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Correlations of head and trunk sways, and sitting and foot pressure distributions during chewing in the sitting position
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Purpose: The purpose of this study was to determine a reference value for masticatory performance (MP) by measuring the amount of glucose extracted(AGE) from chewing gummy jelly.
Methods: A total of 237 young adults (young group, 20-39 years), 147 middle-aged adults (middle-aged group, 40-59 years), and 177 older adults (old group, 60-87 years) participated in this study. All participants had natural dentition, excluding the third molars. AGE was measured when the participant chewed gummy jelly and used as a parameter of MP. AGE was compared among the three groups. Next, AGE in each group was compared between the habitual chewing side and non-habitual chewing side, and between males and females. The correlation between age and AGE was also investigated.
Results: AGE in the young, middle, and old groups were similar, and no significant differences were observed. AGE was significantly higher in the habitual chewing side compared to the non-habitual chewing side, and in males than that in females. No significant correlations were found between age and AGE. AGE in the habitual chewing side of all ages was 221.9 ± 34.4 mg/dL for males and 206.0 ± 28.7 mg/dL for females. The mean-2SD (standard deviation) value representing the reference value of healthy adults was 153.1 mg/dL for males and 148.6 mg/dL for females, which was close to 150 mg/dL.
Conclusion: It was concluded that the reference value of masticatory performance as measured by the amount of glucose extraction after chewing gummy jelly was 150 mg/dL.
Backgrounds
Jaw and neck muscles may be activated by chewing load using a hard food. However, it remains unclear how effects the gum hardness to the coordinated features in jaw and neck muscle activities during chewing performance.
Objectives
This study was conducted to quantitatively elucidate the effects of the hardness of the gum on coordinated features in jaw and neck muscle activities using intermuscular EMG–EMG transfer function and EMG–EMG coherence function analyses in 18 healthy subjects.
Methods
Jaw and neck muscle activities were aggregated into the first peak frequency of the power spectrum, and power, gain, phase, and coherence parameters between jaw and neck muscle activities were examined in the first peak frequencies during soft and hard gum chewing.
Results
The first peak frequency was not significantly different between soft and hard gum chewing. In contrast, power values of the jaw and neck muscles were significantly increased by chewing of hard gum as compared with soft gum, whereas gain, phase, and coherence were not significantly changed by gum hardness.
Conclusions
The chewing rhythm, the quantitative and temporal coordination, and the functional coordination in jaw and neck muscle activities were not changed during soft and hard gum chewing, as well as increased jaw and neck muscles activities. It is therefore concluded that the chewing rhythmicity and jaw and neck muscles coordination accompanied with the increased jaw and neck muscle activities are maintained under the condition of the chewing load using gum hardness in the healthy individuals.
It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices.
Background:
Mandibular functions are associated with electromyographic activity of the jaw muscles and also the sternocleidomastoid muscle (SCM). The precise spatiotemporal relation of SCM and masticatory muscles activities during chewing is worthy of investigation.
Objective:
To analyze the sequential recruitment of SCM and masseter activities during chewing as indicated by the spatiotemporal locations of their activity peaks.
Methods:
Jaw movements and bilateral surface electromyographic activity of SCM and masseter were recorded during gum chewing in 20 healthy subjects. The timing order was decided by comparing the length of time from the time when the opening started to the time when the surface electromyographic activity reached its peak value. Spatial order was analyzed by locating the peak electromyographic activity onto a standard chewing cycle which was created based on 15 unilateral chewing cycles. Paired t-test, One-way ANOVA and Student-Newman-Keuls post-test were used for comparisons.
Results:
Although the Time to Peak for the balancing side SCM appeared shorter than for the other three tested muscles, most often it did not reach a level of significance. However, the location of the balancing side SCM's peak activity was further from the terminal chewing position (TCP) than the working side SCM and bilateral masseters (P < 0.05).
Conclusions:
The balancing side SCM activity reached its peak significantly further away from TCP than the other three tested muscles during chewing. Further studies with spatiotemporal variables included should be helpful to understand the roles of the head, neck, and jaw muscles in orofacial and cervical dysfunctional problems. This article is protected by copyright. All rights reserved.
Recent evidence has indicated that chewing gum can enhance attention, as well as promoting well-being and work performance. Four studies (two experiments and two intervention studies) examined the robustness of and mechanisms for these effects. Study 1 investigated the acute effect of gum on mood in the absence of task performance. Study 2 examined the effect of rate and force of chewing on mood and attention performance. Study 3 assessed the effects of chewing gum during one working day on well-being and performance, as well as postwork mood and cognitive performance. In Study 4, performance and well-being were reported throughout the workday and at the end of the day, and heart rate and cortisol were measured. Under experimental conditions, gum was associated with higher alertness regardless of whether performance tasks were completed and altered sustained attention. Rate of chewing and subjective force of chewing did not alter mood but had some limited effects on attention. Chewing gum during the workday was associated with higher productivity and fewer cognitive problems, raised cortisol levels in the morning, and did not affect heart rate. The results emphasise that chewing gum can attenuate reductions in alertness, suggesting that chewing gum enhances worker performance.
Background and aims:
There is an important role of the neck sensory motor system in control of body posture and balance, and it is reasonable to believe that the jaw sensory motor system can directly and indirectly influence the modulation of the postural control system. The purpose of this study was to evaluate possible effects of dynamic jaw position while chewing on the postural control system.
Materials and methods:
We compared the mean center of gravity (COG) velocity during quite standing on a foam surface with eyes closed during three test conditions: (i) with resting jaw position, (ii) with open jaw position, and (iii) while chewing standard bolus of chewing gum. One hundred and sixteen normal healthy male subjects (average age 31.56 ± 8.51 years; height 170.86 ± 7.26 cm) were recruited for the study. Their COG velocity (deg/s) was measured using the NeuroCom® Balance Master Version 8.5.0 (Clackamas, OR, USA).
Statistical analysis:
Data was tested by the Friedman test.
Results and conclusions:
The results show that COG velocity decreased significantly while chewing in comparison to both open and resting jaw position (p < 0.0001). Our finding corroborates previous studies and suggests that the jaw sensory motor system can modulate postural control mechanisms. Gum chewing activity can enhance the postural stability during upright standing on an unstable surface and in the absence of visual input in healthy young adults. Our results should be taken into consideration in treatment and rehabilitation planning for patients with postural instability.
The purpose of the present study was to investigate the relationship between mastication and head posture using foods with different degrees of hardness. A total of 12 healthy, dentulous volunteers participated in the study. Each participant was required to chew two types of gummy candy with two levels of hardness while sitting upright. Measurements were conducted using an optoelectric jaw-tracking system with 6 degrees of freedom (Gnatho-Hexagraph II JM-2000®). The horizontal plane perpendicular to the direction of gravitational force served as the reference plane. Analysis of the gradient of the Frankfurt plane (head posture) and pitching of the head during masticatory movement was conducted. The influence of the type of test food on these parameters was evaluated during mastication. During stable mastication, the gradient of the Frankfurt plane was 4.66 degrees on average, close to the horizontal plane. The time course of the Frankfurt plane gradient revealed a tendency toward dorsal flexion during the first to middle phases of mastication, and a tendency toward ventral flexion during the middle to last phases, regardless of the hardness of the test food. The participants were divided into two groups based on change in head posture during chewing. The results showed while there was no change in head posture in the group with marked pitching of the head, head posture did change in the group with little pitching.
The stability of upright posture was evaluated in nine young and nine elderly subjects by measuring the maximum voluntary excursion of the centre-of-foot pressure in the anteroposterior and mediolateral directions during maximal voluntary leaning. Normalized maximum voluntary excursion, lean path, and mean time to attain maximum voluntary excursion, as well as range of centre-of-foot pressure oscillations at maximum voluntary excursion showed age-related changes. The elderly had a significantly smaller maximum voluntary excursion than the young in the backward and left leans with a non-significant reduction in maximum voluntary excursion leaning forward and right. The elderly approached maximum voluntary excursion in a less controlled manner exhibiting greater variability in their lean paths, and had greater range of oscillations at their maximum voluntary excursion. The elderly also took a significantly longer time to reach maximum voluntary excursion in the forward-lean trials.
Purpose:
The aim of this pilot study was to compare the vertical reaction forces (N) generated in three different Action 3 manual one-arm drive wheelchairs: dual handrim, a lever drive and a Neater Uni-wheelchair (NUW). A CONFORmat® Pressure measurement mat, placed on top of the users' prescribed cushion, measured vertical force at the buttock/seat interface on both hemiplegic and non-hemiplegic sides in each wheelchair.
Methods:
Fifteen hemiplegic users were randomly assigned each wheelchair to drive around an indoor obstacle course. During propulsion of a multiple sensor, continuous measurement of force was recorded. Time taken to complete the circuit was recorded. Mean force and confidence intervals for each buttock were calculated per user per wheelchair.
Results:
The dual handrim produced the highest vertical force during propulsion under the right buttock (x= 484.43; SD = 55.4; p < 0.001) and the lever drive produced the least force (x= 368.05; SD = 53.55; p < 0.01). The NUW completed the course quickest (p < 0.01).
Conclusions:
The dual-handrim wheelchair requires the greatest vertical force during propulsion. Since increases in this seat vertical reaction force may be related to the propulsive force. Further investigation is indicated as this may be a significant factor for clinicians when prescribing one-arm drive wheelchairs. Implications for Rehabilitation Review of clinical reasoning in prescribing wheelchairs. Addition of the Neater Uni-wheelchair to wheelchair services prescribing lists.
Brain mechanisms underlying mastication have been studied in non-human mammals but less so in humans. We used functional magnetic resonance imaging (fMRI) to evaluate brain activity in humans during gum chewing. Chewing was associated with activations in the cerebellum, motor cortex and caudate, cingulate, and brainstem. We also divided the 25-second chew-blocks into 5 segments of equal 5-second durations and evaluated activations within and between each of the 5 segments. This analysis revealed activation clusters unique to the initial segment, which may indicate brain regions involved with initiating chewing. Several clusters were uniquely activated during the last segment as well, which may represent brain regions involved with anticipatory or motor events associated with the end of the chew-block. In conclusion, this study provided evidence for specific brain areas associated with chewing in humans and demonstrated that brain activation patterns may dynamically change over the course of chewing sequences.
Background
Clinicians need a practical, objective test of postural control that is sensitive to mild neurological disease, shows experimental and clinical validity, and has good test-retest reliability. We developed an instrumented test of postural sway (ISway) using a body-worn accelerometer to offer an objective and practical measure of postural control.
Methods
We conducted two separate studies with two groups of subjects. Study I: sensitivity and experimental concurrent validity. Thirteen subjects with early, untreated Parkinson’s disease (PD) and 12 age-matched control subjects (CTR) were tested in the laboratory, to compare sway from force-plate COP and inertial sensors. Study II: test-retest reliability and clinical concurrent validity. A different set of 17 early-to-moderate, treated PD (tested ON medication), and 17 age-matched CTR subjects were tested in the clinic to compare clinical balance tests with sway from inertial sensors. For reliability, the sensor was removed, subjects rested for 30 min, and the protocol was repeated. Thirteen sway measures (7 time-domain, 5 frequency-domain measures, and JERK) were computed from the 2D time series acceleration (ACC) data to determine the best metrics for a clinical balance test.
Results
Both center of pressure (COP) and ACC measures differentiated sway between CTR and untreated PD. JERK and time-domain measures showed the best test-retest reliability (JERK ICC was 0.86 in PD and 0.87 in CTR; time-domain measures ICC ranged from 0.55 to 0.84 in PD and from 0.60 to 0.89 in CTR). JERK, all but one time-domain measure, and one frequency measure were significantly correlated with the clinical postural stability score (r ranged from 0.50 to 0.63, 0.01 < p < 0.05).
Conclusions
Based on these results, we recommend a subset of the most sensitive, reliable, and valid ISway measures to characterize posture control in PD: 1) JERK, 2) RMS amplitude and mean velocity from the time-domain measures, and 3) centroidal frequency as the best frequency measure, as valid and reliable measures of balance control from ISway.
Plantar pressure systems are increasingly being used to evaluate foot function in both research settings and in clinical practice. The purpose of this study was to investigate the reliability of the TekScan MatScan(R) system in assessing plantar forces and pressures during barefoot level walking.
Thirty participants were assessed for the reliability of measurements taken one week apart for the variables maximum force, peak pressure and average pressure. The following seven regions of the foot were investigated; heel, midfoot, 3rd-5th metatarsophalangeal joint, 2nd metatarsophalangeal joint, 1st metatarsophalangeal joint, hallux and the lesser toes.
Reliability was assessed using both the mean and the median values of three repeated trials. The system displayed moderate to good reliability of mean and median calculations for the three analysed variables across all seven regions, as indicated by intra-class correlation coefficients ranging from 0.44 to 0.95 for the mean and 0.54 to 0.97 for the median, and coefficients of variation ranging from 5 to 20% for the mean and 3 to 23% for the median. Selecting the median value of three repeated trials yielded slightly more reliable results than the mean.
These findings indicate that the TekScan MatScan(R) system demonstrates generally moderate to good reliability.
The central nervous system (CNS) utilizes anticipatory (APAs) and compensatory (CPAs) postural adjustments to maintain equilibrium while standing. It is known that these postural adjustments involve displacements of the center of mass (COM) and center of pressure (COP). The purpose of the study was to investigate the relationship between APAs and CPAs from a kinetic and kinematic perspective. Eight subjects were exposed to external predictable and unpredictable perturbations induced at the shoulder level while standing. Kinematic and kinetic data were recorded and analyzed during the time duration typical for anticipatory and compensatory postural adjustments. When the perturbations were unpredictable, the COM and COP displacements were larger compared to predictable conditions with APAs. Thus, the peak of COM displacement, after the pendulum impact, in the posterior direction reached 28+/-9.6mm in the unpredictable conditions with no APAs whereas it was 1.6 times smaller, reaching 17+/-5.5mm during predictable perturbations. Similarly, after the impact, the peak of COP displacement in the posterior direction was 60+/-14 mm for unpredictable conditions and 28+/-3.6mm for predictable conditions. Finally, the times of the peak COM and COP displacements were similar in the predictable and unpredictable conditions. This outcome provides additional knowledge about how body balance is controlled in presence and in absence of information about the forthcoming perturbation. Moreover, it suggests that control of posture could be enhanced by better utilization of APAs and such an approach could be considered as a valuable modality in the rehabilitation of individuals with balance impairment.
Recent observations in man of concomitant mandibular and head movements during single maximal jaw-opening/-closing tasks suggest a close functional relationship between the mandibular and the head-neck motor systems. This study was aimed at further testing of the hypothesis of a functional integration between the human jaw and neck regions. Spatiotemporal characteristics of mandibular and associated head movements were evaluated for 3 different modes of rhythmic jaw activities: self-paced continuous maximal jaw-opening/-closing movements, paced continuous maximal jaw-opening/-closing movements at 50 cycles/minute, and unilateral chewing. Mandibular and head-neck movements were simultaneously recorded in 12 healthy young adults, by means of a wireless opto-electronic system for 3-D movement recordings, with retro-reflective markers attached to the lower (mandible) and upper (head) incisors. The results showed that rhythmic mandibular movements were paralleled by head movements. An initial change in head position (head extension) was seen at the start of the first jaw-movement cycle, and this adjusted head position was retained during the following cycles. In addition to this prevailing head extension, the maximal jaw-opening/-closing cycles were paralleled by head extension-flexion movements, and in general the start of these head movements preceded the start of the mandibular movements. The results support the idea of a functional relationship between the temporomandibular and the cranio-cervical neuromuscular systems. We therefore suggest a new concept for human jaw function, in which "functional jaw movements" are the result of activation of jaw as well as neck muscles, leading to simultaneous movements in the temporomandibular, atlanto-occipital, and cervical spine joints.
We have previously demonstrated the existence of a functional-rhythmical coupling between the head and the mandible using maxillary and mandibular incisal tracking points. However, that data did not provide information neither on the movement of the head as a whole nor on the location of its instantaneous centre of rotation. Thus, the objective of the present study was to determine whether the head undergoes a rotational motion during mouth opening and to locate its putative instantaneous centre of rotation. The same 6 d.f. (degree of freedom) measuring device employed in our previous studies was used again to analyse data from five male adults (age range: 26-29 years old) chosen as subjects. Concomitant head and mandibular movements were assessed in the sagittal plane by allocating several reference points in the head (upper incisor, cranial base, occipital and parietal points) and a mandibular incisor point during maximal mouth open-close movements. Then, the magnitude and inclination of the vectors of motion in each reference point during the opening phase were calculated. The instantaneous centre of rotation was defined as the point showing the least amount of motion in a determined area around each head reference point. The mandibular incisal point and the maxillary incisal point showed concomitant movements; that is, during opening the mandibular point moved downwards and the maxillary incisor point upwards. Making a large jaw opening movement caused an inferior-anterior displacement in the O point, a posterior-inferior displacement of the P point, and an anterior-superior displacement in the C point in all subjects. During jaw closing all points followed a trajectory opposite to that described above. In other words, during opening the head moved clockwise and counter-clockwise during closing, at least in the sagittal plane of the subjects' left side. These results suggest that the head undergoes a rotation-like sagittal movement during mouth opening whose rotation centre seems to be located above the cranial base point, which was set close to the centre of mass of the head. However, its location varies according to the magnitude of mouth opening.
In literature, it has been suggested that the CNS anticipates spontaneous change in body position during quiet stance and continuously modulates ankle extensor muscle activity to compensate for the change. The purpose of this study was to investigate whether velocity feedback contributes by modulating ankle extensor activities in an anticipatory fashion, facilitating effective control of quiet stance. Both theoretical analysis and experiments were carried out to investigate to what extent velocity feedback contributes to controlling quiet stance. The experiments were carried out with 16 healthy subjects who were asked to stand quietly with their eyes open or closed. During the experiments, the center of pressure (COP) displacement (COPdis), the center of mass (COM) displacement (COMdis), and COM velocity (COMvel) in the anteroposterior direction were measured. Rectified electromyograms (EMGs) were used to measure muscle activity in the right soleus muscle, the medial gastrocnemius muscle, and the lateral gastrocnemius muscle. The simulations were performed using an inverted pendulum model that described the anteroposterior kinematics and dynamics of quiet stance. In the simulations, an assumption was made that the COMdis of the body would be regulated using a proportional-derivative (PD) controller. Two different PD controllers were evaluated in these simulations: 1) a controller with the high-derivative/velocity gain (HDG) and 2) a controller with the low-derivative/velocity gain (LDG). Cross-correlation analysis was applied to investigate the relationships between time series obtained in experiments 1) COMdis and EMGs and 2) COMvel and EMGs. Identical cross-correlation analysis was applied to investigate the relationships between time series obtained in simulations 3) COMdis and ankle torque and 4) COMvel and ankle torque. The results of these analyses showed that the COMdis was positively correlated with all three EMGs and that the EMGs temporally preceded the COMdis. These findings agree with the previously published studies in which it was shown that the lateral gastrocnemius muscle is actively modulated in anticipation of the body's COM position change. The COMvel and all three EMGs were also correlated and the cross-correlation function (CCF) had two peaks: one that was positive and another that was negative. The positive peaks were statistically significant, unlike the negative ones; they were larger than the negative peaks; and their time shifts were much shorter compared with the time shifts of the negative peaks. When these results were compared with the CCF results obtained for simulated time series, it was discovered that the cross-correlation results for the HDG controller closely matched cross-correlation results for the experimental time series. On the other hand, the simulation result obtained for LDG controller did not match the experimental results. These findings suggest that the actual postural control system during quiet stance adopts a control strategy that relies notably on velocity information and that such a controller can modulate muscle activity in anticipatory manner without using a feed-forward mechanism.
The purpose of this study was to evaluate the effect of changing mandibular position on body posture and reciprocally, body posture on mandibular position. Forty-five (45) asymptomatic subjects (24 males and 21 females, ages 21-53 years, mean age 30.7 years) were included in this study and randomly assigned to one of two groups, based on the table of random numbers. The only difference between group I and group II was the sequence of the testing. The MatScan (Tekscan, Inc., South Boston, MA) system was used to measure the result of changes in body posture (center of foot pressure: COP) while subjects maintained the following 5 mandibular positions: (1) rest position, (2) centric occlusion, (3) clinically midlined jaw position with the labial frena aligned, (4) a placebo wax appliance, worn around the labial surfaces of the teeth and (5) right eccentric mandibular position. The T-Scan II (Tekscan, Inc., South Boston, MA) system was used to analyze occlusal force distribution in two postural positions, with and without a heel lift under the right foot. Total trajectory length of COP in centric occlusion was shorter than in the rest position (p < 0.05). COP area in right eccentric mandibular position was larger than in centric occlusion (p < 0.05). When subjects used a heel lift under the right foot, occlusal forces shifted to the right side compared to no heel lift (p < 0.01). Based on these findings, it was concluded that changing mandibular position affected body posture. Conversely, changing body posture affected mandibular position.
Introduction Mastication involves complex tongue movements, coordination of lip, and cheek movements and is associated with head movement to facilitate the intraoral transport of food from ingesting to swallowing; it affects many functions of the whole body. However, studies to evaluate the relationship between masticatory movements and the body posture are still lacking to our knowledge. The purpose of this study was to characterize the effects of masticatory movements on the head, trunk, and body sway during the standing position. Methodology A total of 30 healthy subjects were evaluated. The MatScanTM system was used to analyze changes in body posture (center of foot pressure: COP) and the 3-dimensional motion analysis system was used to analyze changes in the head and trunk postures while subjects remained in the standing position with the rest position, centric occlusion, and masticating chewing gum. Results The total trajectory length of COP and head and trunk sways during masticating chewing gum were significantly shorter and smaller respectively than it was in the rest position and centric occlusion (p<0.016). COP area during masticating chewing gum was significantly smaller than it was in the 2 mandibular positions (p<0.016). Conclusion Masticatory movements positively affect the stability of the head, trunk, and body sways and enhance the postural stability during the standing position.
Purpose:
The purpose of this study was to test the hypothesis in healthy subjects that masticatory movements affect head and trunk sways, and sitting and foot pressure distributions during sitting position.
Methods:
A total of 30 healthy male subjects with an average age of 25.3 years (range, 22-32 years) were evaluated. The CONFORMatTM and MatScanTM system were used to analyze changes in sitting pressure distribution (center of sitting pressure: COSP) and changes in foot pressure distribution (center of foot pressure: COFP) respectively, and the 3-dimensional motion analysis system was used to analyze changes in head and trunk postures while subjects remained sitting position with rest position, centric occlusion, and chewing. The total trajectory length of COSP/COFP, COSP/COFP area, and head and trunk sway values were compared between the three conditions to evaluate whether masticatory movement affected the stability of head and trunk sways, and sitting and foot pressure distributions.
Results:
Total trajectory length of COSP and COSP area during chewing were significantly shorter and smaller respectively than it was in rest position and centric occlusion (p < 0.016). Head sway value during chewing was significantly larger than it was in rest position and centric occlusion (p < 0.016).
Conclusion:
Masticatory movements affect sitting pressure distribution and head movements during sitting position.
Postural control continues to develop during middle childhood as shown by the decrease in body sway in stance between the ages of 5 and 11. Although head and trunk control is crucial for balance control during both static and dynamic activities, evaluating its specific development and its contribution to overall postural control is methodologically challenging. Here, we used an unstable sitting device adapted to ensure that only the axial segments could control the balance of the device and thus the balance of the upper body. This study aimed to assess the development of the postural stabilization of axial body segments during middle childhood. Thirty-six children (in three age groups: 6-7yo, 8-9yo, and 10-11yo) and 11 adults sat on the unstable sitting device and had to stabilize their axial segments under several conditions: a moderate vs. high level of balance challenge, and eyes open vs. eyes closed. Upper-body postural sway (area, mean velocity and root mean square (RMS) of the center of pressure (CoP) displacement) decreased progressively with age (6-7yo > 8-9yo > 10-11yo > adults), and this effect was accentuated when the balance challenge was high (for CoP area) or in the “eyes closed” condition (for CoP area and RMS). The stabilization strategies were assessed by anchoring indexes computed from three-dimensional kinematics. A progressive shift was showed, from an “en bloc” pattern at 6–7 years of age toward a more articulated (i.e. adult-like) pattern at 10–11. A head-on-space stabilization strategy first emerged at the age of 8–9. Middle childhood is an important period for the development of axial segment stabilization, which continues to mature until adulthood. This development might be related to the introduction and progressive mastery of feedforward sensorimotor processes and might contribute strongly to the development of overall postural control.
Background:
Seated postural stability can be measured using Tekscan, CONFORMat. Standing postural stability has gained great clinical and, research value by use of different force platforms with mostly good reliability. No reliability testing or biologic variation assessment has been documented regarding seated balance. This study determines the reliability of the parameters of seated balance in healthy children using the Tekscan CONFORMat equipment.
Methods:
Sixty-six healthy children completed six measurements of seating position the first three with the child seated in a relaxed normal back position and the next three with the child seated in a complete up-right back position. The SAM software calculated five default parameters of balance (area, distance, variability, antero-posterior (AP) excursion and left-right excursion).
Results:
Reliability parameters were assessed by one-way analysis of variance intra-class correlation (ICC) proving excellent reliability for relaxed and up-right back position with respect to distance (0.75/0.84) and good reliability with respect to variability (0.61/0.62) and area (0.61/0.60). AP excursion (0.41/0.59) and left-right excursion (0.54/0.24) showed fair to poor reliability.
Conclusion:
In conclusion, two of the five default parameters of balance used in the Tekscan CONFORMat system are direction-independent parameters and have been found reproducible for measuring seated balance in children. This study can be used as reference for comparisons of seated balance in children with affected seated postural control and for evaluating a clinical treatment effect.
To investigate the role of proprioceptors of different skeletal muscles in postural control, in normal subjects and patients with unilateral labyrinthine dysfunction (ULD), the effect of vibration on these muscles was studied by postulography. The subjects comprised 59 normal subjects and 12 patients with ULD due to resection of acoustic tumours. Sagittal body sway was observed during vibration to the triceps surae, tibialis anterior and upper dorsal neck muscles. No significant change in sway was observed in the frontal plane in normal subjects. Significant differences between normal subjects and patients were found on stimulation of the muscle groups of triceps surae and biceps femoris during vibration. In patients with ULD, vibration to the dorsal neck muscles caused a deviation towards the diseased side. It can be speculated that the upper dorsal neck muscle plays an important role in maintaining the body balance in the frontal plane in patients with ULD. On the other hand, the lower extremity muscles...
The purpose of the present study was to compare the location of the body center of mass (CoM) determined by using a high accuracy reaction board (RB) and two different segment parameter models for motion analysis (Dempster, 1955, DEM and de Leva, 1996 adjusted from Zatsiorsky and Seluyanov, ZAT). The body CoM (expressed as percentage of the total body height) was determined from several subjects including athletes as well as physically active students and sedentary people. Some significant differences were found in the location of the body CoM between the used segment models and the reaction board method for all male subjects (n=58, 57.03±0.79%, 56.20±0.76% and 57.60±0.76% for RB, ZAT and DEM, respectively) and separately for male (n=12, RB 57.02±0.41%, ZAT 56.74±0.62%, DEM 58.19±0.60%) and female (n=12, RB 55.91±0.88%, ZAT 57.24±0.77%) students of physical activity. The ZAT model was a good match with RB for high jumpers (56.26±0.94% and 56.63±0.56%) whereas the DEM model was better for gymnasts (57.38±0.46% and 57.89±0.49%) and throwers (58.19±0.69% and 57.79±0.45%). For ice hockey players (IH) and ski jumpers (SJ) both segment models, ZAT and DEM, differed significantly from the reaction board results. The results of the present study showed that careful attention should be paid while selecting the proper model for motion analysis of different type of athletes.
Previous findings, during chewing, that boluses of larger size and harder texture result in larger amplitudes of both mandibular and head-neck movements suggest a relationship between increased chewing load and incremental recruitment of jaw and neck muscles. The present report evaluated jaw (masseter and digastric) and neck [sternocleidomastoid (SCM) and trapezius] muscle activity during the chewing of test foods of different sizes and textures by 10 healthy subjects. Muscle activity was recorded by surface electromyography and simultaneous mandibular and head movements were recorded using an optoelectronic technique. Each subject performed continuous jaw-opening/jaw-closing movements whilst chewing small and large boluses of chewing gum and rubber silicone (Optosil). For jaw opening/jaw closing without a bolus, SCM activity was recorded for jaw opening concomitantly with digastric activity. During chewing, SCM activity was recorded for jaw closing concomitantly with masseter activity. Trapezius activity was present in some, but not all, cycles. For the masseter and SCM muscles, higher activity was seen with larger test foods, suggesting increased demand and recruitment of these muscles in response to an increased chewing load. This result reinforces the previous notion of a close functional connection between the jaw and the neck motor systems in jaw actions and has scientific and clinical significance for studying jaw function and dysfunction.
When chewing solid food, part of the bolus is propelled into the oropharynx before swallowing; this is named stage II transport (St2Tr). However, the tongue movement patterns that comprise St2Tr remain unclear. We investigated coronal jaw and tongue movements using videofluorography. Fourteen healthy young adults ate 6 g each of banana, cookie, and meat (four trials per foodstuff). Small lead markers were glued to the teeth and tongue surface to track movements by videofluorography in the anteroposterior projection. Recordings were divided into jaw motion cycles of four types: stage I transport (St1Tr), chewing, St2Tr, and swallowing. The range of horizontal tongue motion was significantly larger during St1Tr and chewing than during St2Tr and swallowing, whereas vertical tongue movements were significantly larger during chewing and St2Tr than during swallowing. Tongue movements varied significantly with food consistency. We conclude that the small horizontal tongue marker movements during St2Tr and swallowing were consistent with a "squeeze-back" mechanism of bolus propulsion. The vertical dimension was large in chewing and St2Tr, perhaps because of food particle reduction and transport in chewing and St2Tr.
A previous study in our laboratory demonstrated that the soleus H reflex was facilitated during mastication in humans. In the present study, we investigated whether there was any modulation of the magnitude of the pretibial H reflex during mastication in five healthy adult volunteers. The pretibial H reflex was significantly facilitated during mastication, and there was no significant difference in the facilitation between jaw-closing and jaw-opening phases; that is, the gain of the H reflex was modulated tonically but not in a phase-dependent manner during mastication. Furthermore, in the same subjects, we confirmed that the soleus H reflex was facilitated during mastication. Based on our findings, we conclude that the H reflexes in both the pretibial and soleus muscles undergo a nonreciprocal facilitation during mastication. It is suggested that mastication contributes to stabilization of postural stance in humans. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1142–1148, 2001
The purpose of this study was to quantitatively evaluate the effects of experimental leg length discrepancies on body posture and dental occlusion. Thirty asymptomatic subjects (15 males and 15 females, ages 19-33, mean age 25.6 years) were included in this study and randomly assigned to one of two groups based on a table of random numbers. The only difference between group A and group B was the sequence of testing. Experimental leg length discrepancies were provided by using ten types of insoles with heights ranging from one to ten mm at one mm intervals, placed under both feet. The MatScan (Nitta Corp., Osaka, Japan) system was used to measure changes in body posture (center of foot pressure: COP) while subjects maintained the following three postural positions: 1. natural standing posture (control); 2. control with a heel lift under the right foot; or 3. control with a heel lift under the left foot. The T-Scan II system (Nitta Corp., Osaka, Japan) was used to analyze the results of changes in dental occlusion (center of occlusal force: COF) in the above-mentioned three postural positions. When subjects used a heel lift of six mm or more under the right foot, lateral weight distribution (LWD) shifted to the right side compared to the control (p<0.05). When a heel lift of four mm or more was used under the left foot, LWD shifted to the left side compared to the control (p<0.05). When subjects used a heel lift of eight mm or more under the right foot, occlusal force shifted to the right side compared to the control (p<0.05). When subjects used a heel lift of seven mm or more under the left foot, occlusal force shifted to the left side compared to the control (p<0.05). Based on these findings, it was concluded that leg length discrepancy affected body posture and dental occlusion.
The finding that chewing gum can moderate stress and mood changes following a multi-task cognitive stressor (Scholey et al., 2009) was re-examined. In a repeated measures cross-over design, thirty participants completed a 20-min multi-tasking stressor on consecutive days, both with and without chewing gum. Both prior to and post stressor, participants provided salivary cortisol samples and self-rated measures of stress, state anxiety, calmness, contentedness, and alertness. Contrary to Scholey et al. (2009), chewing gum failed to attenuate both salivary cortisol levels and the increase in self-rated stress. Self-rated anxiety, calmness, and contentedness were not impacted by chewing gum. This suggests that the stress effects reported by Scholey et al. may be constrained by particular features of that study (e.g. morning testing). However, consistent with Scholey et al. (2009), chewing gum was shown to increase alertness following the stressor. The mechanisms underpinning heightened alertness are unclear; however, such increases may be linked to greater cerebral activity following the chewing of gum (Fang Li, Lu, Gong, & Yew, 2005).
Non‐technical summary
Homeostasis, the physiological control of variables such as body position, is founded on negative feedback mechanisms. The default understanding, consistent with a wealth of knowledge related to peripheral reflexes, is that feedback mechanisms controlling body position act continuously. For more than fifty years, it has been assumed that sustained control of position is best interpreted using continuous paradigms from engineering control theory such as those which regulate speed in a vehicle ‘cruise control’ system. Using a joystick to control an unstable load that falls over like a person fainting, we show that control using intermittent gentle taps is natural, more effective and robust to unexpected changes than continuous hand contact, works best with two taps per second, and can explain the upper frequency limit of control by both methods. Serial ballistic control, limited to an optimum rate, provides a new physiological paradigm for interpreting sustained control of posture and movement.
The purpose of this study was to investigate the effect of masticating chewing gum on postural stability during upright standing. To address this issue, 12 healthy subjects performed quiet standing on a force platform for the posturography study. The subjects were instructed to stand as stable as possible on the force platform in order to record the trajectory of the center-of-pressure (COP). After measuring the postural sway in the initial condition (pre-condition), the subjects were asked to stand while masticating chewing gum (gum-condition). Following the gum-condition, quiet standing without mastication was evaluated (post-condition) to ensure the effect of masticating chewing gum on postural stability. The trajectory and velocity of the COP were analyzed for each condition. We found that the postural stability tended to enhance during mastication of chewing gum. The rectangle area of the COP trajectory significantly diminished in the gum-condition and significantly enlarged in the post-condition. A similar effect was observed in the maximum velocity and standard deviation (SD) of the fore-aft amplitude of the COP trajectory. The values were significantly smaller in the gum-condition compared to those in the post-condition. These findings suggest that mastication of chewing gum affects the postural control by enhancing the postural stability during upright standing.
Progress in rehabilitation medicine requires an understanding of the basic rules of motor coordination, as well as of the contribution of adaptive processes within the central nervous system to the patterns of impaired movements. We assume that patterns of voluntary movements reflect rules of coordination that are used by the intact central nervous system of healthy persons. In pathological conditions that may include cognitive, central neurological, and peripheral disorders, the central nervous system may reconsider these rules leading to different peripheral patterns of voluntary movements. In such conditions, changed motor patterns may be considered adaptive to a primary disorder. They may even be viewed as optimal for a given state of the system of movement production. We suggest that the emphasis of therapeutic approaches must be placed not on restoring the motor patterns to 'as close to normal as possible', but on assisting the central nervous system to develop optimal adaptive reactions to the original underlying problem.
To clarify the response of muscle sympathetic nerve activity (MSNA) to static stimulation of otolith organs in a craniocaudal direction (+Gz) in humans, we examined the effect of otolith stimulation on MSNA without changing the effect of cardiopulmonary baroreceptors using a 6-8.5 degrees head-down tilt (HDT) and lower body negative pressure (LBNP) device. Before the study, we established that 6-8.5 degrees HDT with 10 mmHg LBNP caused a fluid shift to the degree that the thoracic impedance was the same as the supine position without LBNP. Subjects were young male volunteers aged 22.1 +/- 3.8 years who gave informed consent. MSNA was recorded from the tibial nerve by microneurography simultaneously with heart rate (ECG), thoracic fluid volume (impedance method), and blood pressure (tonometric method). During 6-8.5 degrees HDT with 10 mmHg LBNP, MSNA was suppressed slightly without significantly changing heart rate, thoracic impedance, or mean arterial blood pressure. The results suggest that the sympathosuppression was related not to the result of cardiopulmonary [correction of cardioplumonary] loading but to the -Gz change (caudocranial direction [correction of dirction]) of 0.1 G. It is estimated that the vestibulo-sympathetic reflex may suppress sympathetic outflow to muscles in humans.
This research contains the data about the center of gravity in parts of human body that is useful for the analysis of human gait, above all, to indicate the locus of center of gravity of the whole human body in gait. My results show how the individual difference of the physique affects on the center of gravity in parts of human body and to what extent we can use the value of the cadaver upon living body.
To examine trunk stability in unstable sitting posture in 2 different functional activities.
A randomized crossover design.
Rehabilitation center in Italy.
Ten healthy subjects and 10 patients with multiple sclerosis.
Subjects were seated on an unstable support surface. A task in which the subjects had to keep their trunk as stable as possible was compared with tasks in which they had to track an object with the head or grasp an object.Main outcome measures Angular displacement and mean absolute angular velocity in the anteroposterior and mediolateral planes of the support surface.
Angular displacement showed differences between patients and healthy subjects both in the sagittal plane (P<.0001) and frontal plane (P<.002). Velocity of angular displacement differentiated between the groups in both planes (P<.0001). Differences between velocity of angular displacement in different tasks were also detected (P<.0001). Correlation coefficients between sitting balance scores and laboratory measures were low and not statistically significant. In the healthy subjects, instability in the frontal plane correlated positively with the subjects' weight and height.
Both patients and healthy subjects had more difficulty with frontal plane stability than with sagittal plane stability. Angular velocity for a given task showed the greatest difference between the groups and between postural challenge tasks within a group. Patients were more unstable than healthy subjects during head movements in the frontal plane; conversely, arm movements produced larger angular displacement, especially in the sagittal plane.
The purpose of the present study was to assess whether any differences existed in the upper body accelerations of young and elderly subjects during natural speed walking. Head and trunk accelerations in eight young subjects (aged 23+/-4 years) and eight healthy elderly subjects (aged 74+/-3 years) were measured during level walking on a 20 m walkway using a pair of tri-axial accelerometers. Heel contact and toe-off events were determined using a footswitch system embedded in the innersole of the right shoe. Gait measures assessed included; stride, stance and swing durations, cadence, gait velocity, step length and 3D head and trunk accelerations. All acceleration variables were normalised to walking speed before statistical analysis. The main findings of this study were: (1) the peak positive anterior-posterior (AP) trunk acceleration associated with push-off was significantly lower for elderly subjects, (2) the peak negative AP head and trunk accelerations following heel contact was significantly higher for elderly subjects, and (3) the time delay between trunk and head accelerations experienced in the AP direction was significantly lower for the elderly compared to the young group. Together, these results suggest that elderly subjects exhibit different patterns of upper body motion in the direction of travel compared to younger subjects. These differences are probably motivated by the need to maximise dynamic stability during critical parts of the gait cycle.
Mastication is a sensory-motor activity aimed at the preparation of food for swallowing. It is a complex process involving activities of the facial, the elevator and suprahyoidal muscles, and the tongue. These activities result in patterns of rhythmic mandibular movements, food manipulation and the crushing of food between the teeth. Saliva facilitates mastication, moistens the food particles, makes a bolus, and assists swallowing. The movement of the jaw, and thus the neuromuscular control of chewing, plays an important role in the comminution of the food. Characteristics of the food, e.g. water and fat percentage and hardness, are known to influence the masticatory process. Food hardness is sensed during mastication and affects masticatory force, jaw muscle activity, and mandibular jaw movements. When we chew for instance a crispy food, the jaw decelerates and accelerates as a result of resistance and breakage of food particles. The characteristic breakage behaviour of food is essential for the sensory sensation. This study presents a short review of the influence of oral physiology characteristics and food characteristics on the masticatory process.
Examination of lower facial skin movements during left-and right-side chewing
- K Sakaguchi
- N Maeda
- A Yokoyama
Sakaguchi, K.; Maeda, N.; Yokoyama, A. Examination of lower facial skin movements
during left-and right-side chewing. J. Prosthodont. Res. 2011, 55, 32-39.
https://doi.org/10.1016/j.jpor.2010.08.002.
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Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?
- F B Horak
Horak, FB. Postural orientation and equilibrium: what do we need to know about neural
control of balance to prevent falls? Age Ageing. 2006, 35-S2, ii7-ii11.
https://doi.org/10.1093/ageing/afl077.
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Feedforward ankle strategy of balance during quiet stance in adults
- P Gatev
- S Thomas
- T Kepple
- M Hallett
Gatev, P.; Thomas, S.; Kepple, T.; Hallett, M. Feedforward ankle strategy of balance
during quiet stance in adults. J. Physiol. 1999, 514(Pt 3)(Pt 3), 915-928.
https://doi.org/10.1111/j.1469-7793.1999.915ad.x.
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