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  • Interpersonal interactions ...
    Steinl, S.M.; Sparto, P.J.; Atkeson, C.G.; Redfern, M.S.; Johannsen, L.

    Gait & posture, 09/2018, Letnik: 65
    Journal Article

    •Passive support mode demonstrated its advantages in increased strength of the IPC.•Active support mode decreased the postural sway to a greater extent.•More partnership based methods should be considered for balance rehabilitation.•Postural control can be responsive to social factors. Caregiver–patient interaction relies on interpersonal coordination during support provided by a therapist to a patient with impaired control of body balance. The purpose of this study was to investigate in a therapeutic context active and passive participant involvement during interpersonal support in balancing tasks of increasing sensorimotor difficulty. Ten older adults stood in semi-tandem stance and received support from a physical therapist (PT) in two support conditions: 1) physical support provided by the PT to the participant’s back via an instrumented handle affixed to a harness worn by the participant (“passive” interpersonal touch; IPT) or 2) support by PT and participant jointly holding a handle instrumented with a force-torque transducer while facing each other (“active” IPT). The postural stability of both support conditions was measured using the root-mean-square (RMS) of the Centre-of-Pressure velocity (RMS dCOP) in the antero-posterior (AP) and medio-lateral (ML) directions. Interpersonal postural coordination (IPC) was characterized in terms of cross-correlations between both individuals’ sway fluctuations as well as the measured interaction forces. Active involvement of the participant decreased the participant’s postural variability to a greater extent, especially under challenging stance conditions, than receiving support passively. In the passive support condition, however, stronger in-phase IPC between both partners was observed in the antero-posterior direction, possibly caused by a more critical (visual or tactile) observation of participants’ body sway dynamics by the therapist. In-phase cross-correlation time lags indicated that the therapist tended to respond to participants’ body sway fluctuations in a reactive follower mode, which could indicate visual dominance affecting the therapist during the provision of haptic support. Our paradigm implies that in balance rehabilitation more partnership-based methods promote greater postural steadiness. The implications of this finding with regard to motor learning and rehabilitation need to be investigated.