Network Analysis of Bodywide Coordination Supporting Suprapostural Dexterity

Prevailing understandings of movement disorders characterize "broken" movements in a piecewise fashion, for instance, focusing on motor control, muscle tone, posture, or cognition independently of each other. These fractured approaches to movement coordination are blind to the body's functional integrity. Consequently, rehabilitative interventions target the limb or body parts most affected by the disorder, seeking to support the whole body by mending the broken part. However, dexterity is global, functional coordination spanning the whole body. In other words, task completion draws on fundamental interactivity, allowing the body to coordinate various anatomical parts. This coordination may be more vital to healthy movement than individual anatomical parts. Understanding this interactivity is thus paramount to developing novel rehabilitative interventions to prevent falls and improve the quality of life in pathological populations. Studying bodywide coordination for suprapostural dexterity requires innovation in experimental setup and analytical techniques. This project integrates a customizable life-size Trail Making Test with posturography, whole-body movement tracking, eye tracking, and state-of-the-art cascade modeling and network analysis methods to assess functional coordination across the whole body. The experimenters will leverage causal network analyses of multiplicative interactions instrumental in previous studies of whole-body exploratory motor behavior but not yet utilized in studying suprapostural dexterity. Aim 1 will investigate how multiplicative interactions among movement-system components support suprapostural dexterity. The experimenters hypothesize that maintaining an upright stance would produce a functional network of multiplicative interactions among movement-system components. The experimenters also hypothesize that participating in the Trail Making Test would produce a succession of distinct, modular networks of multiplicative interactions among movement-system components. Aims 2 will investigate how multiplicative interactions among movement-system components support suprapostural dexterity in the face of postural instability. The experimenters hypothesize that destabilizing contact with the ground surface when maintaining an upright stance will produce modular networks of multiplicative interactions with increased connectivity among these modules compared to stable standing. The experimenters also hypothesize that destabilizing contact with the ground surface in the Trail Making Test would produce a succession of distinct, modular networks of multiplicative interactions with increased connectivity among these modules compared to stable standing. This modeling framework offers a new way to understand suprapostural dexterity and its breakdown in various movement disorders in light of recent theoretical developments in cascade modeling and network physiology.

Study Overview

• Status: Completed
• Conditions: Balance Board; Trail Making Task
• Intervention / Treatment: Behavioral: Trail Making Task; Behavioral: Balance board

Detailed Description

It is estimated that 42 million people in the United States might suffer from some form of movement disorder. Prevailing understandings of these movement disorders characterize "broken" movements in a piecewise fashion, for instance, focusing on motor control, muscle tone, posture, or cognition independently of each other. These fractured approaches to movement coordination are blind to the body's functional integrity. Consequently, rehabilitative interventions target the limb or body parts most affected by the disorder seeking to support the whole body by mending the broken part. However, dexterity is global, functional coordination spanning the whole body. Suprapostural dexterity, for instance, when the task requires an upright posture, is a prime example of how functionality can triumph over anatomical separability. Whatever starts at one or more anatomical areas can swiftly spread throughout the entire body, destabilizing the body on the potential path to task completion. In individuals with movement disorders, the impaired coordination between task engagement and postural instability amplifies the risk of falling. Developing novel rehabilitative interventions to prevent falls and improve the quality of life in individuals with movement disorders thus requires understanding how task completion depends on essential interaction that enables the body to coordinate different anatomical parts.

This project investigates how multiplicative interactions support suprapostural dexterity from two complementary premises. First, movement science has established that postural stability requires a modular structure of functional networks shaped by anatomical constraints. This arrangement indicates a soft assembly and disassembly of functional modules as an individual engages in a task and responds to changing task demands, respectively. Second, movement science has yet to grapple with the multiplicative interactions among movement-system components producing highly complex and unpredictable behaviors beyond the scope of dominant linear modeling approaches. The scientific premises for this proposal are that the dominant network approaches to dexterity are linear, and network approaches can give voice to the nonlinearity we all know is there.

Studying multiplicative interactions among movement-system components and suprapostural dexterity requires innovation in experimental setup and analytical techniques. This project integrates a customizable life-size Trail Making Test (TMT) with posturography, whole-body movement tracking, and eye tracking, along with state-of-the-art cascade modeling and network analysis methods to assess functional coordination across the whole body. The experimenters will leverage causal network analyses of multiplicative interactions instrumental in previous studies of whole-body exploratory motor behavior but not yet utilized in studying suprapostural dexterity.

Specific Aim 1: To investigate how multiplicative interactions among movement-system components support suprapostural dexterity.

Hypothesis 1.1: The experimenters hypothesize that maintaining an upright stance would produce a functional network of multiplicative interactions among movement-system components.

Hypothesis 1.2: The experimenters hypothesize that participating in the Trail Making Test would produce a succession of distinct, modular networks of multiplicative interactions among movement-system components.

Specific Aim 2: To investigate how multiplicative interactions among movement-system components support suprapostural dexterity in the face of postural instability.

Hypothesis 2.1: The experimenters hypothesize that destabilizing contact with the ground surface when maintaining an upright stance will produce modular networks of multiplicative interactions with increased connectivity among these modules compared to stable standing.

Hypothesis 2.2: The experimenters hypothesize that destabilizing contact with the ground surface in the Trail Making Test would produce a succession of distinct, modular networks of multiplicative interactions with increased connectivity among these modules compared to stable standing.

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Nebraska
    • Omaha, Nebraska, United States, 68182
      • Biomechanics Research Building

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Be able to provide informed consent
• Be able to stand and walk independently without an assistive device

Exclusion Criteria:

• Self-report any diagnosis of a neurological disease
• Self-report any diagnosis of any limb disabilities, injuries, or disease.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Trail Making Task on Stable Surface; Participants perform the Trail Making Task while standing on stable force plates.	Behavioral: Trail Making Task; Participants will perform a modified, life-size version of the Trail Making Test (TMT) while standing upright, either on a stable (force plates) or unstable (balance board) surface. The task involves visually searching for and tracing a sequential path through spatially randomized numerical targets projected onto a large screen using a laser pointer. This dual-task condition simultaneously engages cognitive, visual, and motor planning systems while requiring continuous postural control. The task is designed to elicit suprapostural coordination, capturing the dynamic interplay between postural stability and goal-directed behavior.
Experimental: Standing on Unstable Surface; Participants maintain upright stance on a balance board placed atop force plates (no cognitive task).	Behavioral: Balance board; Participants will maintain an upright stance on a commercially available balance board positioned atop dual force plates. The unstable surface introduces controlled postural instability, requiring continuous sensorimotor adaptation to preserve balance without external support. This condition is administered alone and in combination with the Trail Making Task to simulate dual-task challenges that more closely resemble real-world balance demands.
Experimental: Trail Making Task on Unstable Surface; Participants perform the Trail Making Task while standing on a balance board, requiring simultaneous postural and cognitive-motor coordination.	Behavioral: Trail Making Task; Participants will perform a modified, life-size version of the Trail Making Test (TMT) while standing upright, either on a stable (force plates) or unstable (balance board) surface. The task involves visually searching for and tracing a sequential path through spatially randomized numerical targets projected onto a large screen using a laser pointer. This dual-task condition simultaneously engages cognitive, visual, and motor planning systems while requiring continuous postural control. The task is designed to elicit suprapostural coordination, capturing the dynamic interplay between postural stability and goal-directed behavior.; Behavioral: Balance board; Participants will maintain an upright stance on a commercially available balance board positioned atop dual force plates. The unstable surface introduces controlled postural instability, requiring continuous sensorimotor adaptation to preserve balance without external support. This condition is administered alone and in combination with the Trail Making Task to simulate dual-task challenges that more closely resemble real-world balance demands.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Network structure	The outcome measure characterizes the directional, weighted network of multiplicative interactions across the human movement system, derived from vector autoregression (VAR) analysis of multifractal fluctuations in center-of-pressure (CoP), center-of-mass (CoM), and 79 anatomical marker displacement series. Each node in the network represents a body segment or anatomical location, and each edge captures the strength and direction of influence in nonlinear fluctuation propagation across time. These networks are modeled individually for each participant and task condition.	Day 1

Collaborators and Investigators

• Sponsor: University of Nebraska

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2023
• Primary Completion (Actual): July 31, 2024
• Study Completion (Actual): July 31, 2024

Study Registration Dates

• First Submitted: June 25, 2025
• First Submitted That Met QC Criteria: July 7, 2025
• First Posted (Actual): July 11, 2025

Study Record Updates

• Last Update Posted (Actual): July 11, 2025
• Last Update Submitted That Met QC Criteria: July 7, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Fall prevention; Motor coordination; Postural instability; Movement disorder; Posturography; Eye tracking; Dexterity; Network analysis; Suprapostural control; Whole-body coordination; Multiplicative interactions; Modular motor networks; Nonlinear movement variability; Trail Making Test (TMT); Whole-body kinematics; Rehabilitation science
• Other Study ID Numbers: 0055-23-EP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No