Postural control has been the subject of numerous studies for more than a century. From the pioneering investigations of Hinsdale in the US and Vierordt in Germany to the most recent studies involving up-to-date techniques, such as TMS or virtual surroundings, thousands of publications were devoted to this scientific field.
One feature of research on postural control is that it includes both fundamental and clinical approaches. This feature alone justifies the interest of NCCN, which claims to provide “the most recent and prominent developments in neurophysiologic investigations of the central and peripheral nervous system and of the muscle of normal or ill human beings”. Healthy subjects and disabled individuals are, indeed, commonly involved in protocols, whereas balance control is achieved by loops mobilizing various levels of the central nervous system (CNS), hence justifying the design of this NCCN special issue.
Our choice of the topics that will be developed in this issue comes from our wish to survey all the main issues dealing with postural control.
As postural control can be challenged by the subject itself or by various laboratory settings, several approaches or protocols can be used depending on the biomechanical constraints (does the subject need to displace his centre of gravity or doesn’t he?) or instructions (should the subject stand still or should he displace one or several segments?). The complexity of postural control comes from the multiple motor strategies that can be implemented to achieve balance. This diversity explains why posturokinetic coordination and gait control can also help better assess our knowledge of postural control mechanisms. A growing number of articles nowadays deal with upright quiet stance control and its technique of measure, that is, posturography. However, there is no real consensus about the way to analyse these data that are obtained from force platforms.
Moreover, if the main objective is to control a reference variable (body segments motions or centre-of-gravity position), the sensory information that is used to this aim is complex, as it can involve vestibular, somatosensory, and visual information. In healthy individuals, each of these sensory dimensions can be preferentially used, depending on the nature of the task and the experiences that have been lived through in the past. Accordingly, reviews about the specific role played by each sensory input (visual, somatosensory, gravitational, and vestibular) will be proposed.
Moreover, various diseases and impairments share the particularity to interfere with postural control capacities. Therefore, we chose to include both neurological and orthopaedic impairments in the clinical part of this issue.
Postural control can involve more or less automatic networks, involving higher- or lower-level structures of the CNS. We are now far away from the concepts developed by Sir Charles Sherrington, who was considering postural control as a pure automatic mechanism based on stretch reflex loops.
Finally, the risk of falling becomes the main cause of morbidity in the elderly. Therefore, we will provide a review of the increasing number of studies that have been conducted in order to detect these individuals with a potential risk to fall.
We are aware that many NCCN readers may not be familiar with this scientific field. All papers have been written with the objective to be accessible to non-specialist readers. We seize the opportunity to warmly thank all contributors who spent a lot of time for collecting the appropriate references in each domain and try to be mostly didactic. We hope that you will enjoy reading all these articles.
Good reading!