Anticipatory postural adjustment patterns during gait initiation across the adult lifespan

Lu, Chiahao; Huffmaster, Sommer L. Amundsen; Harvey, Jack C.; MacKinnon, Colum D.

doi:10.1016/j.gaitpost.2017.06.010

Cited by 30 publications

(28 citation statements)

References 33 publications

(46 reference statements)

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“…This perspective not only fits with the gradual worsening of postural deficits we documented here when passing from healthy children to patients with NonP and to patients with SlowP but would also explain why patients with adult-onset cerebellar lesions show even more pronounced postural deficits [46]. Indeed, neural plasticity gradually but consistently decreases over the lifespan [50].…”

Section: Disease Progression and Postural Behaviorsupporting

confidence: 76%

Postural Control in Children with Cerebellar Ataxia

et al. 2020

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Controlling posture, i.e., governing the ensemble of involuntary muscular activities that manage body equilibrium, represents a demanding function in which the cerebellum plays a key role. Postural activities are particularly important during gait initiation when passing from quiet standing to locomotion. Indeed, several studies used such motor task for evaluating pathological conditions, including cerebellar disorders. The linkage between cerebellum maturation and the development of postural control has received less attention. Therefore, we evaluated postural control during quiet standing and gait initiation in children affected by a slow progressive generalized cerebellar atrophy (SlowP) or non-progressive vermian hypoplasia (Joubert syndrome, NonP), compared to that of healthy children (H). Despite the similar clinical evaluation of motor impairments in NonP and SlowP, only SlowP showed a less stable quiet standing and a shorter and slower first step than H. Moreover, a descriptive analysis of lower limb and back muscle activities suggested a more severe timing disruption in SlowP. Such differences might stem from the extent of cerebellar damage. However, literature reports that during childhood, neural plasticity of intact brain areas could compensate for cerebellar agenesis. We thus proposed that the difference might stem from disease progression, which contrasts the consolidation of compensatory strategies.

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Section: Disease Progression and Postural Behaviorsupporting

confidence: 76%

Postural Control in Children with Cerebellar Ataxia

et al. 2020

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“…The fact that slightly different results were found between groups on peak values vs. the pattern analyses, indicates that automatic postural reactions are also highly individualized. The individual nature of postural strategies was recently demonstrated in a study regarding anticipatory postural control, showing that anticipatory postural adjustments (APAs) prior to gait initiation differ between healthy people in general and that these differences are not related to aging ( 35 ), and possibly also not to disease. As such, postural differences may also be difficult to generalize to a population as a whole.…”

Section: Discussionmentioning

confidence: 99%

Adaptations to Postural Perturbations in Patients With Freezing of Gait

et al. 2018

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Introduction: Freezing of gait (FOG) is a powerful determinant of falls in Parkinson's disease (PD). Automatic postural reactions serve as a protective strategy to prevent falling after perturbations. However, differences in automatic postural reactions between patients with and without FOG in response to perturbation are at present unclear. Therefore, the present study aimed to compare the response patterns and neuromuscular control between PD patients with and without FOG and healthy controls (HCs) after postural perturbations.Methods: 28 PD patients (15 FOG+, 13 FOG−) and 22 HCs were included. Participants stood on a moveable platform while random perturbations were imposed. The first anterior platform translation was retained for analysis. Center of pressure (CoP) and center of mass (CoM) trajectories and trunk, knee and ankle angles were compared between the three groups using the Statistical Parametric Mapping technique, allowing to capture changes in time. In addition, muscle activation of lower leg muscles was measured using EMG.Results: At baseline, FOG+ stood with more trunk flexion than HCs (p = 0.005), a result not found in FOG−. Following a perturbation, FOG+ reacted with increased trunk extension (p = 0.004) in comparison to HCs, a pattern not observed in FOG−. The CoM showed greater backward displacement in FOG− and FOG+ (p = 0.008, p = 0.027). Both FOG+ and FOG− showed increased co-activation of agonist and antagonist muscles compared to HCs (p = 0.010), with no differences between FOG+ and FOG−.Conclusions: Automatic postural reactions after a sudden perturbation are similar between PD subgroups with and without FOG but different from HCs. Reactive postural control, largely regulated by brain stem centers, seems to be modulated by different mechanisms than those governing freezing of gait. Greater differences in initial stance position, enhanced by joint stiffening, could however underlie maladaptive postural responses and increase susceptibility for balance loss in FOG+ compared to FOG−.

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“…To shed more light on the potential utility of the reticulospinal system for controlling such movements, we studied the StartReact effect during gait initiation in patients with pure HSP. The APA prior to gait initiation involves concerted tibialis anterior (TA) muscle activation and soleus (SO) inhibition of the stepping leg to move the centre of pressure of the ground reaction forces backwards and towards the stepping leg to accelerate the centre of mass forwards and towards the stance leg [ 10 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

StartReact during gait initiation reveals differential control of muscle activation and inhibition in patients with corticospinal degeneration

et al. 2018

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Corticospinal lesions cause impairments in voluntary motor control. Recent findings suggest that some degree of voluntary control may be taken over by a compensatory pathway involving the reticulospinal tract. In humans, evidence for this notion mainly comes from StartReact studies. StartReact is the acceleration of reaction times by a startling acoustic stimulus (SAS) simultaneously presented with the imperative stimulus. As previous StartReact studies mainly focused on isolated single-joint movements, the question remains whether the reticulospinal tract can also be utilized for controlling whole-body movements. To investigate reticulospinal control, we applied the StartReact paradigm during gait initiation in 12 healthy controls and 12 patients with ‘pure’ hereditary spastic paraplegia (HSP; i.e., retrograde axonal degeneration of corticospinal tract). Participants performed three consecutive steps in response to an imperative visual stimulus. In 25% of 16 trials a SAS was applied. We determined reaction times of muscle (de)activation, anticipatory postural adjustments (APA) and steps. Without SAS, we observed an overall delay in HSP patients compared to controls. Administration of the SAS accelerated tibialis anterior and rectus femoris onsets in both groups, but more so in HSP patients, resulting in (near-)normal latencies. Soleus offsets were accelerated in controls, but not in HSP patients. The SAS also accelerated APA and step reaction times in both groups, yet these did not normalize in the HSP patients. The reticulospinal tract is able to play a compensatory role in voluntary control of whole-body movements, but seems to lack the capacity to inhibit task-inappropriate muscle activity in patients with corticospinal lesions.

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Anticipatory postural adjustment patterns during gait initiation across the adult lifespan

Cited by 30 publications

References 33 publications

Postural Control in Children with Cerebellar Ataxia

Postural Control in Children with Cerebellar Ataxia

Adaptations to Postural Perturbations in Patients With Freezing of Gait

StartReact during gait initiation reveals differential control of muscle activation and inhibition in patients with corticospinal degeneration

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