Lewis M. Nashner's research while affiliated with Washington University in St. Louis and other places

Publications (61)

Article
During the last 10 years, computerized dynamic posturography has yielded various patterns of sway on the sensory organization test and the motor control test that have been associated with a variety of organic balance disorders. Some aspects of performance during computerized dynamic posturography, however, are under conscious control. Voluntary mo...
Article
Athletic trainers and team physicians are often faced with decisions concerning the severity and timing of an athletes return to play following mild head injury (MHI). These decisions can be the most difficult ones facing clinicians because of the limited amount of quantitative information indicating injury severity. Several authors have published...
Article
Healthy human subjects can maintain adequate balance despite distorted somatosensory or visual feedback or vestibular feedback distorted by a peripheral vestibular disorder. Although it is not precisely known how this sensorimotor integration task is achieved, the nervous system coordinates information from multiple sensory systems to produce motor...
Chapter
Postural abnormalities associated with Parkinson’s disease (PD) have been elegantly illustrated by Purdon-Martin [11]. While tremor, rigidity, and brady-kinesia can be readily evaluated by the trained clinician, even semiquantitative assessments of the postural deficits associated with this disorder have proven more challenging. The appearance of p...
Article
Full-text available
In order to identify the types of postural deficits seen in parkinsonian patients with postural instability, we compared the performance of parkinsonian subjects with young and old control subjects in 3 aspects of postural control: (1) the use of sensory information for postural orientation, (2) the coordination of postural movement patterns in res...
Article
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This study examines the roles of somatosensory and vestibular information in the coordination of postural responses. The role of somatosensory information was examined by comparing postural responses of healthy control subjects prior to and following somatosensory loss due to hypoxic anesthesia of the feet and ankles. The role of vestibular informa...
Article
Long-term recovery from surgically induced unilateral loss of vestibular function was studied in 14 patients. Seven patients underwent surgical extirpation or section of the vestibular nerve, and seven patients underwent labyrinthectomy without vestibular nerve section. The vestibulo-ocular reflex (VOR) and postural control were evaluated preoperat...
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1. The effect of central set on automatic postural responses was studied in humans exposed to horizontal support-surface perturbations causing forward sway. Central set was varied by providing subjects with prior experience of postural stimulus velocities or amplitudes under 1) serial and random conditions, 2) expected and unexpected conditions, an...
Article
We analyse two components of posture control in standing human subjects: (1) the mechanical properties which constrain the body's ability to execute stabilizing postural movements and (2) the mechanical and neural properties which constrain the ability of the vestibular system to sense changes in body orientation. Rules are then proposed to describ...
Article
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1. The role of sensory information in shaping muscle activation patterns to postural perturbations in humans was investigated by varying velocity, amplitude, or duration of the perturbing stimulus. Ten normal subjects were exposed to 120 backward translations of the support surface under conditions of varying velocities (10-35 cm/s, constant amplit...
Article
The coordination of head and trunk movement during postural sway in the anterior/posterior plane was examined in three normal adults. Postural sway about the ankles of hips was elicited in two ways: (1) In free-fall sway trials, the subject passively fell forward while the feet remained in place on the support surface (ankle sway). (2) In perturbed...
Article
The development of a systematic approach to the diagnosis and management of ataxias of vestibular origin depends critically on the elucidation of the complex sensory and motor interactions involved in human postural control. In this paper, the results of studies of both sensory and motor control of posture in adults and children with peripheral ves...
Article
Full-text available
The effect of the direction of unexpected horizontal perturbations of stance on the organization of automatic postural responses was studied in human subjects. We recorded EMG activity from eight proximal and distal muscles acting on joints of the legs and hip known to be involved in postural corrections, while subjects stood on an hydraulic platfo...
Article
Clinically, the definitive diagnosis of perilymph fistulas can only be made by tympanotomy. Results of various fistula tests based upon the vestibulo-ocular reflex have not correlated well with findings during tympanotomy. A new fistula test has been developed based upon vestibulo-spinal responses. By systematic removal of both visual and support-s...
Article
This study examines the interactions between anteroposterior postural responses and the control of walking in human subjects. In the experimental paradigm, subjects walked upon a treadmill, gripping a rigid handle with one hand. Postural responses at different phases of stepping were elicited by rapid arm pulls or pushes against the handle. During...
Article
Full-text available
We studied the extent to which automatic postural actions in standing human subjects are organized by a limited repertoire of central motor programs. Subjects stood on support surfaces of various lengths, which forced them to adopt different postural movement strategies to compensate for the same external perturbations. We assessed whether a contin...
Article
The following study examined two aspects of balance control in the older adult: the coordination of the timing and the amplitude of muscle responses to postural perturbations, and the ability of the participant to reorganize sensory inputs and subsequently modify postural responses as a consequence of changing environmental conditions. Coordination...
Article
In order to maintain equilibrium standing and walking, the posture control system must keep the body center of mass located over the feet. While standing erect with the feet stationary, the range of possible equilibrium positions is limited to a cone in which the vertical projection of the center of body mass is located over some portion of the bas...
Article
A scheme for understanding the organization of human postural movements is developed in the format of a position paper. The structural characteristics of the body and the geometry of muscular actions are incorporated into a three-dimensional graphical representation of human movement mechanics in the sagittal plane. A series of neural organizationa...
Chapter
A functional approach to the assessment of CNS movement disorders is based upon a series of studies in which the posture and equilibrium controls of normal subjects were quantified. This approach uses a movable platform system to perturb the equilibrium of a freely standing subject in a number of different directions. The platform includes a suppor...
Article
Abnormal vestibular function disrupts postural and ocular muscle control system references to gravity (earth) vertical. Vestibular disorders also prevent satisfactory resolution of normally redundant, but often conflicting, visual and somatosensory spatial references required for normal postural control during active and passive body motion. Using...
Article
Abnormal vestibular function disrupts a subject's reference to gravity (earth) vertical, and prevents resolution of conflicting or inaccurate visual and somatosensory spatial references. However, errors which patients make when attempting to resolve conflicting visual and somatosensory orientation inputs during upright stance differed markedly in p...
Chapter
Any movement of the body to maintain or regain erect posture results from a combination of internal, muscular forces with external forces exerted most commonly by the support surface on the foot. That is, erect human posture is characterized by a continuous interaction among the muscular and external forces acting upon the body segments.
Article
Assessment of postural control in vestibular deficient subjects with and without visual and ankle joint sway information permitted: 1) a quantitative assessment of the overall vestibular information used by the individual patient for control of upright posture; 2) an estimate of the extent to which the vestibular deficient subject can appropriately...
Article
This study has focused upon the automatic components of posture and movement in a group of ten cerebral palsy children carefully selected to represent a spectrum of abnormalities relatively pure by clinical standards and ten age-matched normals. Each subject stood unsupported upon a movable platform and within a movable visual surround and was then...
Article
Abnormal vestibular function disrupts a subject's reference to gravity (earth) vertical, and prevents resolution of conflicting or inaccurate visual and somatosensory spatial references. However, errors which patients make when attempting to resolve conflicting visual and somatosensory orientation inputs during upright stance differed markedly in p...
Article
Environmental context influences the strategy for executing a motor act 1) by affecting the information content of movement-associated sensations, and 2) by changing the mechanical configuration for which postural support must be provided. This article describes the postural reactions produced by freely standing subjects attempting to compensate fo...
Article
Full-text available
Patients whose deficits were limited to clinically well qualified vestibular disorders have been exposed to a number of altered support surface and visual environments while standing unsupported. A six-degrees-of-freedom platform employing movable support surfaces for each foot and a movable visual surround deprived patients of normal inputs derive...
Article
Full-text available
Normal young children ranging in age from 1 1/2 to 10 years were assessed in a number of experimental paradigms testing the ability to adapt quickly their strategy of control to altered support surface and visual conditions. The experimental protocols, using a movable platform and visual surround, and the analytic techniques, using EMGs and measure...
Article
Full-text available
Patients whose deficits were limited to clinically well qualified vestibular disorders have been exposed to a number of altered support surface and visual environments while standing unsupported. A six- degrees-of-freedom platform employing movable support surfaces for each foot and a movable visual surround deprived patients of normal inputs deriv...
Article
1. We have examined rapid postural adjustments associated with a class of voluntary movements that disturb postural equilibrium. In the text that follows, these motor activities are termed associated postural adjustments and voluntary focal movements, respectively. Standing human subjects performed a variety of movement tasks on a hand-held manipul...
Article
The present study demonstrated inhibition of the Achilles tendon reflex in freely standing humans during platform perturbations which elicited a long-latency postural response (90 to 110 ms) in the stretched antagonist tibialis anterior musculature. The inhibition was apparent under those conditions in which the long-latency postural response had a...
Article
This study contrasts the properties of compensatory postural adjustments in response to movements of the support surface with those of reaction-time voluntary movements in human subjects. Subjects stood upon a six degrees-of-freedom movable platform and performed tone and movement-triggered voluntary sways about the ankle joints both under conditio...
Chapter
The generation of a purposeful movement requires that the sensorimotor system regulate and control three kinds of activities: (1) the basic patterns of the movement must be generated in each limb and the patterns of activities among the limbs must be coordinated, (2) the muscular activities generating the basic movement pattern must be adaptively m...
Article
The principal aim of this project was to examine the earliest components of EMG adjustments that followed the perturbation of walking human subjects. Subjects were perturbed while walking at their own preferred rates of travel by the unexpected movements of a platform incorporated into the surface of the walkway. The forces and motions associated w...
Article
This study has described the organization of EMG activities among the muscles of a standing subject's legs during rapid postural adjustments (95–120 ms latencies). Adjustments were elicited by the horizontal translation of both feet (causing antero-posterior sway), by the synchronous vertical displacement of both feet (causing changes in height) an...
Article
This chapter aims to synthesize a hierarchical model of posture control from experimental observations of stance posture control of normal human subjects. A conceptual synthesis of human experimental observations enhances knowledge about sensorimotor controls derived from the study of animal preparations in several important ways. Studies of chroni...
Article
The aim of this study has been to present firmer evidence that during stance functionally related postural muscles in the legs are activated according to fixed patterns. The importance of fixed patterns of activation for stabilization, balance, and movement control has received considerable theoretical and experimental attention. With regard to pos...
Article
Doubt about the role of stretch reflexes in movement and posture control has remained in part because the questions of reflex “usefulness” and the postural “set” have not been adequately considered in the design of experimental paradigms. The intent of this study was to discover the stabilizing role of stretch reflexes acting upon the ankle muscula...
Article
This study described the effects of low level (75–250 μA) galvanic stimulation of the labyrinths of the human posture control system. Experiments demonstrated a transient EMG response in gastrocnemius-soleus (GS) muscle with a latency of 100 msec after initiation of galvanic current pulses of 75–250 μA and 50–150 msec duration. These transient EMG...
Chapter
The regulation of antero-posterior body sway about the ankle joints has been the object of this study of human posture control. The stabilizing influences of two of the relevant sensory systems have been studied: (1) postural responses initiated by the vestibular system as a consequence of body sway motion and (2) muscle proprioceptive reflexes and...
Article
Current models for physiological components and a posture control experiment conducted with three normal subjects form the basis for a model which seeks to describe quantitatively the control of body sway when only vestibular motion cues are used. Emphasis is placed on delineating the relative functional roles of the linear and the angular accelera...
Article
An experimental technique was developed which facilitated the formulation of a quantitative model describing vestibular detection of body sway motion in a postural response mode. All cues, except vestibular ones, which gave a subject an indication that he was beginning to sway, were eliminated using a specially designed 2 degree-of-freedom platform...

Citations

... As a result, balance tests can measure postural control under the presumed reliance upon the unperturbed vestibular inputs by modifying the testing environment to manipulate the veracity of visual (e.g., blindfold or moving visual scene) and support surface (e.g., standing on foam) cues. The observations of marked instability in patients with known vestibular lesions (Fetter et al., 1991) have made such assessment techniques a standard approach for identifying balance dysfunction mediated by impaired vestibular sensation (Nashner et al., 1982;Nashner and Peters, 1990;Horak, 2009;Wagner et al., 2021a), including in older adults. ...
... [2,3]. 이로 인해 기능 및 활동 제한을 겪고 일상생활 활동의 제약과 의료비용이 증가하게 된다 [4,5]. ...
... So, the difference in knee flexion between trials performed with EO and EC may be due to the difficulty of the postural task (i.e., unipedal vs. bipedal and EC vs. EO). During unipedal stance performed without vision, participants may need to increase knee flexion in order to optimally use that joint to maintain their balance (e.g., suspensatory strategy [41]). However, as this study is the first one to investigate the effect of fatigue on joint angles during unipedal stance, no other literature can be used to support our assumptions. ...
... (b) Dynamic posturography: is based on the use of a platform placed on a horizontally movable support, which inclines forward or backward and rotates around an axis that is collinear with the ankles. One of the best-known dynamic posturography systems was developed by Nashner ([30]) and then studied by Black [31,32]. Throughout this research, we have used a modern static posturography device called Balance Master, manufactured by NeuroCom ® International [33]. ...
... Following mild traumatic brain injury (mTBI), postural problems are commonly reported in challenging situations (i.e., unstable support surface, absence of or conflicting visual information, added cognitive load) in both adults (1)(2)(3)(4)(5)(6)(7)(8) and children (9,10); yet, these findings are often ignored in clinical practice guidelines and not adequately tested before patients are discharged from follow-up programs. ...
... Also, in contrast to face, neck and proximal muscles of the upper limbs, startle responses are rare in lower limb muscles, where they appear with latencies that are longer in distal than in proximal muscles (Brown et al. 1991). MEPI20 is probably not a startle response since the latencies for MEP~20 responses from proximal and distal anterior compartment muscles are similar and are shorter than those from proximal and distal posterior compartment muscles, a pattern which is more characteristic of postural control (Nashner 1985). ...
... It is apparent that the volitional component of movement is a primary deficit in Parkinsonism (Panzer-Decius et al., 1996). Voluntary weight shifting is reduced in amplitude and is clearly abnormal (Panzer-Decius et al., 1996). ...
... The cause of falls in people with HD has not yet been empirically determined; however it is most probably multifactorial. Platform posturography studies have shown that people with PD have abnormal responses to external and self-generated perturbations to their centre of mass [99][100][101] . Generally for PD patients, the sequence of muscle activation in response to perturbation is intact [99][100][101] . ...
... A population-based study estimated that 7.5 million patients with dizziness are examined in the ambulatory care setting in the United States each year and it is associated with functional disability in about 10-20% of sufferers [3][4][5][6]. Dizziness is used to describe many different sensations and can be classified into 4 groups: vertigo, which is an illusion of movement, either of the person or the visual surround, dysequilibrium without vertigo, presyncope (near-faint), and psychophysiologic dizziness, which is often associated with anxiety and panic [4][5][6][7][8][9]. In the developing countries like Nigeria, poor access to medical service may mean that medical conditions that could otherwise be promptly treated may become chronic and therefore predispose to hearing impairment. ...
... To our knowledge, this is the first study that has identified knee strategy in maintaining postural control in perturbed balance tasks. Previous work has suggested that a hip strategy would follow the ankle strategy 3,16,44,45 . We suggest that our novel finding is likely due to (1) the smaller amplitude of floor motion used compared to previous studies, (2) methodologies used in previous studies. ...