Trunk Stability during Postural Control: Tool Development and Analysis

Trunk instability is a major problem for people with spinal cord injury (SCI); it not only limits their independence, but also leads to secondary health complications such as kyphosis, pressure sores, and respiratory dysfunction. In exploring mechanisms that may facilitate or compromise postural stability, dynamic models are very useful because the spine dynamics are difficult to study in vivo compared to other structures of the body. Therefore, one objective of this work was to develop a detailed three-dimensional dynamic model of the human trunk as a tool for investigating the neural-mechanical control strategy that healthy people apply to maintain trunk stability during various tasks. Since trunk control is fairly complex, however, another objective of this work was to provide insights into the balance control strategy of a simpler neuro-musculo-skeletal system that may facilitate future studies on trunk control. For this purpose, the control of the ankle joint complex during quiet standing (anterior-posterior degree of freedom) was studied in place of the trunk.

The obtained results reveal that a neural-mechanical control scheme using a proportional-derivative controller as the neural control strategy can overcome a large sensory-motor (feedback) time delay and stabilize the ankle joint during quiet standing. Moreover, a detailed dynamic model of the trunk has been developed that is: (1) based on highly accurate geometric models; and (2) universally applicable. Thus, this work also responds to the postulation that structurally more complex models are needed to better characterize the biomechanics of multifaceted systems. Combining the developed biomechanical tools for the trunk with the postural control insights for the ankle joint during standing will be beneficial for: (1) understanding the neural-mechanical control strategy that facilitates trunk stability in healthy people; and for (2) developing neuroprostheses for trunk stability after SCI and other neurological disorders.