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Plantar Pressure, Cutaneous Sensation and Stochastic Resonance: An Examination of Factors Influencing the Control and Perception of Posture

The goal of this dissertation was to understand how people control posture in the context of sensory loss. To do so we explored three potential influences on the detection of external information and how they relate to the control of posture and perception of body orientation: 1) does changing posture alter the forces under the foot, and do these changes impact the ability to detect external vibrations? 2) Does decreasing the temperature of the foot influence the ability to detect external vibrations, the perception of body orientation, and the control of posture? And 3) does stochastic resonance (SR) improve the perception of body orientation and the control of posture when the sensory thresholds are elevated to clinical levels through cooling of the feet? The results of the experiments indicate that: 1) increasing the pressure under the feet, elicited by changes in posture, elevates the cutaneous sensory threshold, and that the forefoot appears to be more sensitive than the rearfoot to changes in weighting; 2) decreasing the temperature of the skin elevates cutaneous sensory thresholds, and impacts postural control by constraining the fluctuations of the medial-lateral center of pressure; and 3) applying SR to the soles of the feet improves the ability to perceive body position, with greater amounts of skin cooling resulting in greater improvements in postural performance due to SR. This dissertation demonstrates that decreasing plantar loading lowers cutaneous sensory thresholds, indicating that the changes in postural fluctuations frequently observed among those with clinical sensory loss may serve as a mechanism that allows for improved access to external information if they prove to reduce the pressure under sensory impaired portions of the feet. Additionally, we add to the growing body of literature identifying SR as a means to improve postural performance when cutaneous sensory function is impaired. From a clinical perspective, the results presented here indicate that aids designed to apply SR to the soles of the feet, as a means to improve posture and gait, should modulate their signal such that they apply a signal amplitude appropriate to the amount of loading the foot experiences.
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