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Today, off-grid communities rely mainly on diesel gensets with limited electrical efficiency and diesel furnaces for electricity and heat generation, respectively. The CO2 emissions associated with this electricity production can be reduced by improving the electrical efficiency of the system thus reducing the fuel consumption. Additionally, waste heat from the electricity production can be recovered for heating thus creating a combined heat and power system. In this work, a solid oxide fuel cell combined heat and power system hybridized to a battery was proposed for this purpose. Simulation of the annual electricity and heat production were performed using real temporal electrical demand data. Results showed that a reduction of up to 36 % in primary energy consumption can be reached compared with the current situation.

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 (

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.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.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.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.Our findings provide a new perspective on neural factors associated with a common spine deformation, adolescent idiopathic scoliosis.

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.

International audience; 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.

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.

A few years after their bilateral vestibular loss, individuals usually show a motor repertoire that is almost back to normal. This recovery is thought to involve an up-regulation 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 patients (n = 10) with bilateral vestibular loss than in an aged-matched healthy group (n = 10). Showing significant greater somatosensory evoked potentials (i.e., P1N1) in patients than in controls, 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 pending wrist, enhanced the internal representation of body orientation and motion relative to a gravitational reference frame. The large decreased in alpha/beta power in the right posterior parietal cortex (and not in the left) is in line with this assumption. Finally, our behavioral analyses showed smaller body sway oscillations for patients, likely originated from a tactile-based control strategy. Conversely, healthy subjects showed smaller head oscillations suggesting a vestibular-based control strategy, the head serving as a reference for balance control.HighlightsSomatosensory cortex excitability is greater in patients with bilateral vestibular loss than in aged-matched healthy individualsTo control balance, healthy individuals “locked” the head while vestibular patients “locked” their pelvisFor vestibular patients, increasing loading/unloading mechanism enhances the internal representation of body state in the posterior parietal cortex

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.

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.

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 (P50N90) 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 P50N90 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.

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.

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.

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.

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.

Introduction Adolescence idiopathic scoliosis (AIS) is a 3D deformity of the spine that occurs during growth. It affects 2–3 % of adolescents, and the prevalence is ∼10 times higher in girls compared to boys. There is growing evidence that alteration in the processing of vestibular signals results in asymmetrical activity in the vestibulospinal pathway. Since the latest modulates back muscles activity, an asymmetrical functioning of the vestibulospinal pathway could be related to AIS. To assess the symmetry of the vestibular pathway, we calculated coherence between vestibular evoked activity and postural response. Material and methods Nineteen adolescent girls (4 with AIS and 15 with no AIS) participated in this study. Participants received stochastic electrical vestibular stimulation (EVS; frequency spectrum: 0–25 Hz, amplitude ± 3 mA, DS5 stimulator, Digitimer Ltd) while standing upright on a force platform (model OPTIMA, Advanced Mechanical Technology, Inc.), arms alongside, eyes closed, and head immobilized ∼18° tilted upward (Laerdal Medical). Binaural or monaural (left and right) EVS induced changes in ground reaction forces along the anteroposterior (AP) and medio-lateral (ML) axis. Vestibulomotor coherence between EVS and ML or AP forces was calculated. Results Compared to controls, adolescents with AIS showed a greater asymmetry in vestibulomotor coherence along the ML axis when comparing right and left monaural EVS. Although the EVS should mainly evoke changes in ML axis, vestibulomotor coherence was observed between EVS and forces along the AP axis only in the AIS group. Discussion/conclusion The results suggest An asymmetrical vestibulomotor transformation in the adolescents with idiopathic scoliosis is suggested.

Introduction Several studies revealed balance control alterations in adolescents with idiopathic scoliosis (AIS) suggesting cortical sensorimotor processing impairments. This study aims at examining the cortical dynamics of sensorimotor information processing related to balance control in different sensory tasks in participants with AIS and in age-matched controls (CTL) using electroencephalography (EEG). Methods Cortical dynamics during normal standing balance and during ankle tendons co-vibration (proprioception alteration) and post-vibration (proprioception reintegration) were assessed in 16 girls with AIS and 15 CTL using EEG. The participants stood on a force platform. Fourier transform and time-frequency analysis were used to determine alpha peak frequency (APF) and band power synchronization/desynchronization in all conditions with and without vision. Balance performances were assessed through the distance covered by the center of pressure (COP). Results COP did not differ between groups in all conditions. APF was larger in the AIS group at central, frontal and parietal regions. In the co-vibration condition, a significant desynchronization 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 AIS compared to CTL. In the post-vibration condition, significant desynchronization in beta and gamma (30–50 Hz) band power were observed in the AIS group in the non-vision condition. Discussion/conclusion Differences in APF and frequency band power in AIS compared to CTL may indicate the need for increased cortical processing to maintain balance control. Future investigations may help understand the pathomechanism of progressive scoliosis.

Updating the position of an earth-fixed target during whole-body rotation seems to rely on cognitive processes such as the utilization of external feedback. According to perceptual learning models, improvement in performance can also occur without external feedback. The aim of this study was to assess spatial updating improvement in the absence and in the presence of external feedback. While being rotated counterclockwise (CCW), participants had to predict when their body midline had crossed the position of a memorized target. Four experimental conditions were tested: (1) Pre-test: the target was presented 30° in the CCW direction from participant’s midline. (2) Practice: the target was located 45° in the CCW direction from participant’s midline. One group received external feedback about their spatial accuracy (Mackrous and Simoneau, 2014) while the other group did not. (3) Transfer T 30 CCW : the target was presented 30° in the CCW direction to evaluate whether improvement in performance, during practice, generalized to other target eccentricity. (4) Transfer T 30 CW : the target was presented 30° in the clockwise (CW) direction and participants were rotated CW. This transfer condition evaluated whether improvement in performance generalized to the untrained rotation direction. With practice, performance improved in the absence of external feedback ( p = 0.004). Nonetheless, larger improvement occurred when external feedback was provided ( p s = 0.002). During T 30 CCW , performance remained better for the feedback than the no-feedback group ( p = 0.005). However, no group difference was observed for the untrained direction ( p = 0.22). We demonstrated that spatial updating improved without external feedback but less than when external feedback was given. These observations are explained by a mixture of calibration processes and supervised vestibular learning.

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.

Introduction Important for balance control, the activation of the cutaneous foot receptors largely depends on the speed and amplitude of the body oscillations during standing. Material and methods Here, we tested the hypothesis that the transmission of cutaneous inputs to the cortex is reduced during prolonged intervals of small body sways due to continued local skin compression and that under such circumstances, central mechanisms trigger large sways to reactivate the cutaneous receptors. We compared the amplitude of the somatosensory cortical potentials (P50-N90) evoked by electric stimulations of the foot sole during either small or large sways in 16 adults that were standing still with the eyes closed. Results We found greater P50-N90 amplitude when the stimulation occurred during large body sways, consistent with an increased sensory transmission. Importantly, body oscillations computed 200 ms prior to large sways had smaller amplitude than intervals that were not followed by large sways. Discussion The hypothesis of a depressed sensory transmission during continued skin compression was supported by our microneurographic recordings showing adaptation/suppression of tactile fibres discharge during continuous pressure applied to the mechanoreceptors. Finally, the hypothesis that large sways during standing correspond to a self-generated functional behaviour to release skin compression is supported by cortical source and EMG analyses showing respectively that large sways were preceded by activation of cortical areas known to be engaged in motor planning (supplementary motor area and dorsolateral prefrontal cortex) and by ankle muscle activations. Together, the present findings provide evidence for an important sensory function of large body sways for balance control.

Introduction During balance control, proprioceptive, vestibular and visual afferences are continuously reweighted. To assess the role of a sensory system, it is common to induce sensory illusions and measure the effect on body sway. The objective was to assess sensory reintegration during and after the stimulation of one sensory system (single condition - SS) or successive stimulation of different senses (mix condition - MX). In SS, ankle proprioception or vestibular signal was altered. In MX, VIB (EVS) was followed by EVS (VIB). Material and methods Participants stood on a force platform with eyes closed, head turned at ∼90° and tilted upward ∼18°, while EVS and Achilles tendon vibration induced backward body sway. The scalar distance between the center of pressure and the center of gravity (COP-COG), stabilisation time (ST), and linear impulse during and following sensory alteration were calculated. We contrasted VIB and EVS in SS, and compared SS and MX. Results: In SS, COP-COG during sensory reintegration was larger in VIB compared to EVS (P = 0.018). No difference was found during stimulation (P Discussion/conclusion Reweighting sensory information was poorer following alteration in ankle proprioception than vestibular information. Increase in ST in the MX compared to the SS revealed that the sensorimotor integration mechanisms did not benefit from successive stimulation of different sensory systems.

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.

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.

Epidemic excess of weight is considered as a critical and common health problem. It is associated with many physiological and psychological disorders. Other than metabolic problems, obesity also affects the efficient execution of daily living activities such as the simple act of standing, walking or grabbing an object while standing. This article aims at presenting a state of knowledge of recent studies illustrating the detrimental effect of obesity and the beneficial effect of weight loss on postural stability and on the speed and accuracy of upper-limb goal-directed movements performed from a standing posture. Evidence supporting the suggestion that greater strength and training, at least for standing conditions, do not overcome the functional limitations imposed by obesity are presented. It is suggested that obese individuals may suffer from a reduced plantar sole sensitivity. As a conclusion to this work, we confirm the deleterious effect of overweight on motor control as weight loss translates into an improved balance control and upper limb speed-accuracy performance when standing.

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. 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 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 (that were expected) 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.

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/m2), overweight (n = 15, age = 71.7 ± 4.3 years; BMI = 27.3 ± 1.3 kg/m2), and obese (n = 15, age = 71.1 ± 4.3 years; BMI = 33.1 ± 3.4 kg/m2) 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

The aging of the population, combined with the overrepresentation of older drivers in car crashes, has engendered a whole body of research destined at finding simple and efficient assessment methods of driving capacities. Such a search is destined to fail, given that car crashes and unsafe driving behaviors can result from myriad interacting factors. This review highlights the main problems of the current assessment methods and training programs and presents theoretical and empirical arguments justifying the need of reorienting the research focus. In our discussion, we elaborate the fundamental principle of specificity in learning and practice. We also identify overlooked variables that are deterministic when assessing and training a complex ability like driving. We especially focus on the role of the sensorimotor transformation process. Finally, we propose alternative methods of assessment and training that, in line with recent trends in education, use virtual reality and simulation technologies.

Overweight individuals sway more than normal weight individuals. Major weight loss improves their balance control despite a related decrease in muscle strength. Presumably, muscular strength is an important factor for balance control. This study investigated the effect that a change in body mass has on relative strength and balance control.Force (isometric knee extension) and balance control (center of pressure speed and range) were studied in three groups; normal weight (BMI25 kg m(-2)), obese (30 kg m(-2)BMI40 kg m(-2)) and excess obese (BMI40 kg m(-2)) Caucasian male individuals.The excess obese individuals who underwent bariatric surgery as a weight loss strategy were studied before, 3 and 12 months after losing on average, 66.9 kg (+/-95% CI 55.8, 77.9 kg; on average, 45% of their weight). The obese individuals who underwent diet modifications were studied before dieting and when resistance to weight loss occurred after losing on average 11.7 kg (+/-95% CI 9.3, 14.2 kg; on average, 12% of their weight). The control group was studied twice, 50 weeks apart. In obese and excess obese individuals, losing weight reduced absolute knee muscular strength on average, by 8.2 kg (+/-95% CI 3.9, 12.5 kg; on average, 10% of their strength) and 23.9 kg (+/-95% CI 12.1, 35.8 kg; on average, 33% of their strength). However, it also increased balance control measured with speed of the center of foot pressure, on average, by 0.10 cm s(-1) (+/-95% CI 0.05, 0.14 cm s(-1); or increased of 12%) and 0.28 cm s(-1) (+/-95% CI 0.07, 0.47 cm s(-1); increased of 27%), respectively. Relative strength increased approximately by 22% for only the excess obese group 12 months post surgery.This suggests, in overweight individuals, weight loss is more efficient at improving balance control than increasing, or even maintaining muscle strength. In these individuals, training programs aimed at improving balance control should primarily target weight loss.