Rambling–trembling analysis separates the center of pressure into two components: the rambling component (RM: supraspinal) and trembling component (TM: muscle stiffness/reflex). We hypothesized that persons with spinal cord injury (SCI) would demonstrate decreased RM resulting from altered supraspinal processing and increased TM resulting from increased muscle stiffness. We also anticipated that the TM component would be greater in SCI patients with Harrington rods than in those without them. The seated postural control was assessed in 18 persons with SCI, comprising 12 with and six without Harrington rods, and 18 age-matched controls. The SCI group had greater center of pressure sway, RM, and TM components than the controls, with no difference in the postural sway between the SCI subgroups, suggesting that the impairment of seated postural control in individuals with SCI results from disturbed supraspinal and peripheral mechanisms, but that the control itself is unaffected by internal fixation with Harrington rods. These were not entirely consistent with our hypothesis.
Sunghoon Shin and Jacob J. Sosnoff
Sunghoon Shin, Robert W. Motl and Jacob J. Sosnoff
The rambling-trembling analysis of postural control maintains that the center of pressure (COP) trajectory can be decomposed into deviations resulting from supraspinal (i.e., rambling; RM) and spinal processes (i.e., trembling; TM). The purpose of this investigation was to test the rambling and trembling hypothesis by comparing persons with multiple sclerosis (MS) who had either elevated or normal spinal reflexes to healthy controls. 16 subjects with MS and 16 age and gender matched control subjects completed a postural control task. The persons with MS were divided into groups with high (MShigh) or low (MSlow) H-reflex amplitude. The MShigh group had an elevated ratio of TM to COP compared with healthy controls, but no differences in the ratio between RM and COP. The findings are congruent with the assumptions of the rambling-trembling hypothesis. Further work is needed to determine if RM and TM represent distinct spinal and supraspinal mechanisms to postural control.