Cenciarini, Massimo and Robert J. Peterka. Stimulus-dependent changes in the vestibular contribution to human postural control. J Neurophysiol 95: 2733-2750, 2006. First published February 8, 2006 doi:10.1152/jn.00856.2004. 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, W p , and showed that W p declined with increasing SS amplitude. If the sensoryreweighting hypothesis is true, then the decline in W p should be accompanied by a corresponding increase in W g , the graviceptive weighting factor, and responses to the GVS should increase in proportion to the value of W g derived from responses to SS rotations. Results were consistent with the predictions of the proposed sensoryreweighting hypothesis. GVS-evoked sway increased with increasing SS amplitude, and W g measures derived from responses to GVS and from responses to SS rotations were highly correlated.

Upright balance is believed to be maintained through active and passive mechanisms, both of which have been shown to be impacted by aging. A compensatory balance response often observed in older adults is increased co-contraction, which is generally assumed to enhance stability by increasing joint stiffness. We investigated the effect of aging on standing balance by fitting body sway data to a previously-developed postural control model that includes active and passive stiffness and damping parameters. Ten young (24 ± 3 y) and seven older (75 ± 5 y) adults were exposed during eyes-closed stance to perturbations consisting of lateral pseudorandom floor tilts. A least-squares fit of the measured body sway data to the postural control model found significantly larger active stiffness and damping model parameters in the older adults. These differences remained significant even after normalizing to account for different body sizes between the young and older adult groups. An age effect was also found for the normalized passive stiffness, but not for the normalized passive damping parameter. This concurrent increase in active stiffness and damping was shown to be more stabilizing than an increase in stiffness alone, as assessed by oscillations in the postural control model impulse response.

Cognitive tasks impact postural control when performed concurrently as dual-tasks. This is presumed to result from capacity limitations in relevant brain regions. We used functional near-infrared spectroscopy (fNIRS) to measure brain activation of the left motor, temporal, and dorsal-lateral prefrontal brain regions of younger (n=6) and older (n=10) adults. Brain activation was measured during an auditory choice reaction task (CRT) and standing on a dynamic posturography platform, both as single-tasks and concurrently as dual-task. Body sway was assessed by median absolute deviation (MAD) of anterior-posterior translation of the center of mass (COM). Brain activation was measured as changes in oxy-hemoglobin by fNIRS. During both single- and dual-task conditions, we found that older adults had greater brain activation relative to younger adults. During dual task performance, the total activation was less than expected from the sum of individual conditions for both age groups, indicating a dual-task interference (reduction in younger adults=53% [p=0.02]; in older adults=53%; [p=0.008]). This reduction was greater for the activation attributable to the postural task (reduction younger adults=75% [p=0.03]; older adults=59% [p=0.005]) compared to the CRT task (reduction younger adults=10%, [p=0.6]; older adults=7.3%, [p=0.5]) in both age groups. Activation reduction was not accompanied by any significant changes in body sway in either group (older adults: single-task MAD=0.94 cm, dual-task MAD=1.10 cm, p=0.20; younger adults: single-task RMS =0.95 cm, dual-task MAD=1.08 cm, p=0.14). Our results indicate that neural resources devoted to postural control are reduced under dual-task conditions that engage attention.

This paper presents an analysis of the human biomechanical considerations related to the development of lower limb exoskeletons. Factors such as kinematic alignment and compatibility, joint range of motion, maximum torque, and joint bandwidth are discussed in the framework of a review of the design specifications for exoskeleton prototypes discussed in the literature. From this analysis, we discuss major gaps in the research related to the topic and how those might be filled.

In this study, we describe the mechanical design and control scheme of a quasi-passive knee exoskeleton intended to investigate the biomechanical behavior of the knee joint during interaction with externally applied impedances. As the human knee behaves much like a linear spring during the stance phase of normal walking gait, the exoskeleton implements a spring across the knee in the weight acceptance (WA) phase of the gait while allowing free motion throughout the rest of the gait cycle, accomplished via an electromechanical clutch. The stiffness of the device is able to be varied by swapping springs, and the timing of engagement/disengagement changed to accommodate different loading profiles. After describing the design and control, we validate the mechanical performance and reliability of the exoskeleton through cyclic testing on a mechanical knee simulator. We then describe a preliminary experiment on three healthy adults to evaluate the functionality of the device on both left and right legs. The kinetic and kinematic analyses of these subjects show that the exoskeleton assistance can partially/fully replace the function of the knee joint and obtain nearly invariant moment and angle profiles for the hip and ankle joints, and the overall knee joint and exoskeleton complex under the applied moments of the exoskeleton versus the control condition, implying that the subjects undergo a considerable amount of motor adaptation in their lower extremities to the exoskeletal impedances, and encouraging more in-depth future experiments with the device.