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We investigated the effect of age on predictive and reactive grip force control. We compared the coupling between the grip and load force when participants tapped the object (i.e., self-TAP condition) held in their contralateral hand or when the experimenter tapped the object (i.e., external-TAP condition). Participants held the object either with their dominant or their non-dominant hands. Neurophysiological changes occur in the brain throughout childhood, so we hypothesized that these changes would make motor prediction less reliable in adolescents than adults. We compared adolescents' predictive and reactive grip force control (n = 19) to adults (n = 19). We quantified the coupling between grip and load forces using cross-correlation. The lags determined whether peak grip force occurred before (predictive control) or after (reactive control) peak load force. In the self-TAP condition, the change in grip force occurred significantly earlier in adults compared to adolescents by ~ 24 ms for the dominant and ~ 12 ms for the non-dominant hands. During the external-TAP condition, the peak grip force lagged the peak load force for both groups, but the lags were shorter for adolescents than adults for both hands. Smaller finger sizes with larger neural afferent density could enhance the cutaneous reflex responses caused by the sudden change in loading. For the self-TAP condition, results confirmed less efficient motor prediction in adolescents. Morphological and neurophysiological changes unfold in the developing brain during childhood; they can introduce variability into the neural circuits responsible for refining motor prediction., (© 2024. Crown.)

We explored whether ankle torque variability or plantar perceptual threshold explains human balance control more effectively. We hypothesized that ankle torque variance is a better indicator of center of pressure (COP) velocity variance than plantar perceptual sensitivity. Two conditions were tested: loaded (23-kg vest added) and unloaded, as loading should diminish plantar sensitivity and increase COP velocity variability. We created a linear feedback model to assess the noise change in the sensorimotor loop induced by loading. Plantar sensitivity was quantified using a psychophysical approach while participants stood barefoot. A linear motor applied a force impulse on the participant's heel. A "yes-no" method of limits was selected to identify plantar sole sensory thresholds in both conditions. We observed reduced plantar sensitivity in loaded compared with unloaded conditions. In the loaded condition, participants exhibited greater COP velocity variance, with significant positive Pearson's correlations confirming a substantial association between ankle torque and COP velocity variances for both loaded [variance accounted for (VAF): r 2 = 44.56%, P = 0.018] and unloaded conditions (VAF: r 2 = 58.83%, P = 0.004). No significant correlation existed between COP velocity variance and plantar sensitivity threshold for both loaded (VAF: r 2 = 0.002%, P = 0.99) and unloaded conditions (VAF: r 2 = 21.81%, P = 0.35). The model confirmed an ∼88% rise in sensorimotor loop noise in the loaded condition. Ankle torque variance assesses the precision of nonperceptual and perceptual detection mechanisms in evaluating whole body motions and the accuracy in converting sensory cues into ankle torque. NEW & NOTEWORTHY Plantar cutaneous information contributes to balance control by modulating motor commands, but plantar perceptual sensitivity is a suboptimal indicator of balance performance. Multiple sensory cues encode whole body dynamics, guiding sensorimotor mechanisms to minimize body sway variability. Ankle torque variance is proposed as a superior measure for explaining balance control performance and evaluating the sensorimotor loop's functioning in balance control.

Our mental representation of our body depends on integrating various sensory modalities, such as tactile information. In tactile distance estimation (TDE) tasks, participants must estimate the distance between two tactile tips applied to their skin. This measure of tactile perception has been linked to body representation assessments. Studies in individuals with fibromyalgia (FM), a chronic widespread pain syndrome, suggest the presence of body representation distortions and tactile alterations, but TDE has never been examined in this population. Twenty participants with FM and 24 pain-free controls performed a TDE task on three Body regions (upper limb, trunk, lower limb), in which they manually estimated the interstimuli distance on a tablet. TDE error, the absolute difference between the estimation and the interstimuli distance, was not different between the Groups, on any Body region. Drawings of their body as they felt it revealed clear and frequent distortions of body representation in the group with FM, compared to negligible perturbations in controls. This contrast between distorted body drawings and unaltered TDE suggests a preserved integration of tactile information but an altered integration of this information with other sensory modalities to generate a precise and accurate body representation. Future research should investigate the relative contribution of each sensory information and prior knowledge about the body in body representation in individuals with FM to shed light on the observed distortions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Augière, Metral, Simoneau and Mercier.)

Our brain constantly integrates afferent information, such as visual and tactile information, to perceive the world around us. According to the maximum-likelihood estimation (MLE) model, imprecise information will be weighted less than precise, making the multisensory percept as precise as possible. Individuals with fibromyalgia (FM), a chronic pain syndrome, show alterations in the integration of tactile information. This could lead to a decrease in their weight in a multisensory percept or a general disruption of multisensory integration, making it less beneficial. To assess multisensory integration, 15 participants with FM and 18 pain-free controls performed a temporal-order judgment task in which they received pairs of sequential visual, tactile (unisensory conditions), or visuotactile (multisensory condition) stimulations on the index and the thumb of the non-dominant hand and had to determine which finger was stimulated first. The task enabled us to measure the precision and accuracy of the percept in each condition. Results indicate an increase in precision in the visuotactile condition compared to the unimodal conditions in controls only, although we found no intergroup differences. The observed visuotactile precision was correlated to the precision predicted by the MLE model in both groups, suggesting an optimal integration. Finally, the weights of the sensory information were not different between the groups; however, in the group with FM, higher pain intensity was associated with smaller tactile weight. This study shows no alterations of the visuotactile integration in individuals with FM, though pain may influence tactile weight in these participants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Augière, Simoneau and Mercier.)

The processing of proprioceptive information in the context of a conflict between visual and somatosensory feedbacks deteriorates motor performance. Previous studies have shown that seeing one's hand increases the weighting assigned to arm somatosensory inputs. In this light, we hypothesized that the sensory conflict, when tracing the contour of a shape with mirror-reversed vision, will be greater for participants who trace with a stylus seen in their hand (Hand group, n = 17) than for participants who trace with the tip of rod without seen their hand (Tool group, n = 15). Based on this hypothesis, we predicted that the tracing performance with mirror vision will be more deteriorated for the Hand group than for the Tool group, and we predicted a greater gating of somatosensory information for the Hand group to reduce the sensory conflict. The participants of both groups followed the outline of a shape in two visual conditions. Direct vision: the participants saw the hand or portion of a light 40 cm rod directly. Mirror Vision: the hand or the rod was seen through a mirror. We measured tracing performance using a digitizing tablet and the cortical activity with electroencephalography. Behavioral analyses revealed that the tracing performance of both groups was similarly impaired by mirror vision. However, contrasting the spectral content of the cortical oscillatory activity between the Mirror and Direct conditions, we observed that tracing with mirror vision resulted in significantly larger alpha (8-12 Hz) and beta (15-25 Hz) powers in the somatosensory cortex for participants of the Hand group. The somatosensory alpha and beta powers did not significantly differ between Mirror and Direct vision conditions for the Tool group. For both groups, tracing with mirror vision altered the activity of the visual cortex: decreased alpha power for the Hand group, decreased alpha and beta power for the Tool group. Overall, these results suggest that seeing the hand enhanced the sensory conflict when tracing with mirror vision and that the increase of alpha and beta powers in the somatosensory cortex served to reduce the weight assigned to somatosensory information. The increased activity of the visual cortex observed for both groups in the mirror vision condition suggests greater visual processing with increased task difficulty. Finally, the fact that the participants of the Tool group did not show better tracing performance than those of the Hand group suggests that tracing deterioration resulted from a sensorimotor conflict (as opposed to a visuo-proprioceptive conflict)., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

A few years after their bilateral vestibular loss, patients usually show a motor repertoire that is almost back to normal. This recovery is thought to involve an upregulation of the visual and proprioceptive information that compensates for the lack of vestibular information. Here, we investigated whether plantar tactile inputs, which provide body information relative to the ground and to the Earth vertical, contribute to this compensation. More specifically, we tested the hypothesis that somatosensory cortex response to electric stimulation of the plantar sole in standing adults will be greater in humans ( n = 10) with bilateral vestibular hypofunction (VH) than in an age-matched healthy group ( n = 10). Showing significantly greater somatosensory evoked potentials (i.e., P 1 N 1 ) in VH than in control subjects, the electroencephalographic recordings supported this hypothesis. Furthermore, we found evidence that increasing the differential pressure between both feet, by adding a 1-kg mass at each pendant wrist, enhanced the internal representation of body orientation and motion relative to a gravitational reference frame. The large decrease in alpha power in the right posterior parietal cortex (and not in the left) is in line with this assumption. Finally, behavioral analyses showed that trunk oscillations were smaller than head oscillations in VH and showed a reverse pattern for healthy participants. These findings are consistent with a tactile-based postural control strategy in the absence of vestibular input and a vestibular-based control strategy in healthy participants where the head serves as a reference for balance control. NEW & NOTEWORTHY Somatosensory cortex excitability is greater in participants with bilateral vestibular hypofunction than in age-matched healthy humans. To control balance, healthy humans "locked" the head whereas participants with vestibular hypofunction "locked" their pelvis. For participants with vestibular hypofunction, increasing loading/unloading of the feet enhances the internal representation of body state in the posterior parietal cortex.

People with fibromyalgia have been shown to experience more somatosensory disturbances than pain-free controls during sensorimotor conflicts (i.e., incongruence between visual and somatosensory feedback). Sensorimotor conflicts are known to disturb the integration of sensory information. This study aimed to assess the cerebral response and motor performance during a sensorimotor conflict in people with fibromyalgia. Twenty participants with fibromyalgia and twenty-three pain-free controls performed a drawing task including visual feedback that was either congruent with actual movement (and thus with somatosensory information) or incongruent with actual movement (i.e., conflict). Motor performance was measured according to tracing error, and electrocortical activity was recorded using electroencephalography. Motor performance was degraded during conflict for all participants but did not differ between groups. Time-frequency analysis showed that the conflict was associated with an increase in theta power (4-8 Hz) at conflict onset over the left posterior parietal cortex in participants with fibromyalgia but not in controls. This increase in theta suggests a stronger detection of conflict in participants with fibromyalgia, which was not accompanied by differences in motor performance in comparison to controls. This points to dissociation in individuals with fibromyalgia between an altered perception of action and a seemingly unaltered control of action.

The aim of this comprehensive review was to provide an overview of pain in Parkinson's disease (PD) by identifying different clinical features and potential mechanisms, and presenting some data on the evaluation and management of pain in PD. PD is a multifocal degenerative and progressive disease, which could affect the pain process at multiple levels. Pain in PD has a multifactorial aetiology, with a dynamic process based on pain intensity, complexity of symptoms, pain pathophysiology and presence of comorbidities. In fact, pain in PD responds to the concept of multimorphic pain, which can evolve, in relation to the different factors, whether they are linked to disease and its management. Understanding the underlying mechanisms will help in guiding of treatment choices. Providing scientific support useful for clinicians and health professionals involved in management of PD, the aim of this review was to bringing practical suggestions and clinical perspectives on the development of a multimodal approach guided by a multidisciplinary clinical intervention through a combination of pharmacological and rehabilitative approaches, to manage pain to improve the quality of life on individuals with PD., (© 2023 European Pain Federation - EFIC ®.)

For individuals with altered sensory cues, vibrotactile feedback improves their balance control. However, should vibrotactile feedback be provided every time balance control is compromised, or only one-third of the time their balance is compromised? We hypothesized that vibrotactile feedback would improve balance control more when provided every time their balance is compromised. Healthy young adults were randomly assigned to two groups: group 33% feedback (6 males and 6 females) and group 100% feedback (6 males and 6 females). Vibrotactile feedbacks related to the body's sway angle amplitude and direction were provided, while participants stood upright on a foam surface with their eyes closed. Then, we assessed if balance control improvement lasted when the vibrotactile feedback was removed (i.e., post-vibration condition). Finally, we verified whether or not vibrotactile feedback unrelated to the body's sway angle and direction (sham condition) altered balance control. The results revealed no significant group difference in balance control improvement during vibrotactile feedback. Immediately following vibrotactile feedback, both groups reduced their balance control commands; body sway velocity and the ground reaction forces variability decreased. For both groups, unrelated vibrotactile feedback worsened balance control. These results confirmed that participants processed and implemented vibrotactile feedback to control their body sways. Less vibrotactile feedback was effective in improving balance control.

Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.

Low back pain (LBP) often modifies spine motor control, but the neural origin of these motor control changes remains largely unexplored. This study aimed to determine the impact of experimental low back pain on the excitability of cortical, subcortical, and spinal networks involved in the control of back muscles. Thirty healthy subjects were recruited and allocated to pain (capsaicin and heat) or control (heat) groups. Corticospinal excitability (motor-evoked potential; MEP) and intracortical networks were assessed by single- and paired-pulse transcranial magnetic stimulation, respectively. Electrical vestibular stimulation was applied to assess vestibulospinal excitability (vestibular MEP; VMEP) and the stretch reflex for excitability of the spinal or supraspinal loop (R1 and R2, respectively). Evoked back motor responses were measured before, during, and after pain induction. Nonparametric rank-based ANOVA determined if pain modulated motor neural networks. A decrease of R1 amplitude was present after the pain disappearance ( P = 0.01) whereas an increase was observed in the control group ( P = 0.03) compared with the R1 amplitude measured at prepain and preheat period, respectively (group × time interaction, P < 0.001). No difference in MEP and VMEP amplitude was present during and after pain ( P > 0.05). During experimental LBP, no change in cortical, subcortical, or spinal networks was observed. After pain disappearance, the reduction of the R1 amplitude without modification of MEP and VMEP amplitude suggests a reduction in spinal excitability potentially combined with an increase in descending drives. The absence of effect during pain needs to be further explored. NEW & NOTEWORTHY In the presence of experimental low back pain, spinal, subcortical, and cortical motor networks involved in the control of back muscles were not modified. However, once the pain disappeared, a reduction in motoneuronal excitability was observed without change in corticospinal and vestibulospinal excitability, suggesting a reduction in descending drive. Experimental low back pain may elicit long-term plasticity even after pain extinction.

Objective: Although adolescent idiopathic scoliosis is thought to be an orthopedic disorder, sensorimotor deficits resulting in asymmetric neural drive to the axial musculature have been proposed as contributing factors. Asymmetry in the vestibular control of spinal motoneurons can cause spine deformation reminiscent of idiopathic scoliosis in animal models., Methods: To examine the neural control of axial muscles, we compared common oscillatory drive to bilateral lumbar muscles between 19 participants with adolescent idiopathic scoliosis and 19 healthy adolescents. We measured right and left paraspinal muscle activity during steady isometric back extensions at 15% or 30% of their maximum voluntary contraction., Results: The variance in exerted force and symmetry in bilateral muscle activation were similar between groups. We estimated the strength of common oscillations between muscle motoneuron pools using intermuscular coherence. Compared to controls, participants with adolescent idiopathic scoliosis exhibited smaller intermuscular coherence between paraspinal muscles in the alpha and beta bands. To identify the cause of the observed decreased in intermuscular coherence, we quantified variability of electromyography power ratio and relative activation timing between the paraspinal muscle. Intermuscular phase between muscle oscillations across the alpha band demonstrated larger variability in adolescent with idiopathic scoliosis. The variability of the ratio of lumbar muscles power was similar between groups in the alpha and beta bands., Conclusion: Our results suggest that altered bilateral control of axial muscles characterized by increased variability in the timing of alpha oscillations may be linked to spine deformation in adolescents., Significance: Our findings provide a new perspective on neural factors associated with a common spine deformation, adolescent idiopathic scoliosis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2022. Published by Elsevier B.V. All rights reserved.)

This systematic review and meta-analysis aims to identify and quantify the current available evidence of hypnosis efficacy to manage pain in patients with chronic musculoskeletal and neuropathic pain. Randomized Control Trials (RCTs) with hypnosis and/or self-hypnosis treatment used to manage musculoskeletal and/or neuropathic chronic pain in adults and assessing pain intensity were included. Reviews, meta-analyses, non-randomized clinical trials, case reports and meeting abstracts were excluded. Five databases, up until May 13th 2021, were used to search for RCTs using hypnosis to manage chronic musculoskeletal and/or neuropathic pain. The protocol is registered on PROSPERO register (CRD42020180298) and no specific funding was received for this review. The risk of bias asessement was conducted according to the revised Cochrane risk of bias tool for randomized control trials (RoB 2.0). Nine eligible RCTs including a total of 530 participants were considered. The main analyses showed a moderate decrease in pain intensity (Hedge's g: -0.42; p = 0.025 after intervention, Hedge's g: -0.37; p = 0.027 after short-term follow-up) and pain interference (Hedge's g: -0.39; p = 0.029) following hypnosis compared to control interventions. A significant moderate to large effect size of hypnosis compared to controls was found for at 8 sessions or more (Hedge's g: -0.555; p = 0.034), compared to a small and not statistically significant effect for fewer than 8 sessions (Hedge's g: -0.299; p = 0.19). These findings suggest that a hypnosis treatment lasting a minimum of 8 sessions could offer an effective complementary approach to manage chronic musculoskeletal and neuropathic pain. Future research is needed to delineate the relevance of hypnosis in practice and its most efficient prescription., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Most of our knowledge on the human neural bases of spatial updating comes from functional magnetic resonance imaging (fMRI) studies in which recumbent participants moved in virtual environments. As a result, little is known about the dynamic of spatial updating during real body motion. Here, we exploited the high temporal resolution of electroencephalography (EEG) to investigate the dynamics of cortical activation in a spatial updating task where participants had to remember their initial orientation while they were passively rotated about their vertical axis in the dark. After the rotations, the participants pointed toward their initial orientation. We contrasted the EEG signals with those recorded in a control condition in which participants had no cognitive task to perform during body rotations. We found that the amplitude of the P 1 N 1 complex of the rotation-evoked potential (RotEPs) (recorded over the vertex) was significantly greater in the Updating task. The analyses of the cortical current in the source space revealed that the main significant task-related cortical activities started during the N 1 P 2 interval (136-303 ms after rotation onset). They were essentially localized in the temporal and frontal (supplementary motor complex, dorsolateral prefrontal cortex, anterior prefrontal cortex) regions. During this time-window, the right superior posterior parietal cortex (PPC) also showed significant task-related activities. The increased activation of the PPC became bilateral over the P 2 N 2 component (303-470 ms after rotation onset). In this late interval, the cuneus and precuneus started to show significant task-related activities. Together, the present results are consistent with the general scheme that the first task-related cortical activities during spatial updating are related to the encoding of spatial goals and to the storing of spatial information in working memory. These activities would precede those involved in higher order processes also relevant for updating body orientation during rotations linked to the egocentric and visual representations of the environment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Blouin, Pialasse, Mouchnino and Simoneau.)

While spinal cord stimulation (SCS) is a well-established therapy to address refractory persistent spinal pain syndrome after spinal surgery (PSPS-T2), its lack of spatial selectivity and reported discomfort due to positional effects can be considered as significant limitations. As alternatives, new waveforms, such as burst stimulation and different spatial neural targets, such as dorsal root ganglion stimulation (DRGS), have shown promising results. Comparisons between DRGS and standard SCS, or their combination, have never been studied on the same patients. "BOOST DRG" is the first prospective, randomized, double-blinded, crossover study to compare SCS vs. DRGS vs. SCS+DRGS. Sixty-six PSPS-T2 patients will be recruited internationally in three centers. Before crossing over, patients will receive each stimulation modality for 1 month, using tonic conventional stimulation. After 3 months, stimulation will consist in switching to burst for 1 month, and patients will choose which modality/waveform they receive and will then be reassessed at 6 and 12 months. In addition to our primary outcome based on pain rating, this study is designed to assess quality of life, functional disability, psychological distress, pain surface coverage, global impression of change, medication quantification, adverse events, brain functional imaging and electroencephalography, with the objective being to provide a multidimensional insight based on composite pain assessment.

Introduction: The study of motor responses induced by electrical vestibular stimulation (EVS) may help clarify the role of the vestibular system in postural control. Although back muscles have an important role in postural control, their EVS-induced motor responses were rarely studied. Moreover, the effects of EVS parameters, head position, and vision on EVS-induced back muscles responses remain little explored. Objectives: To explore the effects of EVS parameters, head position, and vision on lumbar erector spinae muscles EVS-induced responses. Design: Exploratory, cross-sectional study. Materials and Methods: Ten healthy participants were recruited. Three head positions (right, left and no head rotation), 4 intensities (2, 3, 4, 5 mA), and 4 EVS durations (5, 20, 100, 200 ms) were tested in sitting position with eyes open or closed. EVS usually induced a body sway toward the anode (placed on the right mastoid). EMG activity of the right lumbar erector spinae was recorded. Variables of interest were amplitude, occurrence, and latency of the EVS-induced modulation of the EMG activity. Results: The short-latency response was inhibitory and the medium-latency response was excitatory. Increased EVS current intensity augmented the occurrence and the amplitude of the short- and medium-latency responses (more inhibition and more excitation, respectively). EVS duration influenced the medium-latency response differently depending on the position of the head. Right head rotation produced larger responses amplitude and occurrence than left head rotation. Opposite head rotation (left vs. right) did not induce a reversal of the short- and medium-latency responses (i.e., the inhibition did not become an excitation), as typically reported in lower legs muscles. The eyes open condition did not modulate muscle responses. Conclusion: Modulation of EVS parameters (current intensity and duration of EVS) affects the amplitude and occurrence of the lumbar erector spinae responses. In contrast, vision did not influence the responses, suggesting its minimal contribution to vestibulomotor control in sitting. The lack of response reversal in sagittal plane may reflect the biomechanical role of lumbar erector spinae to fine-tune the lumbar lordosis during the induced body sway. This hypothesis remains to be further tested., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Desgagnés, Desmons, Cyr, Simoneau and Massé-Alarie.)

Cutaneous foot receptors are important for balance control, and their activation during quiet standing depends on the speed and the amplitude of postural oscillations. We hypothesized that the transmission of cutaneous input to the cortex is reduced during prolonged small postural sways due to receptor adaptation during continued skin compression. Central mechanisms would trigger large sways to reactivate the receptors. We compared the amplitude of positive and negative post-stimulation peaks (P 50 N 90 ) somatosensory cortical potentials evoked by the electrical stimulation of the foot sole during small and large sways in 16 young adults standing still with their eyes closed. We observed greater P 50 N 90 amplitudes during large sways compared with small sways consistent with increased cutaneous transmission during large sways. Postural oscillations computed 200 ms before large sways had smaller amplitudes than those before small sways, providing sustained compression within a small foot sole area. Cortical source analyses revealed that during this interval, the activity of the somatosensory areas decreased, whereas the activity of cortical areas engaged in motor planning (supplementary motor area, dorsolateral prefrontal cortex) increased. We concluded that large sways during quiet standing represent self-generated functional behavior aiming at releasing skin compression to reactivate mechanoreceptors. Such balance motor commands create sensory reafference that help control postural sway., (© The Author(s) 2020. Published by Oxford University Press.)

The aims of this narrative review are to provide scientific support to characterize the postural instability commonly observed in Parkinson's disease (PD), and to emphasize how bottom-up rehabilitation programs stimulating the sole of the foot can improve postural stability in PD. Postural instability is a typical characteristic of individuals with PD, which increases the frequency of falls and may worsen their consequences. It thus seems relevant to diagnose these alterations as early as possible, in order to develop specific rehabilitative treatment. The association between sensitivity of the sole of the foot and postural instability in individuals with PD is linked to the key role of peripheral alterations of the sensorimotor system in balance and motor symptoms. By enhancing sensory feedback coming from the feet, bottom-up stimulation allows patients to improve their sensorimotor control. In clinical practice, health practitioners can use sensory stimulation to improve postural control. By improving postural stability, a decrease in fall risk can be achieved and the secondary impairments associated with falls prevented., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Diabetes peripheral neuropathy (DPN) leads to balance impairment among diabetes mellitus (DM). The aims of this study were to (1) distinguish between DM patients who have/do not have DPN and to (2) compare quadriceps' strength and balance performance of DM, DPN, and healthy groups. Fifteen healthy females and 33 females with type 2 diabetic patients participated. The electrodiagnostic method was used to classify diabetic patients into DM and DPN. A dynamometer was used to measure quadriceps' strength. Single-leg standing on a force plate was also used to quantify participants' balance. Smaller conduction velocity and amplitude and greater distal latency of all nerves were observed in the DPN compared with the DM in particular for sensory nerve. In DPN, conduction velocity was asymmetrical. The quadriceps' strength of both legs in DPN and the right leg in DM was smaller than in the control group. The root mean square of the center of pressure was similar between DM and DPN. But it was larger in DPN than in the control group. DPN is associated with asymmetrical conduction velocity, smaller quadriceps' strength, and weaker balance performance that is suggestive of higher risk of falling. Balance training is recommended for the DPN group during their rehabilitation to reduce their falling risk.

Adolescent idiopathic scoliosis (AIS) is a multifactorial disorder characterized by a tridimensional deformation of the spine. AIS pathophysiology is still unclear and its aetiology is unknown. Results from several studies revealed balance control alterations in adolescents with AIS suggesting cortical sensorimotor processing impairments. Studies assessing cortical activity involved in balance control revealed an increase in alpha peak frequency (APF), which is a neurophysiological marker of thalamo-cortical transmission, related to a more challenging balance task. The objective of this study is to assess APF of adolescents with AIS during balance control in upright standing posture using electroencephalography (EEG). EEG was recorded in 16 girls with AIS and 15 control girls in normal standing posture on a force platform. The participants stood upright for 2 min with eyes open and 2 min with eyes closed. Fast Fourier transformations of EEG data were calculated to obtain APF. Balance performances were assessed through the area of an ellipse covering the center of pressure (COP) displacement and the root mean square value of the COP velocity. Compared to the control group, APF was higher in the AIS group at central, frontal, parietal and occipital regions. Further, COP analyses did not reveal any difference between AIS and control groups. A higher APF may indicate the need for increased cortical processing to maintain balance control in normal upright standing in adolescents with AIS compared to healthy controls. We suggest that this may be a compensatory strategy to overcome balance control challenges., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In humans, to reduce deviations from a perfect upright position, information from various sensory cues is combined and continuously weighted based on its reliability. Combining noisy sensory information to produce a coherent and accurate estimate of body sway is a central problem in human balance control. In this study, we first compared the ability of the sensorimotor control mechanisms to deal with altered ankle proprioception or vestibular information (i.e., the single sensory condition). Then, we evaluated whether successive stimulation of difference sensory systems (e.g., Achilles tendon vibration followed by electrical vestibular stimulation, or vice versa) produced a greater alteration of balance control (i.e., the mix sensory condition). Electrical vestibular stimulation (head turned ~90°) and Achilles tendon vibration induced backward body sways. We calculated the root mean square value of the scalar distance between the center of pressure and the center of gravity as well as the time needed to regain balance (i.e., stabilization time). Furthermore, the peak ground reaction force along the anteroposterior axis, immediately following stimulation offset, was determined to compare the balance destabilization across the different conditions. In single conditions, during vestibular or Achilles tendon vibration, no difference in balance control was observed. When sensory information returned to normal, balance control was worse following Achilles tendon vibration. Compared to that of the single sensory condition, successive stimulation of different sensory systems (i.e., mix conditions) increased stabilization time. Overall, the present results reveal that single and successive sensory stimulation challenges the sensorimotor control mechanisms differently., Competing Interests: The authors have declared that no competing interests exist.

A challenge in motor control research is to understand the mechanisms underlying the transformation of sensory information into arm motor commands. Here, we investigated these transformation mechanisms for movements whose targets were defined by information issued from body rotations in the dark (i.e., idiothetic information). Immediately after being rotated, participants reproduced the amplitude of their perceived rotation using their arm (Experiment 1). The cortical activation during movement planning was analyzed using electroencephalography and source analyses. Task-related activities were found in regions of interest (ROIs) located in the prefrontal cortex (PFC), dorsal premotor cortex, dorsal region of the anterior cingulate cortex (ACC) and the sensorimotor cortex. Importantly, critical regions for the cognitive encoding of space did not show significant task-related activities. These results suggest that arm movements were planned using a sensorimotor-type of spatial representation. However, when a 8 s delay was introduced between body rotation and the arm movement (Experiment 2), we found that areas involved in the cognitive encoding of space [e.g., ventral premotor cortex (vPM), rostral ACC, inferior and superior posterior parietal cortex (PPC)] showed task-related activities. Overall, our results suggest that the use of a cognitive-type of representation for planning arm movement after body motion is necessary when relevant spatial information must be stored before triggering the movement., (Copyright © 2019 Blouin, Saradjian, Pialasse, Manson, Mouchnino and Simoneau.)

Objective: This study aims at examining the cortical dynamics of sensorimotor information processing related to balance control in participants with adolescent idiopathic scoliosis (AIS) and in age-matched controls (CTL)., Methods: Cortical dynamics during standing balance control were assessed in 13 girls with AIS and 13 age-matched controls using electroencephalography. Time-frequency analysis were used to determine frequency power during ankle proprioception alteration (ankle tendons co-vibration interval) or reintegration of ankle proprioception (post-vibration interval) with or without vision., Results: Balance control did not differ between groups. In the co-vibration interval, a significant suppression in alpha (8-12 Hz) and beta (13-30 Hz) band power and a significant increase in theta (4-7 Hz) band power were found respectively in the vision and non-vision condition in the AIS group compared to the CTL group. In the post-vibration interval, significant suppressions in beta (13-30 Hz) and gamma (30-50 Hz) band power were observed in the AIS group in the non-vision condition., Conclusion: Participants with AIS showed brain oscillations differences compared to CTL in the sensorimotor cortex while controlling their balance in various sensory conditions., Significance: Future study using evaluation of cortical dynamics could serve documenting whether rehabilitation programs have an effect on sensorimotor function in AIS., (Copyright © 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

As we move, perceptual stability is crucial to successfully interact with our environment. Notably, the brain must update the locations of objects in space using extra-retinal signals. The vestibular system is a strong candidate as a source of information for spatial updating as it senses head motion. The ability to use this cue is not innate but must be learned. To date, the mechanisms of vestibular spatial updating generalization are unknown or at least controversial. In this paper we examine generalization patterns within and between different conditions of vestibular spatial updating. Participants were asked to update the position of a remembered target following (offline) or during (online) passive body rotation. After being trained on a single spatial target position within a given task, we tested generalization of performance for different spatial targets and an unpracticed spatial updating task. The results demonstrated different patterns of generalization across the workspace depending on the task. Further, no transfer was observed from the practiced to the unpracticed task. We found that the type of mechanism involved during learning governs generalization. These findings provide new knowledge about how the brain uses vestibular information to preserve its spatial updating ability.

The weighting of the sensory inputs is not uniform during movement preparation and execution. For instance, a transient increase in the transmission to the cortical level of cutaneous input ~700 ms was observed before participants initiated a step forward. The sensory facilitation occurred at a time when feet cutaneous information is critical for setting the forces to be exerted onto the ground to shift the center of mass toward the supporting side prior to foot-off. Despite clear evidence of task-dependent modulation of the early somatosensory signal transmission, the neural mechanisms are mainly unknown. One hypothesis suggests that during movement preparation the premotor cortex and specifically the supplementary motor area (SMA) can be the source of an efferent signal that facilitates the somatosensory processes irrespectively of the amount of sensory inputs arriving at the somatosensory areas. Here, we depressed mechanically the plantar sole cutaneous transmission by increasing pressure under the feet by adding an extra body weight to test whether the task-dependent modulation is present during step preparation. Results showed upregulation of the neural response to tactile stimulation in the extra-weight condition during the stepping preparation whereas depressed neural response was still observed in standing condition. Source localization indicated the SMA and to a lesser extent the superior parietal lobule (SPL) areas as the likely origin of the response modulation. Upregulating cutaneous inputs (when mechanically depressed) at an early stage by efferent signals from the motor system could be an attempt to restore the level of sensory afferents to make it suitable for setting the anticipatory adjustments prior to step initiation.

This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n=17) and adolescents with idiopathic scoliosis (n=52) with either mild (Cobb angle≥15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Achilles tendon vibration generates proprioceptive information that is incongruent with the actual body position; it alters the perception of body orientation leading to a vibration-induced postural response. When a person is standing freely, vibration of the Achilles tendon shifts the internal representation of the verticality backward thus the vibration-induced postural response realigned the whole body orientation with the shifted subjective vertical. Because utricular otoliths information participates in the creation of the internal representation of the verticality, changing the natural orientation of the head-neck system during Achilles tendon vibration could alter the internal representation of the earth vertical to a greater extent. Consequently, it was hypothesized that compared to neutral head-neck orientation, alteration in the head-neck orientation should impair balance control immediately after Achilles tendon vibration onset or offset (i.e., sensory transition) as accurate perception of the earth vertical is required. Results revealed that balance control impairment was observed only immediately following Achilles tendon vibration offset; both groups with the head-neck either extended or flexed showed larger body sway (i.e., larger root mean square scalar distance between the center of pressure and center of gravity) compared to the group with the neutral head-neck orientation. The fact that balance control was uninfluenced by head-neck orientation immediately following vibration onset suggests the error signal needs to accumulate to a certain threshold before the internal representation of the earth vertical becomes incorrect., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Vibrating ankle muscles in freely standing persons elicits a spatially oriented postural response. For instance, vibrating the Achilles tendons induces a backward displacement of the body while vibrating the tibialis anterior muscle tendons induces a forward displacement. These displacements have been called vibration induced falling (VIF) responses and they presumably are automatic. Because of the long delay between the onset of the vibration and the onset of the VIF (about 700 ms), and the widespread cortical activation following vibration, there is a possibility that the sensory signals available before the VIF can be used by the central nervous system to plan a hand pointing action. This study examined this suggestion. Ten healthy young participants stood on a force platform and initially were trained to point with and without vision to a target located in front of them. Then, they were exposed to conditions with vibration of the Achilles tendons or tibialis anterior muscle tendons and pointed at the target without vision. The vibration stopped between each trial. Trials with vision (without vibration) were given every five trials to maintain an accurate perception of the target's spatial location. Ankle vibrations did not have an effect on the position of the center of foot pressure (COP) before the onset of the pointing actions. Furthermore, reaction and movement times of the pointing actions were unaffected by the vibration. The hypotheses were that if proprioceptive information evoked by ankle vibrations alters the planning of a pointing action, the amplitude of the movement should scale according to the muscle tendons that are vibrated. For Achilles tendon vibration, participants undershot the target indicating the planning of the pointing action was influenced by the vibration-evoked proprioceptive information (forward displacement of the body). When the tibialis anterior were vibrated (backward displacement of the body), however, shorter movements were also observed. Longer movements would have increased the backward response of the sensed body movement. Thus, it is possible that pointing actions were adjusted on the basis of the expected consequences of the planned pointing action to avoid a response that could have compromised postural stability.

The driving performance of individuals with mild cognitive impairment (MCI) is suboptimal when compared to healthy older adults. It is expected that the driving will worsen with the progression of the cognitive decline and thus, whether or not these individuals should continue to drive is a matter of debate. The aim of the study was to provide support to the claim that individuals with MCI can benefit from a training program and improve their overall driving performance in a driving simulator. Fifteen older drivers with MCI participated in five training sessions in a simulator (over a 21-day period) and in a 6-month recall session. During training, they received automated auditory feedback on their performance when an error was noted about various maneuvers known to be suboptimal in MCI individuals (for instance, weaving, omitting to indicate a lane change, to verify a blind spot, or to engage in a visual search before crossing an intersection). The number of errors was compiled for eight different maneuvers for all sessions. For the initial five sessions, a gradual and significant decrease in the number of errors was observed, indicating learning and safer driving. The level of performance, however, was not maintained at the 6-month recall session. Nevertheless, the initial learning observed opens up possibilities to undertake more regular interventions to maintain driving skills and safe driving in MCI individuals.

Purpose: This study aims at verifying if impaired sensorimotor control observed in adolescents and young adults with scoliosis is also present in adult patients who underwent surgery to reduce their spine deformation., Methods: The study included ten healthy adults and ten adults with idiopathic scoliosis who underwent surgery to reduce their spine deformation. Galvanic vestibular stimulation was delivered to assess sensorimotor control. Vertical forces under each foot and horizontal displacement of the upper body were measured before, during and after stimulation. Balance control was assessed by calculating the root mean square values of kinematic and kinetic variables., Results: The amplitude of the vestibular-evoked postural response was 3.4 % (0.8-6.0 %) and 4.5 % (-0.4 to 9.5 %) of the maximal range of motion. Therefore, spine surgery did not limit the postural response. Patients with idiopathic scoliosis exhibited larger body sway than the healthy controls during and immediately after vestibular stimulation. The maximal normalized lateral displacement of the body was 0.85 and 0.40 cm/m and maximal normalized vertical force was 0.78 vs. 0.39 N/kg, for idiopathic scoliosis and healthy groups, respectively., Conclusions: This result suggests that dysfunctional sensorimotor integration is still present even in adult idiopathic scoliosis that underwent spine deformation correction.

Objective: It has been hypothesized that the impaired sensorimotor control observed in adolescents with idiopathic scoliosis (IS) may be related more to the onset of scoliosis than to the maturation of sensory systems or sensorimotor control mechanisms. The objective of this study was to assess sensorimotor control in adults diagnosed with IS in adolescence versus healthy controls., Methods: The study included 20 young adults 20 to 24 years of age (10 healthy controls and 10 diagnosed with adolescent IS but not treated for it). Binaural bipolar galvanic vestibular stimulation (GVS) was delivered to assess sensorimotor control. Vertical forces under each foot and upper body kinematics along the frontal plane were measured before GVS (2-second window), during GVS (2-second window), immediately after the cessation of GVS (1-second window), and during the following 2 seconds. Balance control was assessed by calculating the root mean square values of vertical forces and upper body kinematics., Results: Compared with healthy controls, the IS group showed greater body sway upon GVS; the amplitude of this sway was even greater immediately after the cessation of GVS-an outcome requiring sensorimotor control., Conclusion: Compared with normal controls, adults who had been diagnosed with IS in adolescence showed altered balance control immediately following GVS. This finding suggests that dysfunctional sensorimotor control may be related to the onset of scoliosis rather than to a transient suboptimal development of the sensory systems or sensorimotor control mechanisms., (Copyright © 2016. Published by Elsevier Inc.)

Previous studies on the control of human balance suggested that increased pressure under the feet, leading to reduced plantar sole mechanoreceptors sensitivity, increases body sway. Although this suggestion is attracting, it is unclear whether increased plantar sole pressure simply reduces the transmission of plantar sole afferent to the cortex or also alters the sensorimotor integrative mechanisms. Here we used electrical stimulation applied under the sole of the foot to probe the sensorimotor mechanisms processing foot mechanoreceptors. Balance control of healthy individuals was assessed either when wearing a loaded vest or in normal-weight condition. In the Loaded condition, we observed decreased cortical activity over the primary somatosensory cortex (SI) for both an early P50-N90 somatosensory evoked potential (SEP) and for oscillatory brain activity within the gamma band (30-80 Hz). These reductions were interpreted as a disrupted early sensory transmission (i.e., decreased early SEP) leading to a decreased perception of plantar sole sensory information (i.e., decreased gamma band power). These early sensory mechanisms for the Loaded condition were associated with an increase in the late P170-N210 SEP and oscillatory brain activity within the beta band (19-24 Hz). These neural signatures involved areas which are engaged in sensorimotor integrative processes (secondary somatosensory cortex (SII) and right temporoparietal junction). Altered early and late sensory processes may result from the increase pressure on the mechanoreceptors of the foot sole and not from postural instability per se. Indeed, postural instability with normal weight condition did not lead to SEP changes.

Adolescent idiopathic scoliosis is a multifactorial disorder including neurological factors. A dysfunction of the sensorimotor networks processing vestibular information could be related to spine deformation. This study investigates whether feed-forward vestibulomotor control or sensory reweighting mechanisms are impaired in adolescent scoliosis patients. Vestibular evoked postural responses were obtained using galvanic vestibular stimulation while participants stood with their eyes closed and head facing forward. Lateral forces under each foot and lateral displacement of the upper body of adolescents with mild (n = 20) or severe (n = 16) spine deformation were compared to those of healthy control adolescents (n = 16). Adolescent idiopathic scoliosis patients demonstrated greater lateral displacement and net lateral forces than controls both during and immediately after vestibular stimulation. Altered sensory reweighting of vestibular and proprioceptive information changed balance control of AIS patients during and after vestibular stimulation. Therefore, scoliosis onset could be related to abnormal sensory reweighting, leading to altered sensorimotor processes.

Idiopathic scoliosis is the most frequent spinal deformity in adolescence. While its aetiology remains unclear, impairments in balance control suggest a dysfunction of the sensorimotor control mechanisms. The objective of this paper is to evaluate the ability of patients with idiopathic scoliosis to reweigh sensory information. Using a neuromechanical model, the relative sensory weighting of vestibular and proprioceptive information was assessed. Sixteen healthy adolescents and respectively 20 and 16 adolescents with mild or severe scoliosis were recruited. Binaural bipolar galvanic vestibular stimulation was delivered to elicit postural movement along the coronal plane. The kinematics of the upper body, using normalized horizontal displacement of the 7th cervical vertebra, was recorded 1s before, 2s during, and 1s following vestibular stimulation. The neuromechanical model included active feedback mechanisms that generated corrective torque from the vestibular and proprioceptive error signals. The model successfully predicted the normalized horizontal displacement of the 7th cervical vertebra. All groups showed similar balance control before vestibular stimulation; however, the amplitude (i.e., peak horizontal displacement) of the body sway during and immediately following vestibular stimulation was approximately 3 times larger in patients compared to control adolescents. The outcome of the model revealed that patients assigned a larger weight to vestibular information compared to controls; vestibular weight was 6.03% for controls, whereas it was 13.09% and 13.26% for the mild and severe scoliosis groups, respectively. These results suggest that despite the amplitude of spine deformation, the sensory reweighting mechanism is altered similarly in adolescent patients with scoliosis., (Copyright © 2015 Elsevier B.V. All rights reserved.)

It has been shown that during the planning of a voluntary movement the transmission of cutaneous afferent inputs to the somatosensory cortex is attenuated shortly before the motor output as well as during movement execution. However, it is not known whether the sensory suppression observed during the planning phase (i.e., before any movement execution) is a systemic phenomenon or whether it is dependent on movement context. For example, movements such as step initiation are controlled based on information received from cutaneous receptors in the feet. Because afferent information emerging from these receptors is critical for movement initiation, we hypothesized that suppression of these inputs may not occur during the planning phase prior to gait initiation. To examine this hypothesis we measured the cortical response to somatosensory stimulation during the planning phase of step initiation and during movement execution. Sensitivity to cutaneous stimulation was assessed by measuring the amplitude of the cortical somatosensory-evoked potential (SEP, over the Cz electrode) following electrical stimulations of the plantar sole of one foot. Two stimulations were provided during the planning phase of a step movement and two stimulations during movement execution. It was found that the P50-N80 SEP was facilitated in the early planning phase (-700 ms before motor execution) compared with when participants remained still (control standing task). This mechanism might contribute to an enhanced perception of cutaneous input leading to a more accurate setting of the forces to be exerted onto the ground to shift the body's weight toward the supporting side prior to foot-off., (Copyright © 2015 the American Physiological Society.)

The aim of this study was to investigate if sensory reweighting occurred to control balance when the sensitivity of the plantar sole is reduced using cooling. To address this question, visual information was manipulated and/or ankle proprioception was altered by Achilles tendon vibration. It was expected that Achilles tendon vibration and vision deprivation would induce greater center of pressure (CoP) excursions and/or increase of electromyographic (EMG) activity of the ankle muscles (triceps surea and tibialis anterior) with than without cooling of the plantar sole. To verify these hypotheses, the CoP and EMG activity of the ankle muscles were simultaneously recorded during quiet standing trials of 30s before and after feet cooling procedure. Results showed that plantar sole sensitivity alteration did not lead to larger CoP excursions even during Achilles tendon vibration in absence of vision. This could be explained by an increase in the EMG activity of the triceps surae after the cooling procedure without modification of tibialis anterior EMG activity. This study suggests that to compensate alteration in plantar sole sensitivity, the central nervous system increased the muscular activity of the triceps surae to limit CoP excursions., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The contribution of vestibular signals to motor control has been evidenced in postural, locomotor, and oculomotor studies. Here, we review studies showing that vestibular information also contributes to the control of arm movements during whole-body motion. The data reviewed suggest that vestibular information is used by the arm motor system to maintain the initial hand position or the planned hand trajectory unaltered during body motion. This requires integration of vestibular and cervical inputs to determine the trunk motion dynamics. These studies further suggest that the vestibular control of arm movement relies on rapid and efficient vestibulomotor transformations that cannot be considered automatic. We also reviewed evidence suggesting that the vestibular afferents can be used by the brain to predict and counteract body-rotation-induced torques (e.g., Coriolis) acting on the arm when reaching for a target while turning the trunk.

It is acknowledged that various factors impaired balance control. Among them, heavy body weight is associated with poor balance control because the location of the center of mass is further away from the ankle joint. Thus, a larger active ankle torque is required to counter the greater gravitational torque. Because balance motor commands have signal-dependent noise whose standard deviation increases with the absolute value of the neural control signal, it was hypothesized that faster center of pressure speed observed in obese individuals would be related to larger balance motor commands variability. A feedback-control model and parametric system identification technique was used to estimate the variability in the balance motor commands and neural controller parameters based on previously published experimental data. Results of the neuromechanical model confirmed that the balance motor commands of obese individuals are more variable than that of lean individuals., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The initiation of human walking involves postural motor actions for body orientation and balance stabilization that must be effectively integrated with locomotion to allow safe and efficient transport. Our ability to coordinately adapt these functions to environmental or bodily changes through error-based motor learning is essential to effective performance. Predictive compensations for postural perturbations through anticipatory postural adjustments (APAs) that stabilize mediolateral (ML) standing balance normally precede and accompany stepping. The temporal sequencing between these events may involve neural processes that suppress stepping until the expected stability conditions are achieved. If so, then an unexpected perturbation that disrupts the ML APAs should delay locomotion. This study investigated how the central nervous system (CNS) adapts posture and locomotion to perturbations of ML standing balance. Healthy human adults initiated locomotion while a resistance force was applied at the pelvis to perturb posture. In experiment 1, using random perturbations, step onset timing was delayed relative to the APA onset indicating that locomotion was withheld until expected stability conditions occurred. Furthermore, stepping parameters were adapted with the APAs indicating that motor prediction of the consequences of the postural changes likely modified the step motor command. In experiment 2, repetitive postural perturbations induced sustained locomotor aftereffects in some parameters (i.e., step height), immediate but rapidly readapted aftereffects in others, or had no aftereffects. These results indicated both rapid but transient reactive adaptations in the posture and gait assembly and more durable practice-dependent changes suggesting feedforward adaptation of locomotion in response to the prevailing postural conditions., (Copyright © 2014 the American Physiological Society.)

Background: Wrist movement-related injuries account for a large number of repetitive motion injuries. Remarkably little, if any, empirical data exist to quantify the impact of neuromuscular disorders affecting the wrist or to validate the effectiveness of rehabilitation training programs on wrist functions. The aim of this project was to develop a biomechanical model for quantifying wrist and forearm kinetics during unconstrained movements, to assess its reliability and to determine its sensitivity., Methods: Twenty healthy subjects with no history of upper arm and wrist pain volunteered for the experiment. To evaluate the reliability of the data, we quantified their forearm and wrist kinetics on two different days (minimum and maximum number of days between experimental sessions were 1 and 4 days respectively). To measure forearm and wrist kinetics, an apparatus was built to offer rotational inertia during forearm and wrist movements. An inertial measurement unit was located near the top of the device measuring its angular position along the frontal and sagittal planes. We used a mathematical model to infer forearm and wrist torque. Thereafter, we calculated the product of torque and angular velocity to determine forearm and wrist power., Results: Results revealed that for 75% of the power and torque measurements the ICC was greater than 0.75 (range: 0.77 - 0.83). Torque and power measurements for adduction movements, however, were less reliable (i.e., ICC of 0.60 and 0.47, respectively) across testing sessions. The biomechanical model was robust to small measurement errors, and the power peaks between the first and second testing session were not different indicating that there was no systematic bias (i.e., motor performance improvement) between testing sessions., Conclusions: The biomechanical model can be used to assess the effectiveness of rehabilitation programs, document the progression of athletes or conduct research-oriented testing of maximum forearm and wrist kinetic capacities. Nonetheless, caution should be taken when assessing forearm and wrist power adduction movements. Future studies should aim at defining a set of normative values, for various age groups, for forearm and wrist joint torque and power in healthy individuals.

Scoliosis is the most frequent spinal deformity among adolescents. In 80 % of cases, it is defined as idiopathic as no individual cause has been identified. However, several factors linked to Adolescent Idiopathic Scoliosis (AIS) have been identified and are under investigation. One of these factors is neurological dysfunction. Increase in body sway has been observed either during or following sensory manipulation in AIS patients. It is believed that impairment in sensory processing could be related to scoliosis onset. Impairment in sensory processing could induce a body schema distortion. The aim of this case series was to evaluate if conventional orthopaedic treatments could improve balance control thus implying a better body representation. Although, no strong conclusion can be drawn from a case series, results suggest that alteration in body representation should be investigated in future studies.

When tracing a template with mirror-reversed vision (or distorted vision), the sensory information arising from the movement does not match the expected sensory consequences. In such situations, participants have to learn a new visuomotor mapping in order to trace the template with an accuracy and speed approaching that observed when tracing with direct vision. There are several suggestions that such visuomotor learning requires lowering the gain of the proprioceptive inputs. Generally, subjects learn this task in a seated condition offering a stable postural platform. Adapting to the new visuomotor relationship in a standing condition could add complexity and even hinder sensorimotor adaptation because balance control and processing of additional information typically interfere with each other. To examine this possibility, older individuals and young adults (on average, 70 and 22 years of age, respectively) were assigned to groups that trained to trace a shape with mirror-reversed vision in a seated or a standing condition for two sessions. For a third session, the seated groups (young and elderly) transferred to the standing condition while the standing groups continued to perform the tracing task while standing. This procedure allowed comparing the tracing performance of all groups (with the same amount of practice) in a standing condition. The standing groups also did a fourth session in a seated condition. Results show that older participants initially exposed to the standing condition were much slower to trace the template than all other groups (including the older group that performed the tracing task while seated). This slowness did not result from a baseline general slowness but from a genuine interference between balance control and the visuomotor conflict resulting from tracing the pattern with mirror-reversed vision. Besides, the Standing-Old participants that transferred to a seated condition in the fourth session immediately improved their tracing by reducing the total displacement covered by the pen to trace the template. Interestingly, the results did not support a transfer-appropriate practice hypothesis which suggests that training in a standing condition (at the third session) should have benefited the performance of those individuals who initially learned to trace the mirror pattern in a standing condition. This has important clinical implications: training at adapting to new sensory contexts or environmental conditions in conditions that do not challenge balance control could be necessary if one desires to attenuate the detrimental consequences on the postural or motor performances brought up by the interference between maintaining balance and the sensory reweighing processes.

Balance control can be interpreted as a combination of state feedback control with optimal state estimation. In this framework, state estimation uses an internal model of body and sensor dynamics to process sensory information and determine body orientation. The aim of this study was to assess the ability of the brain to create accurate state estimation when the congruence between sensory information was altered. Participants stood upright on a force platform with a monitor directly in front of them at eye level displaying their center of pressure (CP) position in real-time. When a target appeared on the monitor, participants had to move their CP as fast and as accurately as possible within the target. Voluntary balance pointing movements were made with the head either straight or rotated about the trunk, and mapping directions of the CP were changed on the basis of experimental conditions. Manipulating the sensory information congruency caused less accurate state estimation of the body motion leading to larger signed and absolute angular errors and a greater area of the final CP position were measured. These results suggest that performing head-centered to trunk-centered sensorimotor transformation reduces the accuracy in the state estimation of body motion during a balance pointing task., (Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.)

The countermovement jump test is often adopted to monitor lower-limb power of an individual. Despite several studies on the validity of this test, there is still a need to determine the minimal difference needed to be confident that a difference in power between two individuals is present or that a true change in the performance of an individual has occurred. In this study, power was measured from ground reaction forces and compared to that obtained from predictive equations for two groups of subjects (67 trained and 20 highly trained individuals). The height of each jump was determined with kinematic techniques. The main outcome is a large discrepancy between power calculated from ground reaction forces and that calculated from predictive equations. For the trained group, the R-square value between power and predicted power was 0.53 and the minimal difference to consider that two individuals were different was 821.7 W. For the highly trained individuals, a much larger R-square value was obtained (0.94). Despite this, the minimal difference to consider that two individuals were different was still large (689.3 W). The large minimal differences obtained raise serious concerns about using countermovement jumps for appraisal and monitoring of lower-limb power of an individual.

Background: Rotation of the torso while reaching produces torques (e.g., Coriolis torque) that deviate the arm from its planned trajectory. To ensure an accurate reaching movement, the brain may take these perturbing torques into account during movement planning or, alternatively, it may correct hand trajectory during movement execution. Irrespective of the process selected, it is expected that an underestimation of trunk rotation would likely induce inaccurate shoulder and elbow torques, resulting in hand deviation. Nonetheless, it is still undetermined to what extent a small error in the perception of trunk rotations, translating into an inappropriate selection of motor commands, would affect reaching accuracy., Methods: To investigate, we adapted a biomechanical model (J Neurophysiol 89: 276-289, 2003) to predict the consequences of underestimating trunk rotations on right hand reaching movements performed during either clockwise or counter clockwise torso rotations., Results: The results revealed that regardless of the degree to which the torso rotation was underestimated, the amplitude of hand deviation was much larger for counter clockwise rotations than for clockwise rotations. This was attributed to the fact that the Coriolis and centripetal joint torques were acting in the same direction during counter clockwise rotation yet in opposite directions during clockwise rotations, effectively cancelling each other out., Conclusions: These findings suggest that in order to anticipate and compensate for the interaction torques generated during torso rotation while reaching, the brain must have an accurate prediction of torso rotation kinematics. The present study proposes that when designing upper limb prostheses controllers, adding a sensor to monitor trunk kinematics may improve prostheses control and performance.

Older individuals have impaired balance control, particularly those that are frail and/or have sensory deprivations. Obese individuals show faster body sway during upright stance than normal weight individuals, suggesting that they also have difficulty controlling balance even if they do not have the same sensory issues as the older people. Therefore, the objective of this study was to examine if obesity is associated to a decreased balance control in older women. Postural sway of normal weight (n = 15, age = 70.8 ± 5.5 years; BMI = 22.2 ± 1.9 kg/m(2)), overweight (n = 15, age = 71.7 ± 4.3 years; BMI = 27.3 ± 1.3 kg/m(2)), and obese (n = 15, age = 71.1 ± 4.3 years; BMI = 33.1 ± 3.4 kg/m(2)) women was measured with a force platform for normal quiet stance lasting for 30 s in opened and closed eyes conditions. The obese group oscillated at a faster speed than the normal weight group (vision 0.99 ± 0.29 cm/s vs. 0.70 ± 0.16 cm/s, p < 0.01; no vision 1.43 ± 0.50 cm/s vs. 0.87 ± 0.23 cm/s, p < 0.01). The obese group exhibited greater range in both axes without vision compared to the normal weight group (p < 0.05). When observing sway density parameters, the obese group also spent less time in stability zones (2 mm radius area in which the center of pressure is relatively stable), and the distance between these stability zones are greater than the normal weight group in both visual conditions (p < 0.01 and p < 0.05, respectively). Obesity clearly affects postural control in older women. Our results suggest that obesity has a negative impact on the capacity of older woman to adequately use proprioceptive information for posture control. As postural instability or balance control deficits are identified as a risk factor for falling, our results also suggest that obesity in older women could be considered as another potential contributing factor for falling.

Results from several studies have suggested that brainstem dysfunction occurs more often in adolescent with idiopathic scoliosis compared to healthy individuals. The vestibular nuclei occupy a prominent position in the brainstem. Because the lateral vestibulospinal tract controls axial muscles, alteration in the brainstem during body growth (i.e., preadolescent and adolescent period) may translate in abnormal trunk activation and thus cause permanent spinal deformities. We conceive that vestibular dysfunction may be observed only in AIS patients with severe spine deviation. Consequently, adolescent with severe idiopathic scoliosis (AIS) would exhibit abnormal vestibulomotor responses compared to healthy age-matched individuals and AIS patients with mild spine deformation. If this hypothesis is confirmed, it will suggest that abnormal vestibulomotor response may contribute to curve progression. On the other hand, if AIS patients with mild severity also show abnormal vestibulomotor response, it will indicate that impaired vestibulomotor may be related to scoliosis onset but is not necessarily related to curve progression. It is expected, however, that regardless of curve severity, not all patients would have abnormal vestibulomotor responses. For instance, in some cases, gene defects may lead to malformation of the semicircular canals or alteration of the vestibular cortical network and cause scoliosis or curve progression., (Copyright © 2012 Elsevier Ltd. All rights reserved.)