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Exp Brain Res (1998) 120:202±216  Springer-Verlag 1998

RESEARCH ARTICLE

I.B.M. van der Fits ´ A.W.J. Klip ´ L.A. van Eykern


M. Hadders-Algra

Postural adjustments accompanying fast pointing movements in standing,


sitting and lying adults

Received: 9 April 1997 / Accepted: 9 October 1997

Abstract The present study evaluated the effect of differ- nor effect on the activity of the neck and thoracic extensor
ent positions, which varied in the amount of bodily sup- muscles. This difference in behaviour of lower and upper
port, on postural control during fast pointing movements. postural muscles suggests that they could serve different
Fourteen adult subjects were studied in standing, various postural tasks: the lower muscles being more involved in
sitting and lying positions. Multiple surface electromyo- keeping the centre of mass within the limits of the support
grams (EMGs) of arm, neck, trunk and upper leg muscles surface, and the upper ones in counteracting the reaction
and kinematics were recorded during a standard series of forces generated by movement onset. Increasing task-load
unilateral arm movements. Two additional series, consist- by performing bilateral movements and ± to a minor extent
ing of bilateral arm movements and unilateral arm move- ± during loaded unilateral movements affected the tempo-
ments with an additional weight, were performed to assess ral and quantitative characteristics of the postural adjust-
whether additional task-load affected postural adjustments ments during standing and sitting in a similar way. The ef-
differently in a sitting and standing position. Two pointing fect was present mainly during the early part of the re-
strategies were used ± despite identical instructions. Seven sponse (within 100 ms after prime mover onset). This sug-
subjects showed an elbow extension throughout the move- gests that feedforward or anticipatory mechanisms play a
ments. They used the deltoid (DE) as the prime mover (DE major role in the task-specific modulation of postural ad-
group). The other seven subjects performed the movement justments.
with a slight elbow flexion and used the biceps brachii
(BB) as the prime mover (BB group). The two strategies Key words Anticipatory postural adjustments ´
had a differential effect on the postural adjustments: pos- Arm movements ´ Load ´ Standing ´ Sitting
tural activity was less and substantially later in the BB-
group than in the DE group. Anticipatory postural muscle
activity was only present in the DE group during stance. In Introduction
all positions and task-load conditions the dorsal postural
muscles were activated before their ventral antagonists. Movements are accompanied by a complex of fine-tuned
The activation rate, the timing and ± to a lesser extent ± postural adjustments in order to maintain equilibrium.
the amplitude of the dorsal muscle activity was position The origin of these postural adjustments is twofold. First,
dependent. The position dependency was mainly found the movement causes a change in body geometry. This
in the caudally located lumbar extensor (LE) and ham- may result in a shift of the centre of gravity (COG), which
strings (HAM) muscles. The EMG amplitude of LE and causes a disequilibrium. Second, the forces generated to
HAM was also affected by body geometry (trunk and pel- initiate a movement induce reaction forces in the support-
vis position). Position and body geometry had only a mi- ing segments of the body (Massion 1992).
The majority of studies on the nature of postural con-
I.B.M. van der Fits ´ A.W.J. Klip ´ L.A. van Eykern trol during voluntary movements have been carried out in
M. Hadders-Algra standing adults performing various types of arm move-
Department of Medical Physiology, University of Groningen, ments (e.g. Lee 1980; Bouisset and Zattara 1981; Cordo
Groningen, The Netherlands and Nashner 1982; Friedli et al. 1984; Horak et al.
)
M. Hadders-Algra ( ) 1984; Brown and Frank 1987; Lee et al. 1987; Gurfinkel
University Hospital Groningen, Developmental Neurology, et al. 1988; Aruin and Latash 1995). From these studies it
CMC-IV, 3rd floor, Hanzeplein 1, 9713 GZ Groningen,
The Netherlands can be concluded that the basic organization of postural
e-mail: m.hadders-algra@med.rug.nl, adjustments can be described by three parameters: a spa-
Tel.: +31-50-3614247, Fax: +31-50-3636905 tial, temporal and quantitative one. The spatial distribu-
203

tion of postural muscle activation is guided by direction that the duration of an arm movement is shorter in a stand-
specificity. Forward-directed movements produce a for- ing than in a sitting position.
ward shift of the COG, which results in a primary activa- The above data indicate that position might affect the
tion of the postural muscles at the dorsal side of the body. organization of postural control, but precise data on the
On the other hand, movements inducing a backward shift nature of position-dependent effects on postural control
of the COG evoke an activation of the ventral postural are lacking. However, such knowledge is a prerequisite
muscles (Cordo and Nashner 1982; Friedli et al. 1984; for the understanding of postural adjustments during vol-
Aruin and Latash 1995). The temporal parameter is in- untary movements in those subjects who are unable to use
volved in the timing of postural muscle activation. In spe- the standing position, either because they suffer from a
cific conditions, such as during fast movements, the pos- (neurological) disorder or because they are too young.
tural muscles are activated in an anticipatory manner, that Therefore we assessed the effect of different positions
is, prior to the muscle that initiates the movement. The on the organization of postural adjustments accompany-
timing of postural muscle activation is related to, for in- ing arm movements. To this end 14 healthy adults per-
stance, arm movement velocity (Horak et al. 1984; Lee formed fast unilateral pointing movements in five differ-
et al. 1987; Massion 1992), the predictability of the forth- ent positions that varied in the amount of bodily support:
coming movement (Horak et al. 1984; Brown and Frank standing, three sitting positions (semi-reclined sitting,
1987), or the amount of postural support provided during ªlong-legº sitting, and upright sitting on the edge of a ta-
the movement (Cordo and Nashner 1982; Friedli et al. ble), and lying supine. To further improve our insight into
1984). Furthermore, increasing forward displaced mass, position-specific modulation of postural adjustments, the
by adding a weight to the moving arm or by performing subjects performed additional trials with increased task-
bilateral arm movements instead of unilateral ones, load (unilateral arm movements with a weight in the hand
changes the timing of postural muscle activity substantial- of the moving arm and bilateral arm movements). In all
ly (Bouisset and Zattara 1981; Friedli et al. 1984; Horak conditions we simultaneously recorded EMG activity of
et al. 1984; Zattara and Bouisset 1988; Benvenuti et al. arm, neck, trunk, and upper leg muscles and kinematics.
1990; Aruin and Latash 1995). The quantitative parame- We centred our questions on three issues, which are
ter is involved in electromyogram (EMG) amplitude mod- based on the three parameters of postural organization.
ulation. The EMG amplitude of the postural muscles de- The first one concerned the spatial distribution of postural
creases when additional support is provided during the muscle activation, i.e. the postural activity representing
movement (Cordo and Nashner 1982; Friedli et al. the primary level of postural control (the direction speci-
1984), or increases when the arm is loaded by a weight ficity) and part of the second level (the amount of antag-
(Friedli et al. 1984; Benvenuti et al. 1990; Aruin and onistic activity). We hypothesized that direction-specific
Latash 1995). These findings support the idea of Forss- responses would be present in all positions, but that the
berg and Hirschfeld (1994) that postural adjustments are amount of antagonistic activity would vary with the
organized in two functional levels. At the first level a ba- amount of bodily support (negative relationship) and the
sic, spatially defined or direction-specific muscle activa- load of the task (positive relationship). The second and
tion pattern is generated. At the second level, additional third issues, which dealt with the temporal and quantita-
spatial properties (the amount of antagonistic activity) tive characteristics of postural activity, also addressed
and the temporal and quantitative characteristics of this postural mechanisms at the second, modulatory control
basic, direction-specific pattern can be fine-tuned on the level. We hypothesized that the absolute and relative tim-
basis of task-related parameters (Forssberg and Hirschfeld ing of the postural response would depend on the position
1994; Hadders-Algra and Forssberg 1997). and task-load, in the sense that a decrease in bodily sup-
Little is known about the organization of postural ad- port and an increase in task-load would result in an earlier
justments during voluntary movements in non-standing activation of the postural muscles, and also would induce
positions. Moore and coworkers (1992) and Tyler and an increase in the EMG amplitude of the postural mus-
Hasan (1995) demonstrated that adults who perform arm cles. The kinematic data allowed us to address two addi-
movements in a sitting position also show direction-specif- tional questions: (a) whether eventually position or task-
ic activity in the trunk muscles. In both studies the record- load dependent modulatory effects could be attributed to
ing of the postural muscles was restricted to the trunk mus- changes in arm movement velocity or specific changes
cles (abdominal and paraspinal muscles), thereby preclud- in body geometry, and (b) whether arm velocity and body
ing conclusions on the order of activation within the direc- geometry affected postural adjustments in the different
tion-specific response. Anticipatory activity of the postural positions to a similar extent.
muscles was not consistently present in the sitting position
as the activity of the deltoid muscle usually preceded the
activity of the postural paraspinal muscle (Moore et al.
1992). Other studies on arm movements in sitting posi- Subjects and methods
tions focussed on movement velocity. They demonstrated
Subjects
that movement velocity decreases when contact with the
support surface increases (Lino and Bouisset 1994; Goutal Fourteen healthy adults (7 men and 7 women) between 22 and 36
et al. 1994). Furthermore, Bazalgette et al. (1986) found years of age participated in the study. Their heights ranged from
204
Fig. 1 Five recording positions.
Fast pointing movements were
made during stance (ST), upright
sitting (US), long-leg sitting
(LL), semi-reclined sitting (SR)
and lying supine (LY). The end
position of the arm is displayed
by the dashed arms

160 to 195 cm, and their weights from 65 to 95 kg. All subjects gave
informed consent following the guidelines of the Medical Ethics
Committee of the University Hospital Groningen.

Protocol

The subjects performed pointing movements towards a red dot (di-


ameter 4 cm) placed in the midline of the body at shoulder height
and outstretched arms length away (Fig. 1). Using a simple reaction
time set-up, the subjects were instructed to initiate the movements
immediately after an auditory ªgoº signal, and to execute the move-
ment as quickly as possible. Accuracy of the movement was not em-
phasized. One second after ending the movement the subjects re-
turned their arm(s) to the starting position. Before the start of the ex-
periment two practice trials were allowed. Series of ten unilateral,
right-handed pointing movements were performed in five different
positions: (1) lying supine (LY), (2) sitting semi-reclined with ex-
tended legs and with the back leaning against the back of the chair,
which was at an angle of 45 (SR), (3) non-reclined sitting with ex-
tended legs and a non-supported back (ªlong-legº sitting, LL), (4)
upright sitting on the edge of a table, with the legs flexed and back
and feet unsupported (US), and (5) stance with the feet about 25 cm
apart (ST) (Fig. 1). Task-load effects were studied by adding two se-
ries of ten pointing movements in the upright sitting position and in
the standing position. During the first additional series the subjects
performed bilateral pointing movements ± holding the hands clasped
together in the midline while raising both arms simultaneously (UB
and SB, for the sitting and standing position respectively). The sec-
ond additional series consisted of unilateral pointing movements, Fig. 2A, B Schematic representation of the kinematic marker posi-
which were performed while holding a load of 500 g in the hand tions and angles. A Representation of the position of the kinematic
of the moving arm (UL and SL, respectively). markers: 1 processus condylaris mandibulae, 2 1 cm in front of an-
The time between the movements within the series was 15 s and gulus mandibulae, 3 processus spinosus at C7, 4 processus spinosus
that between the series 5 min. The duration of the whole experiment at T10, 5 processus spinosus at L5, 6 spina iliaca anterior superior, 7
was 1 h. To see whether fatigue might play a role, protocol order proximal edge of the trochanter major, 8 acromion, 9 epicondylis ra-
was reversed in five of the 14 subjects. dialis, 10 processus styloideus radii. B Representation of the calcu-
lated angles in the sagittal plane: head and pelvis rotation in relation
to the X-axis, and the trunk extension angle
EMG recordings

Pilot recordings revealed that upper and lower leg muscles were sel- Kinematics
domly recruited in the non-standing positions. As our equipment on-
ly allowed the recording of a limited number of EMG signals we de- Kinematics were recorded synchronously with the EMGs using a
cided to omit the assessment of lower leg muscle activity, which im- two-camera ELITE system (BTS, Milan, Italy). The data were sam-
plies that we missed a part of postural activity in the standing con- pled at 50 Hz for 3 s, starting about 1 s before movement onset. Re-
ditions. Disposable bipolar surface electrodes (interelectrode dis- flective markers were placed at the right side of the body on the fol-
tance 13 mm; Twente Medical Systems) were placed over the sur- lowing landmarks: (1) processus condylaris mandibulae, (2) 1 cm in
face of the deltoid (DE), pectoralis major (PM), biceps brachii front of angulus mandibulae, (3) processus spinosus at C7, (4) pro-
(BB), triceps brachii (TB), neck flexor (NF, sternocleidomastoide- cessus spinosus at T10, (5) processus spinosus at L5, (6) spina iliaca
us), neck extensor (NE, at the C7 level), rectus abdominis (RA), tho- anterior superior, (7) proximal edge of the trochanter major, (8) ac-
racic extensor (TE, at the T10 level), lumbar extensor (LE, at the L5 romion, (9) epicondylis radialis, and 10) processus styloideus radii
level), the rectus femoris (RF), and the hamstrings (HAM) muscles (Fig. 2A). In the LY and SR positions the marker at the T10 level
at the right side of the body. The EMGs were recorded continuously was excluded.
during the whole session using POLY, a dedicated software program
for long-lasting polygraphic recordings (sampling rate 1000 Hz; In-
spector Research Systems, Amsterdam, The Netherlands).
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Video recordings by covering anticipatory postural muscle activity. T2 and T3 ranged
from prime mover activation to 100 ms and 400 ms respectively af-
Continuous video registrations, time-coupled to the EMG record- ter arm muscle activation, the longer T3 interval including longer-la-
ings, were made during each session. These registrations were used tency and feedback components of the postural adjustments.
to score the onset of the pointing movements with a dedicated com- Rates of activation (calculated by dividing the number of trials
puter program (TAPETIME). The accuracy of the scoring of the during which a muscle was activated by the total number of trials),
movement onset was evaluated by scoring a series of ten trials five mean latencies and mean amplitudes were calculated for each sub-
times each. This procedure revealed that the differences in the onset ject in each position. The non-parametric Wilcoxon and Mann-
times between the five scores was 3.1  3.6 ms. The behavioural da- Whitney tests were used to analyse within-group and between-sub-
ta were merged with the EMG data. ject differences in these values of the various muscles in the differ-
ent positions.

Data analysis
Kinematic analysis
EMG analysis
Off-line analysis consisted of calculation of spatial angles for the
The first step in the EMG analysis was to determine which muscles head (by a vector between markers 1 and 2) and pelvis (by a vector
participated in the activation pattern accompanying the movement. between markers 6 and 7) in relation to the horizontal axis. During
To this end we used a semi-automatic computer algorithm, which long-leg sitting, upright sitting and stance the trunk angle was de-
was developed for the detection of significant phasic muscle activ- fined by calculating the angle of the two intersecting vectors be-
ity. The algorithm, on the basis of the root mean square (RMS) of tween markers 3 and 4 and markers 4 and 5 (Fig. 2B). The ELITE
a full wave rectified signal (200 ms moving window), was construct- data were transformed into ASCII files and further analysed with the
ed as follows. First, baseline activity, determined by a 3.7 s moving help of Datamonster 2.0 (E. Otten, Dept. of Medical Physiology,
window, was subtracted. Next, the signal was enhanced by adding University of Groningen). Arm movement onset was defined as
the first derivative of the signal to the RMS, and a fixed detection the moment at which the velocity of the wrist increased, while the
level (0.4 times baseline activity) was set. Bursts were considered moment at which wrist velocity became zero was considered as
to be present when the activity exceeded the detection level for at the end of the movement. The analysis focused on: (1) the maximum
least 30 ms within a time-window from 1 s prior to the onset of a velocity of elbow and wrist (markers 9 and 10) during the move-
movement as scored on the video, until 2 s after movement onset ment, (2) the angular positions at movement onset, and (3) the angle
(Fig. 3). An interactive assessment offered the possibility of distin- displacements (a) between 100 ms prior to movement onset and
guishing the EMG bursts from cardiac activity. The latter was fre- movement onset (d1), and (b) during the movement (d2). The veloc-
quently present in the PM and the RA muscles. Second, the latencies ity, angle positional and angle displacement values were compared
of muscle activation were defined as the time interval between the for each position using the Wilcoxon and Mann-Whitney tests. A
onset of activation of the first arm muscle (prime mover) and the on- multiple linear regression analysis was used to correlate the kine-
set of responses in the other muscles. Finally, EMG amplitude was matic data with the EMG data.
evaluated by calculating the mean amplitude of the signal after sub- In general, differences with a P value < 0.05 were considered to
traction of baseline activity in three different time windows. T1 cov- be statistically significant, but in the large number of correlations we
ered the 100 ms prior to the activation of the first arm muscle, there- decided to accept only P values < 0.01 as non-chance findings.

Results
Preliminary data analysis revealed that two different strat-
egies were used to perform the pointing movements, not-
withstanding identical instructions. The type of pointing
strategy affected the postural adjustments considerably.
Seven subjects used one strategy. They started the move-
ment with flexion of the shoulder while keeping the arm
extended throughout the movement, and activated the del-
toid (DE) as the first arm muscle (DE group; Figs. 4, 5).
The other seven initiated the movement with a slight flex-
ion of the elbow after which an elevation and extension of
the arm followed. These subjects activated the biceps bra-
chii (BB) as the prime mover (BB group; Figs. 4, 5). The
subject-specific strategy and the preference for the prima-
ry activation of the DE in the DE group and the BB in the
BB group were consistently present in all trials and all po-
sitions. Only in the lying supine position did the DE sub-
jects often activate the BB before the DE muscle (Fig. 5).
Fig. 3A±D Representation of the EMG analysis procedure. A Raw The addition of task-load (unilateral with weight or bilat-
electromyogram (EMG) of the deltoid muscle during a fast pointing eral arm movements) did not change the movement strat-
movement during stance. B The RMS of the same EMG; the hori- egy.
zontal line indicates the baseline activity. C The enhanced EMG sig- Consequently, the onset latencies of the arm and pos-
nal and the detection level (horizontal line). D The detection of the
start and end of an EMG burst. The raw EMG (as in A) together with tural muscles were related to the DE in the DE group
the signal indicating the onset (upward deflection) and the offset and to the BB in the BB group, and, from this point on-
(downward deflection) of phasic EMG activity wards, we will discuss the results of the two groups sep-
206
Fig. 4 Stick diagrams of a fast
pointing movement in a stand-
ing DE subject and BB subject.
A representative fast pointing
trial of a subject in the DE group
(upper part), in the BB group
(lower part). For marker identi-
fication see the legends of Fig. 2.
The sticks are represented every
20 ms

Fig. 5 Latencies to the deltoid (DE) and biceps brachii (BB) muscle in the DE group than in the BB group, but did not vary
in the DE and BB groups. Group data on the mean recruitment la- with position. In contrast, the triphasic activation patterns
tencies of the BB related to the DE in the two groups (DE group,
thick lines; BB group, thin lines) in various positions. The data of the more caudally located muscle pairs were affected
are presented as the ranges (horizontal bars) and median values by the position of the subject, but not by pointing strategy
(vertical bars). The 0 line indicates the onset of the DE. Asterisks (Fig. 8). Here, the triphasic patterns were most frequently
indicate significant differences between the recruitment latencies present during stance (LE-RA-LE and HAM-RF-HAM),
of the two arm muscles (Wilcoxon: *P £ 0.05)
and during upright sitting (LE-RA-LE). The decrease in
the amount of triphasic LE-RA-LE pattern was related
arately. Protocol order, age and sex did not affect the re- to a significant decrease in LE activation during long-
sults. leg sitting, semi-reclined sitting and lying, whereas the
drop in HAM-RF-HAM activation occurred because the
two leg muscles were rarely activated in the non-standing
Spatial distribution of postural adjustments conditions.
These results demonstrate that the amount of agonistic
Pointing movements in the standing condition were al- activity of the dorsal postural muscles is negatively relat-
ways accompanied by a primary activation of the dorsal ed to the support surface, and not, as we expected, the ac-
postural muscles NE, TE, LE, and HAM (Fig. 6). Also tivation rate of the antagonists. The addition of task-load,
in the other positions and in the different task-load condi- by means of bilateral movements or loaded unilateral
tions the dorsal muscles were recruited before their ven- movements, did not affect the rate and type of postural ac-
tral antagonists, thereby confirming the basic nature of tivation patterns. Thus, our hypothesis of the existence of
the direction-specific organization of postural adjust- a positive relation between the amount of antagonistic ac-
ments. However, the extent to which the dorsal postural tivity and task-load was rejected.
muscles participated was position dependent in both
groups (Fig. 6). LE was frequently activated in the stand-
ing and upright sitting position, but only occasionally in Temporal characteristics
the other positions (P < 0.05). Substantial HAM muscle
activity was present only during stance. A similar posi- Since the dorsal muscles were always recruited before
tion-dependent recruitment of the more caudally located their ventral antagonists, we focussed on the temporal
dorsal muscles was found in the load conditions. and quantitative characteristics of the dorsal postural mus-
The neck muscles (NE and NF) usually showed a pat- cles.
tern of co-activation in both groups and in all positions During stance the dorsal postural muscles in the DE
(Figs. 7, 8). In the trunk and leg muscles, however, tripha- group were recruited in a caudal-to-cranial order
sic activation patterns were found (TE-RA-TE, LE-RA- (Fig. 9). Only the HAM muscle was recruited prior the
LE, and HAM-RF-HAM; Figs. 7, 8). The rate of the tri- prime mover DE (P < 0.05; median latency ±36 ms). In
phasic pattern showed a cranial-to-caudal gradient, with the BB group the dorsal postural muscles were in general
the TE-RA-TE pattern occurring most frequently activated later than in the DE group (Fig. 9). This was
(Fig. 8). The TE-RA-TE pattern was more often present most pronounced for the LE muscle. Anticipatory activa-
207

Fig. 6 Frequencies of dorsal muscle activation in the various posi- vation of LE, TE and, to a lesser extent, NE (Fig. 10).
tions. Group data on the frequencies of trials during which the dorsal This effect was found in both groups (DE and BB) and
muscles (NE neck extensor, TE thoracic extensor, LE lumbar exten-
sor, HAM hamstring) were activated. For each subject in each con- in both positions (stance and upright sitting; P < 0.05 dur-
dition the rate of activation of the various muscles was calculated by ing sitting). The changes in the onset of muscle activity
dividing the number of trials during which a muscle was activated induced a reversal of the recruitment order in the sitting
by the total number of trials, resulting in an muscle-activation rate position: instead of the top-down order that was present
per individual. The vertical bars denote the range of the individual
values and the horizontal bars the median values of the group of
during unilateral pointing, a caudal-to-cranial sequence
subjects. Thick lines represent the results of the DE group, thin lines was present. In the standing position such a bottom-up re-
those of the BB group. Asterisks indicated the differences between cruitment was already found during the unilateral arm
the standing (ST), various sitting (US, LL, SR), and lying (LY) posi- movements. This order persisted during bilateral move-
tions (Wilcoxon: *P £ 0.05). No differences were present between ments. In standing DE group, the earlier postural muscle
the DE and the BB group
activity resulted in an anticipatory activation of LE and
HAM (7 ms and 16 ms respectively before the onset of
the prime mover DE). The other task-load condition, the
tion of the postural muscles was not found in this group. unilateral arm movements with additional weight, did
In the BB group the caudally located HAM muscle was not affect the temporal characteristics of the postural re-
activated before the cranial NE and TE muscles. LE, how- sponse.
ever, was activated much later than the other postural The temporal data confirmed our hypothesis that a de-
muscles, thereby interfering with the appearance of a real crease in bodily support and an increase in task-load by
caudal-to-cranial recruitment order as was present in the means of bilateral arm movements induces an earlier ac-
DE group. In both groups the more caudally located LE tivation of the postural muscles. This effect was mainly
and HAM muscles in particular were recruited later when found in the more caudally located LE and HAM muscles.
the support provided in the various positions increased
(Fig. 9). This resulted in a reversed (top-down) order of
activation in the various sitting and lying positions. In
these positions no anticipatory activation of the postural Quantitative characteristics
muscles was present.
Increasing task-load by performing the pointing task In both groups the mean amplitudes of the dorsal neck
with two arms simultaneously, resulted in an earlier acti- (NE) and trunk muscles (TE and LE) were low during
208
Fig. 7 EMG patterns during fast
pointing in the ST and US po-
sitions of the DE and BB
groups. Averaged EMG patterns
of a DE subject during stance
and upright sitting (upper part),
of a BB subject in the same
positions (lower part). The ver-
tical lines denote the onset of
the DE in the DE subject, of the
BB in the BB subject (DE del-
toid, PM pectoralis major, BB
biceps brachii, TB triceps bra-
chii, NF neck flexor, NE neck
extensor, RA rectus abdomis, TE
thoracic extensor, LE lumbar
extensor, RF rectus femoris,
HAM hamstring)

the 100 ms prior to activation of the prime mover (T1) in HAM was not affected (Fig. 11). Unilateral load did not
all recorded positions. Only leg muscle activity during the change EMG amplitudes during T1. The effects of load
T1 interval showed position-dependent differences in on the T2 amplitudes were restricted to the standing posi-
both groups of subjects. HAM activity was low in the sit- tion. Both bilateral and loaded unilateral movements re-
ting and lying positions, but during standing it was signif- sulted in a decreased NE amplitude and an increased am-
icantly increased (P < 0.05). During the first 100 ms after plitude of TE, LE and, especially, HAM (Fig. 11). In con-
prime mover activation (T2) the mean amplitudes of NE, trast, the addition of task-load in the BB group had little
TE and LE were in general higher than during T1, and the effect on postural EMG amplitudes.
amplitudes were affected by position and ± to a lesser ex- The quantitative data support the idea that a decrease
tent ± pointing strategy. As during T1, HAM muscle ac- in support surface and an increase in task-load induce
tivity during the T2 interval was again significantly high- an increase in postural EMG activity. This modulatory ef-
er during stance than in the other positions (P < 0.05). fect, present in the periods just prior to and after prime
This was true for both groups. For the other postural mus- mover onset, was mainly present in the DE group.
cles, the position dependency of the EMG amplitudes var-
ied for the two groups. In the DE group the NE and LE
amplitudes were higher in upright sitting and stance than Kinematics
in the other positions (P < 0.05), whereas in the BB group
such an effect was absent. During the longer interval after Arm movement velocity was clearly affected by pointing
prime mover activation (T3) the amplitudes of NE, TE, strategy, the position of the subjects, and additional task-
LE and HAM were lower than during T2. Only in the load. In general, the BB group showed a significantly
DE group did NE show a position dependency, which higher maximum velocity of the wrist during the standing
was similar to that found during T2. and sitting positions than did the DE group (during US
The addition of task-load particularly affected the am- and LL, P < 0.01). In line with the results of other studies
plitudes of the dorsal postural muscles during the 100 ms (Lino et al. 1994; Goutal et al. 1994), the maximum ve-
before and after prime mover activation (T1 and T2). In locity of the wrist decreased step-wise from standing to
the DE group the effects varied with amplitude interval upright sitting, long-leg sitting and semi-reclined sitting
(T1 or T2), position, and the type of task-load. Bilateral in both groups (P < 0.05). However, during lying supine
arm movements during standing and sitting induced sig- wrist velocity increased again ± the DE group reaching
nificantly higher amplitudes in the T1 interval of NE, the highest wrist velocities in this position (P < 0.05). El-
TE and LE (P < 0.05), whereas the T1 amplitude of bow velocities showed a similar position dependency. In
209

Fig. 8 Activation patterns of dorsal and ventral postural muscles.


Group data on the frequencies of trials during which co-activation
patterns were present in the neck (NE-NF; difference in recruitment
latency < 50 ms), during which triphasic patterns were found in
trunk and leg muscles (TE-RA-TE, LE-RA-LE, HAM-RF-HAM)
in both groups. Thick lines represent the DE group, thin lines the
BB group (see legend to Fig. 6). The data are presented as the ranges
(vertical bars) and the median values of the group (horizontal bars).
Asterisks indicate the frequency differences between the various po-
sitions (Wilcoxon: *P £ 0.05), and the black boxes indicate the dif-
ferences between the DE and BB groups (Mann-Whitney: n P £ 0.05)

contrast, the duration of the arm movement did not vary


with position. Increasing task-load by performing the
movement bilaterally did not affect arm movement veloc-
ity and duration. On the other hand, loaded unilateral
movements were associated with significantly lower wrist
velocities (P < 0.05 in sitting and standing BB group) and
longer movement durations (P < 0.05 in the standing BB

Fig. 9 Latencies to dorsal postural muscle activation in the DE and c


BB group. Group data on the latencies of the various muscles of the
DE group (thick lines) and the BB group (thin lines). The vertical
line (t = 0) denotes the onset of EMG activity in the prime mover.
The data are presented as the ranges (horizontal bars) and the medi-
an values (vertical bars). Asterisks indicate the differences between
the latency of the various dorsal postural muscles, between dorsal
muscles and the prime mover (Wilcoxon: *P £ 0.05), the black box-
es indicate the differences between the DE and BB groups (Mann-
Whitney: n P £ 0.05, n n P £ 0.01)
210

group and sitting DE group) than non-loaded unilateral


movements.
During the 100 ms before movement onset (d1) very
little angle displacements occurred in either group or
any of the positions (Figs. 12, 13). Therefore, we will re-
port only the angle positions at movement onset and the
angle displacements during the movement (d2). In both
groups the position of the head at movement onset was
similar in all positions. Only in the long-leg sitting posi-
tion did the head tend to be more anteflexed compared
with the other positions. Within a single subject head dis-
placement was consistently small: < 7 in all subjects,
Fig. 10 Latencies to dorsal postural muscle activation in the DE and and in 80% of the subjects even < 3. But, a considerable
BB groups during bilateral arm movements. Group data on the laten- interindividual variation was present, ranging, for exam-
cies of the dorsal postural muscles in the DE group (thick lines) and ple, during upright sitting from a mean head anteflexion
the BB group (thin lines) during stance (SB) and upright sitting
(UB). Details as for Fig. 9 of 3.7 in one subject to a mean head extension of 4.1
in another subject. The trunk was slightly anteflexed at
movement onset in the standing, upright sitting and
long-leg sitting positions. The arm movement was accom-
panied by a trunk extension of about 7 (median value) in

Fig. 11 Mean EMG amplitudes


of the dorsal postural muscles
during the load conditions in DE
subjects. Group data on mean
amplitudes of the various mus-
cles for the intervals T1 and T2
(100 ms prior to activation of
the first arm muscle, 100 ms
after prime mover activation
respectively) of the DE group
during stance (upper part) and
upright sitting (lower part) dur-
ing unilateral movements (ST
and US), bilateral movements
(SB and UB), and loaded uni-
lateral movements (SC and UC).
The data are presented as the
ranges (vertical bars) and me-
dian values (horizontal bars).
Asterisks indicate the difference
between the amplitude of the
muscles in the various positions
(Wilcoxon: *P £ 0.05,
**P £ 0.01)
211

Fig. 12 Kinematic data of eight representative trials of one DE Fig. 14A±C Schematic representation of the results of the multiple
group subject. Displacements of the angles of the head, the trunk regression analysis of EMG amplitudes and kinematic parameters,
the pelvis during stance (left) and upright sitting (right). The traces subject and group. Filled squares denote a significant effect
are aligned according to the start of the arm movement, which is in- (P < 0.01) on the EMG amplitudes of A maximum wrist velocity
dicated by the vertical line. The interval of 100 ms prior to move- (range of R2: 0.18±0.55, P < 0.01), B trunk position at movement
ment onset is denoted by d1. The d2 interval denotes the interval be- onset, increased trunk angle denoting extension (range of R2:
tween the onset of the movement and the mean end of the eight 0.23±0.47, P < 0.01), C pelvis position at movement onset, in-
movements creased pelvis angle reflecting anteflexion (range of R2: 0.14±0.43,
P < 0.01). The colour of the squares indicate the direction of the re-
lations (black squares signifying a positive relation, grey squares a
these positions. Of course, the pelvis angle differed signif- negative relation). T1, T2 and T3 correspond to the amplitude during
the various time intervals
icantly between the various positions (P < 0.05), and was
most extended during stance (Fig. 13). During the arm
movement the pelvis anteflexed slightly (about 1; medi-
an value) in all positions (Fig. 13). The addition of task- The maximum wrist velocity was not related to the on-
load did not affect the position of head, trunk, and pelvis set latencies of the dorsal postural muscles, but it showed
position at arm movement onset, or the angular displace- a positive correlation with the EMG amplitude in the dif-
ments during the pointing movement (d2) in all standing ferent time intervals (P < 0.01; Fig. 14A). This positive
and sitting subjects. relation was most frequently present in the NE and TE
muscles. Occasionally, a negative relation between
EMG amplitude and wrist velocity was present [in TE
Kinematics and EMG and HAM during stance (T1), and in TE (T2 and T3) dur-
ing upright sitting]. Elbow velocity correlated with pos-
A multiple linear regression was performed with the tural EMG activity in the same way as did wrist velocity.
groups and subjects as independent co-variables, since ki- The multiple regression analysis did not show a relation
nematic and EMG differences were present both between between the duration of the arm movement and postural
groups and between subjects. EMG characteristics.

Fig. 13 Pelvis position and pel-


vis displacement in the DE
group. DE group data on mean
pelvis position at the onset of
the movement, mean pelvis dis-
placement 100 ms before
movement onset (d1), mean
pelvis displacement during the
movement (d2). Data are pre-
sented as the ranges (vertical
bars) and median values (hori-
zontal bars) of the group. As-
terisks indicate the differences
between the various positions
(Wilcoxon: *P £ 0.05)
212

movements induced a relation between head anteflexion


at movement onset and NE amplitudes: during stance in-
creased head anteflexion resulted in higher NE ampli-
tudes, whereas during upright sitting it was related to low-
er NE amplitudes (Fig. 15).

Discussion
The present study demonstrated that postural adjustments
accompanying fast pointing movements depend on the
pointing strategy, the position of the subject, the load of
the task, and the body geometry.

Fig. 15 Schematic representation of the results of the multiple re-


gression analysis of the position of head, trunk and pelvis, subject Different pointing strategies
and group. Presence of squares denotes a significant effect
(P < 0.01) of head, trunk or pelvis position on EMG amplitude Each subject consistently selected one of two pointing
(range of R2: 0.18±0.54, P < 0.01). The colour of the squares indi-
cates the direction of the relations (black squares signifying a pos- strategies, notwithstanding the fact that all subjects re-
itive relation, grey squares a negative relation). T1, T2 and T3 cor- ceived identical instructions. Half the subjects, who used
respond to the amplitude during the various time intervals. Increased DE as the prime mover, initiated the movement with a
angle of the head denotes anteflexion, of the trunk denotes exten- shoulder flexion. They kept the arm extended throughout
sion, of the pelvis reflects anteflexion the pointing movement. The other subjects, who activated
BB as the prime mover, started the movement with a
slight flexion of the elbow, which was followed by an
To see whether the different positions or an increase in arm elevation and extension. Other studies on postural
task-load affected input-output relations, the effects of po- control during voluntary arm movements never reported
sition and load on relations between initial body geometry the presence of different strategies (Bouisset and Zattara
and EMG characteristics were evaluated. The head, trunk 1981; Lee et al. 1987; Gurfinkel et al. 1988; Moore et
and pelvis positions at movement onset were not related al. 1992; Aruin and Latash 1995; Latash et al. 1995).
to the recruitment latencies of the dorsal postural muscles, Two studies on the ªcentral setº effect on postural control
with the exception of an earlier activation of LE when the did mention differences between subjects (Brown and
trunk position was more extended during long-leg sitting Frank 1987; Horak et al. 1989). Brown and Frank
(P < 0.01). However, the initial positions of the trunk and (1987) reported that in half their subjects preparatory
pelvis did affect the amplitudes of trunk and leg muscle set affected the reaction time, whereas such a set effect
activity. Trunk position at movement onset was positively was absent in the other half. Likewise, Horak and cowork-
correlated with the amplitude of TE and LE muscles dur- ers (1989) demonstrated set-dependent differences in the
ing T1 and T2 (Fig. 14B). The amplitudes increased when EMG amplitudes of the postural muscles after platform
the trunk was more extended at movement onset. The pel- perturbations in only half the group tested. The finding
vis angle was positively related to the LE muscle and neg- of subject-specific strategies reflects the ability of the ner-
atively related to HAM activity in the different positions vous system to generate different motor patterns to reach
(Fig. 14C). an identical goal.
Task-load addition affected the relationships between The pointing strategy affected the postural adjustments
the kinematic and EMG parameters, but the effects were substantially, having its main effect on the temporal char-
different in the two conditions and positions. The rela- acteristics. In general, postural activity occurred later in
tions between arm movement velocity and EMG ampli- the BB group than in the DE group. This difference could
tudes were only affected during bilateral pointing in the not be attributed to a difference in arm velocity as maxi-
standing position. In this condition the relations between mum wrist and elbow velocity of the DE group never ex-
increased arm movement velocity and larger EMG ampli- ceeded that of the BB-group (cf. Horak et al. 1984; Lee et
tude were strengthened in all postural muscles. Additional al. 1987). However, the arm movement trajectories dif-
task-load especially affected the relations between body fered considerably between the two groups. The arm tra-
geometry and EMG amplitudes. Bilateral arm movements jectory consisted of a single segmented movement in the
in both positions usually resulted in a disappearance of the DE group, and of a ªtwo-stepº movement in the BB
relation between the initial position of the trunk and pel- group. The single segmented movement probably induced
vis and the amplitudes of the postural muscles (Fig. 15). higher inertial moments, which in turn resulted in an ear-
This was also found during loaded unilateral movements lier activation of the postural muscles in the DE group (cf.
in the sitting position, but during stance the relations be- Horak et al. 1984; Friedli et al. 1984).
tween trunk and position and EMG amplitude remained
virtually unchanged. Furthermore, loaded unilateral
213

Spatial characteristics: agonist and antagonist activity Temporal characteristics

Direction-specific responses were present in the postural The temporal characteristics of the postural adjustments
muscles in all positions and task-load conditions, indicat- were dependent on the position of the subject and on
ing that the dorsal postural muscles were always activated the task-load conditions. During stance the dorsal postural
before their ventral antagonists. This preservation of di- muscles were activated in a caudal-to-cranial order, a
rection specificity in all conditions fits with the idea that finding which is in agreement with previous reports
direction specificity is a basic characteristic of postural (Cordo and Nashner 1982; Friedli et al. 1984; Horak et
adjustments (cf. MacPherson 1988; Forssberg and Hirsch- al. 1984; Zattara and Bouisset 1988). In the sitting and ly-
feld 1994; Hadders-Algra and Forssberg 1997). But even ing positions the order was reversed due to the delayed
at this basic level of direction specificity, postural re- activation of LE and HAM (cf. Friedli et al. 1984). This
sponses can be adapted to task-specific conditions, as suggests that position had more impact on the recruitment
the number of muscles recruited increased with the pos- time of the lower postural muscles than on the timing of
tural challenge imposed by the task (cf. Friedli et al. the more cranially located ones. A similar effect on re-
1984; Hadders-Algra et al. 1997). The position dependen- cruitment order was found by increasing the task-load
cy of agonist activity was restricted to the more caudally by performing bilateral pointing movements. Bouisset
located postural muscles, suggesting that these muscles and coworkers, who recorded the activity of paraspinal
are especially involved in the maintenance of equilibrium, and leg muscles, including muscles involved in hip ab-
i.e. in keeping the centre of mass within the limits of the duction [gluteus maximus (GM) and tensor fasciae latae]
support surface. The position-independent activation of and hip adduction (semitendinosus, ST), showed that bi-
the upper trunk and neck muscles probably serves to op- lateral movements do not induce an earlier activation of
pose the reaction forces induced by the arm movement. all postural muscles (Bouisset and Zattara 1981; Zattara
The trunk and leg muscles were often activated in a tri- and Bouisset 1988). They reported an earlier activation
phasic, agonist-antagonist-agonist pattern. This was also of the ipsilateral paraspinal muscles and the contralateral
reported in other studies on postural adjustments (Friedli GM and ST, and a delayed recruitment of the ipsilateral
et al. 1984; Aruin and Latash 1995). We found a similar GM and ST muscles during bilateral arm movements.
triphasic activation pattern in the arm muscles, pointing to This means that muscles which mainly operate in the sag-
the ballistic nature of these arm movements (Hallett et al. ittal plane, such as LE and TE, are activated earlier when
1975). The early part of the triphasic pattern of ballistic task-load is increased by means of bilateral arm move-
movements is thought to reflect a pre-programmed motor ments. The situation for the hip-stabilizing muscles,
control (Hallett et al. 1975; Sanes and Jennings 1984). which play a role in the counteraction of the torsional
The finding that triphasic patterns were present both in forces, is different. The torsional reaction forces are larger
the arm and postural muscles supports the notion of a cou- during unilateral arm movements than during bilateral
pled feedforward control of posture and movement (cf. movements. This probably explains why ipsilateral hip
Friedli et al. 1984; Massion 1992; Palmer et al. 1994; muscles are recruited earlier during unilateral than bilater-
Aruin and Latash 1995). The later part of the triphasic ac- al arm movements.
tivation pattern (the antagonist activity and the second Our data indicate that during the most destabilizing
burst of the agonist) is affected by feedback mechanisms, conditions ± during stance with or without additional load
the concurrent afferent information playing a role in the and during sitting with load ± the most caudally located
fine-tuning of the pattern to task-specific parameters muscles are recruited first. These findings underline the
(Forget and Lamarre 1987; Dietz 1992; Massion 1992). notion of body-segment-specific postural behaviour, and
In this respect it is interesting to note that the amount point to a primary role of the lower postural muscles in
of antagonistic activity in the postural response patterns the maintenance of equilibrium.
did not vary with position or task-load condition. This Anticipatory postural activity was only present during
might be interpreted as an additional piece of evidence stance in the DE group, notwithstanding the fact we used
for a major role of feedforward mechanisms controlling a reaction time set-up which is known to reduce anticipa-
postural adjustments during voluntary arm movements. tory postural activity (Horak et al. 1984; Lee et al. 1987).
Interestingly, the neck flexor and extensor muscles Our kinematic data did not show angular displacements
were co-activated during the arm movement (cf. prior to movement onset, but probably more sensitive re-
Gurfinkel et al. 1988). Hogan (1984) argued that co-acti- cordings with the help of accelerometers would have been
vation in antagonists promotes joint stabilization. Head able to demonstrate head, trunk or pelvis displacements
stabilization is one of the major goals in postural control before the start of the movement (cf. Bouisset and Zattara
(Pozzo et al. 1990). Pozzo and coworkers (1990) reported 1981; Zattara and Bouisset 1988). The EMG data did re-
that during various locomotor tasks head movements do veal an anticipatory activation of the HAM muscle, i.e.
not exceed a 20 rotation. In our study head movements HAM activation before the activation of the prime mover.
were even smaller (less than 7 in all subjects), possibly This anticipatory activation occurred at similar latencies
reflecting the need for head stabilization during goal-di- as has been described by others using reaction time para-
rected arm movements (cf. Herman et al. 1981; Jeannerod digms (Bouisset and Zattara 1981; Friedli et al. 1984; Lee
1988). et al. 1987; Zattara and Bouisset 1988). In general, we did
214

not find an anticipatory activation of the trunk muscles. that an increase in task-load modulates postural muscle
Such an early activation of LE was only found during bi- activity in proportion to the weight of the forward dis-
lateral movements in standing DE group (cf. Friedli et al. placed mass. Not surprisingly, the load effects were more
1984). Zattara and Bouisset (1988) reported that anticipa- pronounced in the DE group, in which the onset of the
tory trunk muscle activity could be found during unloaded single-segmented movement induces higher inertial forc-
unilateral movements as well, but only at the side contra- es than does the two-step movement of the BB group.
lateral to the arm movement. During sitting and lying an- Increasing the task-load affected the EMG amplitude
ticipatory activation of the postural muscles was absent during the 100 ms before and after prime mover activa-
(cf. Moore et al. 1992). Our results indicate that anticipa- tion (T1 and T2), and not during the longer 400-ms inter-
tory activation of the postural muscles is only called into val after activation of the prime mover (T3). This early
play when the support surface is small and a large effort adaptation suggests that the contribution of feedback
has to be performed to keep the centre of mass within the mechanisms in the fine-tuning of postural muscle activity
stability limits (Massion 1992). during pointing movements is limited (cf. Friedli et al.
1984; Horak et al. 1989). Furthermore, the finding that
not only an extrinsically induced increase in the task-load
Quantitative characteristics (addition of weight) causes an increase in the postural
EMG activity, but also an intrinsically evoked task-load
The amplitudes of the postural adjustments were clearly (bilateral arm movements), suggests that feedforward or
related to body geometry at movement onset, and only anticipatory mechanisms play a major role in the modula-
to a minor extent to position. A more extended position tion of postural activity to task-specific constraints (cf.
of the trunk and pelvis resulted in a higher activity of Massion 1997). Possibly, such an anticipatory modulation
the dorsal trunk muscles, whereas an increase in pelvis of postural activity is comparable to a form of central
extension was associated with a decreased activation of ªsetº ± the capacity of the central nervous system to pre-
the pelvis extensor HAM. Furthermore, EMG amplitudes pare the sensory and motor systems for a particular task
were positively related to arm movement velocity (cf. Lee (Prochazka 1989). But usually the term ªsetº is used for
et al. 1987), a parameter which showed position-depen- short-term adaptation based on prior experience (Friedli
dent variations. The lowest arm movement velocities et al. 1984; Keshner et al. 1987; Horak et al. 1989; Bur-
were found in the two sitting positions with a relatively leigh and Horak 1996).
large support area. These findings, as well as the higher The addition of load had a different effect on the rela-
velocities during upright sitting and standing, are in tions between EMG parameters and kinematics in the sit-
agreement with those of others reporting lower velocities ting and standing positions. In stance the relations be-
when the support surface increases (Bazalgette et al. tween body geometry and EMG amplitude disappeared
1986; Lino and Bouisset 1994; Goutal et al. 1994). A larg- when task-load was increased sufficiently. Apparently,
er support surface induces a decrease in the posturo-kinet- the modulatory effects of body geometry were overruled
ic capacity of the body, thereby limiting the body to coun- by the movement parameters. This is supported by the
teract the perturbation induced by the dynamics of the finding that bilateral arm movements facilitated the rela-
movement (cf. Bouisset and Zattara 1987). The finding tion between wrist movement velocity and EMG ampli-
of high movement velocities during lying seems at vari- tude. In the sitting position the effect of load differed
ance with this body dynamics hypothesis. It is possible for the upper and lower postural muscles (cf. Aruin and
that the subjects, especially those of the DE group, exert- Latash 1995). In the lower postural muscles the relation
ed a thrust on the supporting surface in the lying position between body geometry and EMG amplitude disappeared,
as they showed a reversal in the onset of the prime mover whereas in the upper postural muscles a new relation be-
(starting with BB instead of DE in this position). tween body geometry and EMG amplitude appeared.
Our study indicated that bilateral pointing movements Again, this finding underlines the hypothesis that the up-
induce an increase in postural muscle activity. This was per postural muscles are involved in opposing the reaction
not reported in earlier studies (Bouisset and Zattara forces induced by the movement, since the inertial forces
1981; Zattara and Bouisset 1988). The way in which bilat- are larger when task-load increases.
eral arm movements modulated postural EMG activity re-
sembled the modulatory effect of unilaterally applied
weight reported by others (Bouisset and Zattara 1981; Concluding remarks
Horak et al. 1984; Zattara and Bouisset 1988; Benvenuti
et al. 1990; Aruin and Latash 1995). In the present study Our data confirm the idea of Forssberg and Hirschfeld
we were, however, unable to demonstrate such a clear-cut (1994) that postural adjustments are organized in two
effect of unilateral load. This discrepancy can be attribut- functional levels. The basic postural response during fast
ed to the weights used: ³ 900 g in the other studies and pointing movements consist of an activation of the direc-
only 500 g in ours. This relatively small weight (0.5± tion-specific dorsal muscles. Fine-tuning of this basic re-
0.8% of body weight) was chosen because of our ontoge- sponse can be achieved by regulating the number of dor-
netic interests: the weight was proportional to the maxi- sal muscles that participate in the response, and the timing
mal weight that can be used in infants. The results suggest and quantity of the dorsal muscle activity. The fine-tuning
215

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Acknowledgements We thank Ria Willemse for her help during effects of movement velocity, mass displacement, task certain-
the recordings and data analysis, Dr. E. Otten for his technical assis- ty on associated postural adjustments made by normal and
tance during the analysis of the kinematic data, and Prof. Dr. B.C.L. hemiplegic subjects. J Neurol Neurosurg Psychiatry 47:
Touwen, Prof. Dr. A. Gramsbergen and Prof. Dr. D. Kernell for crit- 1020±1028
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