Stiffness and postural stability in adults with Down syndrome

The purpose of this study was to characterize postural sway in quiet standing under eyes-open and eyes-closed conditions, and to obtain a measure of postural stiffness during quiet standing in adults with Down syndrome (DS) versus control subjects. We obtained descriptive measures from centre-of-pressure (COP) data and analysed and compared COP trajectories and postural stiffness estimates from two stochastic models, the “pinned polymer” (PP) and “inverted pendulum” (IP) models. These estimates were correlated with clinical measures of muscle tone. Our results showed that overall, estimated values for postural stiffness from both models were larger for the DS group than for normal controls. In addition, average stiffness measures were greater under the eyes-closed condition than under the eyes-open condition for the DS group. The IP model detected significant trends over trials whereas the PP model did not. Clinical assessment of muscle tone for the DS group ranged from low to high-normal and there was no significant correlation with the postural stiffness measures obtained from either model. These results suggest that individuals with DS have the ability to modulate their underlying “stiffness” under conditions of quiet standing. Furthermore, there appears to be no strong relationship between clinical measures of muscle tone and postural stiffness measures under dynamic conditions.

[1]  J. Collins,et al.  Random walking during quiet standing. , 1994, Physical review letters.

[2]  J. Collins,et al.  Open-loop and closed-loop control of posture: A random-walk analysis of center-of-pressure trajectories , 2004, Experimental Brain Research.

[3]  D. Winter,et al.  Stiffness control of balance in quiet standing. , 1998, Journal of neurophysiology.

[4]  M. Schieppati,et al.  Stance control is not affected by paresis and reflex hyperexcitability: the case of spastic patients , 2001, Journal of neurology, neurosurgery, and psychiatry.

[5]  M. Latash,et al.  What are “normal movements” in atypical populations? , 1996, Behavioral and Brain Sciences.

[6]  H. J. Arnold Introduction to the Practice of Statistics , 1990 .

[7]  M. Latash,et al.  Organization of a simple two-joint synergy in individuals with Down syndrome. , 1996, American journal of mental retardation : AJMR.

[8]  Romeo Chua,et al.  Perceptual Motor Behavior in Down Syndrome , 2000 .

[9]  A Cappello,et al.  An improved technique for the extraction of stochastic parameters from stabilograms. , 2000, Gait & posture.

[10]  William H. Press,et al.  Numerical recipes : the art of scientific computing : FORTRAN version , 1989 .

[11]  P. Diggle Analysis of Longitudinal Data , 1995 .

[12]  E. Ziegel Introduction to the Practice of Statistics (2nd ed.) , 1994 .

[13]  Digby Elliott,et al.  Visual Feedback Processing and Goal-Directed Movement in Adults with Down Syndrome , 1995 .

[14]  M L Latash,et al.  Preprogrammed reactions in individuals with Down syndrome: the effects of instruction and predictability of the perturbation. , 1993, Archives of physical medicine and rehabilitation.

[15]  P. Vaccaro,et al.  Measurements of neuromuscular tone and strength in Down's syndrome children. , 2008, Journal of mental deficiency research.

[16]  David A. Winter,et al.  Biomechanics and Motor Control of Human Movement , 1990 .

[17]  N. Vuillerme,et al.  Assessment of Static Postural Control in Teenagers with Down Syndrome , 2001 .

[18]  P. Morasso,et al.  Can muscle stiffness alone stabilize upright standing? , 1999, Journal of neurophysiology.

[19]  E. Faragher,et al.  The unreliability of clinical measures of muscle tone: implications for stroke therapy. , 2000, Age and ageing.

[20]  V. Cowie A study of the early development of Mongols , 1970 .

[21]  J. S. Lydic,et al.  Assessment of the quality of sitting and gait patterns in children with Down's syndrome. , 1979, Physical therapy.

[22]  D Cicchetti,et al.  Visual Calibration of Posture in Normal and Motor Retarded Down's Syndrome Infants , 1978, Perception.

[23]  Alexander S. Aruin,et al.  A Coactivation Strategy in Anticipatory Postural Adjustments in Persons with Down Syndrome , 1997 .

[24]  M. Woollacott,et al.  Dynamics of postural control in the child with Down syndrome. , 1985, Physical therapy.

[25]  Hugh Jolly,et al.  Clinics in Developmental Medicine , 1965 .

[26]  Carson C. Chow,et al.  Assessing muscle stiffness from quiet stance in Parkinson's disease , 1999, Muscle & nerve.

[27]  Collins,et al.  Pinned polymer model of posture control. , 1995, Physical review. E, Statistical physics, plasmas, fluids, and related interdisciplinary topics.