A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance

Assessment of reactive balance traditionally imposes some type of perturbation to upright stance or gait followed by measurement of the resultant ...

Utah State University

Mere observation of objects in our surroundings can potentiate movement, a fact reflected by visually-primed activation of motor cortical networks. This mechanism holds potential value for reactive balance control where recovery actions of the arms or legs must be targeted to a new support base to avoid a fall. The present study was conducted to test if viewing a wall-mounted safety handle - the type of handle commonly used to regain balance - results in activation of motor cortical networks. We hypothesized that the hand area of the primary motor cortex would be facilitated shortly after visual access to a safety handle versus when no handle was visible. Here, we used transcranial magnetic stimulation (TMS) to measure corticospinal excitability in hand muscles directly following access to vision while participants performed a seated reach-grasp task. Vision was controlled using liquid crystal lenses and TMS pulses were time-locked to occur shortly after the goggles opened but prior to any cue for movement. Between trials the response environment was unpredictably altered to present either a handle or no handle (i.e. covered). Our results demonstrated a rapid motor facilitation in muscles of the right hand when participants viewed a handle versus trials where this handle was covered. This effect was selective both in terms of the muscles activated and the timing at which it emerged. The First Dorsal Interosseus and Opponens Pollicus muscles (synergists in closing the hand) were facilitated 120 ms after viewing the handle. Interestingly, this effect was absent at earlier (80 ms) and later (160 ms) points. Conversely, Abductor Digiti Minimi, which moves the little finger out from the rest of the hand, tended to diminish when viewing the handle. These findings suggest a rapid engagement of muscles suitable for grasping a handle based on vision. This is consistent with the concept of affordances where vision automatically translates viewed objects into appropriate motor terms. The fact that this affordance effect was present for a wall-mounted safety handle commonly used to regain balance has implications for automatically priming recovery actions with upper limbs suited to our surroundings, even before postural perturbation is detected.

Motor affordance for grasping a safety handle.

Immersion in chest-deep water may augment explicit memory in healthy adults however, there is limited information on how this environment might affect implicit memory or motor learning. The purpose of this study was to compare the speed and accuracy for learning a motor skill on land and in chest-deep water. Verbal word recall and grip strength were included to gain a more complete understanding of the intervention. Sixty-two younger adults (age = 23.3 ± 3.59 yrs.) were randomly assigned to either a water group immersed to the xiphoid or a land group. Participants in both groups completed the same eight practice trials of a mirror-drawing task on two separate days. Outcome measures for this task included time and error numbers to complete each drawing. The number of words recalled using a 12 word recall test, and peak grip strength using a hand dynamometer were measured each day of testing. The influence of environment and repeated practice on each outcome measure were assessed with an analysis of variance and effect sizes (ES). Time and errors for both groups significantly decreased with practice (p < 0.01, ES = 0.11-0.28), however the drawing time was greater in water than on land for trials 1, 5, and 6 (ES = 0.50-0.55). There was a 7% increase in words recalled (9.24 ± 1.19 vs 8.60 ± 1.19) and a 16% increase in grip strength (405 ± 104 vs 342 ± 83) for water than land groups (ES 0.54-0.64). Healthy adults in chest-deep water and on land display comparable mirror-drawing speed and accuracy after minimal practice. Curiously, water immersion may augment verbal word recall and grip strength abilities.

Comparison of motor skill learning, grip strength and memory recall on land and in chest-deep water.

To interact successfully with an uncertain environment, organisms must be able to respond to both unanticipated and anticipated events. For unanticipated events, organisms have evolved stereotyped motor behaviors mapped to the statistical regularities of the environment, which can be trigged by specific sensory stimuli. These "reflexive" responses are more or less hardwired to prevent falls and represent, maybe, the best available solution to maintaining posture given limited available time and information. With the gift of foresight, however, motor behaviors can be tuned or prepared in advance, improving the ability of the organism to compensate for, and interact with, the changing environment. Indeed, foresight's improvement of our interactive capacity occurs through several means, such as better action selection, processing, and conduction delay compensation and by providing a prediction with which to compare our actual behaviors to, thereby facilitating error identification and learning. Here we review the various roles foresight (prediction) plays in maintaining our postural equilibrium. We start by describing some of the more recent findings related to the prediction of instability. Specifically, we cover recent advancements in the understanding of anticipatory postural behaviors that are used broadly to stabilize volitional movement and compensate for impending postural disturbances. We also describe anticipatory changes in the state, or set, of the nervous system that may facilitate anticipatory behaviors. From changes in central set, we briefly discuss prediction of postural instability online before moving into a discussion of how predictive mechanisms, such as internal models, permit us to tune, perhaps our highest level predictive behaviors, namely the priming associated with motor affordances. Lastly, we explore methods best suited to expose the contribution of prediction to postural equilibrium control across a variety of contexts.

Forecast or Fall: Prediction's Importance to Postural Control.

Merely viewing objects within reachable space can activate motor cortical networks and potentiate movement. This holds potential value for smooth interaction with objects in our surroundings, and could offer an advantage for quickly generating targeted hand movements (e.g. grasping a support rail to maintain stability). The present study investigated if viewing a wall-mounted safety handle resulted in automatic activation of motor cortical networks, and if this effect changes with age. Twenty-five young adults (18-30 years) and seventeen older adults (65+ years) were included in this study. Single-pulse, transcranial magnetic stimulation was applied over the motor cortical hand representation of young and older adults shortly after they viewed a safety handle within reaching distance. Between trials, vision was occluded and the environment was unpredictably altered to reveal either a safety handle, or no handle (i.e. covered). Modulation of intrinsic hand muscle activity was evident in young adults when viewing a handle, and this was selective in terms of both the muscles activated and the time at which it emerged. By contrast, older adults failed to show any changes when viewing the safety handle. Specifically, the presence of a handle increased corticospinal activity in hand muscles of young adults when TMS was applied 120 ms after opening the goggles (p = .014), but not in the older adults (p > .954). The fact that the visual priming observed in younger adults was absent in older adults suggests that aging may diminish the ability to quickly put our visual world into automatic motor terms.

Priming of grasping muscles when viewing a safety handle is diminished with age.

When automatic, yet unwanted action is quickly inhibited, short-lived suppression throughout the motor system ensues. This effect is referred to as global suppression. Although response inhibition is essential for behavioral flexibility, widespread motor suppression may delay action reprogramming. In reactive balance control, even fleeting suppression of the motor system could interfere with our ability to adapt compensatory reactions quickly enough to avoid a fall.

Staying upright by shutting down? Evidence for global suppression of the motor system when recovering balance.

The present study explored how motor cortical activity was influenced by visual perception of complex environments that either afforded or obstructed arm and leg reactions in young, healthy adults. Most importantly, we focused on compensatory balance reactions where the arms were required to regain stability following unexpected postural perturbation. Our first question was if motor cortical activity from the hand area automatically corresponds to the visual environment. Affordance-based priming of the motor system was assessed using single-pulse Transcranial Magnetic Stimulation (TMS) to determine if visual access to a wall-mounted support handle influenced corticospinal excitability. We evaluated if hand actions were automatically facilitated and/or suppressed by viewing an available handle within graspable range. Our second question was if the requirement for rapid movement to recover balance played a role in modulating any affordance effect in the hands. The goal was to disentangle motor demands related to postural threat from the impact of observation alone. For balance trials, a custom-built, lean and release apparatus was used to impose temporally unpredictable postural perturbations. In all balance trials, perturbations were of sufficient magnitude to evoke a compensatory change-in-support response; therefore, any recovery action needed to carefully take into account the affordances and constraints of the perceived environment to prevent a fall. Consistent with our first hypothesis, activity in an intrinsic hand muscle was increased when participants passively viewed a wall-mounted safety handle, in both seated and standing contexts. Contrary to our second hypothesis, this visual priming was absent when perturbations were imposed and the handle was needed to regain balance. Our results reveal that motor set is influenced by simply viewing objects that afford a grasp. We suggest that such preparation may provide an advantage when generating balance recovery actions that require quickly grasping a supportive handle. This priming effect likely competes with other task-dependent influences that regulate cortical motor output. Future studies should expand from limitations inherent with single-pulse TMS alone, to determine if vision of our surrounding world influences motor set in other contexts (e.g., intensified postural threat) and investigate if this priming corresponds to overt behavior.

Motor preparation for compensatory reach-to-grasp responses when viewing a wall-mounted safety handle.

Response inhibition involves suppressing automatic, but unwanted action, which allows for behavioral flexibility. This capacity could theoretically contribute to fall prevention, especially in the cluttered environments we face daily. Although much has been learned from cognitive psychology regarding response inhibition, it is unclear if such findings translate to the intensified challenge of coordinating balance recovery reactions.

David A.E. Bolton

Department of Kinesiology & Health Science

Utah State University

A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance

David A.E. Bolton

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Utah State University

A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance

Department of Kinesiology & Health Science