Assessing the role of ankle and hip joint proprioceptive information in balance recovery using vibratory stimulation

Abstract

Background: Previous work suggests that proprioceptive information from ankle and hip are crucial in maintaining balance during upright standing; however, the contribution of these proprioceptive information during stepping balance recovery in not clear. The goal of the current study was to assess the role of ankle and hip proprioceptive information on balance recovery performance by manipulating type 1a afferent in muscle spindles using vibratory stimulation.

Methods: Twenty healthy young participants were recruited (age = 22.2 ± 2.7 years) and were randomly assigned to balance recovery sessions with either ankle or hip stimulation. Trip-like perturbations were imposed using a modified treadmill setup with a protecting harness. Vibratory stimulation was imposed bilaterally on ankle and hip muscles to expose participants to three condition of no-vibration, 40Hz vibration, and 80Hz vibration. Kinematics of the trunk and lower-extremities were measured using wearable sensors to characterize balance recovery performance. Outcomes were response time, recovery step length, trunk angle during toe-off and heel-strike of recovery stepping, and required time for full recovery.

Findings: Ankle vibratory stimulation elicited main effects on reaction time and recovery step length (p < 0.002); reaction time and recovery step length increased by 23.0% and 21.2%, respectively, on average across the conditions. Hip vibratory stimulation elicited significant increase in the full recovery time (p = 0.019), with 55.3% increase on average across the conditions.

Interpretation: Current findings provided evidence that vibratory stimulation can affect the balance recovery performance, causing a delayed recovery initiation and an impaired balance refinement after the recovery stepping when applied to ankle and hip muscles, respectively.

Keywords: Balance perturbation; Lower-extremity; Motor function; Stochastic noise; Treadmill walking.

Fig. 1

Treadmill trip-like perturbation. 1A: Adjustable actuator column and force sensors for measuring the weight tolerated by the harness; 1B: Sudden backward movement of the belt to move the feet posteriorly and induce a forward loss of balance; and 1C: Recovery step execution to maintain the balance.

Fig. 2

Changes in balance recovery outcomes using vibratory stimulation on the ankle joint. 2A: Change in reaction time; 2B: Change in initial recovery step length. Tukey's differences in balance recovery outcomes across vibration frequencies are presented using different alphabets (A, B, AB, C, D, and CD).