Adaptational responses in dynamic stability during disturbed walking in the elderly.

The purpose of this study was to examine the age-related predictive and feedback adaptive locomotor improvements in the components of dynamic stability control during disturbed walking. Thirteen old (62-74 yrs) and ten young (23-30 yrs) male subjects performed a gait protocol on a gangway, which included one covered element. By exchanging this element, the subjects walked either solely over hard surface or experienced a perturbation of the gait on the soft surface element. The gait protocol consisted of a baseline on hard surface and an adaptation phase with 19 trials on soft or hard (2nd, 8th and 19th) surface. The investigation of dynamic stability was made by using the margin of stability (MS), which was calculated as the difference between the base of support and the extrapolated center of mass (CM). Horizontal velocity of CM and its vertical projection in anterior-posterior direction as well as the eigenfrequency of an inverted pendulum generate the extrapolated CM. As a result of the first unexpected disturbance, MS was decreased in the step following the perturbation compared to baselines in both age-groups. This decrease was higher for the old participants compared to the young ones, indicating a more unstable position in the step after the perturbation for the elderly. In the following adaptation phase, MS returned to baseline values in both age-groups. In the hard trial after the first unexpected perturbation, both age-groups increased MS at touchdown of the disturbed leg compared to baseline, reflecting fast predictive adjustments. Our findings show that the well-known age-related biological impairments did not inhibit the adaptive improvements in the components of dynamic stability in the elderly. However, the feedback corrections after the first unexpected perturbation were less effective for the elderly. This may increase the risk of falling.

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