Hi Rodolfo, just a short answer, the main difference is the control between both strategies. Hip strategy asks for a more visual control of the 'inverted pendulum'. Send me a mail '[email protected]) and we can discuss this important topic, cheers, Jan b Eyskens

Let’s continue this conversation here so that those who are interested can participate.

 Ankle and hip strategies, as well as stepping strategies are the three strategies that occurs in the sagittal plane.  The ankle strategy is seen at 10 months of age when the child is holding a support and flexing the hips and knees.  The hip strategy begins at 4 approximately 4 year of age and is never seen without the ankle strategy.  The hip strategy controls forward and backwards sway and is often used when standing on a narrow support such as a rope or beam.   Medial lateral stability does occurs at the hip as there is little ankle movement in those directions.  Recently it has been thought that the pelvis is the primary motion of the body as one leg adducts and the other abducts.  Thus they are proximal distal actions where the ankle strategy is distal to proximal.

Best regards, Judy Carmick

Thanks Judy. I´m interested too, in analyze muscle activitty by EMG, thus I´d like to know what the best muscles I shoud measure both hip and ankle muscles

After the dissection course in Dundee last summer I realized that to much emphasis is given to the 'neural' activity. The fastest mechanical system is the one making use of mechanotransduction, see www.biotensegrity.com The 'civil war' between both steering systems due to self representational errors is to one to take care of. A body needs 'peace' rather than pieces.

Later, Jan

Hip strategy works often in the sagittal plane.  It is unclear as to why you are asking this question.  Do you want to study a large balance recovery in which hips play an important role in the medial lateral direction?  If so I would think that you want to study the hamstrings, hip abductors and adductors and perhaps the short lateral rotators.  Or if you are interested in the ankle and hip strategies that work together in the sagittal plane, you may want to focus on the hip adductors, flexors and extensors and ankle plantar and dorsi flexors..

Judy

You're seeing the civil war between neural mechanism and the mechanical system? Or the components parts and the functional whole?

On both actually, it's non lineair. See Game Theory, also the Dual Gate theory of Pain and the Klein Bottle Logic.  My first article has been published, the second is accepted and will be published mid december. There is an inverse relation between bottom up and top down data in Chronic Fatigue Patients. Please send me your email and I'll send you the articles asap. Kind regards, Jan

Guys, thanks alot for replies. Dear Judy, I want to study the behavior of hip and ankle muscles in controlling balance

Rodolfo,  I hope you do study the muscles for balance and include the hip abductors.  They are often not studied and are difficult to study as they change direction of pull and thus function depending on the joint angles.

Judy Carmick I am very interested in the hip and ankle strategies and noted that you spoke about the ankle strategy already seen at 10 month and the hip at 4 years. Could you kindly steer me in a direction of articles for this as I would like to incorporate this into my Masters write up. Thank you.  

Dear Rodolfo,  Sorry I have not been back to this topic because I see my mistake on 21.55 32.7.  I mentioned abductors and really meant hip adductors.  In those with CP the adductors are spastic but weak.  When they are activated with task specific electrical stimulation abduction increases passively and over time actively.

Look on my web page, JudyCarmick.com to see photos a child who has an equinus gait but is receiving electrical stimulation to the adductors.  He responded by going flat footed, and spontaneously abducted his hips in standing and remained in that position as he played at a bench.  On my web page there are also links to my videos in published papers in which the hip adductors are stimulated.  .  We need more study on this and if you do this it could be very helpful.

Dear Judy. Thanks for your colaboration. Seeing your work with ES on your webpage, your results are impressive, but my question is, are these effects maintained througout the time?

Regards 

It is like exercise, if the person continues to be active and sue what they learned, it continues over time.  I have a few long term observations on cases covering.  During growth spurts we returned to using task specific electrical stimulation for a few weeks and then nothing for 6 months to years.

9 to 24 y years.

Great Judy. Neurological patients is not my area, but I could transport this idea to athlete patients who need to correct an imbalance, alright?!

Hi All, this can eventually help you, just let me know if more info is needed.

In podology and biomechanics, the plantar fascia is seen as part of a truss. It’s upper part, the top of the roof, is where the foot articulates with the tibial and the fibular bones. Due to the fact that the lower part of the bony structure of the truss needs to be prevented from traction (bone is made to be compressed, not to be pulled) another structure takes over the function to hold the longitudinal foot arc. The lower part, the plantar fascia, is needed to protect the bones in heel strike, when standing and in the propulsion phase of walking.

The same tissue strains twice. Due to its “wind axis” anatomy, the plantar fascia strains in heel strike as well as at the end of the propulsion phase. This way, the plantar fascia protects the bony structure of the foot both at heel strike and in the “toe off” phase and in standing. When feet are “hollow,” the plantar fascia cannot function as it should and specific problems occur. While walking, the foot has contact with the floor for a shorter period of time, resulting in higher upward reaction forces directed towards the tibia. In flat feet, on the contrary, the plantar fascia is overloaded and strained. The contact time is prolonged and the ground reaction forces are directed more forward towards the metatarsal bones. Prolonged strain in the plantar fascia leads to reaction of the calcaneal bone and eventually to heel spurs.

The ankle has a specific function in standing and walking. Information from the calf muscles (endogenous data, having a 20 second delay) is used in a procedure called ‘Smith Predictor’ to control our balance. Human balance is often seen as functioning as an inverted pendulum. The plantar fascia, part of the truss, has an important function in order to give the necessary freedom and information to the foot structure as a whole.

When balance is compromised, vision (external, exogenous data, having a 2 second delay) takes over to control the position of our center of mass in relation to the position of our feet and to prevent us from falling. When structures underneath or above this ankle axis are in dysfunction, we loose our ability to use internal data regulating our balance, posture and movement. When we strain our body, our vision becomes more important; our head changes its position in relation to the trunk... Having free ankles can be seen as priming good use in the feet as well as in the rest of the body. This good use results in steering the body with internal rather than external data. When patients are permanently positioning themselves using external visual data, the result will be found in the feet as well as in the rest of the body. More specifically, they tend towards the use of T2 muscle cells and are less energy efficient than T1 muscle cells.

Reinstalling a proper functioning of the Smith predictor function of the cerebellum needs specific techniques. Priming the afferent data needed to use an ankle strategy (a program called emotensegrity using études and not exercises; but also specific imagery) can provide the freedom above the ankle axis to solve problems underneath it, not only plantar fasciitis. The opposite is also true, the program will also influence the function of the feet and, in doing so, influence problems in the rest of the body.

REFERENCES

“Anatomy of the Foot and Ankle, descriptive, topographic, functional” by Shahan K. Sarrafian, J.B. Lippincott Company, Philadelphia, U.S.A., 1993, ISBN 0 397 51042 X.

Ian D. Loram, Peter J. Gawthrop and Martin Lakie, The frequency of human, manual adjustments in balancing an inverted pendulum is constrained by intrinsic physiological factors, J Physiol 577.1 (2006) pp 417–432

Yuri P. Ivanenkol, Nadia Dominic, Development of pendulum mechanism and kinematic coordination from the first unsupported steps in toddlers, Journal of Experimental Biology 207, 3797-3810 (2004)

R.C. Miall, D. J. Weir, D. M. Wolpert, J. F. Stein, Is the Cerebellum a Smith Predictor? Journal of Motor Behavior, 1993, Vol 25, No.3, 203-216

www.bodyinpeace.be: www.bewegingspraktijk.be with some pages in English; www.doorvoeldbewegen.be with some video but also www.posturereleaseimagery.org. 

Drs. Jan b Eyskens, MSc PT, DO, Pr Ph; [email protected]

Dear Jan, You provided me a class about postural control. In really, I had never heard about ‘Smith Predictor’ but I will learn more about it reading the proper reference. Another doubt: Is this true about information from calf muscles lasting 20 seconds delay?

Another point - flat feet. Did you refer to excessive flat feet? In some cases I have seen in my patients (runners - beginner or advanced) that during standing or walking present a flat feet but during running the feet are less flat or even disapeared.

So, Does we have to provide a better function of the feet to the informations reaching the CNS properly and than an adequate postural balance, and a way to provide this is over correct the disfuntions such as mobilization, proprioception, etc.? What do you do in such case?

And, thank you for sent to me your papers by email in the past year, and I would like to know if Body in Peace is avallible in English.

Thanks a lot.

Kind regards 

Hi Rodolfo,

See the following papers, maybe help you.

Souza, R. B., & Powers, C. M. (2009). Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. The Journal of Orthopaedic and Sports Physical Therapy, 39(1), 12–9. http://doi.org/10.2519/jospt.2009.2885

Zazulak, B. T., Ponce, P. L., Straub, S. J., Medvecky, M. J., Avedisian, L., & Hewett, T. E. (2005). Gender comparison of hip muscle activity during single-leg landing. The Journal of Orthopaedic and Sports Physical Therapy, 35(5), 292–299. http://doi.org/10.2519/jospt.2005.1734

Tateuchi, H., Taniguchi, M., Mori, N., & Ichihashi, N. (2012). Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension. Journal of Electromyography and Kinesiology, 22(3), 391–397. http://doi.org/10.1016/j.jelekin.2012.03.003

Dorn, T. W., Schache, A. G., & Pandy, M. G. (2012). Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. The Journal of Experimental Biology, 215(Pt 11), 1944–56. http://doi.org/10.1242/jeb.064527

Lunnen, J. D., Yack, J., & LeVeau, B. F. (1981). Relationship between muscle length, muscle activity, and torque of the hamstring muscles. Physical Therapy, 61(2), 190–5. http://doi.org/10.1016/S0268-0033(02)00070-0

Fujisawa, H., Suzuki, H., Yamaguchi, E., Yoshiki, H., Wada, Y., & Watanabe, A. (2014). Hip Muscle Activity during Isometric Contraction of Hip Abduction. Journal of Physical Therapy Science, 26(2), 187–90. http://doi.org/10.1589/jpts.26.187

Kirker, S. G., Jenner, J. R., Simpson, D. S., & Wing, a M. (2000). Changing patterns of postural hip muscle activity during recovery from stroke. Clinical Rehabilitation, 14(00), 618–626. http://doi.org/10.1191/0269215500cr370oa

Regards,

Dear Adbel-Rahman. Thanks a lot for these papers. It will very helpful. 

Warm regards

Hello, Professor Rodolfo Parreira. I am in the field of Telerehabilitation. One of my present works is related to your main question, which I found really interesting. May i kindly inquire what you have found out so far? I was hoping you have answered your question already. Thank you.

Dear Carl. Thanks for your contact. Actually I haven´t found yet a speific paper regard to this issue, but acording to some related studies, i can see that during postural balance strategy a top-down muscle contraction pattern accour where in the ankle strategy, muscles from shin such as tibialis and peroneal they act to mantain the body balance in small perturbation. But in greater perturbations of postural balance, such muscles does not support the ankle strategy because of the arm level of the inverted pendulum, so the hip comes into action through the hip muscles, mainly gluteus medius. 

In my doctoral thesis, I will investigate this issue. We can keep in touch for further information through my email: [email protected]

I hope that these informations has helped you, or if not, please, let me know. 

Kind regards