Regulation of feed-forward and feedback strategies at the human ankle during balance control.

The dynamics of sway during quiet stance have often been approximated by the movement of an unstable inverted pendulum. Controlling this unstable load requires the nervous system to balance the reliance on feed-forward volitional activation and feedback mechanisms such as stretch reflexes. It has been demonstrated that reflex excitability is heightened when postural stability is threatened by destabilizing forces in the environment. However, the relationship between postural stability, volitional activation, and stretch reflex excitability remains unclear. We addressed this question by characterizing feed-forward and feedback activation strategies during balance of a simulated inverted pendulum. We hypothesized that feed-forward co-contraction and stretch reflex amplitude would scale together as the external support provided by the environment was reduced. Electromyographic (EMG) responses in 5 muscles of the lower limb were used to characterize co-contraction patterns and stretch reflex amplitude as subjects stabilized the simulated loads. Our results revealed that co-contraction magnitude did indeed scale with increasingly destabilizing torques; however reflex amplitude was attenuated as stability was reduced. These findings suggest that the contribution of feedback mechanisms to postural stability depends on both the level of stability provided by the environment and how the environment influences the pattern of volitional activation.