Background
Falls commonly occur due to losses of balance associated with vertical body movements (e.g. reacting to uneven ground, street curbs). Research, however, has focused on horizontal perturbations, such as forward and backward translations of the standing surface. This study describes and compares muscle activation patterns following vertical and horizontal perturbations during standing and walking, and investigates the role of vision during the standing postural responses.
Methods
Fourteen healthy participants (ten males; 27±4 years-old) responded to downward, upward, forward, and backward perturbations while standing and walking in a virtual reality (VR) facility containing a moveable platform with an embedded treadmill; participants were also exposed to visual perturbations in which only the virtual scenery moves. We collected bilateral surface electromyography (EMG) signals from 8 muscles (tibialis anterior, rectus femoris, rectus abdominis, external oblique, gastrocnemius, biceps femoris, paraspinals, deltoids). Parameters included onset latency, duration of activation, and activation magnitude. Standing perturbations comprised dynamic-camera (congruent), static-camera (incongruent) and eyes-closed sensory conditions. ANOVAs were used to compare the effects of perturbation direction and sensory condition across muscles.
Results
Vertical perturbations induced longer onset latencies and durations of activation with lower activation magnitudes in comparison to horizontal perturbations. Downward perturbations while standing generated faster activation of rectus femoris and tibialis anterior, whereas biceps femoris and gastrocnemius were faster to respond to upward perturbations. Initial responses to downward and upward perturbations activated trunk/hip flexors and extensors, respectively. Eyes-closed conditions induced longer durations of activation and larger activation magnitudes, whereas static-camera conditions induced longer onset latencies. During walking, downward perturbations promptly activated contralateral trunk and deltoid muscles, and upward perturbations triggered early activation of trunk flexors. Visual perturbations elicited muscle activation in 67.7% of trials.
Conclusion
Our results demonstrate that vertical (vs. horizontal) perturbations generate unique balance-correcting muscle activations with prioritized control of trunk/hip configuration for postural control after vertical perturbations. Availability of visual input appears to affect response efficiency, and incongruent visual input can adversely affect response triggering. Our findings have clinical implications for the design of robotic exoskeletons (to ensure user safety in dynamic balance environments) and for perturbation-based balance and gait rehabilitation.