Introduction
In addition to the central postural program, multiple
sensory modalities are involved in the organization
and control of human erect posture. Numerous
studies have focused on the specific role of
vestibular,
1,2
visual
3,4
or muscular
5,6
sensory informa-
tion, but little is known about the role of cutaneous
information from the soles. Because they are at the
boundary between the body and the ground, the
cutaneous mechanoreceptors of the soles might play
an important role in controlling balance.
Data supporting this view were obtained through
two experimental approaches. A first method con-
sisted of transiently eliminating the exteroceptive
afferents by cooling
7
or anesthetizing
8,9
the plantar
soles. In all cases, suppressing these inputs increased
the postural instability. The body sways induced by
sinusoidal low frequency (0.3 Hz) displacement of
the supporting surface were also increased when
an ischemic block of afferent fibers was applied
above the ankles.
10,11
In addition, this loss of foot
sensitivity resulted in a new strategy to compensate
the body disequilibrium, that is, an increased hip
strategy instead of the ankle strategy generally used
under normal conditions.
12
The ischemic blocking
method, however, does not selectively exclude
the tactile afferences since it also eliminates all the
somatosensory inputs from the feet, including the
proprioceptive ones.
The second method generally used to study the
role of plantar cutaneous messages in postural control
consisted of changing the characteristics of the
supporting surface on which the subject is standing.
In fact, by recording the pressure distribution under
the soles, Wu and Chiang
13
demonstrated that
standing on a soft (foam) surface reduced the ampli-
tude of the maximal plantar pressures and increased
the contact area between the sole and the support.
The resulting ankle muscle responses induced by a
sudden toes-up rotation of this supporting surface
were then delayed. Conversely, standing on a shot-
gun ball platform
14
resulted in a decrease in the
postural body sways.
The contribution of plantar cutaneous afferents to
balance control is largely evidenced by these proto-
cols excluding or stimulating all of these afferents.
However, how the plantar mechanoreceptors are
functionally involved in balance control remains
unclear. Studies focusing on the mechanoreceptors of
the glabrous skin of the rat foot
15
and of the human
hand
16
and foot
17
have shown there are different types
of mechanoreceptors, whose distribution and density
vary according to the skin areas considered. Because
of their specific functional properties, the mechano-
receptors are able to code together the spatial origin,
Cognitive Neuroscience
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0959-4965 © 1998 Lippincott Williams & Wilkins Vol 9 No 14 5 October 1998 3247
THIS study investigated the role of the plantar
cutaneous information in controlling human balance.
We hypothesized that the cutaneous afferent messages
from the main supporting zones of the feet have suffi-
cient spatial relevance to inform the CNS about the body
position with respect to the vertical reference and conse-
quently to induce adapted regulative postural responses.
Skin mechanoreceptors of anterior and/or posterior
areas of one or both soles of 10 standing subjects
were activated by superficial mechanical vibration with
high frequency and low amplitude. Variations of the
subject’s center of pressure (CoP) were recorded.
Spatially oriented whole-body tilts were observed for
every subject. Their direction depended on the foot areas
stimulated and was always opposite to the vibration-
simulated pressure increase. These responses are found
to subserve a postural regulative function and we
suggest that co-processing of the various cutaneous
messages followed a vector addition mode. NeuroReport
9: 3247–3252 © 1998 Lippincott Williams & Wilkins.
Key words: Center of pressure (CoP); Human posture;
Soles; Tactile afferents; Vibration
The plantar sole is a
‘dynamometric map’ for
human balance control
Anne Kavounoudias,
CA
Régine Roll
and Jean-Pierre Roll
Laboratoire de Neurobiologie Humaine, UMR
6562, CNRS-Université de Provence, Marseille
cedex 20, France
CA
Corresponding Author
Website publication 16 October 1998 NeuroReport 9, 3247–3252 (1998)