The purpose of this dissertation was to explore methods for generating neuroplastic changes in healthy individuals using transcutaneous spinal cord stimulation (TSCS) and perturbation-based training in order to improve balance performance. This was done to gain an understanding of their effects on healthy individuals, which could then be used in designing treatments for both healthy and motor-impaired subjects. Three studies were undertaken. First, we set out to show that the Robotic Upright Stand Trainer (RobUST) could generate improvements in balance after perturbation balance training (PBT). In this same study, we showed that the assist-as-needed support of RobUST generates postural control improvements. Balance performance metrics including (i) margin of stability (MOS), (ii) metrics based on the center of pressure (COP) and center of mass (COM) excursions, (iii) postural muscle activations, (iv) balance strategy selection (between ankle and hip strategies) were used in this study.

"... Our aims were: 1) To characterize reactive balance responses to unannounced forward, backward and lateral surface translations during standing in subacute PwS and in healthy age-matched individuals. This aim included two sub-aims: 1a) To explore the inter-observer reliability of reactive balance capacity and reactive balance strategies assessment in PwS and healthy individuals. 1b) To compare reactive balance capacity, reactive step strategies and reactive step kinematics between PwS and healthy individuals. 2) To explore the associations between reactive balance capacity and commonly used performance-based measures of motor impairments, balance and gait in PwS. 3) To examine the effect of a short-term perturbation-based balance training (PBBT) on reactive balance responses, balance confidence and performance-based measures of balance and gait compared with non-perturbation balance training in subacute PwS. 4) To explore the impact of lesion location in each hemisphere on reactive and anticipatory balance capacity, gait and hemiparetic lower limb function in PwS. ..." - from the abstract.

Falls are a major health concern for older adults. A fall occurs when an individual fails to recover from a balance loss, so programs that improve balance recovery ability should prevent falls. Change-in-support (CIS) reactions, involving rapid stepping and grasping movements, can prevent a fall following a postural perturbation. Age-related impairments in CIS reactions are associated with increased falls risk. This work aims to develop and evaluate a training program involving repeated exposure to unpredictable balance perturbations to train specific age-related impairments in CIS reactions. Older adults (64--80 years) with a history of falls or instability were randomly assigned to either a 6-week perturbation-based training program (PERT) or a stretching and flexibility control group (CON). During training, PERT subjects stood on a platform that translated unpredictably 30cm forward, backward, left or right. Stepping and grasping reactions were trained separately during each session; handrails were removed for step training, and foam blocks were used to prevent stepping during grasp training. Concurrent cognitive and movement tasks were included to simulate 'real world' balance-loss situations. Perturbation magnitude was progressively increased throughout the program. CIS reactions were evaluated before and after training using surface-translation and waist-pull perturbations, allowing for examination of training-specific and generalizable adaptations, respectively. A two-way repeated measures ANOVA with group-by-time interaction was used to assess the training effects on reaction features targeted during PERT training: (a) frequency of multi-step responses, (b) frequency of antero-posterior trials in which extra lateral steps occurred, (c) frequency of lateral trials in which collisions between the swing and stance limb occurred, (d) grasping reaction time, and (e) handrail grasp time.Compared to CON subjects, PERT subjects showed greater reductions in multi-step reactions and frequency of foot collisions; these effects were only statistically significant for surface translation trials (p

Balance Dysfunction in Parkinson's Disease: Basic Mechanisms to Clinical Management presents the most updated information on a variety of topics. Sections help clinicians evaluate the types of balance control issues, dynamic balance dysfunction during turning, and the effects of medication, deep brain stimulation, and rehabilitation intervention on balance control. This book is the first to review the four main postural control systems and how they are affected, including balance during quiet stance, reactive postural adjustments to external perturbations, anticipatory postural adjustments in preparation for voluntary movements, and dynamic balance control during walking and turning. In addition, the book's authors summarize the effects of levodopa, deep brain stimulation, and rehabilitation intervention for each balance domain. This book is recommended for anyone interested in how and why balance control is affected by PD. - Provides the first comprehensive review of research to date on balance dysfunctions in Parkinson's disease - Discusses how to translate current neuroscience research into practice regarding neural control of balance - Provides evidence on the effects of current interventions on balance control

The proliferation of new research in the field of neuroscience and motor control has made it difficult to keep pace with the latest findings. This text bridges the gap between research/theory and practice by focusing on the scientific and experimental basis of new motor control theories. Specific examples of theoretical models are provided to clearly illustrate how recent findings and theories can be applied to clinical practice. Each chapter includes an outline, key terms in boldface type, active learning boxes, and a chapter summary to ensure maximum comprehension of the material. The text is intended for physiotherapy and occupational therapy students.