Effects of age on listening and postural control during realistic multi-tasking conditions

Successful performance of balance-related activities requires the effective integration of sensory, cognitive, and motor processes that can be affected by age-related changes. Of these age-related sensory changes, the effects of declines in hearing on balance have not been well-studied despite the fact that hearing loss has now been acknowledged as a significant risk factor for falls. The goal of this study was to evaluate age-related differences in a “standing while listening” task within increasingly challenging conditions resembling those that are often encountered in realistic, everyday situations.This study used a dual-task paradigm in an immersive Virtual Reality street scene setting in which postural load (firm, compliant), listening load (number of talkers), and visual load (eyes open/closed) were manipulated. A multi-talker divided attention listening task was used. Postural performance was assessed using center of pressure (COP) path length, while listening performance was assessed using spoken word recognition accuracy.Results demonstrated that age-related differences were observed in postural performance when postural demands were the highest and in listening performance when listening demands were the highest. Proportional dual-task costs were more pronounced for postural task performance compared to listening task performance and were more pronounced for older compared to younger adults. Postural dual-task costs increased as a function of increasing listening loads. Removal of visual information improved listening task performance across both groups and reduced the dual-task costs to listening in older adults when listening demands were highest (resulting in dual-task benefits).Taken together, the findings support previously documented age-related declines in postural control and auditory processing, demonstrate that increasing listening demands may result in poorer balance, particularly in older adults, and provide additional insights into the interactive effects of age-related declines when sensory, motor, and cognitive challenges are incremented factorially.     

Visuomotor error augmentation affects mediolateral head and trunk stabilization during walking

Prior work demonstrates that humans spontaneously synchronize their head and trunk kinematics to a broad range of driving frequencies of perceived mediolateral motion prescribed using optical flow. Using a closed-loop visuomotor error augmentation task in an immersive virtual environment, we sought to understand whether unifying visual with vestibular and somatosensory feedback is a control goal during human walking, at least in the context of head and trunk stabilization. We hypothesized that humans would minimize visual errors during walking – i.e., those between the visual perception of movement and actual movement of the trunk. We found that subjects did not minimize errors between the visual perception of movement and actual movement of the head and trunk. Rather, subjects increased mediolateral trunk range of motion in response to error-augmented optical flow with positive feedback gains. Our results are more consistent with our alternative hypothesis – that visual feedback can override other sensory modalities and independently compel adjustments in head and trunk position. Also, aftereffects following exposure to error-augmented optical flow included longer, narrower steps and reduced mediolateral postural sway, particularly in response to larger amplitude positive feedback gains. Our results allude to a recalibration of head and trunk stabilization toward more tightly regulated postural control following exposure to error-augmented visual feedback. Lasting reductions in mediolateral postural sway may have implications for using error-augmented optical flow to enhance the integrity of walking balance control through training, for example in older adults.     

Exploring how arm movement moderates the effect of task difficulty on balance performance in young and older adults

Emerging evidence highlights that arm movements exert a substantial and functionally relevant contribution on quiet standing balance control in young adults. Ageing is associated with “non-functional” compensatory postural control strategies (i.e., lower limb co-contraction), which in turn, may increase the reliance on an upper body strategy to control upright stance. Thus, the primary purpose of this study was to compare the effects of free versus restricted arm movements on balance performance in young and older adults, during tasks of different difficulty. Fifteen young (mean ± SD age; 21.3 ± 4.2 years) and fifteen older (mean ± SD age; 73.3 ± 5.0 years) adults performed bipedal, semi-tandem and tandem balance tasks under two arm position conditions: restricted arm movements and free arm movements. Centre of pressure (COP) amplitude and frequency were calculated as indices of postural performance and strategy, respectively. Especially in older adults, restriction of arm movement resulted in increased sway amplitude and frequency, which was primarily observed for the mediolateral direction. Further, increasing balance task difficulty raised the arm restriction cost (ARC; a new measure to quantify free vs. restricted arm movement differences in postural control) that was more prominent in older adults. These findings indicate the ARC provides a measure of reliance on the upper body for balance control and that arm movement is important for postural control in older adults, especially during tasks of greater difficulty.     

Optimization of postural control in precise gaze shifts and laser pointing

Young adults are known to reduce their postural sway to perform precise visual search and laser pointing tasks. We tested if young adults could reduce even more postural and/or center of pressure sway to succeed in both tasks simultaneously. The methodology is novel because published pointing tasks usually require continuously looking at the pointed target and not exploring an image while pointing elsewhere at the same time. Twenty-five healthy young adults (23.2 ± 2.5 years) performed six visual tasks. In the free-viewing task, participants randomly explored images with no goal. In two visual search tasks, participants searched to locate objects (easy search task) or graphical details (hard search task). Participants additionally pointed a laser beam into a central circle (2°) or pointed the laser turned off. Postural sway and center of pressure sway were reduced complementarily – in various variables – to perform the visual search and pointing tasks. Unexpectedly, the pointing task influenced more strongly postural sway and center of pressure sway than the search tasks. Overall, the participants adopted a functional strategy in stabilizing their posture to succeed in the pointing task and also to fully explore images. Therefore, it is possible to inverse the strength of effects found in the literature (usually stronger for the search task) in modulating the experimental methodology. In search tasks more than in free-viewing tasks, participants mostly rotated their eyes and head, and not their full body, to stabilize their posture. These results could have implications for shooting activities, video console games and rehabilitation most particularly.     

Role of Visual Information in Ball Catching

The present study is concerned with the perceptual information about the body and space underlying the act of catching a ball. In a series of four experiments, subjects were asked to catch a luminous ball under various visual conditions. In general, catching in a normally illuminated room was contrasted with catching the luminous ball in an otherwise completely dark room. In the third and fourth experiments, intermediate conditions of visual information were included. The results suggest that it is possible to catch a ball with one hand when only the ball is visible, but performance is better when the subject has the benefit of a rich visual environment and two hands. The second experiment indicated that subject performance does improve with practice in the dark, but time spent in the darkened room itself doesn't result in a significant decrement in performance. Results of the third study suggest that vision of one's hand does not aid in the performance of this task whereas the presence of a minimal visual frame appears to aid performance. The final study examined the relation between catching performance and body sway under similar visual conditions. Results of this experiment imply that persons who exhibit relatively little postural sway in full-room lighting performed better at this catching task.     

Role of visual information in ball catching

The present study is concerned with the perceptual information about the body and space underlying the act of catching a ball. In a series of four experiments, subjects were asked to catch a luminous ball under various visual conditions. In general, catching in a normally illuminated room was contrasted with catching the luminous ball in an otherwise completely dark room. In the third and fourth experiments, intermediate conditions of visual information were included. The results suggest that it is possible to catch a ball with one hand when only the ball is visible, but performance is better when the subject has the benefit of a rich visual environment and two hands. The second experiment indicated that subject performance does improve with practice in the dark, but time spent in the darkened room itself doesn't result in a significant decrement in performance. Results of the third study suggest that vision of one's hand does not aid in the performance of this task whereas the presence of a minimal visual frame appears to aid performance. The final study examined the relation between catching performance and body sway under similar visual conditions. Results of this experiment imply that persons who exhibit relatively little postural sway in full-room lighting performed better at this catching task.     

Absence of Ankle Stiffening While Standing in Focus and Cognitive Task Conditions in Older Adults

Abstract

Research suggests that an external focus or cognitive task may improve postural control. Removing attention from movement production may promote automaticity, or the tasks may promote ankle stiffening. To investigate these two theories, twenty older adults stood while performing baseline standing, internal focus, external focus, and two cognitive tasks. Changes in postural control occurred in external focus and cognitive task conditions compared to baseline and internal focus, while no change occurred in cocontraction indices. This suggests that an external focus and cognitive task can improve postural control in older adults. Since no change occurred in cocontraction indices across conditions, this suggests that stiffening cannot explain these changes. Instead, changes could be due to automaticity of sway.     

Interacting Constraints and the Emergence of Postural Behavior in ACL-Deficient Subjects

In this study, the authors examined how task, informational, and sensorimotor system constraints influence postural control. Postural behavior of subjects with (n = 15) and without (n = 15) a key sensorimotor system constraint, anterior cruciate ligaments (ACLs) in 1 knee, was examined during 1- and 2-legged stance with and without vision. Postural control was assessed on a commonly used postural sway meter and on a dynamic stabilometer. Data on postural sway characteristics were obtained for 30 s under 6 different conditions: standing, with eyes open and closed, on both legs, on the injured leg, and on the noninjured leg. The interaction of task, informational, and sensorimotor constraints was observed only on the dynamic stabilometer and not the postural sway meter. Vision was the most important informational constraint on postural control for subjects on the dynamic stabilometer, particularly for the ACL-deficient group standing on the injured leg. Under more static task constraints, ACL deficiency did not prove a significant disadvantage, because vision was confirmed as a significant source of exproprioceptive information. The results support the functionality of using dynamic tasks such as a stabilometer in assessing postural behavior of subjects with sensorimotor system constraints.     

Transitions in Visual Proprioception: A Cross-Sectional Developmental Study of the Effect of Visual Flow on Postural Control

In the present study, a moving room paradigm was used that characterized the developmental progression of the effects of visual perturbations on stance control in subjects (N = 39) from 5 months to 10 years of age. Kinematic (probability of recording sway, magnitude of sway response) and electromyographic (probability and patterns of muscle activation, muscle onset latencies) data were found that suggested that visual flow simulating sway activates organized postural muscle responses and results in subsequent sway in standing infants as young as 5 months of age, well before they are able to stand independently. In new walkers, there was an increase in the magnitude of the effect of the visual perturbation, suggesting a possible increase in reliance on visual information. The magnitude of sway decreased to very low levels in older children and adults. The large-amplitude responses observed in the youngest age groups may indicate an inability to switch from an unreliable to a reliable source of perceptual information or an inability to modulate the responses produced following the perturbations. With increasing age and experience, the ability to resolve the conflict increased, with adult subjects demonstrating little sway response.     

Effects of visual and auditory short-term memory tasks on the spatiotemporal dynamics and variability of postural sway

The authors measured postural sway while participants (N = 20 in each experiment) stood on a rigid or a compliant surface, with their eyes open or closed, and while they did or did not perform a short-term memory (STM) task. In Experiment 1, the STM stimuli were presented visually; in Experiment 2, the stimuli were presented auditorily. In both experiments, fine-scaled, mediolateral postural-sway variability decreased as the cognitive load imposed by the STM task increased. That effect was independent of support surface and vision manipulations. The spatiotemporal profile of postural sway was affected by both visual and auditory STM tasks, but to a greater degree by the auditory task. The authors discuss implications of the results for theories and models of postural control.     

Interacting Constraints and the Emergence of Postural Behavior in ACL-Deficient Subjects

In this study, the authors examined how task, informational, and sensorimotor system constraints influence postural control. Postural behavior of subjects with (n = 15) and without (n = 15) a key sensorimotor system constraint, anterior cruciate ligaments (ACLs) in 1 knee, was examined during 1 - and 2-legged stance with and without vision. Postural control was assessed on a commonly used postural sway meter and on a dynamic stabilometer. Data on postural sway characteristics were obtained for 30 s under 6 different conditions: standing, with eyes open and closed, on both legs, on the injured leg, and on the noninjured leg. The interaction of task, informational, and sensorimotor constraints was observed only on the dynamic stabilometer and not the postural sway meter. Vision was the most important informational constraint on postural control for subjects on the dynamic stabilometer, particularly for the ACL-deficient group standing on the injured leg. Under more static task constraints, ACL deficiency did not prove a significant disadvantage, because vision was confirmed as a significant source of exproprioceptive information. The results support the functionality of using dynamic tasks such as a stabilometer in assessing postural behavior of subjects with sensorimotor system constraints.     

Not just standing there: the use of postural coordination to aid visual tasks

Postural control is an integral part of all physical behavior. Recent research has indicated that postural control functions in a manner that facilitates other higher order (suprapostural) tasks. These studies, while showing that postural sway is modulated in a task specific manner, have not examined the form of postural coordination that allows for the achievement of these higher behavioral goals. The current study examined the relation between visual task constraints (viewing distance), environmental constraints (changes in the surface of support), and the postural coordination employed to complete the task. Thirty-one participants were asked to perform a reading task while standing on various surfaces. Postural motion was recorded from the head, cervico-thoracic spine, sacrum (hip), and ankle. It was found that body segment coordination changed as a function of surface characteristics and task constraints. Additionally, the overall pattern of postural sway (head motion) replicated that which was found by Stoffregen et al. [J. Exp. Psychol. Human Percep. Perform. 25 (6) (1999) 1641]. These findings suggest that postural adaptation involves more than basic reduction or increase of motion; it involves the functional coordination of body segments to achieve a particular goal. The data further suggest that there is a need to examine postural control in the absence of external perturbations.     

Effect of preparation on dual-task performance in postural control

The authors applied an overlapping-task design to study the interaction between postural control and cognitive task processes in young (n = 10) and older (n = 10) adults. A rapid destabilizing floor translation was followed at specific time intervals by a simple auditory reaction time (RT) task. The translations were preceded by either an informational cue or no cue. Interference between postural task demands and the RT task was found only in the first 50 ms. Cueing also had an effect on both the onset of the postural recovery response and RT performance. The results suggest (a) only a brief interference between postural and cognitive processing demands in relatively easy tasks, (b) competition for a common central mechanism, possibly a response-selection mechanism, and (c) no differential impact of aging on that interaction.     

Interstimulus Intervals and Sensory Modality Modulate the Impact of a Cognitive Task on Postural Control

The present literature not only reveals the use of a wide variety of cognitive tasks but variability in their interaction with postural control. The question then arises, as to, whether postural control is sensitive to specific features of a cognitive task. The present experiment assessed the impact of cognitive tasks with interstimulus intervals (ISI) of varied duration and sensory modality on postural control in young adults. Seventeen participants (23.71 ± 1.99 years old) were instructed to stand on a force platform while concurrently performing cognitive tasks with ISIs of two and 5 s. The tasks were presented both, auditorily and visually. The visual tasks consisted of counting the total occurrence of a single digit. The auditory tasks consisted of counting the total occurrence of a single letter. Performing the cognitive tasks with an ISI of 2 s resulted only in an increase in the anteroposterior mean power frequency. Presenting the tasks visually also significantly reduced area of 95% confidence ellipse and AP and mediolateral sway variability. These results may suggest that ISIs can modify postural performance by altering the allocation of attentional focus. Also, presenting tasks using a visual sensory modality appears to yield lower postural sway.     

The role of binocular information in ball catching

The role of binocular vision in a ball-catching task involving spatial uncertainty was examined in three experiments. In all three experiments, subjects' catching performance was evaluated during monocular and binocular viewing, in normal room lighting and in complete darkness with a luminescent ball. Subjects' performance was found to be significantly better with binocular than with monocular vision, especially under normal lighting conditions. In the second and third experiments, catching performance was evaluated in the presence of minimal visual frames, consisting of a series of light-emitting diodes (LEDs). In Experiment 2, the visual frame consisted of a single plane of LEDs, whereas in Experiment 3, the visual frame consisted of two planes of LEDs. Catching performance was found to be significantly better with the visual frame than in complete darkness, but this was true only for binocular viewing. This result supports the hypothesis that binocular convergence is used to scale perceived space and that this information enables subjects to contact the ball successfully. It was further found that postural sway varied between lighting conditions and that less sway was accompanied by higher performance. There was no effect of binocular viewing in this respect. In general, the results suggest two additive effects of viewing conditions: a direct effect of binocular vision on ball catching and an indirect effect of lighting on postural stability, which, in turn, affects catching performance.     

Examination of reactive motor responses to Achilles tendon vibrations during an inhibitory stepping reaction time task

Inhibition is known to influence balance, step initiation and gait control. A specific subcomponent of inhibition, the perceptual inhibition process, has been suggested to be specifically involved in the integration of proprioceptive information that is necessary for efficient postural responses. This study aimed to investigate the inhibition requirements of planning and executing a choice step initiation task in young adults following experimental perturbation of proprioceptive information using Achilles tendon vibrations. We developed an inhibitory stepping reaction time task in which participants had to step in response to visual arrows that manipulated specific perceptual or motor inhibition according to two proprioceptive configurations: without or with application of vibrations. Performance of twenty-eight participants (mean age 21 years) showed that Achilles tendon vibrations induced an increase in attentional demands (higher reaction time and longer motor responses). Further, this increase in attentional demands did not affect specifically the different inhibitory processes tested in this reactive stepping task. It suggests that attentional demands associated with the vibratory perturbation to postural control do not lead to a shift from automatic to more attentional inhibition processes, at least in young adults.     

Age-associated differences in global and segmental control during dual-task walking under sub-optimal sensory conditions

The ability to safely perform cognitive-motor dual-tasks is critical for independence of older adults. We compared age-associated differences in global and segmental control during dual-task walking in sub-optimal sensory conditions. Thirteen young (YA) and 13 healthy older (OA) adults walked a straight pathway with cognitive dual-task of walking-while-talking (WT) or no-WT under four sensory conditions. On randomly selected trials, visual and vestibular inputs were manipulated using blurring goggles (BV) and Galvanic Vestibular Stimulation (GVS), respectively. Gait speed decreased more in YA than OA during WT. Gait speed increased with GVS with normal vision but not BV. Step length considerably decreased with WT. Trunk roll significantly decreased only in OA with GVS in WT. Head roll significantly decreased with GVS regardless of age. Results indicate GVS-induced adaptations were dependent on available visual information. YA reduced their gait speed more than OA to achieve a similar pace to safely perform WT. GVS resulted in both age-groups to reduce head movement. However, with the addition of WT during GVS, OA also stiffened their trunk. Therefore, with increased attentional demands healthy OA employed different compensatory strategies than YA to maintain postural control.     

Older adults exhibit altered motor coordination during an upper limb object transport task requiring a lateral change in support

Investigating an ecologically relevant upper limb task, such as manually transporting an object with a concurrent lateral change in support (sidestepping alongside a kitchen counter), may provide greater insight into potential deficits in postural stability, variability and motor coordination in older adults. Nine healthy young and eleven older, community dwelling adults executed an upper limb object transport task requiring a lateral change in support in two directions at two self-selected speeds, self-paced and fast-paced. Dynamic postural stability and movement variability was quantified via whole-body center of mass motion. The onset of lead lower limb movement in relation to object movement onset was quantified as a measure of motor coordination. Older adults demonstrated similar levels of stability and variability as their younger counterparts, but at slower peak movement velocity and increased task duration. Furthermore, older adults demonstrated asymmetrical motor coordination between left and right task directions, while younger adults remained consistent regardless of task direction. Thus, older adults significantly modulated movement speed and motor coordination to maintain similar levels of stability and variability compared to their younger counterparts.     

Stance Width Influences Postural Stability and Motion Sickness

We examined the influence of stance width (the distance between the feet) on postural sway and visually induced motion sickness. Stance width influences the magnitude of body sway, and changes in sway precede the subjective symptoms of motion sickness. Thus, manipulation of stance width may influence motion sickness incidence. Participants (healthy young adults) were exposed to complex, low-frequency oscillation of a moving room. Participants stood with their feet 5 cm, 17 cm, or 30 cm apart. During exposure to visual motion, the widest stance (30 cm) was associated with reduced incidence of motion sickness. For all stance widths, motion sickness was preceded by significant changes in motion of the head and torso. The results support the postural instability theory of motion sickness and suggest practical implications for the prevention of motion sickness. Adoption of wider stance may decrease the risk of motion sickness in operational situations.     

The Dynamics of Visual Reweighting in Healthy and Fall-Prone Older Adults

Multisensory reweighting (MSR) is an adaptive process that prioritizes the visual, vestibular, and somatosensory inputs to provide the most reliable information for postural stability when environmental conditions change. This process is thought to degrade with increasing age and to be particularly deficient in fall-prone versus healthy older adults. In the present study, the authors investigate the dynamics of sensory reweighting, which is not well-understood at any age. Postural sway of young, healthy, and fall-prone older adults was measured in response to large changes in the visual motion stimulus amplitude within a trial. Absolute levels of gain, and the rate of adaptive gain change were examined when visual stimulus amplitude changed from high to low and from low to high. Compared with young adults, gains in both older adult groups were higher when the stimulus amplitude was high. Gains in the fall-prone elderly were higher than both other groups when the stimulus amplitude was low. Both older groups demonstrated slowed sensory reweighting over prolonged time periods when the stimulus amplitude was high. The combination of higher vision gains and slower down weighting in older adults suggest deficits that may contribute to postural instability.