Long-term retention of gait stability improvements.

Evidence of long-term modification of behavior-in particular, gait alterations in response to repeated exposure to slips-within the locomotor-balance control system is limited. The purpose of this study was to examine whether improvements in fall-resisting behavior as reflected by improvements in gait stability could be retained on a long-term basis. Eight healthy young subjects were exposed to a block of repeated slip trials during a single acquisition session consisting of five repeated slip exposures; the same subjects were then re-tested using the same protocol at a minimum of 12 mo later. Pre- and postslip gait stability for all slip trials was measured at touchdown (slipping limb) and liftoff (contralateral limb) based on the center of mass state (i.e., its instantaneous position and velocity) relative to the base of support (BOS) and the predicted thresholds for backward loss of balance. In the acquisition session, subjects were able to increase pre- and postslip stability, which significantly correlated with a decrease in the incidence of balance loss from 100% (1st slip) to 0% (5th slip). All subjects exhibited a similar balance loss on the first slip of the follow-up session. Nonetheless, subjects were able to retain the acquired preslip stability with feedforward control on the first slip but not the postslip stability related to the reactive response. Also, the subjects demonstrated a faster re-acquisition, with only one balance loss on the second slip of the follow-up session, as compared with seven balance losses on the acquisition session. Such rapid improvements were achieved by the significantly greater increase in post- compared with preslip stability; this increase was for the most part, a consequence of reductions in slip intensity (i.e., the peak BOS velocity). We concluded that a single acquisition session could only produce limited long-term retainable effects within the locomotor-balance control system. It appeared, however, that the CNS was still primed to more rapidly update its internal representation of gait stability during re-acquisition.

[1]  F. Gage,et al.  Quantification of hippocampal noradrenaline and zinc changes after selective cell destruction , 2004, Experimental Brain Research.

[2]  H. Diener,et al.  The role of the human cerebellum in short- and long-term habituation of postural responses. , 2004, Gait & posture.

[3]  K. Newell Motor skill acquisition. , 1991, Annual review of psychology.

[4]  Bibiana Scelfo,et al.  Long-Term Synaptic Changes Induced in the Cerebellar Cortex by Fear Conditioning , 2004, Neuron.

[5]  R. Kram,et al.  Metabolic cost of generating muscular force in human walking: insights from load-carrying and speed experiments. , 2003, Journal of applied physiology.

[6]  S. Cummings,et al.  The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. , 1990, Clinical orthopaedics and related research.

[7]  M. Fanselow,et al.  Modality-specific retrograde amnesia of fear. , 1992, Science.

[8]  F. Horak,et al.  Central programming of postural movements: adaptation to altered support-surface configurations. , 1986, Journal of neurophysiology.

[9]  F. Horak,et al.  Influence of central set on human postural responses. , 1989, Journal of neurophysiology.

[10]  E. Bizzi,et al.  Consolidation in human motor memory , 1996, Nature.

[11]  S. Baker,et al.  Fall injuries in the elderly. , 1985, Clinics in geriatric medicine.

[12]  D. Greenfield Risk factors for fracture. , 1998 .

[13]  T Bhatt,et al.  Influence of gait speed on stability: recovery from anterior slips and compensatory stepping. , 2005, Gait & posture.

[14]  R. Ammons,et al.  Acquisition and long-term retention of a simple serial perceptual-motor skill. , 1957, Journal of experimental psychology.

[15]  A. Patla,et al.  Strategies for dynamic stability during locomotion on a slippery surface: effects of prior experience and knowledge. , 2002, Journal of neurophysiology.

[16]  Training and contextual interference effects on memory and transfer. , 1989, Research quarterly for exercise and sport.

[17]  J. R. Bloedel,et al.  Adaptive changes in responses to repeated locomotor perturbations in cerebellar patients , 1998, Experimental Brain Research.

[18]  B. Maki,et al.  Adaptive changes to compensatory stepping responses , 1995 .

[19]  L. D. de Witte,et al.  Impact of gait problems and falls on functioning in independent living persons of 55 years and over: a community survey. , 1999, Patient education and counseling.

[20]  Yi-Chung Pai,et al.  Age influences the outcome of a slipping perturbation during initial but not repeated exposures. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[21]  G. Cavagna,et al.  The sources of external work in level walking and running. , 1976, The Journal of physiology.

[22]  Y-C Pai,et al.  Role of feedforward control of movement stability in reducing slip-related balance loss and falls among older adults. , 2003, Journal of neurophysiology.

[23]  M G Carpenter,et al.  Postural control is scaled to level of postural threat. , 2000, Gait & posture.

[24]  F. Su,et al.  Effect of slip on movement of body center of mass relative to base of support. , 2001, Clinical biomechanics.

[25]  Y C Pai,et al.  Simulated movement termination for balance recovery: can movement strategies be sought to maintain stability in the presence of slipping or forced sliding? , 1999, Journal of biomechanics.

[26]  Mark G. Carpenter,et al.  The influence of postural threat on the control of upright stance , 2001, Experimental Brain Research.

[27]  E. Kandel The Molecular Biology of Memory Storage: A Dialogue Between Genes and Synapses , 2001, Science.

[28]  T. Lockhart,et al.  Effects of age-related gait changes on the biomechanics of slips and falls , 2003, Ergonomics.

[29]  T A Bentley,et al.  Slip, trip and fall accidents occurring during the delivery of mail. , 1998, Ergonomics.

[30]  P. Leva Adjustments to Zatsiorsky-Seluyanov's segment inertia parameters. , 1996 .

[31]  Yi-Chung Pai,et al.  Feedforward adaptations are used to compensate for a potential loss of balance , 2002, Experimental Brain Research.

[32]  R F Reynolds,et al.  The moving platform aftereffect: limited generalization of a locomotor adaptation. , 2004, Journal of neurophysiology.

[33]  P. Laippala,et al.  Fracture Risk Associated with a Fall According to Type of Fall Among the Elderly , 2000, Osteoporosis International.

[34]  T. Bhatt,et al.  Adaptive control of gait stability in reducing slip-related backward loss of balance , 2006, Experimental Brain Research.

[35]  M S Redfern,et al.  Biomechanics of slips , 2001, Ergonomics.

[36]  F. Horak,et al.  Postural perturbations: new insights for treatment of balance disorders. , 1997, Physical therapy.

[37]  F Tjernström,et al.  Adaptation of postural control to perturbations--a process that initiates long-term motor memory. , 2002, Gait & posture.

[38]  M. V. Van Natta,et al.  Epidemiology of Hip Fractures Among the Elderly: Risk Factors for Fracture Type , 1995, Clinical orthopaedics and related research.

[39]  Chuansi Gao,et al.  A systems perspective of slip and fall accidents on icy and snowy surfaces , 2004, Ergonomics.

[40]  F B Horak,et al.  Prediction and set-dependent scaling of early postural responses in cerebellar patients. , 1997, Brain : a journal of neurology.

[41]  T. M. Owings,et al.  Mechanisms of failed recovery following postural perturbations on a motorized treadmill mimic those associated with an actual forward trip. , 2001, Clinical biomechanics.

[42]  Thomas A. McMahon,et al.  Muscles, Reflexes, and Locomotion , 1984 .

[43]  J. H. J. Allum,et al.  Postural coactivation and adaptation in the sway stabilizing responses of normals and patients with bilateral vestibular deficit , 2004, Experimental Brain Research.