Reduced plantar sensitivity alters postural responses to lateral perturbations of balance

Abstract

There is considerable evidence that lower-limb somatosensation contributes to the control of upright balance. In this study, we investigated the specific role of foot sole cutaneous afferents in the generation of balance corrections following lateral accelerations of the support surface. Participants were subjected to balance perturbations before and after targeted anesthesia of the cutaneous soles induced by intradermal injections of local anesthetic. Subject responses were quantified in terms of net joint torques at the ankles, hips and trunk. Contrary to the conclusions drawn in earlier studies, response torque impulses at the ankles and hips were clearly scaled with the perturbation impulse under both control and anesthetized conditions. Reduced plantar sensitivity produced a relative shift in compensatory torque production from the ankles and trunk to the hips. These findings demonstrate that plantar cutaneous afferents play an important role in the shaping of dynamic postural responses. Furthermore, the results suggest that loss of plantar sensation may be an important contributor to the dynamic balance deficits and increased risk of falls associated with peripheral neuropathies.

Balance responses to lateral perturbations in human treadmill walking

“…In our set-up the perturbation is applied close to the CoM. This means that the perturbation is not reflected in the horizontal ground reaction force, so this sensing modality (Meyer et al, 2004;Ting and Macpherson, 2004;Duysens et al, 2008) can at best play an indirect role here. In any case, research on balance in standing suggests that CoM velocities as low as 1degs -1 0.02ms -1 can be perceived (Jeka et al, 2004).…”

Interventions to Promote More Effective Balance-Recovery Reactions in Industrial Settings: New Perspectives on Footwear and Handrails

“…The cutaneous mechanoreceptors on the sole of the foot play an important role in controlling a number of specific aspects of balance [24][25][26][27] , but appear to be particularly important in providing the central nervous system (CNS) with information pertaining to the stability limits of the base-of-support and the state of contact between foot and ground [28][29][30] . This information is crucial for the control of stepping reactions; hence, age-related loss of plantar cutaneous sensation may be an important factor contributing to impaired control of compensatory stepping.…”

“…The facilitation due to the tubing also appeared to have some benefits for healthy young adults (aged [23][24][25][26][27][28][29][30][31]. Specifically, the facilitation improved ability of blindfolded young adults to comply with instructions to resist stepping, in responding to platform perturbations evoking backward loss of balance (p=0.045; Fig.…”

Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position

“…Pathological function of one or more of these physiological systems can be a contributing factor in falling [4][5]. Individuals with lower-limb amputations have reduced measures of postural stability [6][7][8][9] as determined by increased excursion of the center of pressure (CoP) and sway amplitude [9] in the mediolateral [6][7] and anteroposterior directions.…”