This paper reports on the dynamic analysis and experimental validation of a method to perturb the balance of subjects in quiet standing. Electronically released weights pull the subject's waist through a specified displacement sensed by a photoelectric sensor. A dynamic model is derived that computes the force applied to the subject as a function of waist acceleration. This model accurately predicts the acceleration of mock subjects (suspended masses) with high repeatability. The validity and simplicity of this model suggest that this method can provide a standard for provocation testing on stable surfaces. Proof-of-concept trials on human subjects demonstrate that the device can be used with a force platform and motion tracking and that the device can induce both sway and step recoveries in healthy male adults.

References

References
1.
Gantchev
,
G. N.
, and
Dimitrova
,
D. M.
,
1996
, “
Anticipatory Postural Adjustments Associated With Arm Movements During Balancing on Unstable Support Surface
,”
Int. J. Psychophysiol.
,
22
(
12
), pp.
117
122
.
2.
Horak
,
F.
,
1996
,
Acquisition of Motor Behavior in Vertebrates
,
The MIT Press
,
Cambridge, MA
, pp.
57
85
.
3.
Horak
,
F. B.
,
Henry
,
S. M.
, and
Shumway-Cook
,
A.
,
1997
, “
Postural Perturbations: New Insights for Treatment of Balance Disorders
,”
Phys. Ther.
,
77
(
5
), pp.
517
533
.
4.
Conforto
,
S.
,
Schmid
,
M.
,
Camomilla
,
V.
,
D'Alessio
,
T.
, and
Cappozzo
,
A.
,
2001
, “
Hemodynamics as a Possible Internal Mechanical Disturbance to Balance
,”
Gait Posture
,
14
(
1
), pp.
28
35
.
5.
Luchies
,
C. W.
,
Alexander
,
N. B.
,
Schultz
,
A. B.
, and
Ashton-Miller
,
J.
,
1994
, “
Stepping Responses of Young and Old Adults to Postural Disturbances: Kinematics
,”
Am. Geriatr. Soc.
,
42
(
5
), pp.
506
512
.
6.
Gunsolus
,
P.
,
Welsh
,
C.
, and
Houser
,
C.
,
1975
, “
Equilibrium Reactions in the Feet of Children With Spastic Cerebral Palsy and of Normal Children
,”
Dev. Med. Child Neurol.
,
17
(
5
), pp.
580
591
.
7.
Frzovic
,
D.
,
Morris
,
M. E.
, and
Vowels
,
L.
,
2000
, “
Clinical Tests of Standing Balance: Performance of Persons With Multiple Sclerosis
,”
Arch. Phys. Med. Rehabil.
,
81
(
2
), pp.
215
221
.
8.
Musienko
,
P.
,
Zelenin
,
P.
,
Lyalka
,
V.
,
Orlovsky
,
G.
, and
Deliagina
,
T.
,
2008
, “
Postural Performance in Decerebrated Rabbit
,”
Behav. Brain Res.
,
190
(
1
), pp.
124
134
.
9.
Do
,
M. C.
, and
Roby-Brami
,
A.
,
1991
, “
The Influence of a Reduced Plantar Support Surface Area on the Compensatory Reactions to a Forward Fall
,”
Exp. Brain Res.
,
84
(
2
), pp.
439
443
.
10.
Hoshiyama
,
M.
,
Watanabe
,
S.
,
Kaneoke
,
Y.
,
Koike
,
Y.
, and
Takahashi
,
A.
,
1993
, “
Effect of Optokinetic Stimulation on Human Balance Recovery in Unexpected Forward Fall
,”
Neurosci. Res.
,
18
(
2
), pp.
121
127
.
11.
Mademli
,
L.
,
Arampatzis
,
A.
, and
Karamanidis
,
K.
,
2008
, “
Dynamic Stability Control in Forward Falls: Postural Corrections After Muscle Fatigue in Young and Older Adults
,”
Eur. J. Appl. Physiol.
,
103
(
3
), pp.
295
306
.
12.
Arampatzis
,
A.
,
Peper
,
A.
, and
Bierbaum
,
S.
,
2011
, “
Exercise of Mechanisms for Dynamic Stability Control Increases Stability Performance in the Elderly
,”
J. Biomech.
,
44
(
1
), pp.
52
58
.
13.
Carty
,
C. P.
,
Mills
,
P.
, and
Barrett
,
R.
,
2011
, “
Recovery From Forward Loss of Balance in Young and Older Adults Using the Stepping Strategy
,”
Gait Posture
,
33
(
2
), pp.
261
267
.
14.
Curtze
,
C.
,
Hof
,
A. L.
,
Otten
,
B.
, and
Postema
,
K.
,
2010
, “
Balance Recovery After an Evoked Forward Fall in Unilateral Transtibial Amputees
,”
Gait Posture
,
32
(
3
), pp.
336
341
.
15.
Klenk
,
J.
,
Becker
,
C.
,
Lieken
,
F.
,
Nicolai
,
S.
,
Maetzler
,
W.
,
Alt
,
W.
,
Zijlstra
,
W.
,
Hausdorff
,
J.
,
van Lummel
,
R.
,
Chiari
,
L.
, and
Lindemann
,
U.
,
2011
, “
Comparison of Acceleration Signals of Simulated and Real-World Backward Falls
,”
Med. Eng. Phys.
,
33
(
3
), pp.
368
373
.
16.
Chow
,
D. H. K.
,
Holmes
,
A. D.
, and
Tse
,
A. T. K.
,
2002
, “
Sudden Release During a Pulling Task: The Effect of Release Load on Stance Perturbation and Recovery
,”
Gait Posture
,
15
(
3
), pp.
266
273
.
17.
Brown
,
L. A.
, and
Frank
,
J. S.
,
1997
, “
Postural Compensations to the Potential Consequences of Instability: Kinematics
,”
Gait Posture
,
6
(
2
), pp.
89
97
.
18.
Dietrich
,
G.
,
Wing
,
A. M.
,
Gilles
,
M.
, and
Nimmo-Smith
,
I.
,
2002
, “
Modeling Resistance of a Four Link Biped to Lateral Push
,”
Appl. Biomech.
,
18
(
2
), pp.
99
109
.
19.
Yang
,
J.
,
Winter
,
D.
, and
Wells
,
R.
,
1990
, “
Postural Dynamics in the Standing Human
,”
Biol. Cybern.
,
62
(
4
), pp.
309
320
.
20.
Pidcoe
,
P. E.
, and
Rogers
,
M. W.
,
1998
, “
A Closed-Loop Stepper Motor Waist-Pull System for Inducing Protective Stepping in Humans
,”
J. Biomech.
,
31
(
4
), pp.
377
381
.
21.
Wolfson
,
L. I.
,
Whipple
,
R.
,
Amerman
,
P.
, and
Kleinberg
,
A.
,
1986
, “
Stressing the Postural Response. A Quantitative Method for Testing Balance
,”
J. Am. Geriatr. Soc.
,
34
(
12
), pp.
845
850
.
22.
Davidson
,
B. S.
,
Madigan
,
M. L.
,
Nussbaum
,
M. A.
, and
Wojcik
,
L. A.
,
2009
, “
Effects of Localized Muscle Fatigue on Recovery From a Postural Perturbation Without Stepping
,”
Gait Posture
,
29
(
4
), pp.
552
557
.
23.
Owings
,
T. M.
,
Pavol
,
M. J.
, and
Grabiner
,
M. D.
,
2001
, “
Mechanisms of Failed Recovery Following Postural Perturbations on a Motorized Treadmill Mimic Those Associated With an Actual Forward Trip
,”
Clin. Biomech.
,
16
(
9
), pp.
813
819
.
24.
Liu
,
J.
, and
Kim
,
S.
,
2012
, “
Effect of Walking Surface Perturbation Training on Slip Propensity and Local Dynamic Stability
,”
WORK: A Journal of Prevention, Assessment & Rehabilitation
,
41
, pp.
3352
3354
.
25.
Yang
,
F.
,
Bhatt
,
T.
, and
Pai
,
Y.-C.
,
2013
, “
Generalization of Treadmill-Slip Training to Prevent a Fall Following a Sudden (Novel) Slip in Over-Ground Walking
,”
J. Biomech.
,
46
(
1
), pp.
63
69
.
26.
Maki
,
B. E.
,
Holliday
,
P. J.
, and
Fernie
,
G. R.
,
1987
, “
A Posture Control Model and Balance Test for the Prediction of Relative Postural Stability
,”
IEEE Trans. Biomed. Eng.
,
BME-34
(
10
), pp.
797
810
.
27.
Mcllroy
,
W.
, and
Maki
,
B.
,
1995
, “
Adaptive Changes to Compensatory Stepping Responses
,”
Gait Posture
,
3
(
1
), pp.
43
50
.
28.
Burtner
,
P. A.
,
Woollacott
,
M. H.
, and
Qualls
,
C.
,
1999
. “
Stance Balance Control With Orthoses in a Group of Children With Spastic Cerebral Palsy
,”
Dev. Med. Child Neurol.
,
41
(
11
), pp.
748
757
.
29.
Runge
,
C. F.
,
Shupert
,
C. L.
,
Horak
,
F. B.
, and
Zajac
,
F. E.
,
1999
, “
Ankle and Hip Postural Strategies Defined by Joint Torques
,”
Gait Posture
,
10
(
2
), pp.
161
170
.
30.
Brauer
,
S. G.
,
Woollacott
,
M.
, and
Shumway-Cook
,
A.
,
2002
, “
The Influence of a Concurrent Cognitive Task on the Compensatory Stepping Response to a Perturbation in Balance-Impaired and Healthy Elders
,”
Gait Posture
,
15
(
1
), pp.
83
93
.
31.
Rogers
,
M. W.
,
Hain
,
T. C.
,
Hanke
,
T. A.
, and
Janssen
,
I.
,
1996
, “
Stimulus Parameters and Inertial Load: Effects on the Incidence of Protective Stepping Responses in Healthy Human Subjects
,”
Arch. Phys. Med. Rehabil.
,
77
(
4
), pp.
363
368
.
32.
Maki
,
B. E.
, and
McIlroy
,
W. E.
,
1997
, “
The Role of Limb Movement in Maintaining Upright Stance: The Change of Support Strategy
,”
Phys. Ther.
,
77
(
5
), pp.
488
507
.
33.
Boeer
,
J.
,
Mueller
,
O.
,
Krauss
,
I.
,
Haupt
,
G.
,
Axmann
,
D.
, and
Horstman
,
T.
,
2010
, “
Effects of a Sensory Motor Exercise Program for Older Adults With Osteoarthritis or Prosthesis of the Hip Using Measurements Made by the Posturomed Oscillatory Platform
,”
J. Geriatr. Phys. Ther.
,
33
(
1
), pp.
10
15
.
34.
Kiss
,
R. M.
,
2011
, “
A New Parameter for Characterizing Balancing Ability on an Unstable Oscillatory Platform
,”
Med. Eng. Phys.
,
33
(
9
), pp.
1160
1166
.
35.
Muller
,
O.
,
Gunther
,
M.
,
Krauss
,
I.
, and
Horstman
,
T.
,
2004
, “
Physical Characterization of the Therapeutic Device Posturomed as a Measuring Device-Presentation of a Procedure to Characterize Balancing Ability
,”
Biomed. Tech.
,
49
(
3
), pp.
56
60
.
36.
Holnapy
,
G.
,
Illyés
,
A.
, and
Kiss
,
R. M.
,
2013
, “
Impact of the Method of Exposure in Total Hip Arthroplasty on the Variability of Gait in the First Six Months of the Postoperative Period
,”
J. Electromyogr. Kinesiol.
,
23
(
4
), pp.
966
976
.
37.
Pfusterschmied
,
J.
,
Buchecker
,
M.
,
Keller
,
M.
,
Wagner
,
H.
,
Taube
,
W.
, and
Müller
,
E.
,
2013
, “
Supervised Slackline Training Improves Postural Stability
,”
Eur. J. Sport Sci.
,
13
(
1
), pp.
49
57
.
38.
Gildenhuys
,
A.
,
2003
, “
Development and Validation of an Experimental Technique for Studying Dynamic Stability During Standing
,” M.S. thesis,
University of Calgary
,
Calgary, Canada
.
39.
Kooistra
,
L.
,
Ramage
,
B.
,
Crawford
,
S.
,
Cantell
,
M.
,
Wormsbecker
,
S.
,
Gibbard
,
B.
, and
Kaplan
,
B. J.
,
2009
, “
Can Attention Deficit Hyperactivity Disorder and Fetal Alcohol Spectrum Disorder be Differentiated by Motor and Balance Deficits?
,”
Hum. Mov. Sci.
,
28
(
4
), pp.
529
542
.
40.
Wing
,
A.
,
Clapp
,
S.
, and
Burgess-Limerick
,
R.
,
1995
, “
Standing Stability in the Frontal Plane Determined by Lateral Forces Applied to the Hip
,”
Gait Posture
,
3
(
1
), pp.
38
42
.
You do not currently have access to this content.