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Increased use of stepping strategy in response to medio-lateral perturbations in the elderly relates to altered reactive tibialis anterior activity

Afschrift, Maarten, van Deursen, Robert, De Groote, Friedl and Jonkers, Ilse 2019. Increased use of stepping strategy in response to medio-lateral perturbations in the elderly relates to altered reactive tibialis anterior activity. Gait and Posture 68 , pp. 575-582. 10.1016/j.gaitpost.2019.01.010

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Background The influence of aging on reactive control of balance during walking has been mainly investigated in the sagittal plane, whereas balance control in response to frontal plane perturbations is largely unexplored in the elderly. This is remarkable, given that walking mainly requires active control in the frontal plane. An extensive gait perturbation protocol was used to test whether reactive control of walking balance changes with aging and whether these changes are more pronounced in the frontal than in the sagittal plane. Research question Do alterations in reactive muscle activity cause an age-related shift in stepping strategy in response to perturbations in the frontal and sagittal planes during walking? Method A treadmill-based perturbation protocol imposed frontal and sagittal plane perturbations of different magnitudes during different phases of the gait cycle. Motion capture and electromyography measured the response to the different perturbations in a group of eighteen young and ten older adults. Results Only for a small subset of the perturbations, reactive muscle activity and kinematic strategies differed between young and older subjects. When perturbation magnitude increased, the older adults relied more on a stepping strategy for inward directed frontal plane perturbations and for sagittal plane perturbation just before heelstrike. Tibialis anterior activity increased less in the older compared to the young subjects. Using simulations, we related tibialis anterior activity to backward and outward movement of the center of pressure in the stance foot and confirmed its contribution to the ankle strategy. We concluded that deficient tibialis anterior activity predisposes elderly to use stepping rather than lateral ankle strategies to control balance. Significance Rehabilitation targets for fall prevention in elderly need to also focus on ankle muscle reactivity

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Additional Information: Released with a Creative Commons Attribution Non-Commercial No Derivatives License (CC BY-NC-ND)
Publisher: Elsevier
ISSN: 0966-6362
Date of First Compliant Deposit: 14 February 2019
Date of Acceptance: 9 January 2019
Last Modified: 24 Nov 2020 15:22

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