Stroke

Postural Responses to Noisy Support Surface Translations in Stroke Survivors

Healthy standing posture is characterized by the ability to interact with a changing environment while maintaining upright stance. Being adaptable to changing environments affords flexibility and allows the system to encounter novel environments without losing control of posture. The purpose of this research was to determine if stroke survivors could adapt to support surface translations with differing temporal structures. Methods: Eight stroke survivors participated in this research. Participants stood on a force platform on the Neurocom Balance Manager (Neurocom Intl., Clackamas, OR, USA). The support surface was translated in the anteroposterior direction according to waveforms with different temporal structures, this included white noise, pink noise, brown noise, and a sine wave. They also performed a normal standing trial where the platform did not move. Root mean square and detrended fluctuation analysis of the center of pressure signal were calculated to determine amount and temporal structure of variability respectively. Results: During normal standing the stroke survivors’ posture exhibited lack of adaptability. The stroke survivors had increased amount of variability in all conditions compared to normal standing, regardless of the inherent structure of the support surface translations. The temporal structure of variability indicated weakened long-range correlations in all conditions compared to normal standing. This indicates that regardless of the temporal structure of the support surface movement the amount of movement increased while the structure of movement became more random. Previous work has demonstrated that healthy posture is able to adapt to the temporal structure of support surface translations, this adaptability was not seen in a population of stroke survivors. This lack of adaptability makes interactions with environmental perturbations difficult and impacts functionality. Focusing rehabilitation protocols towards regaining healthy temporal structures in postural control could improve functionality in chronic stroke survivors.
Listed In: Biomechanics, Posturography