Mechanical effects of canes on standing posture: beyond perceptual information

Abstract

Background Numerous studies showed that postural balance improves through light touch on a stable surface highlighting the importance of haptic information, seemingly downplaying the mechanical contributions of the support. The present study examined the mechanical effects of canes for assisting balance in healthy individuals challenged by standing on a beam. Methods Sixteen participants supported themselves with two canes, one in each hand, and applied minimal, preferred, or maximum force onto the canes. They positioned the canes in the frontal plane or in a tripod configuration. Statistical analysis used a linear mixed model to evaluate the effects on the center of pressure and the center of mass. Results The canes significantly reduced the variability of the center of pressure and the center of mass to the same level as when standing on the ground. Increasing the exerted force beyond the preferred level yielded no further benefits, although in the preferred force condition, participants exploited the altered mechanics by resting their arms on the canes. The tripod configuration allowed for larger variability of the center of pressure in the task-irrelevant anterior–posterior dimension. High forces had a destabilizing effect on the canes: the displacement of the hand on the cane handle increased with the force. Conclusions Given this static instability, these results show that using canes can provide not only mechanical benefits but also challenges. From a control perspective, effort can be reduced by resting the arms on the canes and by channeling noise in the task-irrelevant dimensions. However, larger forces exerted onto the canes can also have destabilizing effects and the instability of the canes needs to be counteracted, possibly by arm and shoulder stiffness. Insights into the variety of mechanical effects is important for the design of canes and the instructions of how to use them.

Human Foot Force Informs Balance Control Strategies when Standing on a Narrow Beam

“…The ground reaction force data were measured at 500 Hz. Further details of the experimental apparatus and setup can be found in the previous study by Russo et al (10).…”

“…Nevertheless, quiet standing experiments allow for observations of natural stance and longer-term recordings. One form of mild and safe system interrogation is to expose human subjects to a challenging environment without applying perturbations (10)(11)(12)(13). The present study examined human subjects standing on a narrow beam in tandem stance to gain insights into the control mechanisms of postural balance.…”