In the Mind in Movement Lab, we use tools and concepts from cognitive psychology to inform and inspire questions about posture and voluntary movement in healthy young adults and in the context of aging, Parkinson's disease, fall risk, and musculoskeletal pain. We are investigating the idea that cognitive factors such as inhibitory control influence postural alignment and postural tone, which in turn affect balance (postural control), mobility, fall risk, and musculoskeletal pain.
Inhibitory control is the ability to choose not to do something. Inhibitory control is heterogeneous in a healthy young population, and it decreases significantly with age. During movement preparation, inhibition may be important for linking movement elements together in the correct order, including any needed changes in posture. For instance, in step initiation, inhibitory deficits are associated with premature postural adjustments and subsequent delays in stepping.
Biofeedback devices are commonly touted as solutions to postural problems, but if they demand attention that interferes with the primary task, they may not be the best answer. We are examining the effect of auditory biofeedback of head position on neck posture and the possible tradeoffs between attention to posture and performance on a challenging cognitive task. Results from this research could lead to improvements in biofeedback and training to improve posture in office workers at risk for neck pain.
Postural tone, an adaptable system of regulating background muscle activity, is thought to be important for coordinating the limbs and the torso into a single functioning unit. Tone is primarily regulated subcortically, in the brainstem, but cortical regions also have an indirect influence. We have used neuroimaging to show that an area in the brainstem thought to regulate postural tone has structural and functional connections to the frontal cortex, and those connections are altered in people with Parkinson’s disease who have freezing of gait. Thus, we demonstrated a three-way interaction among high level cognitive factors, postural tone, and balance and mobility.
Head Position and CognitionWe are reasearching the connection between forward head posture and cognition. Forward head posture may contribute to neck pain, which is the 4th leading cause of disability in the US. We hypothesize that upright posture is facilitated by engaging inhibitory control to prevent oneself from pulling one’s head forward in response to compelling stimuli. We tested this by asking participants to sit at a computer and play a game. We manipulated motivation by offering some participants a reward if they get a high score. Results suggest that being highly motivated to perform well on the computer game causes people to move their heads forward (toward the computer screen) and that this tendency is associated with poor performance on a test of inhibitory control. We also found a surprisingly strong relation between forward head posture and verbal memory in older adults. We hypothesize that this may be caused by a common reliance of both functions on dopamine, which declines with age. Another study demonstrated that when people think about starting to walk, they project their heads forward in space, and that this tendency is associated with poor inhibitory control.
Cognitive Influence on Muscle OrganizationWe are studying the effects of different ways of thinking about posture on mobility. We have found, for instance, that when we tell people to pull themselves up tall using muscular effort, their necks get shorter, their balance gets worse, and their movements get less smooth. In contrast, when we tell them to maintain a light upward intention with an emphasis on preventing (inhibiting) any impulse to shorten and compress the spine, their necks get longer, their balance improves, and their movements become smoother. Our first publication on this "Lighten Up" effect showed effects in Parkinson's disease. Our second publication showed similar benefits in healthy older adults. In a world where the idea of good posture as something effortful is still very popular, this discovery could have far-reaching implications for health education and physical therapy.
The Poise ProjectWe are collaborating with the Poise Project to bring the "Lighten Up" approach to broad populations, starting with care partners and people with Parkinson's disease. The Poise Project also has its eye on blue-collar workers, truck drivers, and people struggling with pain and addiction. We recently conducted a pilot investigation testing the effects of a group class intervention on neck muscle activation, postural alignment, and self-reported pain, in a sample of adults with chronic neck pain. The intervention was based on the Alexander technique, a set of tools for improving posture and mobility by improving awareness of habits, inhibiting excessive muscle activity, and redistributing postural tone. Previous studies have shown that private lessons in the Alexander technique are beneficial for neck pain, but this is the first investigation of group classes, which are likely to be more affordable for most people. Through this project we have obtained 7 grants, plus one contract to deliver Alexander-based courses to people living with Parkinson's disease and their care partners, as well as two small undergraduate research awards to deliver Alexander-based courses to people with chronic neck pain.
Dr. Cohen has teamed up with several other scholars to develop a website devoted to exploring the scientific foundations of Alexander Technique.
Dr. Cohen and several other scholars are developing a website devoted to exploring the scientific foundations of postural tone.
EEGAn electroencephalogram (EEG) is a test that detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp. Your brain cells communicate via electrical impulses and are active all the time, even when you're asleep. Recently we have looked at which cognitive factors are associated with postural alignment and gait in healthy older adults, at how postural tone affects neck pain, and at how biofeedback may cause a tradeoff between postural alignment and computer task performance. We are also involved in some multi-site intervention studies and neuroimaging studies.