Dynamic postural stability is not impaired by moderate-intensity physical activity in healthy or balance-impaired older people

Older people are increasingly being encouraged to be more physically active but this may lead to physiological fatigue, tiredness and other effects, which, at high levels, can adversely alter postural stability. However, older adults rarely perform physical activity at high intensities. This study aimed to determine whether a single bout of moderate-intensity physical activity, similar to that experienced during daily living, alters dynamic postural stability, particularly among those at risk of falling. Thirty-one healthy young, 33 healthy older and 21 balance-impaired older, adults performed a rapid, voluntary step-up task before and immediately after a 14 min, self-paced, moderate-intensity physical activity protocol. Timing of step components from vertical ground reaction forces, mediolateral displacement of center of pressure, and onset and amplitude of hip abductor muscle activity were recorded during the step task. All groups demonstrated the same changes after the activity, with slightly shorter weight-shift phase duration, smaller displacement of the center of pressure towards the stance leg during weight shifting, and earlier onset of stance leg gluteus medius activity. These changes indicate improved coordination of the step task after activity. Thus this study showed that dynamic postural stability is not adversely affected immediately following moderate-intensity physical activity, even among balance-impaired elderly.     

Assessing mobility in an aging society: Personal and built environment factors associated with older people’s subjective transportation deficiency in the US

This study analyzed subjective transportation deficiency, in terms of missing activities due to lack of transportation, of the older population aged 65 and over in the United States. This study found that those who have lower personal automobile accessibility and minority females are more likely to experience transportation deficiency. Older people who have lower income, have lived for a relatively short period (3–10 years) in their communities, and live with minors are also more likely to experience lack of transportation. Older people who live in suburban communities have greater transportation deficiency, but the placement of activity locations within walking distance can improve transportation deficiency among older people who do not drive. The availability of public transit services within walking distance and knowledge about transportation alternatives do not significantly affect the transportation deficiency of the older population. The results indicate that a substantive focus should be given to how to help the older population keep driving as long as they can, and aid communities with high concentrations of older minority females. Also, developing activity clusters containing commercial and social service facilities in suburban areas with high concentrations of older populations, has the potential to alleviate transportation deficiency among this widely observed group of people who age in place.     

Postural stabilization for the control of touching

We attempted to distinguish between task-related (supra-postural) and perceptual influences on postural motions. Two groups of participants had to make very light tactile contact with an adjacent pliable surface while standing with their eyes closed. In the absence of vision, such light touching with a finger is known to reduce sway. For one group, tactile contact with the surface was merely the result of extending the right forearm. For the other group, variability in the point of tactile contact had to be kept to a minimum. Touching reduced postural sway relative to non-touching only for participants in the latter group. The present results, in combination with others addressing similar task differences, question the assumption that information detected haptically and/or visually is used solely to reduce postural fluctuations. It seems that postural fluctuations are modulated to facilitate performance of tasks over and above the task of standing upright and still.     

Bounded stability of the quiet standing posture: an intermittent control model

The paper presents a control model of body sway in quiet standing, which aims at achieving bounded stability by means of an intermittent control mechanism. Control bursts are generated when the current state vector exits an area of uncertainty around the reference point in the phase plane. This area is determined by the limited resolution of proprioceptive signals and the burst generation mechanism is predictive in the sense that it incorporates a rough, but working knowledge (internal model) of the biomechanics of the human inverted pendulum. We show that such a model, in spite of its simplicity and of the fact that it relies on very noisy measurements, is robust and can explain in a detailed way the measured sway patterns.     

EEG correlates of postural audio-biofeedback

The control of postural sway depends on the dynamic integration of multi-sensory information in the central nervous system. Augmentation of sensory information, such as during auditory biofeedback (ABF) of the trunk acceleration, has been shown to improve postural control. By means of quantitative electroencephalography (EEG), we examined the basic processes in the brain that are involved in the perception and cognition of auditory signals used for ABF. ABF and Fake ABF (FAKE) auditory stimulations were delivered to 10 healthy naive participants during quiet standing postural tasks, with eyes-open and closed. Trunk acceleration and 19-channels EEG were recorded at the same time. Advanced, state-of-the-art EEG analysis and modeling methods were employed to assess the possibly differential, functional activation, and localization of EEG spectral features (power in α, β, and γ bands) between the FAKE and the ABF conditions, for both the eyes-open and the eyes-closed tasks. Participants gained advantage by ABF in reducing their postural sway, as measured by a reduction of the root mean square of trunk acceleration during the ABF compared to the FAKE condition. Population-wise localization analysis performed on the comparison FAKE - ABF revealed: (i) a significant decrease of α power in the right inferior parietal cortex for the eyes-open task; (ii) a significant increase of γ power in left temporo-parietal areas for the eyes-closed task; (iii) a significant increase of γ power in the left temporo-occipital areas in the eyes-open task. EEG outcomes supported the idea that ABF for postural control heavily modulates (increases) the cortical activation in healthy participants. The sites showing the higher ABF-related modulation are among the known cortical areas associated with multi-sensory, perceptual integration, and sensorimotor integration, showing a differential activation between the eyes-open and eyes-closed conditions.     

Assessment of postural control in patients with Parkinson’s disease: Sway ratio analysis

Analysis of the postural stability impairments in neurodegenerative diseases is a very demanding task. Age-related declines in posturographic indices are usually superimposed on effects associated with the pathology and its treatment. We present the results of a novel postural sway ratio (SR) analysis in patients with Parkinson’s disease (PD) and age-matched healthy subjects. The sway ratios have been assessed based upon center of foot-pressure (CP) signals recorded in 55 parkinsonians (Hoehn and Yahr: 1-3) and 55 age-matched healthy volunteers while standing quiet with eyes open (EO) and then with eyes closed (EC). Complementing classical sway measure abnormalities, the SR exhibited a high discriminative power for all controlled factors: pathology, vision, and direction of sway. Both the anteroposterior (AP) and mediolateral (ML) sway ratios were significantly increased in PD patients when compared to the control group. An additional SR increase was observed in the response to eyes closure. The sway ratio changes documented here can be attributed to a progressive decline of a postural stability control due to pathology. In fact, a significant correlation between the mediolateral SR under EO conditions and Motor Exam (section III) score of the UPDRS was found. The mediolateral sway ratios computed for EO and EC conditions significantly correlated with the CP path length (r = .87) and the mean anteroposterior CP position within the base of support (r = .38). Both indices reflect postural stability decline and fall tendency # in parkinsonians. The tremor-type PD patients (N = 34) showed more pronounced relationships between the mediolateral SR and selected items from the UPDRS scale, including: falls (Kendall Tau = .47, p < .05), rigidity (.45, p < .05), postural stability (retropulsion) (.52), and the Motor Exam score (.73). The anteroposterior SR correlated only with tremor (Kendal Tau = .77, p < .05). It seems that in force plate posturography the SR can be recommended as a single reliable measure that allows for a better quantitative assessment of postural stability impairments.     

Effects of disease severity and medication state on postural control asymmetry during challenging postural tasks in individuals with Parkinson’s disease

The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson’s disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n = 8) and bilateral group (n = 11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups × medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups × medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior–posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior–posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks.