Improvement in gait stability in older adults after ten sessions of standing balance training

Abstract

Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.

Time-course of balance training-related changes on static and dynamic balance performance in healthy children

“…Consequently, the results can only be interpreted in the context of studies that examined different age groups. In previous publications on older adults, static and dynamic balance performance already improved after a single session of training [ 4 , 5 ] but improved gradually over multiple sessions [ 4 , 6 ]. In summary, these and our findings suggest that BT leads to improvements early on, but that the potential for adaptations can be further utilized with several training sessions.…”

“…In fact, the time-course of changes in balance with training has so far only been studied in older adults [ 4 – 6 ]. For instance, Alizadehsaravi et al [ 4 ] compared balance robustness (duration of balancing) and balance performance (centre of mass velocity) after one and ten training sessions in adults aged ≥ 65 years.…”

Early sleep after action observation plus motor imagery improves gait and balance abilities in older adults

“…Furthermore, sensorimotor system alterations and high-order cognitive functions decline have been also reported as central nervous system-related mechanisms responsible for gait and balance impairments in older adults 6 , 7 . In this scenario, motor rehabilitation represents an effective intervention to enhance gait and balance and prevent the subsequent decay in terms of functional performance 8 , 9 . Balance exercises should be challenging and tailored on participants’ abilities, requiring a certain level of supervision in order to be effective and safe at the same time 9 .…”

“…In this scenario, motor rehabilitation represents an effective intervention to enhance gait and balance and prevent the subsequent decay in terms of functional performance 8 , 9 . Balance exercises should be challenging and tailored on participants’ abilities, requiring a certain level of supervision in order to be effective and safe at the same time 9 . In fact, literature data have reported the superiority of a supervised home-based balance training on gait and balance abilities, when compared to an unsupervised exercises regimen in older adults 10 , 11 .…”

The Effects of 12-Week Dual-Task Physical–Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study

“…Due to physiological aging, sensory and motor organs undergo gradual changes, which require adapted synergies from the body for proper functioning. For this reason, older adults have a more cautious motor control [ 26 ], which is a response to the barriers that both the environment and motor coordination itself impose on the brain [ 27 ]. Depending on the older adult individual, the task of walking at an adequate speed, simultaneously coordinating the reciprocal swing of the arms with the extension/stabilization of the pelvis and ankles, can be a great challenge [ 28 , 29 ].…”