Does body stability depend on postural chain mobility

or stability area?
Ele onore Kantor
a,
*
, Laurent Poupard
b
, Serge Le Bozec
a
, Simon Bouisset
a
a
Laboratoire de physiologie du mouvement, Universite Paris-Sud, 91405 Orsay, France
b
Laboratoire Signaux et Syste mes, Supe lec, plateau Moulon, 91190 Gif sur Yvette, France
Received 13 March 2001; received in revised form 5 June 2001; accepted 5 June 2001
Abstract
The purpose of this study was to examine whether postural stability depends only on the support base perimeter, that is the stability area,
when body balance is perturbed by respiration. To this end, seven normal subjects were asked to breathe quietly, breathe deeply and to hold
their breath (apnoea). They were asked to maintain a standing posture (Sta), and two sitting postures differing by the ischio femoral contact
with the seat (Sit100 and Sit30). In other words, these three postures differed not only by the stability area, but also by pelvis mobility. The
thoracic perimeter, displacement of the centre of pressure (CP) and iliac crest acceleration (Ah), taken as an index of pelvis mobility, of seven
normal subjects were recorded. The results showed that the sway path (SP) was longer in seated subjects than in standing ones, and in Sit100
than in Sit30. The distance between the CP extreme positions (DXp) varied in the opposite direction to SP. Iliac crests and thoracic
displacements were shown to be in phase in Sit condition, and did not display any particular pattern in Sta. It was concluded that postural
steadiness depends on the postural chain mobility in addition to stability area. As pelvis and lumbar column mobility are related, it is
proposed that both contribute to postural chain mobility, owing to respiratory perturbation being compensated. q 2001 Elsevier Science
Ireland Ltd. All rights reserved.
Keywords: Respiration, Balance, Stability, Steadiness, Mobility, Sitting, Standing
In neurophysiological mechanisms underlying postural
reactions, Andre-Thomas [1] distinguished two phenomena:
on the one hand, the phenomena triggered by a perturbation
unknown to the subjects (`reaction equilibration') and, on
the other, those resulting from an anticipated perturbation
(`action equilibration'), such as voluntary movements
controlled by the sensory-motor system. Even if they are
controlled primarily by the autonomic nervous system,
voluntary variations of respiratory rate can be considered
in the same way [4]. Indeed respiratory volume variations
perturb body balance. Hence, a counter-perturbation must
be developed to maintain equilibrium.
The ability to develop a counter-perturbation to the
postural perturbation induced by voluntary movement has
been termed Posturo Kinetic Capacity (PKC) [3]. PKC is
assumed to depend not only on static but also on dynamic
equilibrium conditions, body posture and support base
conguration in particular. It has been claimed that PKC
depends on postural chain mobility [5], that is it is a function
of the range of postural joint displacement, which is related
to body posture. Moreover, it has been shown that as move-
ment induces a dynamic perturbation, the counter-perturba-
tion must be dynamic as well [15]. Consequently, if postural
chain mobility is constrained, fewer postural segments
could be accelerated, the counter-perturbation would be
limited, and performance reduced [3]. Experimental series
have suggested that PKC was favoured by the mobility of
the postural chain [12,13].
Respiratory movements have been shown to be more or
less completely compensated for by the antiphasic displace-
ments of other parts of the body [7]. Moreover, the compen-
sation has been proved to be more efcient in a standing
than in a sitting posture [4]. From a biomechanical stand-
point, sitting provides a larger support base than standing,
but fewer parts of the body are free to be accelerated.
The aim of this study was to examine body balance stabi-
lity, that is steadiness [15], related to respiratory perturba-
tion. To this end, three different postural condition were
considered which present distinct combinations of the
postural chain mobility and the area of stability. If a stand-
ing posture differs from a sitting posture by stability area,
the two sitting postures differ only by the ischio-femoral
contact with the seat (30 and 100%) which induces more
Neuroscience Letters 308 (2001) 128132
0304-3940/01/$ - see front matter q 2001 Elsevier Science Ireland Ltd. All rights reserved.
PII: S0304- 3940( 01) 01986- 3
www.elsevier.com/locate/neulet
* Corresponding author.
E-mail address: eleonore.kantor@lpm.u-psud.fr (E. Kantor).
(30%) or less (100%) pelvis mobility. The acceleration of
iliac crests was taken as an index of pelvis displacements.
A triangular force-platform was used [2] to measure
continuously the displacement of the centre of pressure
(CP). The resonance frequency of the platform was about
50 Hz, which was largely superior to the postural frequen-
cies. Local kinematics were recorded by two tri-axial accel-
erometers (ENTRAN, ECG D, ^5 g) xed to appropriately
shaped splints and attached at the iliac crests. The kinematic
study was completed by a measure of thoracic perimeter
(xtr) variations with a sensing belt (Respitrace Plus). The
respiratory perturbation was estimated from the minute-
volume, which is the product of the respiratory input volume
and the respiratory frequency. The pneumograph measured
the thoracic surface using an electromagnetic method
[6,14]. Data were collected (50 Hz), stored and processed
by a microcomputer using Matlab software.
Subjects were invited to hold onto the force platform in
standing (Sta) and in seated postures. For the sitting
postures, two experimental conditions were considered:
Sit100 was sitting with full ischio-femoral contact, and
Sit30 was sitting with one-third ischio-femoral contact.
Seven subjects were examined, none of whom suffered
from any known respiratory or neurological disease. They
were free from obvious physical disabilities and from any
recent history of skeletal or muscular injury. They gave their
informed consent, and the experiments were conducted in
accordance with legal requirements (Huriet's law).
Subjects were asked to perform successively ve blocks
of 25 s, ve of quiet breathing (QB), ve of deep breathing
(DB) and ve of apnoea, in each of the three postures (Sta,
Sit30, Sit100). For the standing condition, the subjects stood
in their natural posture with their arms loosely hanging at
the sides and feet comfortably apart. They had to x a target,
situated 2 m ahead them at eye level. For each seated condi-
tion, the subjects sat on a rigid stool placed on the platform,
in their natural posture, with their upper limbs hanging
relaxed alongside the trunk and their feet on the platform.
The displacement of the centre of pressure, as well as the
acceleration of iliac crests, were considered along the
antero-posterior axis. Indeed, the respiration effect on the
CP displacement according to this axis was known to be
greater [4]. Moreover, lower limb and trunk joint mobility
was known to be lesser according to the lateral axis. As a
consequence, global body mobility was limited according to
this axis, as compared to the antero-posterior one. Minute-
volume (V

) was calculated for each subject and condition by

multiplying mean respiratory frequency by the mean ampli-
tude of thoracic perimeter variations.
Two classic stabilometric parameters were calculated
from the CP co-ordinates, for each condition and subject,
in order to dene postural sway characteristics [15]. The
Sway Path (SP) was the CP total excursion along the
antero-posterior axis during the recording time [8]: greater
SP was considered as an index of lesser steadiness. It was
known to be very sensitive to the transient perturbations of
postural phenomena, such as those induced by respiration.
The other parameter was the distance between the CP
extreme positions along the antero-posterior axis (DXp):
lesser DXp values were considered an index of greater stabi-
lity. It was considered to be more related to stability area
and more sensitive to low frequency oscillations, such as
those induced by a reduction of the stability area [15].
They were averaged, and compared statistically
(Student's paired t-test).
In the seated posture, the movements of the left and right
iliac crests can be considered as being linked, and their
accelerations were averaged. In addition, to accentuate the
differences between postural conditions, the periodic varia-
tions of thoracic perimeter were compared to those of the
iliac crest acceleration (Ah). Correlation coefcients were
calculated by a normalized covariance method. They
allowed the authors to test the degree of coherence between
Ah and xtr. For the Sta condition, the correlation coefcient
of left and right iliac crest accelerations with xtr were calcu-
lated separately. For each subject, the right and left corre-
sponding means were averaged.
The results showed that the minute-volume (V

) did not
differ according to the posture. In addition, it was signi-
cantly higher for deep breathing than for quiet breathing in
all postural conditions (Table 1). Therefore, the respiratory
conditions were the same whatever the postural condition,
but differed according to the respiratory rate.
The CP antero-posterior displacement was cyclical in Sit
conditions (Fig. 1). As it was absent during apnoea, these
oscillations were considered to be related to respiration. In
other words, respiratory cyclic variations seem to represent
a perturbation to body balance, even if it was not apparent in
Sta condition, at least from visual inspection.
For QB, SP was signicantly greater for Sit100 than for
Sit30, and for both sitting conditions than for Sta (Table 1).
On the contrary, DXp was signicantly higher when the
subjects were standing than when they were sitting. It was
not signicantly different for Sit100 than for Sit30.
For DB, SP was signicantly greater for Sit100 than for
Sit30, and for both than for Sta. On the contrary, DXp was
signicantly higher in the standing than in the sitting condi-
tion, but there was no signicant difference between the
seated postures (Table 1).
The difference between respiratory conditions showed
that SP and DXp were signicantly higher for DB, as
compared to QB for all postural conditions (Table 1).
Correlation coefcients between Ah and xtr were nega-
tive and signicantly higher in absolute value for DB as
compared to QB for both the seated conditions (Table 2).
In other words, the iliac crest acceleration and thoracic
displacement were antiphasic (Fig. 2). As iliac crest accel-
eration is a sinusoidal phenomenon, acceleration is antipha-
sic to displacement. Therefore, iliac crest and thoracic
displacements can be considered in phase. For Sta, the
correlation coefcients were negative (20.29 ^0.07 for
QB, 20.49 ^0.1 for DB; N 4), or positive (0.23 ^0.05
E. Kantor et al. / Neuroscience Letters 308 (2001) 128132 129
for QB, 0.31 ^0.09 for DB; N 3), according to the
subject.
This study offers original results which can be discussed
in relation to the inuence of postural chain mobility on
body steadiness.
First of all, it is clear that respiratory movements perturb
the CP displacement in the seated posture in a cyclic manner
because the respiratory component is present, whereas it is
absent during apnoea. On the contrary, standing subjects
displayed CP displacements of a greater amplitude, and
seemed to oscillate according to a stochastic behaviour,
without a respiratory cyclic component. Even if the respira-
tory component is not apparent by visual inspection in a
standing posture, it has been established, using a sensitive
method (time-locked averaging) [4], that a signicant
respiratory component could be extracted from the CP
signal in the QB condition, for six out of the ten subjects.
These subjects were those breathing at the highest minute-
volumes. It has also been found that this respiratory compo-
nent is present in all subjects in the DB condition, in accor-
dance with Hunter and Kearney [9]. These results conrm
that, for Sta, there are highly signicant SP and DXp differ-
ences when subjects are breathing deeply, as reported by
Jeong [10] who considered only the respiratory frequency.
Therefore, these results reinforce the contention according
to which the minute-volume constitutes a signicant pertur-
bation to body stability.
With respect to the posturographic parameters, it appeared
that SP was sensitive to all the postural conditions, for both
minute-volumes conditions. On the other hand, DXp did not
show signicant differences between sitting postures, when
the subjects were breathing either quietly or deeply. This
result is in accordance with previous results [4], which estab-
E. Kantor et al. / Neuroscience Letters 308 (2001) 128132 130
Fig. 1. Antero-posterior displacement (mm) of the centre of pres-
sure. Fromtop to bottom: Sit100 in apnoea, Sit30, Sit100 and Sta
in deep breathing (DB), as a function of time (s). The measures
are taken from the same subject. Positive slope corresponds to a
forward displacement of the centre of pressure.
Table 2
Correlation coefcients between iliac crest acceleration (Ah) and
variation of thoracic perimeter (xtr)
a
QB DB t
Sit100 20.55 ^0.10 20.73 ^0.10 4.78**
Sit30 20.59 ^0.12 20.76 ^1.13 3.90**
a
Group means and standard deviations for sitting postures, in
quiet (QB) and deep (DB) breathing.
Table 1
Respiratory and stabilometric parameters in quiet (QB) and deep
(DB) breathing
a
QB DB t(DB/QB)
V

(au/m)
Sta 2.9 ^1.4 6.2 ^2.8 5**
Sit30 3.1 ^1.9 5.6 ^2.5 5.4**
Sit100 3.2 ^1.6 5.7 ^2.6 5**
DXp(mm)
Sta 15.2 ^3.3 18.4 ^4.3 4.6**
Sit30 5.4 ^1.0 7.9 ^1.0 8.7***
Sit100 5.5 ^1.1 7.9 ^0.9 4.7**
SP(mm)
Sta 360 ^40.1 364 ^42 3*
Sit30 448 ^55.8 479 ^80 4.3**
Sit100 500 ^60.7 523 ^97 2.5*
DXp
t(Sta/Sit100) 6.8*** 6.0***
t(Sta/Sit30) 6.8*** 6.0***
t(Sit30/Sit100) 0.3
NS
0.0
NS
SP
t(Sta/Sit100) 6.6*** 4.4**
t(Sta/Sit30) 5.8** 4.0**
t(Sit30/Sit100) 2.9* 4.3**
a
From top to bottom: respiratory minute volume (V

) in arbi-
trary units mn
21
. Stabilometric parameters: DXp, in mm, ampli-
tude of CP displacement along the antero-posterior axis; sway
path (SP) in mm. Means, standard deviations, Student's t-tests
(t) are reported in the standing posture (Sta) and in the sitting
posture with one-third ischio-femoral contact (Sit30) and with
full ischio-femoral contact (Sit100). t(Sta/Sitl00), t(Sta/Sit30),
t(Sit30/Sitl00) refers respectively to the statistical comparison
between Sta and Sit100, Sta and Sit30, Sit30 and Sit 100, for
DXp or SP. t(DB/QB) refers to the comparison between deep
(DB) and quiet (QB) breathing. The symbols *, ** and *** indi-
cate statistically signicant differences at P , 0:05, P , 0:0l and
P , 0:001, respectively;
NS
indicates non-signicant differences.
lished that SP is very sensitive to the transient regulations of
postural phenomena, such as those induced by respiration.
This SP feature can be explained by the way in which SP is
calculated [8], which confers a greater weighting to instan-
taneous variations, unlike DXp, which takes into account the
distance between the CP extreme position and is mostly
related to the overall stability area.
The three postural conditions considered allow to discuss
the inuence of stability area as compared to that of postural
chain mobility. Indeed, the perimeter of the support base is
larger when the subjects are seated than when they are
standing, and there are signicant differences for SP and
DXp between Sta and Sit conditions. This result could be
explained either by a reduction of the stability area in Sit
conditions or by a reduction of the postural chain, in agree-
ment with Bouisset and Duchene [4]. But there are also
signicant differences for a given perimeter. Indeed, at
least for SP, Sit30 and Sit100 displayed signicant differ-
ences for both respiratory conditions. In other words, there
are signicant differences even though the stability area was
the same. Therefore, stability area is not the only discrimi-
native parameter for body stability.
Lastly, the `hips and the lower limbs' antiphasic move-
ments have been assumed to compensate for respiratory
movements in the standing posture [7]. It can be asked
whether the same explanation holds true in a sitting posture,
which it is now possible to dispute. On the one hand, these
results showed that SP values for Sit30 are between those
obtained for Sta and Sit100. On the other hand, pelvis mobi-
lity is known to decrease from Sta to Sit30, and to Sit30 to
Sit100. Therefore, respiration is better compensated for in
the standing posture, and in Sit30 than in Sit100, that is
when the pelvis is more mobile.
In both seated conditions the increase of the correlation
coefcients, when the minute-volume is increased, suggests
a close linear relationship between respiratory movements
and iliac crest displacements. In other words, the link
between the thorax and pelvis is closer when respiration is
more perturbing. Also, the iliac crest movements are in
phase with the variations of thoracic perimeter. Since the
pelvic displacements are in phase with those of the thorax,
they cannot compensate for respiratory perturbation. There-
fore, compensation is very likely initiated between the
thorax and pelvis, that is at the level of the lumbar column.
In this context, it is interesting to stress that when standing
erect, the lumbar column is curved sagittally: there is a
lumbar lordosis. When the sitting position is taken, the
pelvis rotates backwards and the lumbar lordosis attens
in proportion to the ischio-femoral contact [11]. Conse-
quently, as the pelvis and lumbar column are closely linked,
it is likely that both contribute to postural chain mobility.
Therefore, since pelvic movements are in phase with thor-
acic movements, it is assumed that the respiratory perturba-
tion to body balance is compensated for at the lumbar
column level: the lumbar column appears to be a key PKC
factor.
In conclusion, respiration appears to be a signicant input
to the postural control system, in the sitting as well as in the
standing posture. The postural compensation to respiratory
perturbation depends not only on stability area, but also on
postural chain mobility, that is on the free play of postural
joints. In this study, it is a function of pelvic and lumbar
column mobility. Therefore, PKC is largely dependent on
lumbar column mobility.
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