Postural sway increases with age. The decreased stability associated with postural sway often has been related to the reduced peripheral sensibility in the visual, vestibular, and proprioceptive systems. We examined whether the micropostural adjustments necessary for maintaining balance also require some cognitive processing. Young and older subjects were submitted to an auditory reaction time task while maintaining an upright posture on a force platform. The auditory stimuli were presented randomly when subjects were in a central or in an eccentric less stable postural position in four conditions of vision/surface. If the postural adjustments require some cognitive processing, a more eccentric position of the center of foot pressure (COP) would require more attention than a stable position of the COP because when an eccentric position is identified, a corrective response subsequently needs to be selected, programmed, and executed. The visual and surface conditions were altered to determine if additional attentional resources need to be allocated to the postural task when there is a reduction of the sensory information available. Results showed that as the sensory information decreased, the postural task became increasingly difficult for the elderly and required more of their attentional capacity (as indexed by increases in reaction time).

Numerous authors have reported that elderly persons are more affected than young adults when submitted to reduced or conflicting sensory inputs conditions. These results, however, do not permit to evaluate whether the elderly suffer from a reduced peripheral sensibility or from a deficit in the central integrative mechanisms responsible for configuring the postural set. The present experiment evaluated the ability of elderly to reconfigure the postural set when submitted to successive reduced and augmented visual sensory conditions. Results showed that young and elderly subjects' sway dispersion increased when they were exposed to a reduced visual sensory condition (i.e., vision/no-vision transition). However, when exposed to augmented sensory condition (i.e., no-vision/vision transitions) young adult were able to adapt rapidly and reduced their sway dispersion whereas the elderly exhibited an increased sway dispersion. This inability to adapt to an augmented sensory condition suggest that elderly persons, in addition to a reduced peripheral sensibility, have a deficit with central integrative mechanisms responsible for reconfiguring the postural set.

In order to study voluntary and reflexive mechanisms of postural control, young and elderly persons were given large-fast and small-slow ankle-rotation postural disturbances while standing on a movable platform capable of measuring ground reaction forces. Large-fast rotations were employed to activate long-loop reflexes, and small-slow rotations were employed to tap the higher level sensory integration aspects of postural control. Overall, the elderly persons exhibited more perturbation induced sway and showed a slowing in voluntary, as opposed to reflexive mechanisms of correcting postural disturbance. For both age groups, reflexive mechanisms were found to be relatively intact. When small perturbations were given, the elderly persons swayed more than young participants and produced sporadic reflexive activity. Moreover, elderly persons did not adapt to the small perturbations and exhibited increased postural sway to repetitive presentation of the perturbation, whereas young participants substantially decreased their postural sway. These data demonstrate that elderly persons are at some disadvantage when posture is under the control of slower, higher level sensory integrative mechanisms.

Results on a mirrow drawing task showed that a deafferented patient had no problem completing the pattern, whereas normal subjects needed more than four trials to attain a similar performance. The results suggest the presence of integrated visual and proprioceptive maps. The inversion of visual coordinates requires the need for a recalibration. Without proprioception, the task is more like a simple visual tracking task.

Balance control is influenced by the availability and integrity of sensory inputs as well as the ability of the balance control mechanisms to tailor the corrective action to the gravitational torque. In this study, to challenge balance control, visual and ankle proprioceptive information were perturbed (eyes closed and/or tendon vibration). We masked sensory inputs in order: (1) to test the hypothesis that adolescent idiopathic scoliosis (AIS), compared to healthy adolescent, relies more on ankle proprioception and/or visual inputs to regulate balance and (2) to determine whether it is the variation or the amplitude of the balance control commands of AIS that leads to greater body sway oscillations during sensory deprivation. By manipulating the availability of the sensory inputs and measuring the outcomes, center of pressure (CP) range and velocity variability, we could objectively determine the cost of visual and/or ankle proprioception deprivation on balance control. The CP range was larger and the root mean square (RMS) of the CP velocity was more variable for AIS than for control participants when ankle proprioception was perturbed. This was observed regardless of whether vision was available or not. The analysis of the sway density curves revealed that the amplitude rather than the variation of the balance control commands was related to a larger CP range and greater RMS CP velocity for AIS. The present results suggest that AIS, compared to control participants, relies much more on ankle proprioception to control the amplitude of the balance control commands.