The Neuroscience and Future Technology based upon the Bobath Concept
Postural Control; Kaoru Takakusaki, Asahikawa Medical University
This lecture considers neuronal mechanisms of postural control. Clinical studies have shown that posture-gait disturbance is attributed to the dysfunction of the whole neuraxis and the musculoskeletal system. The cerebral cortex, basal ganglia, cerebellum, brainstem, and spinal cord temporally and spatially integrate and coordinate multisensory feedback and efferent copies of the motor command. Therefore, the extensive repertoire of voluntary movements can be coupled with anticipatory and reactive postural adjustments to provide the framework for supporting and stabilizing the goal-directed gait activity. Redundancies in the system allow adaptation and compensation through reward-oriented and error-based learning processes implemented through the BG and cerebellar pathways, respectively. However, the impairment of these systems may compromise the capacity to adapt and lead to maladaptive changes, impairing posture-gait control. When these impairments occur, the risk of falls can significantly increase, and interventions are required to reduce morbidity.
This lecture will outline 1) the fundamental postural control systems in the brainstem and spinal cord, 2) the roles of the neurotransmitters that regulate their activity, and 3) the higher function of postural control by the cerebral cortex, basal ganglia, and cerebellum. Finally, the pathophysiology of posture-gait disorders in Parkinson's disease is discussed based on the above mechanisms.
Prof. Naitoh
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Prof. Yamazaki
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