Dataset Information

Older adults can improve compensatory stepping with repeated postural perturbations.

ABSTRACT: The ability to respond quickly and accurately to an external perturbation with a stepping response is critical to avoid falls and this ability is impaired in older, compared to young adults. However, little is known about whether young and older adults improve compensatory stepping responses similarly with practice. This study compares the extent to which young and older adults can improve, retain, and generalize postural compensatory steps in response to external perturbations. Centre of mass displacement, step characteristics and lower leg muscle activation latencies were measured during one training session of compensatory stepping in response to large surface translations in 13 young and 12 older adults. Retention was tested 24 h later. Older adults decreased their center of mass displacements over repeated exposure to large surface translations in both the anterior and posterior directions and retained these improvements. In contrast, young adults only showed adaptation and retention of forward stepping responses. Neither group was able to generalize improvements in stepping responses across directions. These results suggest step training may be beneficial for older adults, however additional, multidirectional training may be necessary to facilitate generalization of postural stepping responses for any direction of a slip or trip.

SUBMITTER: Dijkstra BW

PROVIDER: S-EPMC4612504 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Older adults can improve compensatory stepping with repeated postural perturbations.

Dijkstra Bauke W BW Horak Fay B FB Kamsma Yvo P T YP Peterson Daniel S DS

Frontiers in aging neuroscience 20151021

The ability to respond quickly and accurately to an external perturbation with a stepping response is critical to avoid falls and this ability is impaired in older, compared to young adults. However, little is known about whether young and older adults improve compensatory stepping responses similarly with practice. This study compares the extent to which young and older adults can improve, retain, and generalize postural compensatory steps in response to external perturbations. Centre of mass d ...[more]

PMID: 26539111

Similar Datasets

Project description:BACKGROUND:Compensatory stepping thresholds evaluate the response to postural disturbances. Although such fall-recovery measures are a promising indicator of fall risk, the relationships between stepping thresholds and other measures used to predict falls are not well established. RESEARCH QUESTION:We sought to quantify the relationships between stepping thresholds and other measurements used to assess fall risk in older women, a population at high risk for falls and related injuries, including fractures. METHODS:We studied 112 ambulatory, community-dwelling women, age 65 years or older. Using a treadmill to deliver standing postural disturbances, we determined anterior and posterior single-stepping and multiple-stepping thresholds. These thresholds represented the magnitude of the disturbance that elicited one step or more than one step, respectively. We also assessed balance confidence, functional reach, unipedal stance time, isometric strength, obstacle crossing, postural sway, and gait kinematics. Outcomes were normalized to body size. RESULTS:After accounting for age, stepping thresholds were, at most, moderately correlated (Pearson partial correlation coefficients r?=?0.20 to 0.40 and r = -0.21 to -0.31) to several assessments of gait, postural control, and strength. Approximately 24-52% of the variance in stepping thresholds was explained by a combination of age and other fall risk assessments, which frequently consisted of balance confidence, unipedal stance time, obstacle crossing, the Romberg ratio of postural sway, and/or strength. SIGNIFICANCE:Our results suggest that anteroposterior fall-recovery ability, as assessed by stepping thresholds, can only be partially inferred from age and a combination of assessments of sway, strength, unipedal tasks, and balance confidence. Compensatory stepping thresholds may provide information on stability maintenance unique from other assessments of fall risk. Further investigation would be necessary to determine whether stepping thresholds are better predictors of falls in older women.

Project description:New findingsWhat is the central question of this study? It has been suggested that the cardiovascular responses to a postural perturbation are centrally mediated and reflex mediated. We wanted to know the extent to which the cardiovascular responses to external perturbations could be executed in a feedforward manner, in anticipation of the perturbation. What is the main finding and its importance? We found no anticipatory component driving heart rate and systolic blood pressure responses, suggesting that reflexive mechanisms dominate cardiovascular regulation after a postural perturbation in young adults.AbstractCardiovascular responses to postural perturbations have been reported, but whether the cardiovascular responses to external perturbations could be executed in anticipation of the perturbation is unknown. The purpose of this study was to determine the effect of anticipated and reactionary perturbations on heart rate (HR) and systolic blood pressure (SBP) responses in healthy young adults. A secondary aim was to determine whether perceived state anxiety scores were correlated with the change in HR response during postural perturbation. Twenty healthy young adults stood on a treadmill and experienced two perturbation conditions (anticipatory vs. reactionary), each with two intensity levels (Step vs. No Step). The HR and SBP were collected continuously. Two-way repeated-measures statistical non-parametric mapping tests were used to compare HR and SBP responses to the perturbations over time (from -3 to +8 s). The results indicated that HR was significantly elevated in the higher intensity perturbations [Step vs. No Step, at 0.56-1.32 s (P < 0.0001) and 1.92-3.44 s (P < 0.0001) post-perturbation], while there were no differences in HR between perturbation types (anticipatory vs. reactionary) or in SBP between perturbation types and intensity levels. The perceived state anxiety scores did not differ between perturbation types and intensity levels but were correlated with the change in HR post-perturbation (P = 0.013). We suggest that reflexive mechanisms dominate cardiovascular regulation after anticipatory and reactionary perturbations. The data highlight the cardiovascular mechanism(s) associated with perturbations that should be considered when assessing postural stability in populations with poor balance performance.

Project description:BackgroundSquare-Stepping Exercise (SSE) is a type of physical-cognitive exercise. Such exercise has been used as an exercise approach in different studies with older adults. This scoping review provides an overview of the protocols and outcomes of studies employing the SSE in older adults.MethodsWe searched in the PubMed, CINAHL, Scopus, CABI Global Health, and Web of Science databases for articles published between 2006 (first research article published on SSE) to December 2023 that met a robust inclusion criterion. The search yielded 424 articles, and after inclusion criteria being applied, 37 articles were included in the final analysis.ResultsA total of 37 studies were included in the final analysis. Thirty-three out of the 37 studies focused on apparently healthy older adults, while four were conducted with older adults with neurological disease (i.e., multiple sclerosis, Parkinson's disease, and stroke). Most studies (n = 25) adopted an experiment (i.e., randomized controlled trial) or quasi-experimental approach, while 12 were classified as non-randomized (i.e., cross-sectional, mixed methods). The studies were conducted in different parts of the globe and adopted three major formats of intervention delivery, namely in-person, online, and home-based. Frequency, SSE session duration and intervention length significantly varied among studies, and reported outcomes were in the domains of physical and cognitive function.ConclusionThis review comprehensively described the characteristics of 37 studies employing SSE in apparently healthy older adults and older adults with neurological diseases. The findings demonstrated that SSE has been used by researchers across the globe, adopting a variety of forms of delivery, and to particularly improve physical and cognitive function of different segments of the older adult population. The review further identified important gaps in research, including the restricted outcomes, and the lack of studies combining SSE with more traditional exercise modalities to address potential combinatory effects.

Project description:Background: Falls are the leading cause of fatal and non-fatal injuries among older adults. Perturbation-Based-Balance Training (PBBT) is a promising approach to reduce fall rates by improving reactive balance responses. PBBT programs are designed for older adults who are able to stand and walk on a motorized treadmill independently. However, frail older adults, whose fall rates are higher, may not have this ability and they cannot participate. Thus, there is a critical need for innovative perturbation exercise programs to improve reactive balance and reduce the fall risks among older adults in a wider range of functioning. Trunk and arms are highly involved in reactive balance reactions. We aim to investigate whether an alternative PBBT program that provides perturbations during hands-free bicycling in a sitting position, geared to improve trunk and arm reactive responses, can be transferred to reduce fall risks and improve balance function among pre-frail older adults. Methods: In a single-blinded randomized-controlled trial, 68 community-dwelling pre-frail older adults are randomly allocated into two intervention groups. The experimental group receives 24-PBBT sessions over 12-weeks that include self-induced internal and machine-induced external unannounced perturbations of balance during hands-free pedaling on a bicycle-simulator system, in combination with cognitive dual-tasks. The control group receives 24 pedaling sessions over 12-weeks by the same bicycle-simulator system under the same cognitive dual-tasks, but without balance perturbations. Participants' reactive and proactive balance functions and gait function are assessed before and after the 12-week intervention period (e.g., balance reactive responses and strategies, voluntary step execution test, postural stability in upright standing, Berg Balance Test, Six-meter walk test, as well as late life function and fear of falling questionnaires). Discussion: This research addresses two key issues in relation to balance re-training: (1) generalization of balance skills acquired through exposure to postural perturbations in a sitting position investigating the ability of pre-frail older adults to improve reactive and proactive balance responses in standing and walking, and (2) the individualization of perturbation training to older adults' neuromotor capacities in order to optimize training responses and their applicability to real-life challenges. Clinical Trial Registration: www.clinicaltrials.gov, NCT03636672 / BARZI0104; Registered: July 22, 2018; Enrolment of the first participant March: 1, 2019. See Supplementary File.

Dataset Information

Older adults can improve compensatory stepping with repeated postural perturbations.

Publications

Older adults can improve compensatory stepping with repeated postural perturbations.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets