Augmented visual feedback increases finger tremor during postural pointing

Physiological tremor in the upper limb of eight adults was examined during the performance of a unilateral pointing task under conditions where the visual feedback, limb used and target size were altered. All subjects were required to aim a hand-held laser pointer at a circular target 5.5 m away with the goal of keeping the laser emission within the centre of the target. Visual feedback was defined as either normal vision (NV) of their limb tremor, where the laser was switched off, or augmented vision (AV) where the laser was switched on. Postural tremor from the segments of the upper limb, forearm muscle EMG activity, and target accuracy measures were recorded and analysed in the time and frequency domains. Accuracy-tremor relations were assessed using cross correlation and linear regression. Results revealed a high degree of similarity in the general pattern of the tremor output seen for each limb segment across conditions with only scalar (amplitude) changes being seen as a function of the different constraints imposed. For any single condition the tremor amplitude increased from proximal to distal segments. The frequency profile for the tremor in any segment displayed two prominent frequency peaks (at 2–4 Hz and 8–12 Hz). A third, higher frequency peak (18–22 Hz) was observed in the index fingers only. Across all conditions significant coupling relations were observed only between the hand-finger and forearm-upper arm segment pairs. Altering the visual feedback was shown to have the greatest effect on limb tremor with increased tremor and EMG activity and decreased coupling being seen under AV conditions. In trying to reduce tremor output when the augmented feedback was provided novice subjects instead increased muscle activity which resulted in increased tremor. Overall these results indicate that the physiological tremor output observed in neurologically normal subjects is not simply the product of intrinsic oscillations but is influenced by the nature of the task being performed.     

Effects of body lean and visual information on the equilibrium maintenance during stance

Maintenance of equilibrium was tested in conditions when humans assume different leaning postures during upright standing. Subjects ( n=11) stood in 13 different body postures specified by visual center of pressure (COP) targets within their base of support (BOS). Different types of visual information were tested: continuous presentation of visual target, no vision after target presentation, and with simultaneous visual feedback of the COP. The following variables were used to describe the equilibrium maintenance: the mean of the COP position, the area of the ellipse covering the COP sway, and the resultant median frequency of the power spectral density of the COP displacement. The variability of the COP displacement, quantified by the COP area variable, increased when subjects occupied leaning postures, irrespective of the kind of visual information provided. This variability also increased when vision was removed in relation to when vision was present. Without vision, drifts in the COP data were observed which were larger for COP targets farther away from the neutral position. When COP feedback was given in addition to the visual target, the postural control system did not control stance better than in the condition with only visual information. These results indicate that the visual information is used by the postural control system at both short and long time scales.     

Inter- and intra-limb coordination in arm tremor

Inter- and intra-limb coordination in arm tremor was examined in adult subjects under vision and no vision conditions using accelerometery techniques. The accelerometer data were analyzed using standard time and frequency domain analyses and the regularity of the acceleration time series was determined using an approximate entropy (Ap En) measure. The data analysis was structured to examine the hypothesis that there is a functional compensatory relation between the motion (tremor) of the limb segments in the arm coordination postural pointing task. The results showed that the level of acceleration increased in a proximal to distal direction within a single arm and was symmetrical across homologous arm segments. The frequency analysis showed the established power spectral profiles for each limb segment in postural tremor tasks, but the finger motion included (beyond the normal 8–12 Hz and 20 Hz tremor) a third slower peak at around 2–3 Hz, due possibly to the reactive forces of the other arm links. There was no effect of vision on the level or frequency patterns of acceleration in the limb segments. The coordination analysis showed that there was no linkage between the arms in either the time or frequency domain in the execution of this postural task. This result would tend to suggest that the neuronal commands underlying normal tremor are not derived from a common central oscillator within the central nervous system but are organized in a parallel fashion. The strength of the coupling of intra-limb coordination varied according to the particular adjacent limb links. There were significant correlations in the time domain and coherence in the frequency domain in the acceleration signals between upper arm and forearm, and between hand and finger. The phase lag of the arm units within each of these respective segment pairs was close to in phase or 0 deg. Significant coherence in the frequency domain was also evident between upper arm and hand motion, with the phase lag between these segments being close to 180 deg out of phase. The Ap En analysis of the acceleration signals revealed that there was more regularity to the upper arm and hand accelerometer signals than the forearm and finger signals. The findings show that the intra-limb coordination of the arm links in a two-limb postural pointing task is effected by a compensatory synergy organized about the action of the wrist and shoulder joints. This compensatory synergy reduces the coordination of the 4 within-limb degrees of freedom (arm links) to, in effect, a single degree of freedom arm control task that is not coupled in organization to the motion of the other limb or the torso. It is proposed that this coordination solution reduces the degrees of freedom independently regulated for realization of the task goal but preserves independent body segment control in critical degrees of freedom for potential adaptation to postural perturbations.     

Stance and sensory feedback influence on postural dynamics

This study examined the effects of ice-induced plantar desensitization and the withdrawal of visual feedback on the magnitude and time-dependent structure of postural sway variability. The magnitude of variability was quantified as the area of an ellipse enclosing 95% of the center of pressure (COP) time-series during normal and tandem stances. The same time-series were also analyzed using Approximate Entropy (ApEn) and Cross-Approximate Entropy (CrossApEn) as indices of irregularity and asynchrony between the mediolateral and anteroposterior COP motions. Variability increased during tandem stance and this increase was compounded by both visual feedback withdrawal and cutaneous desensitization. Both ApEn (mediolateral and anteroposterior COP motion) and CrossApEn increased with the withdrawal of visual feedback during the tandem stance, but decreased significantly during normal stance. The results of the study demonstrate that plantar desensitization only affected the magnitude of sway variability but did not alter its time-dependent structure. Contrasting effects on the structure of postural sway variability with visual feedback withdrawal were observed during the different stances, highlighting the role of task demands in postural dynamics.     

Role of the vestibular system in the arterial pressure response to parabolic-flight-induced gravitational changes in human subjects

This study examined how different weighting coefficients imposed on individual finger force regulate bimanual finger force coordination patterns under the influence of bilateral coupling and visual information of the force output. The weighted sum of the two forces was computed as the total force output to match two target force levels (10% and 35% MVC) in separate conditions, and visual feedback of the total force output was provided in the experiment. The results revealed higher performance error at 35% in comparison with 10% MVC with the greatest error at the unequal coefficient setting. The correlation between the individual forces and the force output ratios correlated nonlinearly with the weighting coefficient ratios; however, the extent of change was much smaller than the coefficient ratios. The results suggest that bilateral coupling and task constraints interact to determine the coordination strategy. The irregularity of the individual finger forces increased with the weighting coefficient while the irregularity of the total force remained the same. The results support the hypothesis that the organization of redundant motor coordination patterns emerges from the interactive effect of the constraints on movement.     

Coordination between the transport and the grasp components during prehension movements

In this study, the possible influence of the transport on the grasp component of prehension movements was investigated. The first phase of the transport (acceleration phase) and of the grasp (finger aperture phase) kinematics were studied under conditions of visual and non-visual object presentation (prehension experiment). In the non-visual condition, object size was estimated by haptics and object position was estimated by proprioception. Eight subjects were required to reach and grasp three objects of different size located at two distances. An additional experiment (matching experiment) was carried out to control the scaling of object size in the two conditions. The results showed that in the matching experiment size estimation for large objects was similar in the two conditions, whereas small stimuli were underestimated in the haptic condition. In the prehension experiment, maximal finger aperture and velocity of finger aperture were greater in the non-visual than in the visual condition, and the difference was greater for small than for large stimuli. Moreover, in both conditions, finger opening was larger for prehension movements directed to the far than to the near objects, but only for smaller stimuli. Hand trajectory variability increased in the non-visual condition and with the distance, whereas finger opening variability was only affected by the non-visual condition. For smaller stimuli, increased finger opening with distance was positively correlated with the increase in wrist variability in the visual condition, but not in the non-visual condition. Furthermore, increased finger opening between visual and non-visual conditions was correlated with the increase in wrist variability, for smaller objects at the near object location. No positive correlations were found between finger opening and grip variability. These results are interpreted in favour of the dependence of finger opening on transport, when control requirements during reaching increase.     

The effects of weight load and joint immobilization on reorganization of postural tremor

To investigate change in coordinative strategies due to wrist immobilization and index loading, postural tremors from the index, hand, and forearm were recorded during different postural holding tasks. The wrist joint was immobilized with a thermoplastic splint in the constrained condition, and a copper mass of 100 grams was applied to the index finger in the loaded condition. The structures of the postural tremors of all upper limb segments among the unloaded-unconstrained, unloaded-constrained, loaded-unconstrained, and loaded-constrained conditions were compared. Index loading exaggerated index/forearm postural tremor, while the load-induced tremor enhancement was no longer evident for wrist immobilization. In the unloaded condition, wrist immobilization resulted specifically in enhancement of carpal postural tremor, rather than in the index and forearm. Index loading induced a marked tremor peak and relative power in the range of 5-8 Hz. Wrist immobilization potentiated the carpal tremor peak of 1-4 Hz in association with enhancement of carpal-forearm mechanical coupling. In light of structural changes in postural tremor, our data suggest that (1) a wrist splint is effective to counteract load-induced enhancement of postural tremor, and (2) freezing of the wrist joint might facilitate compensatory strategies to minimize passive fluctuation transmission from the carpal to index.     

The amplitude of physiological tremor can be voluntarily modulated

The objective of this study was to determine whether it was possible to voluntarily modulate physiological tremor (PT), i.e., reduce its amplitude. We recorded the postural index finger tremor of 30 healthy participants with a laser in four conditions: (A) eyes closed, without any attempt to modulate PT amplitude, (B) no visual feedback, trying to reduce PT amplitude, (C) visual feedback, trying to reduce PT amplitude. For conditions B and C, subjects were asked to avoid using muscle contraction as a means to stabilize the finger. Finally, (D) subjects were asked to reduce PT amplitude using voluntary muscle contraction to stabilize the finger. We used electromyography to monitor the extensor digitorum communis and flexor digitorum superficialis. Total amplitude of PT did not change significantly between conditions A and B. In condition C, a significant decrease of PT amplitude was observed. A significant increase in tremor amplitude was observed in D compared with other conditions, confirming that co-contraction was not used to modulate the amplitude of PT in other conditions. Subsequently, we formed three subgroups based on their ability to modulate PT: Most Improved (n = 7), Least Improved (n = 16) and Not Improved (n = 7). Although oscillations within the low frequency bands increased only in the Not Improved group, oscillations within the 8–12 and 16–30 Hz bands either remained stable or decreased for all participants, supporting a disassociation between mechanical-reflex and central components of PT. Our results show that it is possible to voluntarily modulate PT. Therefore, a cortical influence is being exerted on tremor.     

Age differences in visual sensory integration

Summary Numerous authors have reported that elderly persons are more affected than young adults when submitted to reduced or conflicting sensory inputs conditions. These results, however, do not permit to evaluate whether the elderly suffer from a reduced peripheral sensibility or from a deficit in the central integrative mechanisms responsible for configuring the postural set. The present experiment evaluated the ability of elderly to reconfigure the postural set when submitted to successive reduced and augmented visual sensory conditions. Results showed that young and elderly subjects' sway dispersion increased when they were exposed to a reduced visual sensory condition (i.e., vision/no-vision transition). However, when exposed to augmented sensory condition (i.e., no-vision/vision transitions) young adults were able to adapt rapidly and reduced their sway dispersion whereas the elderly exhibited an increased sway dispersion. This inability to adapt to an augmented sensory condition suggest that elderly persons, in addition to a reduced peripheral sensibility, have a deficit with central integrative mechanisms responsible for reconfiguring the postural set.     

Tactile feedback contributes to consistency of finger movements during typing

Touch typing movements are typically too brief to use on-line feedback. Yet, previous studies have shown that blocking tactile feedback of the fingertip of typists leads to an increase in typing errors. To determine the contribution of tactile information to rapid fine motor skills, we analyzed kinematics of the right index finger during typing with and without tactile feedback. Twelve expert touch typists copy-typed sentences on a computer keyboard without vision of their hands or the computer screen. Following control trials, their right index fingertip was anesthetized, and sentences were typed again. The movements of the finger were recorded with an instrumented glove and electromagnetic position sensor. During anesthesia, typing errors of that finger increased sevenfold. While the inter-keypress timing and average kinematics were unaffected, there was an increase in variability of all measures. Regression analysis showed that endpoint variability was largely accounted for by start location variability. The results suggest that tactile cues provide information about the start location of the finger, which is necessary to perform typing movements accurately.     

Age-related changes in the frequency profile of children's finger tremor

Little consensus exists as to the age-related pattern of change in the frequency characteristics of postural tremor through childhood. We investigated postural finger tremor of children (6 and 10 years) and adults (18-22 years) using accelerometers under dual and single limb conditions (10s trials). The postural tremor of the children exhibited proportionally more power below 10 Hz and less power above 20 Hz than that of the adults. It also showed a significantly lower peak frequency and lower proportion of power at the peak frequency than the adults in the 15-30 Hz frequency band but did not differ significantly from the adults in peak frequency or proportion of power at the peak frequency in the 5-15 Hz frequency band. The greater relative contribution of fast time scales over the 1-30 Hz frequency band in the organization of the postural tremor of the adults in comparison to the children may be a contributing factor to adult's typically observed reduced motor skill performance variability.     

Contributions of delayed visual feedback and cognitive task load to postural dynamics

In this experiment, we examined the extent to which postural control is influenced by visual and cognitive task performance. Fourteen healthy young participants performed a balance task in eyes-open (EO) and delayed visual feedback (DVF) conditions. DVF was presented at delays ranging from 0 to 1200 ms in 300 ms increments. Cognitive load was implemented by a simple, serial arithmetic task. High and low-pass filtering (f_c = 0.3 Hz) distinguished LOW and HIGH frequency components, which were used to compute the variability of Anteroposterior (AP) Center of Pressure (COP) trajectories on fast (>0.3 Hz) and slow (<0.3 Hz) times cales. Imposed visual delay increased sway variability at both LOW and HIGH components. Cognitive task performance, however, influenced only the variability of fast (HIGH) sway components. Our results support distinct timescale mechanisms for postural control, but also demonstrate that vision predominantly influences low frequency components of postural sway. Moment-to-moment COP fluctuations are dependent on cognitive performance during delayed visual feedback postural control.     

Multisensory information for human postural control: integrating touch and vision

Despite extensive research on the influence of visual, vestibular and somatosensory information on human postural control, it remains unclear how these sensory channels are fused for self-orientation. The focus of the present study was to test whether a linear additive model could account for the fusion of touch and vision for postural control. We simultaneously manipulated visual and somatosensory (touch) stimuli in five conditions of single- and multisensory stimulation. The visual stimulus was a display of random dots projected onto a screen in front of the standing subject. The somatosensory stimulus was a rigid plate which subjects contacted lightly (<1 N of force) with their right index fingertip. In each condition, one sensory stimulus oscillated (dynamic) in the medial-lateral direction while the other stimulus was either dynamic, static or absent. The results qualitatively supported five predictions of the linear additive model in that the patterns of gain and variability across conditions were consistent with model predictions. However, a strict quantitative comparison revealed significant deviations from model predictions, indicating that the sensory fusion process clearly has nonlinear aspects. We suggest that the sensory fusion process behaved in an approximately linear fashion because the experimental paradigm tested postural control very close to the equilibrium point of vertical upright.     

Judgment of disability stages in Parkinson disease patients due to pathological tremor of index finger

The purpose of this study is to investigate the disability stages of Parkinson disease (PD) patients by wave analysis of parkinsonian pathological tremor. Physiological tremor and pathological tremor for the index finger are detected by accelerator sensor. The power spectrum is calculated by an auto-regressive model (AR model). The peak frequency and the peak power of the tremor for the index finger are evaluated under two conditions: (1) maintaining the index finger in a horizontal position using visual feedback with or without a weight load of 50 g, in which tremor is referred to as postural tremor, (2) resting the index finger with eyes closed, in which the tremor is referred to as resting tremor. The physiological tremor and the pathological tremor for the finger are characterized by two peak frequency components in which the first peak frequency component is 8-12 Hz, and the second is 20-25 Hz under the two conditions stated above. The peak frequency and the peak power for the PD patients at the two peak frequency components show the characteristics for the disability level of the PD patients. The first peak power especially around 8-12 Hz in the postural tremor without and with the weight load significantly increases as the disability stage determined by the Hoehn-Yahr method worsens, and there is significant difference of the peak powers for the stages. These results suggest that the first peak power around 8-12 Hz for the postural tremor without and with the weight load is a useful index to judge PD disability stage. It is found that postural tremor without and with the weight load gives the significant peak frequency and peak power compared with those for normal persons. It is pointed out that the first peak frequency component of 8-12 Hz originates from the central nervous system, and the first peak power reflects the degrees of disorder in the central nervous system, since PD is caused by the functional lowering of the central nervous system.     

The interaction of visual and proprioceptive inputs in pointing to actual and remembered targets

Errors in pointing to actual and remembered targets presented in three-dimensional (3D) space in a dark room were studied under various conditions of visual feedback. During their movements, subjects either had no vision of their arms or of the target, vision of the target but not of their arms, vision of a light-emitting diode (LED) on their moving index fingertip but not of the target, or vision of an LED on their moving index fingertip and of the target. Errors depended critically upon feedback condition. 3D errors were largest for movements to remembered targets without visual feedback, diminished with vision of the moving fingertip, and diminished further with vision of the target and vision of the finger and the target. Moreover, the different conditions differentially influenced the radial distance, azimuth, and elevation errors, indicating that subjects control motion along all three axes relatively independently. The pattern of errors suggest that the neural systems that mediate processing of actual versus remembered targets may have different capacities for integrating visual and proprioceptive information in order to program spatially directed arm movements.     

Recurrence analysis of human postural sway during the sensory organization test

The present study examined how the availability of and alterations in sensory information during the sensory organization test (SOT) influenced the amount, variability, and temporal structure of spontaneous postural sway in young, healthy adults. Findings indicated that postural sway tended to increase in amount and variability as the SOT condition became increasingly difficult (i.e. as the SOT condition moved from eyes open to eyes closed, to sway-referenced visual surround or support surface, and to sway-reference surface and visual surround). In addition, recurrence quantification analysis revealed that the temporal structure of postural sway tended to become increasingly regular as the SOT condition increased in difficulty. The functional utility of the observed changes in the temporal structure of postural sway across sensory conditions was discussed.     

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.     

Gaze affects pointing toward remembered visual targets after a self-initiated step

We have investigated pointing movements toward remembered targets after an intervening self-generated body movement. We tested to what extent visual information about the environment or finger position is used in updating target position relative to the body after a step and whether gaze plays a role in the accuracy of the pointing movement. Subjects were tested in three visual conditions: complete darkness (DARK), complete darkness with visual feedback of the finger (FINGER), and with vision of a well-defined environment and with feedback of the finger (FRAME). Pointing accuracy was rather poor in the FINGER and DARK conditions, which did not provide vision of the environment. Constant pointing errors were mainly in the direction of the step and ranged from about 10 to 20 cm. Differences between binocular fixation and target position were often related to the step size and direction. At the beginning of the trial, when the target was visible, fixation was on target. After target extinction, fixation moved away from the target relative to the subject. The variability in the pointing positions appeared to be related to the variable errors in fixation, and the co-variance increases during the delay period after the step, reaching a highly significant value at the time of pointing. The significant co-variance between fixation position and pointing is not the result of a mutual dependence on the step, since we corrected for any direct contributions of the step in both signals. We conclude that the co-variance between fixation and pointing position reflects 1) a common command signal for gaze and arm movements and 2) an effect of fixation on pointing accuracy at the time of pointing.     

The interaction of visual and proprioceptive inputs in pointing to actual and remembered targets in Parkinson's disease.

We previously reported that Parkinson's disease patients could point with their eyes closed as accurately as normal subjects to targets in three-dimensional space that were initially presented with full vision. We have now further restricted visual information in order to more closely examine the individual and combined influences of visual information, proprioceptive feedback, and spatial working memory on the accuracy of Parkinson's disease patients. All trials were performed in the dark. A robot arm presented a target illuminated by a light-emitting diode at one of five randomly selected points composing a pyramidal array. Subjects attempted to "touch" the target location with their right finger in one smooth movement in three conditions: dark, no illumination of arm or target during movement; movement was to the remembered target location after the robot arm retracted; finger, a light-emitting diode on the pointing fingertip was visible during the movement but the target was extinguished; again, movement was to the remembered target location; and target, the target light-emitting diode remained in place and visible throughout the trial but there was no vision of the arm. In the finger condition, there is no need to use visual-proprioceptive integration, since the continuously visualized fingertip position can be compared to the remembered location of the visual target. In the target condition, the subject must integrate the current visible target with arm proprioception, while in the dark condition, the subject must integrate current proprioception from the arm with the remembered visual target. Parkinson's disease patients were significantly less accurate than controls in both the dark and target conditions, but as accurate as controls in the finger condition. Parkinson's disease patients, therefore, were selectively impaired in those conditions (target and dark) which required integration of visual and proprioceptive information in order to achieve accurate movements. In contrast, the patients' normal accuracy in the finger condition indicates that they had no substantial deficits in their relevant spatial working memory. Final arm configurations were significantly different in the two subject groups in all three conditions, even in the finger condition where mean movement endpoints were not significantly different. Variability of the movement endpoints was uniformly increased in Parkinson's disease patients across all three conditions.The current study supports an important role for the basal ganglia in the integration of proprioceptive signals with concurrent or remembered visual information that is needed to guide movements. This role can explain much of the patients' dependence on visual information for accuracy in targeted movements. It also underlines what may be an essential contribution of the basal ganglia to movement, the integration of afferent information that is initially processed through multiple, discrete modality-specific pathways, but which must be combined into a unified and continuously updated spatial model for effective, accurate movement.     

Children's coordination of force output in a pinch grip task

This study examined the role of sensorimotor system noise in the organization of the force output of the thumb and index finger and the coordination between the two digits in an isometric pinch grip force task as a function of age (6, 8, 10, 18-22 years), feedback condition (with and without visual feedback information), and force level (5, 15, 25, and 35% of maximal voluntary force. With increases in age under the visual feedback conditions, the signal-to-noise ratio increased, the sequential structure of the force output signals became more irregular, the degree of coherence between the digits at higher force levels was enhanced, and the digits exhibited a greater degree of coherence across the higher frequencies of the power spectrum at all force levels. However, these age differences were either minimized or eliminated under conditions without feedback. These findings show that the age-related performance differences in grip force variability are primarily due to more effective use of visual information rather than age differences in intrinsic sensorimotor noise.