24. Balance and Cognition

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Our school entertained retreats for ninth and twelfth graders about three weeks into the fall semester at separate sites where professional outdoor educators worked on team and individual problem-solving skills, integrating climbing and cooperative maneuvering challenges. One of them is a dual horizontal rope exercise where the lower rope hovers about one foot off the ground and forms an oval about the size of a softball diamond. The other rope is several feet above the ground for grasping purposes. The objective? Walk across the circumference of the lower rope. It might seem easy at first because you can hold onto the higher rope for balance, but your shoes slip, and you end up walking sideways so that the rope matches the width of your shoe where the heel meets the sole. It is still wobbly, and we find it difficult to 'walk' the course, stumbling often.

After the first round, the camp counselor asked us to repeat the route but added another wrinkle: pass one another, that is, maneuver our bodies around the next person until each of us has made a pass over the other team members, starting over if we touched the ground. In my mind, it was a ridiculous request after that first go-around and worried that I might embarrass myself in front of the students. We got started. For some reason in the interval between my solo attempt and this pass-over trial, the movement was easier. I experienced a minor amount of imbalance but traversed the rope course and easily maneuvered around the students, feeling a genuine sense of control over my body. What happened? How is it that the ineptitude in the first trial did not reappear?

My brain made a psychomotor leap that maintained balance and coordination, an amazing adjustment in such a brief period for all of us. The cerebellum, the region of the brain above the spinal column associated with motor control, coordinated with other regions in the brain to expedite this adjustment. The inner ear's balance center, the vestibular area worked in conjunction with the prefrontal cortex to make the successful transition. My brain touched base with memories related to balance, such as learning to ride a bike, and activated a correction scheme that made it easier during the next trial. However, in this case I must have performed a similar balance maneuver involving my feet at some point in life and made the psychomotor adjustment.

The vertical perspective

In addition to the implementation of student-led and team-based lessons to improve attentiveness in students is the realm of motion, critical in brain development when the psychomotor function is summoned. The human balance system incorporates sight, touch, and vestibular elements to orient us in the present environment. When it is not working properly we feel dizzy, nauseated, and have difficulty concentrating. Balance means your center of gravity is positioned upright or in a preferred position using your musculature whether motionless or moving all day without giving it much attention. Moreover, the balance system serves to keep your vision clear, orient you with respect to the gravitational force on your body, and maintain the direction and speed of your desired movement.

That includes maneuvers performed by gymnasts, waiting in line at a checkout counter, sitting in front of a computer, or walking across a rope course at a retreat. The deterioration of the vestibular system results in difficulty maintaining balance and even mental confusion – often noted in the elderly. Children with underdeveloped vestibular systems have coordination and/or learning issues.

How does this incredible system work? The visual component related to balance gives a vertical frame of reference of the objects in view and adjusts that reference as you move and tilt your head. That is coupled with the entire complement of proprioceptive (feel) receptors that record stretching and pressure by the musculature and skin. The feet and ankles, for instance, take into consideration the frictional component of the walking surface (icy sidewalk versus dry, tile, or carpeting) to gauge foot placement. The neck is important, too, and helps center the eyes and ears to maintain the vertical perception. The vestibular apparatus (inner ear) is what gives us the vertical reference by the endolymph fluid shifting, interpreting the dimensional and angular perspectives as it bounces against the inner cavity walls. The central nervous system, then, has a complicated relay scheme that connects nerve axons throughout the brain to orient our head in space, developing episodic and contextual memories that allow navigation behaviors amidst background visual cues.

It is the encoded memory, for instance, that recognizes the subtle sensation while you wait at a red light that you are not moving backward while the adjoining car is creeping forward. You might be able to stand on one foot reasonably well but not maintain that position if you close your eyes (Alert: Don't attempt unless you are grasping a chair or wall). Gymnasts are so accustomed to moving their heads at various angles that they don't lose the vertical-awareness when performing stunts such as cartwheels and other acrobatic movements. Astronauts are trained in spinning centrifuges to handle high g-forces to accommodate the >3-g they experience upon lift-off. We are 1-g on earth and pass out at 3-g for an extended time due to blood loss to the head. Roller coasters occasionally attain pulls higher than 3-g.

It is an amazing complement of tools that keeps us steady, so we don't struggle like we did as infants. Consider the myriad of motions we perform every day: walking, bending, making our bed, opening and closing doors, navigating our car, eating and drinking, typing, playing the piano, and getting dressed. More strenuous movements may require 'planning' but we gauge our strength and angles to carry them out or even deny making the attempt based on perception of difficulty. Think of the concern many of us have obtaining comfortable shoes and the firms that sell inserts to alleviate foot, back, and hip pain. We must consider that the proprioceptive areas maintain the strong connection to the arousal areas of the brain to assess whether a challenging task can be expedited: "Do I have the skill to perform this task?"



Coordinating everything in the brain

There is a concert here. The combination of sensory data from the eyes, musculature, and inner ear extend to the cerebral cortex, the planning, reasoning, and judgment area of the brain. The motor-directing area or cerebellum then coordinates the movements and positioning of our body parts, at the base of the brain. Based on development from infancy the cerebellum synchronizes and strengthens its connection with the midbrain, the region associated with attention and emotion to produce an enormous sensory retrieval and response system. The cerebellum, though only about ten percent of the brain's volume, has about half of the neurons, with the greatest number of nerve fibers.

The importance of this chapter is inspired from scientific evidence that the cerebellum is not just a motor 'control panel' but also a switchboard connecting the reasoning and judgment features of the frontal cortex as well as the emotional midbrain areas and is consequently tied to learning.

Every movement has a predetermined script that is developed through years of training to work in a deliberate fashion or with great speed.

Better learning via vestibular

Can movement help students become better content area learners, or put this way: does vestibular stimulation improve knowledge acquisition? Should we be doing more in this area? For one, sustaining center of gravity, or balance, as we adjust to the earth's gravitational influence develops the musculoskeletal reflexes needed to perform a myriad of activities. Furthermore, several researchers have found that students receiving ample movement and cardiovascular exercise during the school day improves cognition because the balance-vestibular system is closely tied to the cerebellum and other regions of the brain related to decision-making and memory.

Neuromuscular coordination and vestibular functionality are linked to the attentive academic child.

My wife and I take our grandchildren to a nearby shopping complex that has a play venue with padded apparatus for climbing and crawling. It is designed to accommodate children up to six years of age and we have witnessed a broad range of development. The parents typically sit off to the side and converse with friends or check out their iPhones. Those four and up are noticeably more alert, skilled at leaping and many maneuvers with the visual, proprioceptive, and inner ear mechanisms in concert. They are joyful and sustain the activity for long intervals, breathing faster, yet not warranting a rest, performing motions that are coordinated and lively. Continuous angular adjustments are made to maintain center of gravity while they run, jump, and land.  We observe the range of development each visit from those that are just barely standing to the acrobatic child. Though varied, I observe cooperative play where the most advanced children do not perform maneuvers on the apparatus until the smaller, less skilled have finished their routine. These play sanctuaries are catalysts in child development because they are building the assertive, self-controlled individual through bold movements that are too dangerous to perform in their living rooms.

I ponder how these playful children make the transition from purposeful movement and communication during their summer vacations to school, where there is comparatively less 'vestibular' activity, particularly the ones in second grade and higher where subjects are emphasized. I am confident that intervals of time are allotted for recess and some free play but am not sure if vestibular development is a priority in most schools. It seems that children are asked to be attentive in ways that reduce their energetic endowment in favor of an auditory emphasis. The recreation department in our district, fortunately, provides after-hour lessons covering age appropriate levels in swimming, gymnastics, karate, crafts, music, and sensory play.

Consider this: a team comprised of psychologists from The University of Virginia and The University of California-Davis analyzed results from six data sets, and found that:

Fine motor skill assessment in kindergarten was a better predictor of later achievement in math and reading than early math and reading assessment.2

What are some basic movements in children that promote the development of the balance system? Rolling, crawling, climbing, jumping, swinging, or any move that varies the position of the head relative to the ground and the body's center of gravity. Emphasizing spatial relationships relative to the vertical is particularly important in early years such as up versus down, left versus right, front versus back. Being able to comprehend the meaning of 'close', 'distant', 'superior', 'inferior' are principles that have applications in mathematics (arithmetic and geometry), particularly in biology and history where sets and groups are compared.

To show that the cerebellum is not just a motor control center but also involved in learning, a team from the University of California San Diego Medical School used fMRI to find that cerebellar deficits correlate with an impaired ability to shift attention quickly from one task to another. A major conclusion of their work is that the cerebellum filters and integrates floods of incoming data associated with complex decision making. In other words, the deliberate and judgmental capacity of the prefrontal cortex is every bit involved in all our movements, whether a stroll to another room in our home to find a book or negotiating traffic driving our car, making turns, signaling, and parking to get to a scheduled meeting. Conceptualizing a movement is translated into physical action and coordinated by the cerebellum, vestibular, frontal cortex, and all associated regions that serve the thinking and musculoskeletal system.3

This study is suggesting that hand-eye activities during the school day enhance the interconnectivity of motor and strategizing elements in the brain. That movement should not only be emphasized at the elementary level but through high school. It appears, therefore, that vestibular-proprioceptive development has far reaching consequences that affect a person in several ways: balance on earth and development into a dynamic decision-making machine encompassing academic and psychomotor skills.
Dr. Lyelle Palmer, Professor of Education at Winona State University in Minnesota, revealed how this program was nurtured.

He found that adding a modest portion of time to an assortment of motions that emphasize vestibular stimulation in the classroom and playground such as spinning, rope jumping, balancing, somersaulting, rolling and walking on balance beams, swinging on low jungle gyms, climbing, skating, and performing somersaults throughout an instructional day improved academic performance significantly.

Using standardized tests such as the Slosson Oral Reading Test and Wepman’s Auditory Discrimination Test, Palmer produced significant improvement in automatic quick word recognition and phonemic awareness and auditory discrimination maturity in a poor demographic population from kindergarten through third grade. Nearly all passed the test and placed in the top ten percent for the state – with many in the top five percent. The implication is that instruction in any classroom is augmented if children partake in vestibular routines during designated segments of the school day.4,5

Improve learning

The brain undergoes development in children with sensory stimuli inspiring learning, processed as linking neurons forming memory networks. Beginning from the embryonic stage until about two years of age, neurons form one million synaptic connections per second (Center on the Developing Child, Harvard University 2017), and the greater the amount of stimulation in a child's early life the greater the number of synapses formed.

The approximately ninety billion neurons is an overabundance at birth but is the cellular resource for the manifestation of thousands of interconnections per neuron by age two (Gopnick, et al., 1999) and by age 3 there are 1,000 trillion connections in the brain overall! Furthermore, the brain is timed to undergo a pruning process to maximize the efficiency of the neural network with up to fifty percent of the weakest synapses gone by age ten. That incredible developmental timetable should inspire parents and educators to provide as many wholesome mental and physical experiences for their children as possible.

Conditioning the cerebellum through motion builds the attentive capacity of a child by developing synaptic connections across the reticular activating system from the frontal lobes to the midbrain. It serves to make the child an alert, coordinated, and academic individual.

Women's Collegiate Softball

We use our vestibular and proprioception senses to exist, particularly maneuvering from one location to the next or using devices from automobiles to toothbrushes. Baseball like other competitive sports is an example of how our proprioceptors in muscles, tendons, and joints work collectively to allow athletes to perform competitively. ESPN broadcasts college women's softball tournaments, an event I like to follow because I played on several teams in my youth.

The women are particularly skilled and perform all the motions in an excellent manner. For one, they maneuver well on all infield plays, grasping the ball in the glove, shifting to the throwing hand, and firing to the respective fielder. They do it whether it is hard hit, to their left, and even the more difficult back-handed version when it is to their right. Consider that they anticipate the ball's position, adjust their legs to be in a position so that their wrist rotates the glove, traps it in the web, shifts the ball's placement to the throwing hand, and secures the appropriate grip quickly to make an accurate throw.

There is a transfer of momentum on their feet to their midsection and to their arms to make a fast throw. Accuracy is assured by having the proper grip and fingertip release point on the ball. What I find interesting is not that these athletes field their positions well with a small base separation of 60 feet (90 feet in hardball) and the pitcher to home plate just 43 feet, but that they must also be competent as hitters, gauging the location of the ball as well as its speed to make a successful swing with a narrow cylindrical bat. That, too, is a decision-making event that requires control and balance over another complement of muscles including generating force from the feet to the arms to make contact.

It is clear to all of us that played the sport that these collegiate women are excellent in executing their roles in the game. They make few errors as well as decisions at many levels: batting, running, where to throw, pitching, and more. There is a constant shifting of weight and the competence shown is proportional to their practice schedule where the vestibular and proprioception senses are fine-tuned.

References

1.     Watson, M., Black, F., Good balance is often taken for granted. Vestibular Disorders Association.
        Retrieved from:
        http://vestibular.org/understanding-vestibular-disorder/human-balance-system
2.     Grissmer, D., Grimm, K., Aiyer S., Murrah, W., Steele, J. (2010). Fine Motor Skills and Early Comprehension of the World: Two New School Readiness Indicators. Developmental Psychology, Vol. 46, No. 5. 1008-1017.
3.     Gaffrey, M.S., Kleinhans, N.M., Haist, F., Akshoomoff, N., Campbell, A., Courchesne, E., Muller, R.A. (2007). A typical participation of visual cortex during word processing in autism: An fMRI study of semantic decision. Neuropsychologia, 45(8):1672-84
4.     Palmer, L., Giese, L., DeBoer, R., Early Literacy Champions In North Carolina: Accelerated Learning Documentation for K-3 SMART (Stimulating Maturity through Accelerated Readiness Training)
5.     US Department of Education PR/Award Number Award, Field-Initiated National Activities Projects, through the Minnesota Learning Resource Center.