Integrating ankle and hip strategies for the stabilization of upright standing: An intermittent control model.

Even in unperturbed upright standing of healthy young adults, body sway involves concurrent oscillations of ankle and hip joints, thus suggesting to using biomechanical models with at least two degrees of freedom, namely, a double inverted pendulum (DIP) framework. However, in a previous study, it was demonstrated that the observed coordinated ankle-hip patterns do not necessarily require the independent active control of the two joints but can be explained by a simpler hybrid control system, with a single active component (intermittent, delayed sensory feedback of the ongoing sway) applied to the ankle joint and a passive component (stiffness control) applied to the hip joint. In particular, the proposed active component was based on the internal representation of a virtual inverted pendulum (VIP) that links the ankle to the current position of the global center of mass (CoM). This hybrid control system, which can also be described as an ankle strategy, is consistent with the known kinematics of the DIP and, in particular, with the anti-phase correlation of the acceleration profiles of the two joints. The purpose of this study is to extend the hybrid control model in order to apply to both the ankle and hip strategy, clarifying as well the rationale of mixed strategies. The extension consists of applying the hybrid control scheme to both joints: a passive stiffness component and an active intermittent component, based on the same feedback signals derived from the common VIP but with independent parameter gains for the two joints. Thus, the hip gains are null in the pure ankle strategy, the ankle gains are null in the pure hip strategy, and both ankle and hip gains are specifically tuned in mixed strategies. The simulation of such an extended model shows that it can reproduce both strategies; moreover, the pure ankle strategy is more robust than the hip strategy, because the range of variation (RoV) of the intermittent control gains is larger in the former case than in the latter, and the pure ankle strategy is also more energy efficient. Generally, the simulations suggest that there is no advantage to employ mixed strategies, except in borderline situations in which the control gains are just outside the RoV that provides stable control for either pure strategy: in this case, a stable mixed strategy can emerge from the combination of two marginally unstable pure strategies.