The role of anticipatory postural adjustments in compensatory control of posture: 2. Biomechanical analysis

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.