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Key Points: It is unclear whether the visual input that accompanies a perturbation of a standing person can affect whether a recovery step is taken. Visual motion speeds were manipulated during unexpected forward and backward shoulder pulls. Visual motion that appeared slower than actual body motion reduced the initial in-place resistance to the perturbation. As a result of the modulation of the in-place response, less pull force was needed to trigger a step when visual velocity appeared slower than normal. The visuomotor postural response occurred earlier and was larger when the full-field visual input was paired with a mechanical perturbation., Abstract: The present study aimed to determine how visual motion evoked by an upper body perturbation during standing affects compensatory postural responses. This was investigated by rotating the visual field forwards or backwards about the ankle, time-locked to a forwards or backwards shoulder pull. Kinematic, kinetic and electromyographic responses were recorded to a range of pull forces over 160 trials in 12 healthy adults (mean ± SD = 31 ± 5.8 years). Stepping threshold forces and in-place postural responses were compared between conditions. When the visual field moved in the same direction as the pull, so that the apparent velocity of the body was reduced (SLOW condition), the pull-force required to induce a step was less than when the visual field either rotated in the opposite direction (FAST) or was unaltered (NATURAL). For in-place responses, the body was displaced further in the direction of the pull in the SLOW condition. This was the result of a reduction in the resistive force from lower leg muscles 130 ms after the visual motion onset. In trials with no pull, the visual motion induced postural responses that were later (290 ms) and had smaller amplitudes compared to when visual motion is paired with an unexpected perturbation of the body. The results suggest that the apparent speed of the visual environment during a perturbation does influence whether a compensatory step is taken, not via a direct effect on the decision to step but by modulating the initial in-place response., (© 2020 The Authors. The Journal of Physiology © 2020 The Physiological Society.)

Background: The specific mechanisms responsible for age-related decline in forward stability control remain unclear. Previous work has suggested reactive control of net ground reaction force (GRFnet) eccentricity may be responsible for age-related challenges in mediolateral stability control during the restabilisation phase of forward compensatory stepping responses.Research Questions: Does reactive control of GRFnet eccentricity play a role in managing forward stability control during the restabilisation phase of a forward stepping response to external balance perturbation?Methods: Healthy younger (YA) (n = 20) and older adults (OA) (n = 20) were tethered to a rigid frame, via adjustable cable. Participants were released from a standardised initial forward lean and regained their balance using a single step. Whole-body motion analysis and four force platforms were utilised for data acquisition. Forward instability was quantified as centre of mass (COM) incongruity - the difference between the first local peak and final stable anterior COM positions. The extent of GRFnet eccentricity was quantified as the sagittal-plane angle of divergence of the line of action of the GRFnet relative to the COM. Two discrete points during restabilisation were examined (P1 and P2), which have been suggested to be indicative of proactive and reactive COM control, respectively. Age-related differences in magnitude, timing and trial-to-trial variability of kinematic and kinetic outcome variables were analysed using two-factor ANOVAs with repeated-measures.Results: OA exhibited greater COM incongruity magnitude and variability - both were reduced with trial-repetition. There were no age-related differences in the magnitude or timing of P2. Instead, OA exhibited a reduced magnitude of GRFnet eccentricity at P1. There was a positive correlation between AP COM incongruity magnitude and P1 magnitude.Significance: Different from mediolateral stability control, the present results suggest that OA may experience forward stability control challenges as a function of insufficient preparatory lower limb muscle activation prior to foot-contact. [ABSTRACT FROM AUTHOR]

Introduction: Asymmetrical sensorimotor function after stroke creates unique challenges for bipedal tasks such as walking or perturbation-induced reactive stepping. Preference for initiating steps with the less-involved (preferred) leg after a perturbation has been reported with limited information on the stepping response of the more-involved (non-preferred) leg. Understanding the capacity of both legs to respond to a perturbation would enhance the design of future treatment approaches. This pilot study investigated the difference in perturbation-induced stepping between legs in stroke participant and non-impaired controls. We hypothesized that stepping performance will be different between groups as well as between legs for post-stroke participants. Methods: Thirty-six participants (20 persons post-stroke, 16 age matched controls) were given an anterior perturbation from three stance positions: symmetrical (SS), preferred asymmetrical (PAS−70% body weight on the preferred leg), and non-preferred asymmetrical (N-PAS−70% body weight on the non-preferred leg). Kinematic and kinetic data were collected to measure anticipatory postural adjustment (APA), characteristics of the first step (onset, length, height, duration), number of steps, and velocity of the body at heel strike. Group differences were tested using the Mann-Whitney U -test and differences between legs tested using the Wilcoxon signed-rank test with an alpha level of 0.05. Results: Stepping with the more-involved leg increased from 11.5% of trials in SS and N-PAS up to 46% in PAS stance position for participants post-stroke. Post-stroke participants had an earlier APA and always took more steps than controls to regain balance. However, differences between post-stroke and control participants were mainly found when stance position was modified. Compare to controls, steps with the preferred leg (N-PAS) were earlier and shorter (in time and length), whereas steps with the non-preferred leg (PAS) were also shorter but took longer. For post-stroke participants, step duration was longer and utilized more steps when stepping with the more-involved leg compared to the less-involved leg. Conclusions: Stepping with the more-involved leg can be facilitated by unweighting the leg. The differences between groups, and legs in post-stroke participants illustrate the simultaneous bipedal role (support and stepping) both legs have in reactive stepping and should be considered for reactive balance training. [ABSTRACT FROM AUTHOR]

Previous research on human balance recovery suggests that, prior to an externally triggered postural perturbation, healthy subjects can pre-select their postural response based on the environmental context, but it is unclear whether this pre-selection includes the selection of a stepping leg when performing compensatory steps. We sought to determine how pre-selecting a stepping limb affects the compensatory steps and stability of young, healthy subjects when responding to postural perturbations. Nine healthy subjects (24–37 years of age) stepped in response to backward translations of a platform under their feet when, prior to the perturbations, the subjects either knew whether they were to step with their left or right leg to a visual target (the Predictable condition) or did not know whether to step with their left or right leg until one of two targets appeared at perturbation onset (the Unpredictable condition). The Unpredictable condition also included randomly inserted trials of toes-up rotations and backward translations without targets (catch trials). The results showed that, in the Predictable condition, the subjects consistently exhibited one anticipatory postural adjustment (APA; a lateral weight shift toward the stance limb) before stepping accurately to the target with the correct leg. In the Unpredictable condition, the subjects either (1) exhibited multiple APAs, late step onsets, and forward center-of-mass (CoM) displacements that were farther beyond their base of support, or (2) exhibited an early step with only one APA and kept their CoM closer to the base of support, but also stepped more often with the incorrect leg. Thus, when the subjects had to select a stepping leg at perturbation onset, they either became more unstable and used multiple APAs to delay stepping in order to provide enough time to select the correct stepping leg, or they stepped earlier to remain stable but often stepped with the incorrect leg. In addition, responses to catch trials in the Unpredictable condition included distorted step placements that resembled steps to anticipated targets, despite allowing the subjects to step with a leg of their choice and to a location of their choice. Lastly, the subjects’ voluntary stepping latencies to visual targets presented without perturbations were twice as long as their stepping latencies to the backward platform translations. Therefore, healthy subjects appear to pre-select their stepping limb, even when the perturbation characteristics are unpredictable, because relying on visual input provided at perturbation onset requires a delayed response that leads to greater instability. [ABSTRACT FROM AUTHOR]