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The role of plantar cutaneous sensation in unperturbed stance

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Abstract

Considerable evidence shows that sensation from the feet and ankles is important for standing balance control. It remains unclear, however, to what extent specific foot and ankle sensory systems are involved. This study focused on the role of plantar cutaneous sensation in quasi-static balance control. Iontophoretic delivery of anesthesia was used to reduce the sensitivity of the forefoot soles. In a follow-up experiment, subjects received intradermal injections of local anesthetic into the entire weight-bearing surface of the foot soles. Properties of the center-of-foot-pressure (COP) trajectories and ground reaction shear forces were analyzed using stabilogram–diffusion analysis and summary statistics. Effects of foot-sole anesthesia were generally small and mostly manifested as increases in COP velocity. Magnitude of COP displacement was unaffected by foot-sole anesthesia. Forefoot anesthesia mainly influenced mediolateral posture control, whereas complete foot-sole anesthesia had an impact on anteroposterior control. During bipedal stance, statistically significant effects of foot-sole anesthesia on COP were present only under eyes-closed conditions and included increases in COP velocity (11–12%) and shear force root-mean-square (13%), the latter indicating increases in body center-of-mass accelerations due to the foot-sole anesthesia. Similar effects were seen for unipedal stance in addition to an increase in anteroposterior COP median frequency (36%). Changes in stabilogram–diffusion parameters were confined to the short-term region suggesting that sensory information from the foot soles is mainly used to set a relevant background muscle activity for a given posture and support surface characteristic, and consequently is of little importance for feedback control during unperturbed stance. In general, this study demonstrates that plantar sensation is of moderate importance for the maintenance of normal standing balance when the postural control system is challenged by unipedal stance or by closing of the eyes. The impact of reduced plantar sensitivity on postural control is expected to increase with the loss of additional sensory modalities such as the concomitant proprioceptive deficits commonly associated with peripheral neuropathies.

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Fig. 1A–C
Fig. 2

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Notes

  1. Pressure sensory threshold levels have historically been expressed in arbitrary units (a.u.) that are considered a linear scale of perceived force and correspond approximately to a logarithmic scale of filament buckling force.

  2. The subjects in procedure 2 also performed dynamic tests of balance that will be detailed in future publications. The unperturbed balance tests performed in procedure 2 were confined to a subset of those used in procedure 1 so that sufficient anesthesia could be maintained for both quasi-static and dynamic testing.

  3. Statistically significant increases in COP velocity after whole-sole anesthesia were seen only in the planar dimension. A notable increasing trend (p=0.066) in anteroposterior COP velocity suggests that the increase in planar COP velocity may be primarily due to increases in AP COP velocity.

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Acknowledgements

This work was supported by the National Aeronautics and Space Administration (NASA) Graduate Student Researchers Program Grant NGT-50309 (Meyer). Additional support was provided by Research Retirement Foundation 2001-056 (Oddsson) and NASA NCC9–127 (De Luca). The authors would like to thank Dr. M.T. Bailin for performing the anesthesia procedures and Dr. C.A. Tucker for the loan of critical equipment. They would also like to thank Drs. M.T. Bailin and R.R. Anderson for many useful discussions.

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Correspondence to Lars I. E. Oddsson.

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Meyer, P.F., Oddsson, L.I.E. & De Luca, C.J. The role of plantar cutaneous sensation in unperturbed stance. Exp Brain Res 156, 505–512 (2004). https://doi.org/10.1007/s00221-003-1804-y

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