and slow, long-term adaptation, exemplified by the loss of anticipatory activation of certain muscles by the end of the flight (a conservative process).     

Integration of proprioceptive signals and attentional capacity during postural control are impaired but subject to improvement in dyslexic children

Children with developmental dyslexia suffer from delayed reading capabilities and may also exhibit attentional and sensori-motor deficits. The objective of this study was twofold. First, we aimed at investigating whether integration of proprioceptive signals in balance control was more impaired in dyslexic children when the attentional demand was varied. Secondly, we checked whether this effect was reduced significantly by using a specific treatment to improve eye control deficits and certain postural signs that are often linked to dyslexia (Quercia et al. in J Fr Ophtalmol 28:713–723, 2005, J Fr Ophtalmol 30:380–89, 2007). Thirty dyslexic and 51 treated dyslexic children (>3 months of treatment) were compared with 42 non-dyslexic children in several conditions (mean age: 136.2 ± 23.6, 132.2 ± 18.7 and 140.2 ± 25 months, respectively). Co-vibration of ankle muscles was effected in order to alter proprioceptive information originating from the ankle. In two vibration conditions, ankle muscles were either not vibrated or vibrated at 85 Hz without illusion of any movement. These two vibration conditions were combined with two attentional conditions. In the first such condition, children maintained balance while merely fixing their gaze on a point in front of them. In the second condition, they had to look for smaller or larger stars in a panel showing forty of each kind. Balance was assessed by means of a force plate. Results indicated that the mean velocity (i.e. the total length) of the center of pressure (CoP) displacement in the 85-Hz vibration condition increased significantly more (compared with no vibration) in the dyslexic and the treated dyslexic groups than in the control group, irrespective of the attention task. Interestingly, in the condition without vibration, the attentional performance of treated children was similar to that of the control group, whereas the attentional performance of the untreated dyslexic children was significantly impaired. Altogether, these results suggest that integration of proprioceptive signals in balance control and attentional capacity are impaired in dyslexic children. However, attention capacity during the control of stance could be improved significantly.     

Nonlinear postural control in response to visual translation

Recent models of human postural control have focused on the nonlinear properties inherent to fusing sensory information from multiple modalities. In general, these models are underconstrained, requiring additional experimental data to clarify the properties of such nonlinearities. Here we report an experiment suggesting that new or multiple mechanisms may be needed to capture the integration of vision into the postural control scheme. Subjects were presented with visual displays whose motion consisted of two components: a constant-amplitude, 0.2 Hz oscillation, and constant-velocity translation from left to right at velocities between 0 cm/s and 4 cm/s. Postural sway variability increased systematically with translation velocity, but remained below that observed in the eyes-closed condition, indicating that the postural control system is able to use visual information to stabilize sway even at translation velocities as high as 4 cm/s. Gain initially increased as translation velocity increased from 0 cm/s to 1 cm/s and then decreased. The changes in gain and variability provided a clear indication of nonlinearity in the postural response across conditions, which were interpreted in terms of sensory reweighting. The fact that gain did not decrease at low translation velocities suggests that the postural control system is able to decompose relative visual motion into environmental motion and self-motion. The eventual decrease in gain suggests that nonlinearities in sensory noise levels (state-dependent noise) may also contribute to the sensory reweighting involved in postural control. These results provide important constraints and suggest that multiple mechanisms may be required to model the nonlinearities involved in sensory fusion for upright stance control.     

Abnormal proprioceptive-motor integration contributes to hypometric postural responses of subjects with Parkinson's disease

Subjects with Parkinson's disease exhibit abnormally short compensatory steps in response to external postural perturbations. We examined whether: (1) Parkinson's disease subjects exhibit short compensatory steps due to abnormal central proprioceptive-motor integration, (2) this proprioceptive-motor deficit can be overcome by visual-motor neural circuits using visual targets, (3) the proprioceptive-motor deficit relates to the severity of Parkinson's disease, and (4) the dysfunction of central dopaminergic circuits contributes to the Parkinson's disease subjects' proprioceptive-motor deficit. Ten Parkinson's disease subjects and 10 matched control subjects performed compensatory steps in response to backward surface translations in five conditions: with eyes closed, with eyes open, to a remembered visual target, to a target without seeing their legs, and to a target while seeing their legs. Parkinson's disease subjects were separated into a moderate group and a severe group based on scores from the Unified Parkinson's Disease Rating Scale and were tested off and on their dopamine medication. Parkinson's disease subjects exhibited shorter compensatory steps than did the control subjects, but all subjects increased their step length when stepping to targets. Compared with the other subject groups, the severe Parkinson's disease subjects made larger accuracy errors when stepping to targets, and the severe Parkinson's disease subjects' step accuracy worsened the most when they were unable to see their legs. Thus, Parkinson's disease subjects exhibited short compensatory steps due to abnormal proprioceptive-motor integration and used visual input to take longer compensatory steps when a target was provided. In severe Parkinson's disease subjects, however, visual input does not fully compensate because, even with a target and unobstructed vision, they still exhibited poor step accuracy. Medication did not consistently improve the length and accuracy of the Parkinson's disease subjects' compensatory steps, suggesting that degeneration of dopamine circuits within the basal ganglia is not responsible for the proprioceptive-motor deficit that degrades compensatory steps in Parkinson's disease subjects.     

Adiposity and postural balance control: correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women

OBJECTIVE:

The purpose of this study was to investigate the correlation between body adiposity and postural control in elderly women.

INTRODUCTION:

Aging and obesity account for a significant portion of healthcare spending. Life expectancy is increasing worldwide, and Rio de Janeiro has the largest proportion of elderly residents of all Brazilian states.

METHODS:

A total of 45 women underwent bioelectrical impedance analysis, waist circumference measurements, weight and height measurements, and stabilometric tests in eight different stance conditions (opened and closed bases with both eyes opened and closed and right and left tandem and unilateral stances with eyes opened). During unilateral stances, the number of hand or foot contacts was counted.

RESULTS:

Weight, body mass index, waist circumference, fat percentage, and fat mass showed statistically significant (p<0.05) and positive correlations with the number of contacts made during unilateral stances. The subjects with greater fat mass showed significantly higher anterior-posterior standard deviation and range when their eyes were closed. The sway area was also greater for this group in opened base when their eyes were closed.

DISCUSSION:

The results relating body adiposity and postural control can be explained by the difficulty of maintaining a greater quantity of body fat mass within the limits of the individual support base, especially while assuming a unilateral stance.

CONCLUSION:

The subjects with a greater fat mass exhibited poor balance control, indicating that body adiposity level was associated with postural control in the elderly women examined in the present study.     

Morphine subtracts subcomponents of haloperidol-isolated postural support reflexes to reveal gradients of their integration

Although cataleptic rats do not spontaneously orient, scan, or walk, they will cling, stand, right themselves in the air, and resist being displaced from a stable position (Schallert, Whishaw, De Ryck, & Teitelbaum, 1978). Morphine produces a state of immobility in which all reflexes used for stable static support (e.g., standing, righting, clinging, and bracing) appear to be inhibited (De Ryck, Schallert, & Teitelbaum, 1980). Addition of morphine to haloperidol abolished or reduced those reflexes used to defend against slow postural displacements (e.g., bracing) but left intact those used to protect against fast postural displacements (e.g., righting in the air). However, although intact, these responses to fast postural displacements were completely abolished by labyrinthectomy, showing that they were controlled only by vestibular inputs. During recovery from morphine's effects, the responses to slow postural displacements reemerged, revealing fractional subcomponents. Furthermore, the reorganization of the subcomponents proceeded along specific body gradients; for example, bracing and standing reemerged caudorostrally, while at the same time, righting and clinging reemerged rostrocaudally.     

Stimulus-dependent changes in the vestibular contribution to human postural control

Humans maintain stable stance in a wide variety of environments. This robust behavior is thought to involve sensory reweighting whereby the nervous system adjusts the relative contribution of sensory sources used to control stance depending on environmental conditions. Based on prior experimental and modeling results, we developed a specific quantitative representation of a sensory reweighting hypothesis that predicts that a given reduction in the contribution from one sensory system will be accompanied by a corresponding increase in the contribution from different sensory systems. The goal of this study was to test this sensory-reweighting hypothesis using measures that quantitatively assess the relative contributions of the proprioceptive and graviceptive (vestibular) systems to postural control during eyes-closed stance in different test conditions. Medial/lateral body sway was evoked by side-to-side rotation of the support surface (SS) while simultaneously delivering a pulsed galvanic vestibular stimulus (GVS) through electrodes behind the ears. A model-based interpretation of sway evoked by SS rotations provided estimates of the proprioceptive weighting factor, Wp, and showed that Wp declined with increasing SS amplitude. If the sensory-reweighting hypothesis is true, then the decline in Wp should be accompanied by a corresponding increase in Wp, the graviceptive weighting factor, and responses to the GVS should increase in proportion to the value of Wp derived from responses to SS rotations. Results were consistent with the predictions of the proposed sensory-reweighting hypothesis. GVS-evoked sway increased with increasing SS amplitude, and Wp measures derived from responses to GVS and from responses to SS rotations were highly correlated.     

Motion parallax is used to control postural sway during walking

Three experiments tested the hypothesis that postural sway during locomotion is visually regulated by motion parallax as well as optical expansion. Oscillating displays of three-dimensional scenes were presented to participants walking on a treadmill, while postural sway was recorded. Displays simulated: (a) a cloud, in which parallax and expansion are congruent, (b) a hallway, (c) the side walls of the hallway, (d) a ground surface, (e) a wall, (f) the wall with a central hole, (g) a hall farther from the observer, and (h) a wall farther from the observer. In contrast to previous results with a hallway, responses with the cloud were isotropic and directionally specific. The other displays demonstrated that motion parallax was more effective than simple horizontal flow in eliciting lateral sway. These results are consistent with the hypothesis that adaptive control of sway during walking is based on congruent expansion and parallax in natural environments.     

Evidence for reflex and perceptual vestibular contributions to postural control

Vestibular signals are known to have an important role in stance under specific conditions. Potentially these effects could be modulated by vestibular reflexes or by voluntary responses to perceived vestibular signals. Our preliminary aim was to confirm that vestibulospinal reflexes change in parallel with sway under different postural conditions, and then to determine whether any relationship was present between these reflexes and body sway within fixed postural conditions. Sixteen subjects (eight male, eight female) were tested in conditions assessing the effects of vision (eyes open or closed), support surface (firm or compliant), external support (with or without) and stance width (feet apart or together). Sway (centre of pressure) in the anteroposterior (AP) and mediolateral planes was measured using a force platform. A subgroup of 11 subjects (five male, six female) underwent testing to measure short (SL) and medium latency (ML) reflexes from soleus. Bipolar, transmastoid galvanic stimulation (1 mA, 200 ms) was administered while subjects stood in the most unstable of our conditions (eyes closed, compliant surface and feet together). In the final part, to assess possible perceptual contributions to body sway, short duration AP sway levels were measured and expressed in angular terms (sway in mrad, velocity in mrad s^–1) in the 11 subjects for both our baseline (eyes open, firm surface and feet apart) and most unstable conditions. Average sway levels increased more than seven-fold between conditions and had significant, positive correlations with reported changes in mean vestibulospinal reflexes under similar conditions (overall r =0.75, P <0.001). However, the SL reflex for the subgroup of 11 subjects had a significant negative correlation ( r =–0.71; P =0.014) with the degree of AP sway in the condition with maximum reliance on vestibular inputs (eyes closed, compliant surface, and feet together). Under baseline conditions, 5/125 (4%) of the short-term AP sway displacements were above the threshold previously reported for the detection of imposed sway. In the unstable condition, when sway was increased, 43/138 (31%) of the short-term AP sway movements were above the threshold for perception of imposed body sway based on vestibular signals. Our results confirm that vestibulospinal reflexes appear to be acutely facilitated as body sway increases. For the most unstable condition, when non-vestibular information was absent or attenuated, subjects with larger SL reflexes had less AP sway, suggesting that the SL reflex acted to attenuate sway. Under the same condition, short duration sway levels increased such that 31% were above the previously published threshold for detection using vestibular afferents. We conclude that both vestibular reflexes and perceptual signals appear to have a specific role in the maintenance of upright stance, under conditions in which other sources of postural information are attenuated or absent.     

Age-related differences in postural control in humans in response to a sudden deceleration generated by postural disturbance

Age-related differences in postural control in response to a relatively large deceleration resulting from postural disturbance were investigated in eight normal elderly men (age range 67–72 years) and eight young men as controls (age range 19–22 years) using a moving platform. Data were obtained for the hip, knee and ankle angles, position of the centre of foot pressure (CFP), head acceleration, and muscle activity of the leg muscles. The elderly subjects had slower and larger ankle and hip joint movements, and CFP displacement in response to the disturbance compared to the young controls. The elderly subjects also had a delayed occurrence, and greater magnitude of peak acceleration of head rotation than did the young subjects. For the elderly subjects, the CFP was closely related to angular changes in the hip joint movement, but not to those of the ankle and knee joint movements. For the young subjects, on the other hand, the CFP was significantly correlated with angular change in the ankle joint. Co-contraction of the tibialis anterior and gastrocnemius muscles was observed in the elderly subjects. The results indicated that a movement pattern for postural correction in the elderly adults was different from that of the young adults. The elderly relied more on hip movements while the young controls relied on ankle movements to control postural stability. Electronic Publication     

Tactile directional sensitivity and postural control

People are good at telling the direction of a moving tactile stimulus and this capacity provides a sensitive clinical test of somatosensory disturbances. Tactile directional sensitivity depends on two different kinds of somatosensory information, i.e. spatiotemporal information and information about friction-induced changes in skin stretch. The objective of this study was to compare the relative contribution to postural control of these two types of information for both glabrous and hairy skin. Postural sway amplitudes and sway paths were recorded, with or without access to tactile and/or visual stabilizing stimuli. Subjects were standing on two types of surface, either solid metal or 50 mm foam plastic. Two types of stimulus were used to generate sway-related tactile information. One was a thin air-stream that was used to assess the contribution by spatiotemporal information, and the second was a narrow steel rod that was glued to the skin to assess the contribution by skin-stretch information. The stimuli were applied to the hairy skin of the forearm and to the glabrous skin of the fingertip. In addition, we studied the ability to tell the direction of movement of an air-stream stimulus on glabrous and hairy skin. The air-stream caused significant sway reductions when applied to glabrous, but not hairy skin. The weak effect on hairy skin reflected the perceptually poor directional sensitivity for the air-stream stimulus in this cutaneous area. In contrast, the glued rod reduced sway when applied to both glabrous and hairy skin reflecting the tactile afferents high sensitivity to skin stretch in these areas. Both types of tactile stimulus reduced sway amplitudes more than sway paths for both hairy and glabrous skin. The visual cue, on the other hand, tended to reduce sway paths more than amplitudes. The two types of tactile receptive surface seem to influence postural control in the same manner, despite anatomical and physiological differences. The results invite speculation that patients with poor directional sensitivity might have reduced postural stability compared with healthy individuals.     

Fingertip contact influences human postural control

Touch and pressure stimulation of the body surface can strongly influence apparent body orientation, as well as the maintenance of upright posture during quiet stance. In the present study, we investigated the relationship between postural sway and contact forces at the fingertip while subjects touched a rigid metal bar. Subjects were tested in the tandem Romberg stance with eyes open or closed under three conditions of fingertip contact: no contact, touch contact (<0.98 N of force), and force contact (as much force as desired). Touch contact was as effective as force contact or sight of the surroundings in reducing postural sway when compared to the no contact, eyes closed condition. Body sway and fingertip forces were essentially in phase with force contact, suggesting that fingertip contact forces are physically counteracting body sway. Time delays between body sway and fingertip forces were much larger with light touch contact, suggesting that the fingertip is providing information that allows anticipatory innervation of musculature to reduce body sway. The results are related to observations on precision grip as well as the somatosensory, proprioceptive, and motor mechanisms involved in the reduction of body sway.     

Fingertip contact influences human postural control

Touch and pressure stimulation of the body surface can strongly influence apparent body orientation, as well as the maintenance of upright posture during quiet stance. In the present study, we investigated the relationship between postural sway and contact forces at the fingertip while subjects touched a rigid metal bar. Subjects were tested in the tandem Romberg stance with eyes open or closed under three conditions of fingertip contact: no contact, touch contact (< 0.98 N of force), and force contact (as much force as desired). Touch contact was as effective as force contact or sight of the surroundings in reducing postural sway when compared to the no contact, eyes closed condition. Body sway and fingertip forces were essentially in phase with force contact, suggesting that fingertip contact forces are physically counteracting body sway. Time delays between body sway and fingertip forces were much larger with light touch contact, suggesting that the fingertip is providing information that allows anticipatory innervation of musculature to reduce body sway. The results are related to observations on precision grip as well as the somatosensory, proprioceptive, and motor mechanisms involved in the reduction of body sway.