The integration of multiple proprioceptive information: effect of ankle tendon vibration on postural responses to platform tilt.

Previous studies have looked at co-processing of multiple proprioceptive inputs but few have investigated the effect of separate dynamic and tonic predominantly proprioceptive disruptions applied concurrently at the same segment. The purpose of the present study was to investigate how simultaneous ankle tendon vibration, a tonic stimulus, with a dynamic toes-up (TU) or toes-down (TD) platform perturbation (1) affects postural stability and (2) influences the adaptation process. Sixteen normal subjects (ten male, six female, mean age 26 +/- 4.8 years) stood blindfolded on a moving platform with vibrators attached bilaterally over the Achilles tendons. Participants were tested in quiet stance (QS), and with five successive TU and TD tilts. All tests were conducted both with (QS+V, TU+V, TD+V) and without vibration. Centre of pressure (CoP) displacements and pitch angular trunk velocity were recorded. Results for QS+V showed a significant 1.02-cm backward CoP displacement (P<0.01) and a significant increase in trunk velocity (peak-to-peak amplitude, P<0.05; SD of trunk velocity, P<0.05). TU+V resulted in a non-significant increase of maximum backwards CoP displacement when compared to TU alone. In addition, no notable effect of vibration on other measures of CoP (pre-tilt position, SD and area of sway) and trunk velocity (peak-to-peak, SD and area of sway) indicates that TU+V does not introduce significantly greater instability compared to tilt alone. In the TD condition, vibration was found to be a stabilising influence, causing a significant shift of the mean pre-tilt position 0.85 cm backwards (P<0.01) and a substantial decrease in the area of forward CoP displacement (P<0.01). However, maximum forwards CoP displacement and trunk velocity measures were not significantly altered during TD+V. Furthermore, in neither TU nor TD was the time-course or pattern of adaptation disrupted by the additional application of vibration. In conclusion, although vibration significantly affects postural measures when applied in isolation, this finding does not hold when it is applied in combination with a more dynamic stimulus. Instead it seems that once postural stability has been disrupted the central nervous system can rapidly assess information from a weaker tonic input and utilise or suppress it appropriately, depending on its effect towards overall postural control. It can be concluded that postural responses to the concurrent application of different predominantly proprioceptive stimuli are dependent upon the type of stimulus and the ability of the central nervous system to rapidly assess and re-weigh available sensory inputs.