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JACIII Vol.15 No.8 pp. 997-1010
doi: 10.20965/jaciii.2011.p0997
(2011)

Paper:

A Classification of Postural Sway Patterns During Upright Stance in Healthy Adults and Patients with Parkinson’s Disease

Tomohisa Yamamoto*1, Yasuyuki Suzuki*1, Kunihiko Nomura*2,
Taishin Nomura*1, Takao Tanahashi*3, Kei Fukada*4,
Takayuki Endo*5, and Saburo Sakoda*5

*1Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama-cho, Toyonaka, Osaka 560-8531, Japan

*2Department of Business Information, Osaka University of Economics, Osaka, Japan

*3Graduate School of Medicine, Osaka University, Osaka, Japan

*4Department of Neurology, Osaka General Medical Center, Osaka, Japan

*5Toneyama National Hospital, Osaka Japan

Received:
February 21, 2011
Accepted:
July 1, 2011
Published:
October 20, 2011
Keywords:
posture control, intermittent control, Parkinson’s Disease, postural stability
Abstract
The intermittent control during human quiet upright stance is a new hypothesis which claims that the active neural feedback control generating the ankle muscle torque is switched off and on intermittently at appropriate timings. The intermittent strategy is capable of providing compliant posture while ensuring robust stability. Contrastingly, impairment of postural reflexes in patients with Parkinson’s disease (PD) causes postural instability. Here we hypothesize that the instability in PD patients might be due to a loss of appropriate intermittent activations in the feedback muscle torque during stance. In order to provide evidence for this hypothesis, we characterized stochastic postural sway patterns measured as changes in center of pressure (CoP) and activities of ankle muscles during quiet stance in healthy young and elderly subjects as well as PD patients. To this end, sway patterns and associated ankle muscle activities were quantified by several indices including the CoP sway area, scaling factors of double-power-law power spectra of the sway, as well as levels and patterns of the muscle activations. Hierarchical cluster analysis was performed to suggest that the sway patterns could be classified into two major types. The first type consisted mainly of sway and muscle activation patterns from healthy subjects and some PD patients with the mild level of severity, and they showed features indicating the intermittent control. The second type, consisting mainly of PD patients with relatively severe levels of motor symptoms, was accompanied with non-intermittent but tonic muscle activities and sway areas either smaller or larger than those in the first type. Moreover, the major two types were further classified into several subtypes with distinguishable characteristics. Results suggested that a loss of the intermittent activations in the ankle muscles could be a cause of the postural instability for a population of PD patients.
Cite this article as:
T. Yamamoto, Y. Suzuki, K. Nomura, T. Nomura, T. Tanahashi, K. Fukada, T. Endo, and S. Sakoda, “A Classification of Postural Sway Patterns During Upright Stance in Healthy Adults and Patients with Parkinson’s Disease,” J. Adv. Comput. Intell. Intell. Inform., Vol.15 No.8, pp. 997-1010, 2011.
Data files:
References
  1. [1] D. A. Winter, A. E. Patla, F. Prince, M.. Ishac, and K. Gieloperczak, “Stiffness control of balance in quiet standing,” Journal of Neurophysiology, Vol.80, No.3, pp. 1211-1221, 1998.
  2. [2] P. G.Morasso and M. Schieppati, “Can muscle stiffness alone stabilize upright standing?” Journal of Neurophysiology, Vol.82, No.3, pp. 1622-1626, 1999.
  3. [3] I. D. Loram, C. N.Maganaris, andM. Lakie, “Human postural sway results from frequent, ballistic bias impulses by soleus and gastrocnemius,” Journal of Physiology, Vol.564, Pt.1, pp. 295-311, 2005.
  4. [4] I. D. Loram, C. N. Maganaris, and M. Lakie, “Active, non-springlike muscle movements in human postural sway: how might paradoxical changes in muscle length be produced?” Journal of Physiology, Vol.564, Pt.1, pp. 281-293, 2005.
  5. [5] I. D. Loram, H. Gollee, M. Lakie, and P. J. Gawthrop, “Human control of an inverted pendulum: Is continuous control necessary? Is intermittent control effective? Is intermittent control physiological?” Journal of Physiology, Vol.589, No.2, pp. 307-324, 2011.
  6. [6] S. J. Houtz, “Influence of gravitational forces on function of lower extremity muscles,” J. Appl. Physiol., Vol.19, pp. 999-1004, 1964.
  7. [7] T. E. Milner, “Adaptation to destabilizing dynamics by means of muscle cocontraction,” Experimental Brain Research, Vol.143, No.4, pp. 406-416, 2002.
  8. [8] A. Bottaro, M. Casadio, P.Morasso, and V. Sanguineti, “Body sway during quiet standing: Is it the residual chattering of an intermittent stabilization process?” Human Movement Science, Vol.24, pp. 588-615, 2005.
  9. [9] A. Bottaro, Y. Yasutake, T. Nomura, M. Casadio, and P. Morasso, “Bounded stability of the quiet standing posture: An intermittent control model,” Human Movement Science, Vol.27, pp. 473-495, 2008.
  10. [10] J. G. Milton, J. L. Cabrera, and T. Ohira, “Unstable dynamical systems: Delays, noise and control,” Europhysics Letters, Vol.83, p. 48001, 2008.
  11. [11] J. Milton, J. Townsend, M. A. King, and T. Ohira, “Balancing with positive feedback: the case for discontinuous control,” Philosophical Transactions of Royal Society A, Vol.367, pp. 1181-1193, 2009.
  12. [12] Y. Asai, Y. Tasaka, K. Nomura, T. Nomura, M. Casadio, and P. Morasso, “A model of postural control in quiet standing: Robust compensation of delay-induced instability using intermittent activation of feedback control,” PLoS ONE, Vol.4, No.7, art. no.e6169, 2009.
  13. [13] S. Conforto, M. Schmid, V. Camomilla, T. D’Alessio, and A. Cappozzo, “Hemodynamics as a possible internal mechanical disturbance to balance,” Gait & Posture, Vol.14, No.1, pp. 28-35, 2001.
  14. [14] M. Schmid, S. Conforto, D. Bibbo, and T. D’Alessio, “Respiration and postural sway: Detection of phase synchronizations and interactions,” Human Movement Science, Vol.23, No.2, pp. 105-119, 2004.
  15. [15] R. Peterka, “Postural control model interpretation of stabilogram diffusion analysis,” Biological Cybernetics, Vol.82, pp. 335-343, 2000.
  16. [16] K. Masani, M. R. Popovic, K. Nakazawa, M. Kouzaki, and D. Nozaki, “Importance of body sway velocity information in controlling ankle extensor activities during quiet stance,” Journal of Neurophysiology, Vol.90, pp. 3774-3782, 2003.
  17. [17] C. Maurer and R. Peterka, “A new interpretation of spontaneous sway measures based on a simple model of human postural control,” Journal of Neurophysiology, Vol.93, pp. 189-200, 2005.
  18. [18] A. H. Vette, K. Masani, K. Nakazawa, and M. R. Popovic, “Neuralmechanical feedback control scheme generates physiological ankle torque fluctuation during quiet stance,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, Vol.18, No.1, art. no.5378606, pp. 86-95, 2010.
  19. [19] C. D. Marsden, “Parkinson’s disease (1994),” Journal of Neurology Neurosurgery and Psychiatry, Vol.57, No.6, pp. 672-681, 1994.
  20. [20] W. G. Wright, V. S. Gurfinkel, J. Nutt, F. B. Horak, and P. J. Cordo, “Axial hypertonicity in Parkinson’s disease: Direct measurements of trunk and hip torque,” Experimental Neurology, Vol.208, No.1, pp. 38-46, 2007.
  21. [21] T. Endo, R. Okuno, Yokoe, K. Akazawa, and S. Sakoda, “A novel method for systematic analysis of rigidity in Parkinson’s disease,” Movement Disorders, Vol.24, No.15, pp. 2218-2224, 2009.
  22. [22] V. Dietz, W. Berger, and G. A. Horstmann, “Posture in Parkinson’s disease: Impairment of reflexes and programming,” Annals of Neurology, Vol.24, No.5, pp. 660-669, 1988.
  23. [23] M. Schieppati and A. Nardone, “Free and supported stance in Parkinson’s disease,” Brain, Vol.114, No.3, pp. 1227-1244, 1991.
  24. [24] F. B. Horak, J. G. Nutt, and L. M. Nashner, “Postural inflexibility in parkinsonian subjects,” Journal of the Neurological Sciences, Vol.111, No.1, pp. 46-58, 1992.
  25. [25] M. Schieppati, M. Hugon, M. Grasso, A. Nardone, and M. Galante, “The limits of equilibrium in young and elderly normal subjects and in parkisonians,” Electroencephalography and Clinical Neurophysiology – Electromyography and Motor Control, Vol.93, No.4, pp. 286-298, 1994.
  26. [26] F. Horak, J. Frank, and J. Nutt, “Effects of dopamine on postural control in Parkinsonian subjects: scaling, set, and tone,” J. Neurophysiol., Vol.75, pp. 2380-2396, 1996.
  27. [27] L. Rocchi, L. Chiari, and F. B. Horak, “Effects of deep brain stimulation and levodopa on postural sway in Parkinson’s disease,” J. Neurol. Neurosurg. Psychiatry, Vol.73, pp. 267-274, 2002.
  28. [28] C. G. Goetz, B. C. Tilley, S. R. Shaftman, G. T. Stebbins, S. Fahn, P. Martinez-Martin, W. Poewe, C. Sampaio, M. B. Stern, R. Dodel, B. Dubois, R. Holloway, J. Jankovic, J. Kulisevsky, A. E. Lang, A. Lees, S. Leurgans, P. A. LeWitt, D. Nyenhuis, C. W. Olanow, O. Rascol, A. Schrag, J. A. Teresi, J. J. van Hilten, and N. Nancy LaPelle, “Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale Presentation and Clinimetric Testing Results,” Movement Disorders, Vol.23, No.15, pp. 2129-2170, 2008.
  29. [29] M. K. Viitasalo, V. Kampman, K. A. Sotaniemi, S. Leppavuori, V. V. Myllyla, and J. T. Korpelainen, “Analysis of sway in Parkinson’s disease using a new inclinometry-based method,” Movement Disorders, Vol.17, No.4, pp. 663-669, 2002.
  30. [30] J. W. Baszczyk, R. Orawiec, D. Duda-Kodowska, and G. Opala, “Assessment of postural instability in patients with Parkinson’s disease,” Experimental Brain Research, Vol.183, No.1, pp. 107-114, 2007.
  31. [31] T. E. Prieto, J. B. Myklebust, R. G. Hoffmann, E. G. Lovett, and B. M. Myklebust, “Measures of postural steadiness: differences between healthy young and elderly adults,” IEEE Trans. Biomed. Eng., Vol.43, pp. 956-66, 1996.
  32. [32] J. Collins and C. De Luca, “Random walking during quiet standing,” Physical Review Letters, Vol.73, pp. 764-767, 1994.
  33. [33] C. Chow and J. Collins, “Pinned polymer model of posture control,” Physical Review E, Vol.52, pp. 907-912, 1995.
  34. [34] C. Chow, M. Lauk, and J. Collins, “The dynamics of quasi-static posture control,” Human Movement Science, Vol.18, pp. 725-740, 1999.
  35. [35] K. Nomura, K. Fukada, T. Azuma, T. Hamasaki, S. Sakoda, and T. Nomura, “A quantitative characterization of postural sway during human quiet standing using a thin pressure distribution measurement system,” Gait & Posture, Vol.29, No.4, pp. 654-657, 2009.
  36. [36] Y. Yasutake, S. Taniguchi, and T. Nomura, “Non-asymptotical postural stabilization strategy during human quiet stance,” Annual International Conference of the IEEE Engineering in Medicine and Biology – Proceedings, art. no.4029777, pp. 1189-1192, 2006.
  37. [37] T. Nomura, T. Nakamura, K. Fukada, and S. Sakoda, “Characterizing postural sway during quiet stance based on the intermittent control hypothesis,” AIP Conference Proceedings, 922, pp. 553-556, 2007.
  38. [38] S. Sasagawa, J. Ushiyama, K. Masani, M. Kouzaki, and H. Kanehisa, “Balance control under different passive contributions of the ankle extensors: Quiet standing on inclined surfaces,” Experimental Brain Research, Vol.196, No.4, pp. 537-544, 2009.
  39. [39] I. D. Loram and M. Lakie, “Direct measurement of human ankle stiffness during quiet standing: the intrinsic mechanical stiffness is insufficient for stability,” Journal of Physiology, Vol.543, pp. 1041-1053, 2002.
  40. [40] M. Casadio, P. Morasso, and V. Sanguineti, “Direct measurement of ankle stiffness during quiet standing: Implications for control modelling and clinical application,” Gait & Posture, Vol.21, pp. 410-424, 2005.
  41. [41] S. L. Mitchell, J. J. Collin, C. J. De Luca, A. Burrows, and L. A. Lipsitz, “Open-loop and closed-loop postural control mechanisms in Parkinson’s disease: increased mediolateral activity during quiet standing,” Neuroscience Letters, Vol.197, No.2, pp. 133-136, 1995.

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