ARTICLE | doi:10.20944/preprints202205.0307.v1
Subject: Engineering, Automotive Engineering Keywords: comfort; vibration; biomechanics; postural stabilization
Online: 23 May 2022 (12:14:30 CEST)
In future automated vehicles we will often engage in non-driving tasks and will not watch the road. This will affect postural stabilization and may elicit discomfort or even motion sickness in dynamic driving. Future vehicles shall accommodate this by properly designed seats and interiors whereas comfortable vehicle motion shall be achieved with smooth driving styles and well de-signed (active) suspensions. To support research and development in dynamic comfort, this paper presents validation of a multi-segment full body human model including visuo-vestibular and muscle spindle feedback for postural stabilization. Dynamic driving is evaluated using a “sicken-ing drive” including a 0.2 Hz 4 m/s2 slalom. Vibration transmission is evaluated with compliant automotive seats, applying 3D platform motion and evaluating 3D translation and rotation of pelvis, trunk and head. The model matches human motion in dynamic driving and reproduces fore-aft, lateral and vertical oscillations. Visuo-vestibular and muscle spindle feedback are shown to be essential in particular for head-neck stabilization. Active leg muscle control at the hips and knees is shown to be essential to stabilize the trunk in the high amplitude slalom condition but not in low amplitude horizontal vibrations. However, active leg muscle control can strongly affect 4-6 Hz vertical vibration transmission. Compared to the vibration tests, the dynamic driving tests show enlarged postural control gains to minimize trunk and head roll and pitch, and to align head yaw with the driving direction. Human modelling can create the required insights to achieve breakthrough comfort enhance-ments while enabling efficient development for a wide range of driving conditions, body sizes and other factors. Hence, modelling human postural control can accelerate innovation of seats and vehicle motion control strategies for (automated) vehicles.
ARTICLE | doi:10.20944/preprints202006.0046.v2
Subject: Mathematics & Computer Science, Artificial Intelligence & Robotics Keywords: Postural Balance; Deep Reinforcement Learning; Postural Stabilisation; Biomechanics
Online: 8 June 2020 (10:25:54 CEST)
Learning to maintain postural balance while standing requires a significant fine coordination effort between the neuromuscular system and the sensory system. It is one of the key contributing factors towards fall prevention, especially in the older population. Using artificial intelligence (AI), we can similarly teach an agent to maintain a standing posture, and thus teach the agent not to fall. In this paper, we investigate the learning progress of an AI agent and how it maintains a stable standing posture through reinforcement learning. During training, the AI agent learnt three policies. First, it learnt to maintain the Centre-of-Gravity and Zero-Moment-Point in front of the body. Then, it learnt to shift the load of the entire body on one leg while using the other leg for fine tuning the balancing action. Finally, it started to learn the coordination between the two pre-trained policies. This study shows the potentials of using deep reinforcement learning in human movement studies. The learnt AI behaviour also exhibited attempts to achieve an unplanned goal because it correlated with the set goal (e.g. walking in order to prevent falling). The failed attempts to maintain a standing posture is an interesting by-product which can enrich the fall detection and prevention research efforts.
REVIEW | doi:10.20944/preprints202205.0164.v1
Online: 12 May 2022 (08:52:45 CEST)
Motor control, movement impairment and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized at low back or in the leg induced postural control alteration. While proprioceptive and cortical excitability seems modified with pain, spinal modulation assessment might provide new understanding of the pain phenomenon related to postural control. Literature highlight that the motor control of trunk muscles in patient presenting with low back pain could be dichotomized in two populations, where the first one over-activate trunk muscles, the second one under-activate trunk muscles, and both generating increase of tissues loading. Taking account all this findings, will help clinician to provide adapted treatment for managing both pain and postural control.
ARTICLE | doi:10.20944/preprints202111.0387.v1
Subject: Medicine & Pharmacology, Other Keywords: Aging; Accidental Falls; Frail Elderly; Postural Balance
Online: 22 November 2021 (11:50:39 CET)
This study aimed to characterize the risk of falling in low, moderate and high risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69 % and female: 61.87 %), with no differences between men and women. Also, no differences were found between North vs. South Americans, nor for falls risk levels when male and female groups were compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years’ normative age-range. The prevalence of low falls risk was ~ 61-65 % and the prevalence of moderate to high risk was ~ 16-19 %. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.
ARTICLE | doi:10.20944/preprints202209.0289.v1
Subject: Medicine & Pharmacology, Other Keywords: chronic fatigue syndrome; post-COVID syndrome; postural orthostatic tachycardia; microcirculation; immune system
Online: 20 September 2022 (03:37:00 CEST)
A Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease of unknown aetiology under growing interest now in view of the increasingly recognized post-COVID syndrome as a new entity with similar clinical presentation. We performed the first cross-sectional study of ME/CFS in community population in Russia and then described and compared some clinical and pathophysiological characteristics of ME/CFS and post-COVID syndrome as neuroimmune disorders. Of the cohort of 76 individuals who suggested themselves suffering from ME/CFS 56 subsequently were confirmed as having CFS/ME according to ≥1 of the 4 most commonly used case definition. Of the cohort of 14 individuals with post-COVID-19 syndrome 14 met diagnostic criteria for ME/CFS. The prevalence of clinically expressed and subclinical anxiety and depression in ME / CFS and post-COVID ME/CFS did not differ significantly from that in healthy individuals. Severity of anxiety / depressive symptoms did not correlate with the severity of fatigue neigther in ME / CFS nor in post-COVID ME/CFS, but the positive correlation was found between the severity of fatigue and 20 other symptoms of ME / CFS related to the domains of “post-exertional exhaustion”, “immune dysfunction”, “sleep disturbances”, "dysfunction of the autonomic nervous system", "neurological sensory / motor disorders" and "pain syndromes". Immunological abnormalities were identified in 12/12 patients with ME / CFS according to the results of laboratory testing. The prevalence of postural orthostatic tachycardia assessed by the active standing test was 37.5% in ME / CFS and 75.0% in post-COVID ME/CFS (the latter was higher than in healthy controls, p = 0.02) There was a more pronounced increase in heart rate starting from the 6th minute of the test in post-COVID ME/CFS compared with the control group. Assessment of the functional characteristics of microcirculation by laser doppler flowmetry revealed obvious and very similar changes in ME/CFS and post-COVID ME/CFS compared to the healthy controls. The identified pattern corresponded to the hyperemic form of microcirculation disorders, usually observed in acute inflammatory processes or in deficiency of systemic vasoconstriction influences.
ARTICLE | doi:10.20944/preprints202001.0374.v1
Subject: Medicine & Pharmacology, Nursing & Health Studies Keywords: mild traumatic brain injury; mTBI; concussion; cognitive; sensorimotor; visual; postural balance; methylation; 5-mC%; blood
Online: 31 January 2020 (04:28:21 CET)
People who suffer a mild traumatic brain injury (mTBI) have heterogeneous symptoms and disease trajectories, which make it difficult to precisely diagnose and assess complications long-term. Insufficient information is available regarding how to precisely diagnose and assess mTBI. This study identified and compared deficits in cognitive, psychosocial, visual functions, and balance performance between college students with and without histories of mTBI. Global DNA methylation ratio (5-mC%) in blood was also compared as a peripheral epigenetic marker. Twenty-five volunteers participated in this pilot study, including 11 mTBI cases (27.3% females; mean age of 28.7 years, SD=5.92) and 14 healthy controls (64.3% females; mean age of 22.0, SD=4.13). All the participants were assessed for cognitive (by NIH toolbox—executive function, memory, and processing speed), psychological (by PROMIS—depression, anxiety, and sleep disturbances), visual function (by King-Devick and binocular accommodative tests), postural balance performance (by a force plate), and blood 5-mC% (global methylation) levels. Students with mTBI reported significantly poorer episodic memory, severe anxiety, and more sleep disturbance problems. They also had higher blood 5-mC% level (all p’s<.05). No significant differences were found in visual function and postural balance. These findings validate changes in cognitive, psychosocial, and global DNA methylation long after mTBI.
REVIEW | doi:10.20944/preprints202209.0165.v1
Subject: Engineering, Biomedical & Chemical Engineering Keywords: Diabetic foot; Diabetic neuropathies; Peripheral arterial disease; Foot ulcer; Gait; Walking; Postural balance; Wearable electronic devices; Gait analysis; Digital technology
Online: 13 September 2022 (09:28:22 CEST)
People with diabetic foot frequently exhibit poor gait and balance. However, there is no review to inform digital biomarkers of poor gait and balance related to diabetic foot, measurable by wearables outside traditional gait laboratories. Such information could assist in designing remote patient monitoring platform to track changes in gait and balance dysfunction among people with diabetic foot for timely referral and intervention. Accordingly, we conducted a web-based review using PubMed. Our search was limited to human subjects and English-written papers published in peer-reviewed journals. We identified 20 papers in this review. We found preliminary evidence of digital biomarkers of gait and balance dysfunction in people with diabetic foot, measured by wearables, such as slow gait speed, large gait variability, unstable gait initiation, and large body sway. However, due to heterogeneities in included papers in terms of study design, movement tasks, and small sample size, more studies are recommended to confirm this preliminary evidence. Additionally, based on our review, we recommend establishing appropriate strategies to successfully implement wearable-based assessment into clinical practice for diabetic foot care.
ARTICLE | doi:10.20944/preprints202111.0420.v1
Subject: Medicine & Pharmacology, Behavioral Neuroscience Keywords: Midbrain; postexertional malaise; PEM, arousal; exercise; fMRI; autonomic; postural tachycardia; Myalgic Encephalomyelitis / Chronic Fatigue Syndrome; ME/CFS; Gulf War Illness; GWI
Online: 23 November 2021 (10:53:55 CET)
Background: Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS), Gulf War Ill-ness (GWI) and control subjects had fMRI during difficult cognitive tests performed before and after submaximal exercise provocation (Washington 2020). Exercise caused increased activation in ME/CFS but decreased activation for GWI in the dorsal midbrain, left Rolandic operculum and right middle insula. Midbrain and isthmus nuclei participate in threat assessment, attention, cognition, mood, pain, sleep, and autonomic dysfunction Methods: Activated midbrain nuclei were inferred by re-analysis of data from 31 control, 36 ME/CFS and 78 GWI subjects using a seed region approach and the Harvard Ascending Arousal Network. Results: Before exercise, control and GWI had greater activation during cognition than ME/CFS in left pedunculotegmental nucleus. Postexercise ME/CFS had greater activation than GWI for midline periaqueductal gray, dorsal and median raphe, and right midbrain reticular formation, parabrachial complex and locus coeruleus. The change between days (delta) was positive for ME/CFS but negative for GWI indicating reciprocal patterns of activation. Controls had no changes. Conclusions: Exercise caused opposite effects with increased activation in ME/CFS but decreased activation in GWI indicating different pathophysiological responses to exertion and mechanisms of disease. Midbrain and isthmus nuclei contribute to postexertional malaise in ME/CFS and GWI.