scholarly journals Cortical Engagement Metrics During Reactive Balance Are Associated With Distinct Aspects of Balance Behavior in Older Adults

2021 ◽  
Vol 13 ◽  
Author(s):  
Jacqueline A. Palmer ◽  
Aiden M. Payne ◽  
Lena H. Ting ◽  
Michael R. Borich
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Network Activity ◽  
Beta Activity ◽  
Balance Function ◽  
Potential Biomarker ◽  
Beta Power ◽  
Wide Range ◽  
Motor Cortical ◽  
Reactive Balance

Heightened reliance on the cerebral cortex for postural stability with aging is well-known, yet the cortical mechanisms for balance control, particularly in relation to balance function, remain unclear. Here we aimed to investigate motor cortical activity in relation to the level of balance challenge presented during reactive balance recovery and identify circuit-specific interactions between motor cortex and prefrontal or somatosensory regions in relation to metrics of balance function that predict fall risk. Using electroencephalography, we assessed motor cortical beta power, and beta coherence during balance reactions to perturbations in older adults. We found that individuals with greater motor cortical beta power evoked following standing balance perturbations demonstrated lower general clinical balance function. Individual older adults demonstrated a wide range of cortical responses during balance reactions at the same perturbation magnitude, showing no group-level change in prefrontal- or somatosensory-motor coherence in response to perturbations. However, older adults with the highest prefrontal-motor coherence during the post-perturbation, but not pre-perturbation, period showed greater cognitive dual-task interference (DTI) and elicited stepping reactions at lower perturbation magnitudes. Our results support motor cortical beta activity as a potential biomarker for individual level of balance challenge and implicate prefrontal-motor cortical networks in distinct aspects of balance control involving response inhibition of reactive stepping in older adults. Cortical network activity during balance may provide a neural target for precision-medicine efforts aimed at fall prevention with aging.

scholarly journals Prefrontal-motor and somatosensory-motor cortical network interactions during reactive balance are associated with distinct aspects of balance behavior in older adults

2021 ◽  
Author(s):  
Jacqueline A. Palmer ◽  
Aiden M. Payne ◽  
Lena H. Ting ◽  
Michael R. Borich
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Cortical Network ◽  
Network Activity ◽  
Beta Activity ◽  
Balance Function ◽  
Potential Biomarker ◽  
Beta Power ◽  
Motor Cortical ◽  
Reactive Balance

AbstractHeightened reliance on the cerebral cortex for postural stability with aging is well-known, yet the cortical dynamics of balance control, particularly in relationship to balance function, is unclear. Here we aimed to investigate motor cortical activity in relationship to the level of balance challenge presented during reactive balance recovery, and identify circuit-specific interactions between motor cortex and prefrontal or somatosensory regions to metrics of balance function that predict fall risk. Using electroencephalography, we assessed motor cortical beta power, and beta coherence during balance reactions to perturbations in older adults. We found that individuals with greater somatosensory-motor beta coherence at baseline and lower beta power evoked over motor regions following perturbations demonstrated higher general clinical balance function. At the group-level, beta coherence between prefrontal-motor regions reduced during balance reactions. Older adults with the highest post-perturbation prefrontal-motor coherence showed greater cognitive dual-task interference and elicited stepping reactions at lower perturbation magnitudes. Our results support motor cortical beta activity as a potential biomarker for individual level of balance challenge and implicate prefrontal-and somatosensory-motor cortical networks in different aspects of balance control in older adults. Cortical network activity during balance may provide a neural target for precision-medicine efforts aimed at fall-prevention with aging.

scholarly journals Examining Different Motor Learning Paradigms for Improving Balance Recovery Abilities Among Older Adults, Random vs. Block Training—Study Protocol of a Randomized Non-inferiority Controlled Trial

2021 ◽  
Vol 15 ◽  
Author(s):  
Hadas Nachmani ◽  
Inbal Paran ◽  
Moti Salti ◽  
Ilan Shelef ◽  
Itshak Melzer
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Controlled Trial ◽  
Training Session ◽  
Real Life ◽  
Community Dwelling ◽  
Analysis Of Covariance ◽  
Balance Function ◽  
Balance Test ◽  
Reactive Balance

Introduction: Falls are the leading cause of fatal and nonfatal injuries among older adults. Studies showed that older adults can reduce the risk of falls after participation in an unexpected perturbation-based balance training (PBBT), a relatively novel approach that challenged reactive balance control. This study aims to investigate the effect of the practice schedule (i.e., contextual interference) on reactive balance function and its transfer to proactive balance function (i.e., voluntary step execution test and Berg balance test). Our primary hypothesis is that improvements in reactive balance control following block PBBT will be not inferior to the improvements following random PBBT.Methods and Analysis: This is a double-blind randomized controlled trial. Fifty community-dwelling older adults (over 70 years) will be recruited and randomly allocated to a random PBBT group (n = 25) or a block PBBT group (n = 25). The random PBBT group will receive eight training sessions over 4 weeks that include unexpected machine-induced perturbations of balance during hands-free treadmill walking. The block PBBT group will be trained by the same perturbation treadmill system, but only one direction will be trained in each training session, and the direction of the external perturbations will be announced. Both PBBT groups (random PBBT and block PBBT) will receive a similar perturbation intensity during training (which will be customized to participant’s abilities), the same training period, and the same concurrent cognitive tasks during training. The generalization and transfer of learning effects will be measured by assessing the reactive and proactive balance control during standing and walking before and after 1 month of PBBT, for example, step and multiple steps and fall thresholds, Berg balance test, and fear of falls. The dependent variable will be rank transformed prior to conducting the analysis of covariance (ANCOVA) to allow for nonparametric analysis.Discussion: This research will explore which of the balance retraining paradigms is more effective to improve reactive balance and proactive balance control in older adults (random PBBT vs. block PBBT) over 1 month. The research will address key issues concerning balance retraining: older adults’ neuromotor capacities to optimize training responses and their applicability to real-life challenges.Clinical Trial Registration: Helsinki research ethics approval has been received (Soroka Medical Center approval #0396-16-SOR; MOH_2018-07-22_003536; www.ClinicalTrials.gov, NCT04455607).

Reactive balance control in older adults with diabetes

2018 ◽  
Vol 61 ◽  
pp. 67-72 ◽  
Author(s):  
Pei-Yun Lee ◽  
Yi-Ju Tsai ◽  
Yu-Ting Liao ◽  
Yi-Ching Yang ◽  
Fen-Hwa Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Reactive Balance

scholarly journals Type II muscle fibre properties are not associated with balance recovery following large perturbations during walking in young and older adults

2021 ◽  
Author(s):  
Christopher McCrum ◽  
Lotte Grevendonk ◽  
Gert Schaart ◽  
Esther Moonen-Kornips ◽  
Johanna A Jörgensen ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Muscle Fibre ◽  
Balance Control ◽  
Type Ii ◽  
Fibre Type Composition ◽  
Fibre Properties ◽  
Tissue Properties ◽  
Reactive Balance ◽  
Fibre Characteristics

Falls among older adults are often attributed to declining muscle strength with ageing. Associations between muscle strength and balance control have been reported, but the evidence for, and key mechanisms of resistance exercise in fall prevention are unclear. No studies have directly examined the relationship between muscle fibre characteristics and reactive balance control. Here, we address whether or not Type II muscle fibre characteristics associate with reactive balance during walking in young and older adults with varying muscle fibre type composition. We analyse muscle biopsy-derived fibre characteristics and stability during a treadmill-based walking perturbation (trip-like) task of healthy young adults, healthy, normally active older adults, trained older adults and physically impaired older adults. We find no significant associations between Type II muscle fibre properties and reactive balance during walking, indicating that practitioners and researchers should consider more than just the muscle tissue properties when assessing and intervening on fall risk.

scholarly journals Cortical Beta Oscillatory Activity Evoked during Reactive Balance Recovery Scales with Perturbation Difficulty and Individual Balance Ability

2020 ◽  
Vol 10 (11) ◽  
pp. 860
Author(s):  
Nina J. Ghosn ◽  
Jacqueline A. Palmer ◽  
Michael R. Borich ◽  
Lena H. Ting ◽  
Aiden M. Payne
Keyword(s):  
Time Course ◽  
Balance Control ◽  
Oscillatory Activity ◽  
Support Surface ◽  
Balance Recovery ◽  
Sensorimotor Processing ◽  
Cortical Areas ◽  
Beta Power ◽  
Balance Ability ◽  
Reactive Balance

Cortical beta oscillations (13–30 Hz) reflect sensorimotor processing, but are not well understood in balance recovery. We hypothesized that sensorimotor cortical activity would increase under challenging balance conditions. We predicted greater beta power when balance was challenged, either by more difficult perturbations or by lower balance ability. In 19 young adults, we measured beta power over motor cortical areas (electroencephalography, Cz electrode) during three magnitudes of backward support -surface translations. Peak beta power was measured during early (50–150 ms), late (150–250 ms), and overall (0–400 ms) time bins, and wavelet-based analyses quantified the time course of evoked beta power. An ANOVA was used to compare peak beta power across perturbation magnitudes in each time bin. We further tested the association between perturbation-evoked beta power and individual balance ability measured in a challenging beam walking task. Beta power increased ~50 ms after perturbation, and to a greater extent in larger perturbations. Lower individual balance ability was associated with greater beta power in only the late (150–250 ms) time bin. These findings demonstrate greater sensorimotor cortical engagement under more challenging balance conditions, which may provide a biomarker for reduced automaticity in balance control that could be used in populations with neurological impairments.

scholarly journals A comprehensive score reflecting memory-related fMRI activations and deactivations as potential biomarker for neurocognitive aging

2021 ◽  
Author(s):  
Joram Soch ◽  
Anni Richter ◽  
Hartmut Schütze ◽  
Jasmin M. Kizilirmak ◽  
Anne Assmann ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Aging ◽  
Successful Aging ◽  
Memory Performance ◽  
Network Activity ◽  
Imaging Biomarker ◽  
Age Group ◽  
Potential Biomarker ◽  
Neurocognitive Aging

AbstractOlder adults and particularly those at risk for developing dementia typically show a decline in episodic memory performance, which has been associated with altered memory network activity detectable via functional magnetic resonance imaging (fMRI). To quantify the degree of these alterations, a score has been developed as a putative imaging biomarker for successful aging in memory for older adults (Functional Activity Deviations during Encoding, FADE; Düzel et al., 2011). Here, we introduce and validate a more comprehensive version of the FADE score, termed FADE-SAME (Similarity of Activations during Memory Encoding), which differs from the original FADE score by considering not only activations but also deactivations in fMRI contrasts of stimulus novelty and successful encoding, and by taking into account the variance of young adults’ activations. We computed both scores for novelty and subsequent memory contrasts in a cohort of 217 healthy adults, including 106 young and 111 older participants, as well as a replication cohort of 117 young subjects. We further tested the stability and generalizability of both scores by controlling for different MR scanners and gender, as well as by using different data sets of young adults as reference samples. Both scores showed robust age-group-related differences for the subsequent memory contrast, and the FADE-SAME score additionally exhibited age-group-related differences for the novelty contrast. Furthermore, both scores correlate with behavioral measures of cognitive aging, namely memory performance. Taken together, our results suggest that single-value scores of memory-related fMRI responses may constitute promising biomarkers for quantifying neurocognitive aging.

scholarly journals Perturbation-based balance assessment: Examining reactive balance control in older adults with mild cognitive impairments

2021 ◽  
Author(s):  
Lakshmi N Kannan ◽  
Tanvi S Bhatt
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Balance Control ◽  
Step Length ◽  
Subjective Memory ◽  
Step Initiation ◽  
Risk Of Falls ◽  
Reactive Balance

Abstract Background Older adults with mild cognitive impairment (OAwMCI) present subtle balance and gait deficits along with subjective memory decline. Although these presentations might not affect activities of daily living (ADLs), they attribute to a two-folded increase in falls. While changes occurring in volitional balance control during ADLs have been extensively examined among OAwMCI, reactive balance control, required to recover from external perturbations, has received little attention. Therefore, this study examined reactive balance control in OAwMCI compared to their healthy counterparts. Methods Fifteen older adults with mild cognitive impairment (OAwMCI), fifteen cognitively intact older adults (CIOA) (>55 years), and fifteen young adults (18–30 years) were exposed to stance perturbations at three different intensities. Behavioral outcomes postural COM state stability, step length, step initiation, and step execution were computed. Results Postural COM state stability was the lowest in OAwMCI compared to CIOA and young adults, and it deteriorated at higher perturbation intensities (P < 0.001). Step length was the lowest among OAwMCI and was significantly different from young adults (P < 0.001) but not from CIOA. Unlike OAwMCI, CIOA and young adults increased their step length at higher perturbation intensities (P < 0.001). OAwMCI showed longer recovery step initiation times and shorter execution times compared to CIOA and young adults at higher perturbation intensities (P < 0.001). Conclusion OAwMCI exhibit exacerbated reactive instability and are unable to modulate their responses as the threat to balance control altered. Thus, they are at a significantly higher risk of falls than their healthy counterparts.

scholarly journals Determining the optimal dose of reactive balance training after stroke: study protocol for a pilot randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038073
Author(s):  
Avril Mansfield ◽  
Elizabeth L Inness ◽  
Cynthia J Danells ◽  
David Jagroop ◽  
Tanvi Bhatt ◽  
...  
Keyword(s):  
Older Adults ◽  
Balance Control ◽  
Controlled Trial ◽  
Balance Training ◽  
Optimal Dose ◽  
Pilot Randomised Controlled Trial ◽  
Healthy Older Adults ◽  
Randomised Controlled ◽  
Reactive Balance

IntroductionFalls risk poststroke is highest soon after discharge from rehabilitation. Reactive balance training (RBT) aims to improve control of reactions to prevent falling after a loss of balance. In healthy older adults, a single RBT session can lead to lasting improvements in reactive balance control and prevent falls in daily life. While increasing the dose of RBT does not appear to lead to additional benefit for healthy older adults, stroke survivors, who have more severely impaired balance control, may benefit from a higher RBT dose. Our long-term goal is to determine the optimal dose of RBT in people with subacute stroke. This assessor-blinded pilot randomised controlled trial aims to inform the design of a larger trial to address this long-term goal.Methods and analysisParticipants (n=36) will be attending out-patient stroke rehabilitation, and will be randomly allocated to one of three groups: one, three or six RBT sessions. RBT will replace a portion of participants’ regular physiotherapy so that the total physical rehabilitation time will be the same for the three groups. Balance and balance confidence will be assessed at: (1) study enrolment; (2) out-patient rehabilitation discharge; and (3) 6 months postdischarge. Participants will report falls and physical activity for 6 months postdischarge. Pilot data will be used to plan the larger trial (ie, sample size estimate using fall rates, and which groups should be included based on between-group trends in pre-to-post training effect sizes for reactive balance control measures). Pilot data will also be used to assess the feasibility of the larger trial (ie, based on the accrual rate, outcome completion rate and feasibility of prescribing specific training doses).Ethics and disseminationInstitutional research ethics approval has been received. Study participants will receive a lay summary of results. We will also publish our findings in a peer-reviewed journal.Trial registration numberNCT04219696; Pre results.

DSM-5 alcohol use disorder features among treatment-seeking older adults

2018 ◽  
Vol 64 (4) ◽  
pp. 185-196 ◽  
Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
The Elderly ◽  
Treatment Seeking ◽  
Controlled Clinical Trial ◽  
Dsm 5 ◽  
Wide Range ◽  
And Gender ◽  
International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

scholarly journals Reactive Balance Control for Legged Robots under Visco-Elastic Contacts

2020 ◽  
Vol 11 (1) ◽  
pp. 353
Author(s):  
Thomas Flayols ◽  
Andrea Del Prete ◽  
Majid Khadiv ◽  
Nicolas Mansard ◽  
Ludovic Righetti
Keyword(s):  
Inverse Dynamics ◽  
State Of The Art ◽  
Balance Control ◽  
Contact Stiffness ◽  
Poor Performance ◽  
Admittance Control ◽  
Inverse Dynamics Control ◽  
Rigid Contact ◽  
Reactive Balance ◽  
Shed Light

Contacts between robots and environment are often assumed to be rigid for control purposes. This assumption can lead to poor performance when contacts are soft and/or underdamped. However, the problem of balancing on soft contacts has not received much attention in the literature. This paper presents two novel approaches to control a legged robot balancing on visco-elastic contacts, and compares them to other two state-of-the-art methods. Our simulation results show that performance heavily depends on the contact stiffness and the noises/uncertainties introduced in the simulation. Briefly, the two novel controllers performed best for soft/medium contacts, whereas “inverse-dynamics control under rigid-contact assumptions” was the best one for stiff contacts. Admittance control was instead the most robust, but suffered in terms of performance. These results shed light on this challenging problem, while pointing out interesting directions for future investigation.

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