Gabriele Phillips

Cody Farah
Rebecca Mellman
Noelle Bediamol
KINE 301

Postural sway during dark and light conditions while carrying heavy loads

Introduction
The small amount of horizontal movement around the center of gravity (CoG), exhibited

by humans, during quiet standing is referred to as postural sway. Quiet standing describes a

persons stance that has not been disturbed by the environment or an individuals own behavior.

On average, the amount of postural sway during quiet standing is 8 anteriorly, 4.5 posteriorly,

for a total of 12.5 in the antero-posterior direction (McMackin, 2017).

The integration of visual, somatosensory, and vestibular sensory information control the

ability of an individual to maintain balance (Asslnder & Peterka, 2016, p.272; Anson et al.,

2014, p. 1; Haran & Keshner, 2008, p.186). Research has concluded that increased postural sway

in older adults is relative to the loss of these senses (Anson et al., 2014, p. 2) and increases the

probability of falling (Benjuya, Melzer, & Kaplanski, 2004, p. 16). When one sensory cue is

removed or absent, the ability to balance must then rely on the other sensory systems in a process

described as reweighting (Asslnder & Peterka, 2016, p.272; Haran & Keshner, 2008, p. 186).

Loss of the visual sensory system either through disease, blindness, or light perception results in

an increased reliance on the somatosensory and vestibular sensory systems which can have a

negative effect on sway (Asslnder & Peterka, 2016, p.284).

Reduction in vision, as well as the manipulation of visual stimulation, has been shown to

have the greatest effect on postural sway and balance control (Holden et al., 2016, p. 113;

Benjuya et al., 2004, p. 169). Numerous studies have been conducted on the effect of light and

darkness in relation to the amount of time it took for a change in postural sway to occur or the
effect the speed of a visual stimulus has on sway. These studies concluded that the lack of light

and the manipulation of visual cues had a negative effect on postural sway (Asslnder & Peterka,

2016, p.283; Holten et al., 2016, p.123). Studies on the increased amount of load in addition to

body mass revealed an increase in postural sway (Rugelj, & Sevek, 2011, p. 866). Contradictory

findings in a study on overweight child participants indicated that the extra body mass had no

effect on postural sway as compared to normal weight individuals (Pau, Kim, & Nussbaum,

2012, p. 380).The results of these studies suggest that a persons sensory functions and sway

adjust to constant loads, such as body weight, while added or unexpected load causes

destabilization.

Our research used healthy college aged students because they would have a lesser degree

of postural sway, no age related ailments, and the ability to hold a 21.5 pound load. Negative

outcomes, or increased postural sway, based on the absence of light could be due to the

reweighting effect and the reliance of the somatosensory and vestibular systems in maintaining

postural sway. Research on postural sway, the lack of light affecting the visual system, and

added weight could be beneficial in fall prevention for the elderly. Outcomes from this research

may also have military applications for personnel who frequently patrol at night carrying heavy

equipment and gear.

The purpose of this study is to determine how the addition and removal of light affects

the postural sway of individuals carrying a heavy load. Based on the negative results of previous

research evaluating outcomes of light on the speed of sway and a deficiency of research

evaluating the amount of sway relative to the absence of light, we hypothesis that light

deprivation will negatively affect the subjects postural sway in both the medio-lateral and

antero-posterior directions.
Methods

Participants

Eighteen college aged subjects (13 females and 5 males) participated in this study. They

were required to be healthy and free of injury during the trials, however, if they had previous

injuries they were not excluded. The injuries needed to be completely healed prior to testing.

Procedures

The experiment consisted of subjects carrying the same weight backpack in two

conditions: lights on and lights off. The backpack weighed 1.5 pounds and the added weight was

20 pounds. To verify the weight, a Health O Meter Professional scale (McCook, IL) was used.

To ensure the room was dark enough, all lights were turned off and the computer screen was

turned away from the subject. Subjects stood on both feet during each of the conditions. The

subjects were asked to focus on a dot on the wall directly in front of them during both the light

and dark conditions. For the dark condition the lights remained on until the subject stepped onto

the platform. During the dark condition the subjects were asked to focus on the dot to the best of

their ability. The subjects either wore socks or went barefoot while standing on the force

platform (Bertec, Columbus, OH). Each trial allowed 30 seconds for data collection in MatLab

(Natick, MA).

Data

Data was collected with a force platform at 1000 Hz. The data were sent to a computer

installed with MatLab. MatLab saved the data as Excel (Redmond, WA) spreadsheets. The data

were compared in Excel with paired t-tests. The alpha for this study was set to 0.05.
Results

Figure 1 Participants averages (mm) for the medio - lateral and antero - posterior displacement
for postural sway with lights on. (The 1 = Medio - Lateral and 2 = Antero - Posterior)

Figure 2 Participants averages (mm) for the medial-lateral and antero-posterior displacement for
postural sway with lights off. (The 1 = Medio - Lateral and 2 = Antero - Posterior)
Figure 3 Participants averages (mm) for the medio - lateral displacement for postural sway with
the lights on and off. (The 1 = Medio - Lateral with lights on and 2 = Medio - Lateral with the
lights off)

Figure 4 Participants averages (mm) for the antero - posterior displacement for postural sway
with the lights on and off. (The 1 = Antero - Posterior with lights on and 2 = Antero - Posterior
with the lights off)
 Table 1 Participants sway averages (mm) + SD for two conditions in the Medio-Lateral and
Anterior-Posterior
Types of Conditions Average Medio - Lateral Average Antero - Average Overall Postural
(mm) + SD Posterior (mm)+ SD Sway

Lights On 22.41835 + 4.6616 22.627617 + 4.2993 32.113515

Lights Off 23.010728 + 7.0229 25.027839 + 7.4460 34.613164

Effects of Postural Sway with Lights On Versus Off

The participants averages (mm) of their medio - lateral and antero - posterior directions

(Figure 1 and 2). All eighteen subjects performing the postural sway test with the lights on and

off have a statistical significance set to less than 0.05. A paired t -test was used in Excel to

compare the overall postural sway of lights on and off (p = 0.25). There was no significant

difference between the lights on and off affecting postural sway.

Effects of Postural Sway in Medio - Lateral with Lights On Versus Off

The participants medio - lateral averages (mm) with lights on and off presented a slight

difference between the medio - laterals within their postural sway (Figure 3). The medio - lateral

averages for lights on and off has a 0.59 + 2.06 (mm) difference (Table 1). A paired t-test was

used to compare the overall medio - lateral with lights on and off (p = 0.687). There was no

significant difference between the medio - lateral with the lights on and off.

Effects of Postural Sway in Antero - Posterior with Lights On Versus Off

 The participants antero - posterior averages (mm) with lights on and off presented a

greater difference within their postural sway between the antero - posterior (Figure 4). The

antero - posterior averages for lights on and off has a 2.40 + 3.16 mm difference (Table 1). A

paired t - test was used to compare the overall antero - posteriors with the lights on and off (p =

0.295). There was no significant difference between the antero - posterior with the lights on and

off.

Discussion

The purpose of this study was to determine if darkness negatively affects postural sway in

both the anterior-posterior and medial-lateral directions in health college-aged subjects who

carried a heavy load. This experiment is relevant because it resembles a night hike or for military

personnel who have to carry heavy loads in the dark. The hypothesis stated that the lights off

condition would negatively affect the participants postural sway in both directions. The

hypothesis in this study was rejected and the null hypothesis was accepted. The null hypothesis

stated that the lights off condition did not significantly affect postural sway negatively in the

medial-lateral and anterior-posterior directions when the subjects carried a weighted backpack.

This conclusion was accepted by comparing the lights on and lights off condition through a

paired t-test.

The t-test resulted in a p-value of 0.25 which depicts no significant difference, so

therefore, the null hypothesis was accepted. The average in the medial-lateral and anterior-

posterior directions increased with the lights off, but it was not significantly higher. The average

increased from lights on to lights off in the medial-lateral direction from 22.41835 mm to

23.01073 mm and had a p-value of 0.687. The average increased from lights on to lights off in
the anterior-posterior direction from 22.62762 mm to 25.02784 mm and had a p-value of 0.295.

This is probably due to a small sample size, low variability, and other limitations.

In this experiment, postural sway was examined with normal vision and when vision was

slightly altered due to the subjects vision adapting to the dark. When vision is taken away,

postural sway negatively increases due to the lack of perception. In this study, vision was not

taken away completely, but it was made just slightly more difficult. This idea is supported

because out of all the sensory systems, proprioception and vision affect postural sway the most

(Anson et al., 2014). Additionally, when there is an expectation of an environmental conditional

change that relates to proprioception, there can be an influence on balance control and postural

sway (Asslnder & Peterka, 2016). This relates to this experiment because the subjects knew

about the two conditions and might have expected a change in their postural sway to occur.

Therefore, they might have tried to overcorrect or undercorrect their actual postural sway in the

two conditions.

This experiment had a constant weight load that was applied to each subject. This load

did not change between the two conditions. In future studies, if the weight in the backpack would

have changed, differences in postural sway would not have been significant (Pau, Kim, &

Nussbaum, 2012). The amount of the load does affect postural sway, as well as the location of

the load (Rugelj, & Sevek, 2011). When the load is carried in a backpack, similar to this

experiment, postural sway does increase when there is a greater load being applied, compared to

if the load was carried around the waist, which does not negatively influence postural sway

(Rugelj, & Sevek, 2011).

Limitations
 There were several limitations in this study. The biggest limitation to this study was that

in the room where the study was held, it was not possible to have the room in complete darkness.

The majority of the lights were turned off except for one light in the back of the room that made

the room visible. Ideally, if someone is on a night hike, there could still be some visibility due to

the moon. However, for this experiment, the dot on the wall that the subjects had to focus on was

easily seen. The lack of darkness might have positively affected postural sway. Additionally,

subjects were instructed to stand of both feet. Therefore, postural sway differences were possibly

not as significant.

Another limitation could have been fatigue, from either sleepiness or muscular fatigue

from carrying the heavy backpack. Types of clothing was inconsistent amongst the subjects. An

additional limitation could have been that some of the participants might have been prior

athletes, so they have stable balance and less postural sway due to their prior training. Another

significant limitation could have been that some of the participants have had prior lower

extremity injuries that affected their postural sway. They did not have to stand on a single leg,

which would have shown a greater difference in postural sway in the two compared conditions.

The sample size of 18 participants might have also been slightly too small to show a significant

difference. In future studies, there could be a need of a greater sample size to compare the

conditions effectively. Postural sway in both conditions was not examined in comparison of men

and women.

References
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