Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?
Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?
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DOI：
10.1093/ageing/afl077
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发表时间：
2006-09-01
期刊：
影响因子：
6.7
通讯作者：
Horak, Fay B.
中科院分区：
文献类型：
--
作者：
Horak, Fay B.
姿势控制不再被认为是简单的静态反射的总和，而是一种基于动态感觉运动过程相互作用的复杂技能。姿势行为的两个主要功能目标是姿势定向和姿势平衡。姿势定向涉及躯干和头部相对于重力、支撑表面、视觉环境和内部参考的主动对齐。来自躯体感觉、前庭和视觉系统的感觉信息被整合，并且放置在这些输入中的每一个上的相对权重取决于运动任务的目标和环境背景。姿势平衡涉及运动策略的协调，以在自我引发和外部触发的稳定性障碍期间稳定身体质量的中心。选择的具体应对策略不仅取决于外部姿势位移的特征，还取决于个体的期望、目标和先前的经验。在随意肢体运动之前，预期姿势调整用于通过补偿与移动肢体相关联的不稳定力来维持姿势稳定性。姿势控制所需的认知处理量取决于姿势任务的复杂性和受试者的姿势控制系统的能力。姿势的控制涉及许多不同的潜在生理系统，这些系统可能受到病理学或亚临床约束的影响。对任何基础系统的损害都会导致不同的、特定于背景的不稳定性。为了有效地恢复平衡以改善活动性和防止福尔斯跌倒，需要更好地理解姿势控制的多种机制。
Postural control is no longer considered simply a summation of static reflexes but, rather, a complex skill based on the interaction of dynamic sensorimotor processes. The two main functional goals of postural behaviour are postural orientation and postural equilibrium. Postural orientation involves the active alignment of the trunk and head with respect to gravity, support surfaces, the visual surround and internal references. Sensory information from somatosensory, vestibular and visual systems is integrated, and the relative weights placed on each of these inputs are dependent on the goals of the movement task and the environmental context. Postural equilibrium involves the coordination of movement strategies to stabilise the centre of body mass during both self-initiated and externally triggered disturbances of stability. The specific response strategy selected depends not only on the characteristics of the external postural displacement but also on the individual's expectations, goals and prior experience. Anticipatory postural adjustments, prior to voluntary limb movement, serve to maintain postural stability by compensating for destabilising forces associated with moving a limb. The amount of cognitive processing required for postural control depends both on the complexity of the postural task and on the capability of the subject's postural control system. The control of posture involves many different underlying physiological systems that can be affected by pathology or sub-clinical constraints. Damage to any of the underlying systems will result in different, context-specific instabilities. The effective rehabilitation of balance to improve mobility and to prevent falls requires a better understanding of the multiple mechanisms underlying postural control.