Visuo-postural adaptation during the acquisition of a visually guided weight-shifting task: age-related differences in global and local dynamics

Resilience of visually guided weight shifting to a proprioceptive perturbation depends on the complexity of the guidance stimulus

BACKGROUND

Whole-body tracking of visual motion cues is used in balance training to improve weight shifting ability in old age and sports.

RESEARCH QUESTION

How tracking of a complex (pink noise) and a periodic visual target motion during anteroposterior weight shifting affects postural and muscle responses to unilateral hip vibration.

METHODS

Twenty-six participants performed 160 anteroposterior weight shifting cycles while tracking the vertical motion of a visual target, concurrently receiving Center of Pressure (CoP) feedback. They were randomly divided to groups; (a) the Constant group tracked a visual target motion constructed by 3 sinusoids of different amplitude, and (b) the Pink group tracked a complex visual target motion constructed by a pink noise generation process. Between the 60th and the 120th cycle, vibration was applied to the right gluteus medius, introducing a sideways CoP deviation. CoP displacement and electromyographic (EMG) responses of soleus, tibialis anterior and peroneus longus were recorded and summarized in blocks of 3 cycles.

RESULTS

Sideways CoP deviation induced at the onset/offset of unilateral hip vibration was smaller for the Pink than the Constant group. The Pink group demonstrated greater tibialis anterior and peroneus longus EMG activity around the most anterior sway peak while soleus EMG was similar for the two groups. Both groups successfully coupled weight shifting amplitude to the target motion, but the Pink group tracked the target motion with a greater delay compared to the Constant group.

SIGNIFICANCE

Whole body tracking of complex visual motions evokes perception-based action and increases ankle muscle co-activation making sway more resilient to a proprioceptive perturbation induced by unilateral hip vibration. Complex visual guidance motions should be considered when designing balance rehabilitation regimes, aiming at improving weight shifting ability and dynamic balance control.

Electroencephalographic Study on Sensory Integration in Visually Induced Postural Sway

A periodically reversing optic flow animation, experienced while standing, induces an involuntary sway termed visually induced postural sway (VIPS). Interestingly, VIPS is suppressed during light finger touch to a stationary object. Here, we explored whether VIPS is mediated by parietal field activity in the dorsal visual stream as well as by activity in early visual areas, as has been suggested. We performed a mobile brain/body imaging study using high-density electroencephalographic recording from human participants (11 men and 3 women) standing during exposure to periodically reversing optic flow with and without light finger touch to a stable surface. We also performed recording their visuo-postural tracking movements as a typical visually guided movement to explore differences of cortical process of VIPS from the voluntary visuomotor process involving the dorsal stream. In the visuo-postural tracking condition, the participants moved their center of pressure in time with a slowly oscillating (expanding, shrinking) target rectangle. Source-resolved results showed that alpha band (8-13 Hz) activity in the medial and right occipital cortex during VIPS was modulated by the direction and velocity of optic flow and increased significantly during light finger touch. However, source-resolved potentials from the parietal association cortex showed no such modulation. During voluntary postural sway with feedback (but no visual flow) in which the dorsal stream is involved, sensorimotor areas produced more theta band (4-7 Hz) and less beta band (14-35 Hz) activity than during involuntary VIPS. These results suggest that VIPS involves cortical field dynamic changes in the early visual cortex rather than in the posterior parietal cortex of the visual dorsal stream.

Age induced modifications in the persistency of voluntary sway when actively tracking the complex motion of a visual target

Movement persistency, reflected in systematic cycle to cycle fluctuations of a rhythmical task such as walking or voluntary sway, is compromised with increasing age, making older adults more susceptible to falls. In the present study, we tested whether it is possible to improve rhythmic voluntary sway persistency in old age by actively tracking the complex (i.e. persistent) motion of a visual target. Twenty healthy young and 20 older adults performed 132 cycles of anterior-posterior sway under two conditions: a) self-paced sway and b) sway while tracking the vertical motion of a complex visual target. The persistency of sway cycle amplitude and duration, detected from the center of pressure displacement, was quantified using the Fractal exponent α. We also recorded body kinematics in order to assess the intersegmental coordination that was quantified in the Mean Absolute Relative Phase (MARP) and the Deviation Phase (DPh) between the trunk and the lower limbs. In self-paced sway, older adults showed a lower persistency of cycle duration and a higher MARP and DPh between the trunk and the lower limbs compared to young adults. Tracking the complex visual target motion increased the persistency of cycle amplitude, in young but not in older adults, when compared to the self-paced sway while it decreased the persistency of cycle duration in both groups. The relative phase measures showed a moderate to strong relationship with the persistency of cycle amplitude and duration when older adults swayed in their self-pace. These findings suggest older adults cannot exploit active tracking of the complex visual motion cue to improve voluntary sway persistency. This could be related to the less stable and out of phase intersegmental coordination characterizing rhythmic voluntary sway in old age.

Women with knee osteoarthritis increase knee muscle co-contraction to perform stand to sit

BACKGROUND

There is lack of sufficient research evidence when we examine how knee osteoarthritis (OA) affects performance of stand to sit, a very important task for daily function.

AIM

The aim of this study was to investigate if women with unilateral knee OA perform the stand to sit task in the same way as healthy adults of the same age.

METHODS

Fifteen women with knee OA (age 64.05 ± 4.23 years, height 161.52 ± 5.03 cm, and mass 75.23 ± 8.51 kg) and fifteen healthy subjects of the same age (age 62.13 ± 4.15 years, height 160.73 ± 5.10 cm, and mass 75.20 ± 9.87 kg) volunteered to participate. The experimental task required sitting to a chair starting from a bipedal standing position. Electromyographic activity of the vastus lateralis and biceps femoris was examined for both legs. In addition, joint kinematics of the lower limb and vertical ground reaction forces were recorded bilaterally.

RESULTS

Movement duration was not different between the groups. Women with knee OA showed significantly lower vastus lateralis activation and higher knee muscle co-contraction of the affected leg compared to the same leg of the control group. In addition, they had smaller knee range of motion for both legs compared to the control group participants.

CONCLUSION

Knee muscle co-contraction is employed by women with knee OA to perform the stand to sit movement at the same duration as their healthy counterparts. This compensatory mechanism may be important for the task execution, but at the same time, it can be harmful for the joint.

Swaying to the complex motion of a visual target affects postural sway variability

BACKGROUND

Voluntary shifting body weight in the anteroposterior direction is an important element of daily life activities, such as rising from a chair or initiating a step. In order to accommodate the daily-life challenges of such tasks, voluntary postural sway needs to be flexible and variable.

RESEARCH QUESTION

In this study we asked how whole-body tracking of a complex visual target motion with the concurrent provision of feedback modulates the variability of voluntary sway.

METHODS

Twenty young adults (age: 27.10 ± 9.15years, height: 170.73 ± 9.40 cm, mass: 62.84 ± 11.48 kg) performed 132 cycles of voluntary antero-posterior sway, on a force platform, under two conditions: a) self-paced sway and b) swaying while tracking the complex motion of a visual target. Magnitude and temporal structure of variability of postural sway were investigated with the Coefficient of Variance (CoV) and the fractal exponent α, respectively. This analysis was performed for sway cycle duration, amplitude and velocity. The cross-correlation function between the target and sway cycle parameters was computed as a measure of visuo-postural coupling.

RESULTS

The CoV of sway cycle amplitude, duration and velocity increased during active tracking of the complex target. Fractal exponent α increased for sway cycle amplitude but decreased for cycle duration and remained unchanged for sway velocity. The cross-correlation function revealed a consistent peak at lag+1 indicating an asynchrony between the target and sway cycle duration, while the peak cross-correlation for cycle amplitude was noted at lag 0.

SIGNIFICANCE

Swaying to the complex motion of a visual target improves the variability of sway cycle amplitude, at the cost of cycle duration. This is associated with a more synchronous spatial than temporal coupling to the visual target motion. This knowledge could inform the design of postural tracking paradigms as appropriate exercise interventions, for improving voluntary sway in populations with reduced limits of stability (i.e. older adults).

Harnessing the Power of a Novel Program for Dynamic Balance Perturbation with Supported Body Weight

Self-initiated postural adjustments commonly occur in daily life. To accessibly measure this type of dynamic balance, we developed a simple computer program to induce virtual perturbations and combined it with a commercially available balance board and portable EMG system to measure resulting self-initiated postural adjustments. When performing perturbed balance tests, safety harness with body weight support (BWS) is often used. However, influences of these harnesses on postural reactions are not well known. This study investigated the sensitivity of our assessment tool under different BWS conditions and muscle responses during postural adjustments following perturbation at different directions. Fifteen neurologically intact participants performed self-initiated postural adjustments under conditions with: (1) no harness; (2) harness with no BWS; and (3) harness with 10% BWS. Postural adjustment time and muscle activities of the lower leg were measured. We observed significant increases in postural adjustment time in the harness with no BWS condition and differneces in lower leg muscles response to virtual perturbation. Our findings suggest that the combination of our customized program with EMG is a sensitive and convenient tool to measure postural adjustments that approximate real-world scenarios. This method can be used with light body weight support to ensure safety without influencing muscle synergies.

Posture and gaze tracking of a vertically moving target reveals age-related constraints in visuo-motor coupling

Previously we have demonstrated that the effect of aging on posture and gaze active tracking of a visual target moving in the horizontal direction is dependent on target's complexity. In this study, we asked whether a similar phenomenon is present when tracking a visual target moving with varying complexity in the vertical direction. Ten young (22.98±2.9years) and 10 older adults (72.45±4.72years) tracked for 120s, a visual target moving vertically by shifting their bodyweight in the anterior-posterior direction. Three target motions were tested: a simple periodic (sine wave), a more complex (Lorenz attractor) and an ultra-complex random (Surrogated Lorenz attractor) pattern. Cross-spectral analysis revealed lower sway-target coherence as a function of age, regardless of target motion's complexity. This age effect was significant for the sway-target gain but not for the phase index. Gaze-target analysis revealed age related differences only when tracking the more complex targets. Regardless of age, tracking of the complex target was associated with lower cross Approximate Entropy. It is concluded that tracking of visual targets oscillating in the vertical direction reveals age related constraints that are independent of visual motion's complexity. These constraints are evident in the spatial and not temporal aspects of visuo-motor coupling, which suggests the presence of neuromuscular deficiencies in controlling visually guided postural sway in the anterior-posterior direction.

Aging affects postural tracking of complex visual motion cues

Postural tracking of visual motion cues improves perception-action coupling in aging, yet the nature of the visual cues to be tracked is critical for the efficacy of such a paradigm. We investigated how well healthy older (72.45 ± 4.72 years) and young (22.98 ± 2.9 years) adults can follow with their gaze and posture horizontally moving visual target cues of different degree of complexity. Participants tracked continuously for 120 s the motion of a visual target (dot) that oscillated in three different patterns: a simple periodic (simulated by a sine), a more complex (simulated by the Lorenz attractor that is deterministic displaying mathematical chaos) and an ultra-complex random (simulated by surrogating the Lorenz attractor) pattern. The degree of coupling between performance (posture and gaze) and the target motion was quantified in the spectral coherence, gain, phase and cross-approximate entropy (cross-ApEn) between signals. Sway-target coherence decreased as a function of target complexity and was lower for the older compared to the young participants when tracking the chaotic target. On the other hand, gaze-target coherence was not affected by either target complexity or age. Yet, a lower cross-ApEn value when tracking the chaotic stimulus motion revealed a more synchronous gaze-target relationship for both age groups. Results suggest limitations in online visuo-motor processing of complex motion cues and a less efficient exploitation of the body sway dynamics with age. Complex visual motion cues may provide a suitable training stimulus to improve visuo-motor integration and restore sway variability in older adults.

Effects of Filtering the Center of Pressure Feedback Provided in Visually Guided Mediolateral Weight Shifting

Thirty healthy adults completed a mediolateral weight-shifting balance task in which they were instructed to shift their weight to visually displayed target regions. A model-based filter and three different moving average filters employing 10, 34, and 58 samples were applied to the center of pressure visual feedback that guided the activity. The effects of filter selection on both the displayed feedback and the shift performance were examined in terms of shift time and non-minimum phase behavior. Shift time relates to feedback delay and shift speed, whereas non-minimum phase behavior relates to the force applied in shift initiation. Results indicated that increasing the number of samples in moving average filters (indicative of stronger filtering) significantly increases shift speed and shift initiation force. These effects indicate that careful selection and documentation of data filtering is warranted in future work and suggest opportunities for strategic filtering of visual feedback in clinical weight-shifting balance activities in order to improve outcomes based on such feedback.

Kinematics and knee muscle activation during sit-to-stand movement in women with knee osteoarthritis

BACKROUND

The purpose of this study was to compare joint kinematics, knee and trunk muscle activation and co-activation patterns during a sit-to-stand movement in women with knee osteoarthritis and age-matched controls.

METHODS

Eleven women with knee osteoarthritis (mean and standard deviation, age: 66.90, 4.51 years, height: 1.63, 0.02 m, mass: 77.63, 5.4 kg) and eleven healthy women (mean and standard deviation, age: 61.90, 3.12 years, height: 1.63 m, 0.03, mass: 78.30, 4.91 kg) performed a Sit to Stand movement at a self-selected slow, normal and fast speed. Three-dimensional joint kinematics of the lower limb, vertical ground reaction forces and electromyographic activity of the biceps femoris vastus lateralis and erectus spinae were recorded bilaterally.

FINDINGS

A two-way ANOVA showed that the osteoarhtitis group performed the sit to stand task using a smaller knee and hip range of motion compared with the control group while no differences in temporal kinematics and ground reaction force-related parameters were observed. In addition, women with osteoarhtritis displayed significantly lower vastus lateralis coupled with a higher biceps feomoris electromyographic activity and higher agonist-antagonist co-contraction and co-activation than asymptomatic women. The activation of erectus spinae was not different between groups.

INTERPRETATION

Results indicate that patients with moderate knee osteoarthritis rise from the chair using greater knee muscle co-contraction, earlier and greater activation of the hamstrings which results in reduced hip and knee range of motion. This may be a way to overcome the pain and potential muscle atrophy of knee extensor muscles without compromising overall task duration.

Postural sway and gaze can track the complex motion of a visual target

Variability is an inherent and important feature of human movement. This variability has form exhibiting a chaotic structure. Visual feedback training using regular predictive visual target motions does not take into account this essential characteristic of the human movement, and may result in task specific learning and loss of visuo-motor adaptability. In this study, we asked how well healthy young adults can track visual target cues of varying degree of complexity during whole-body swaying in the Anterior-Posterior (AP) and Medio-Lateral (ML) direction. Participants were asked to track three visual target motions: a complex (Lorenz attractor), a noise (brown) and a periodic (sine) moving target while receiving online visual feedback about their performance. Postural sway, gaze and target motion were synchronously recorded and the degree of force-target and gaze-target coupling was quantified using spectral coherence and Cross-Approximate entropy. Analysis revealed that both force-target and gaze-target coupling was sensitive to the complexity of the visual stimuli motions. Postural sway showed a higher degree of coherence with the Lorenz attractor than the brown noise or sinusoidal stimulus motion. Similarly, gaze was more synchronous with the Lorenz attractor than the brown noise and sinusoidal stimulus motion. These results were similar regardless of whether tracking was performed in the AP or ML direction. Based on the theoretical model of optimal movement variability tracking of a complex signal may provide a better stimulus to improve visuo-motor adaptation and learning in postural control.

Effect of loading parameters on motor performance during a dynamic weight-shift task

Controlling weight shift (WS) is essential to performing motions safely and smoothly during daily and athletic activities. This study investigated the impact of loading parameters on the motor performance and difficulty level of a dynamic WS task performed while standing. Twelve healthy young adults (21.2 ± 0.9 years, 53.5 ± 7.4 kg) were asked to match the target and their weight loads using visual feedback displayed on a computer monitor. Motor performance was estimated by assessment of loading accuracy and pace of motor skill acquisition, measured as a proxy of difficulty level, was estimated by assessment of learning rate. As predicted, both loading accuracy values decreased with increasing target frequency. Notably, the interaction of loading size and frequency had a significant effect on loading accuracy, which was increasingly impaired as the weight load increased at frequencies greater than 0.5 Hz. Moreover, the pace of motor skill acquisition in a dynamic WS task while standing was affected by the weight-load speed independently of the weight-load size. These results indicate that loading accuracy is affected by both the weight-load size and frequency and that 0.5 Hz is a critical frequency at which the difficulty level increases during dynamic WS tasks while standing in healthy youths. These findings suggest that the adequacy of the initial settings used regarding loading size and frequency is an important consideration in rehabilitative and athletic training aimed at evaluating and improving WS while standing.

Impaired visually guided weight-shifting ability in children with cerebral palsy

The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7-12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength.

Assessment of the postural control strategies used to play two Wii Fit™ videogames

The Nintendo Wii Fit™ may provide an affordable alternative to traditional biofeedback or virtual reality systems for retraining or improving motor function in populations with impaired balance. The purpose of this study was to evaluate postural control strategies healthy individuals use to play Wii Fit™ videogames. Sixteen young adults played 10 trials of Ski Slalom and Soccer Heading respectively. Centre of pressure (COP) excursion and three-dimensional movement data were acquired to determine variability in medial-lateral COP sway and shoulder-pelvic movement. While there was no difference in medial-lateral COP variability between games during trial 1, there was a significant difference after 10 trials. COP sway increased (59-75 mm) for Soccer Heading while it decreased (67-33 mm) for Ski Slalom from trial 1 to trial 10. During Ski Slalom participants demonstrated decreased shoulder and pelvic movement combined with increased pelvic-shoulder coupling. Conversely, participants demonstrated greater initial shoulder tilt when playing Soccer Heading, with no reduction in pelvic rotation and tilt. Participants decreased pelvic and trunk movements when skiing, suggesting a greater contribution of lower extremity control while they primarily used a trunk strategy to play Soccer Heading.

Contrasting effects of finger and shoulder interpersonal light touch on standing balance

Sway is reduced by light nonsupporting touch between parts of the body and a fixed surface. This effect is assumed to reflect augmentation of sensory cues for sway by point-of-contact reaction forces. It has been shown that movement of the contact surface can increase sway relative to an earth-fixed contact. Light touch contact with another person, for example, holding hands, affords a moving contact due to partner sway. We asked whether interpersonal light touch (IPLT) would increase sway relative to standing alone. We expected effects on sway to vary as a function of the site of contact and the postural stability of each partner. Eight pairs of participants, standing in either normal bipedal or tandem Romberg stance with eyes closed and using IPLT (finger to finger or shoulder to shoulder) or no contact, provided 4 trials of 30-s duration in each of 12 posture-touch combinations. Sway (SD of the rate of change of upper trunk position at C7) was reliably less with IPLT compared with no contact, with two exceptions: in normal stance, shoulder contact with a partner in tandem stance, and in tandem Romberg stance, finger contact with a partner in the same stance, increased sway. Otherwise, the reduction in sway was greater with shoulder than with finger contact. Measures of interpersonal synchronization based on cross-correlations and coherence analysis between the partners' C7 movements suggest different control factors operate to reduce sway in IPLT with the hand or shoulder contact.

Learning a stick-balancing task involves task-specific coupling between posture and hand displacements

Theories of motor learning argue that the acquisition of novel motor skills requires a task-specific organization of sensory and motor subsystems. We examined task-specific coupling between motor subsystems as subjects learned a novel stick-balancing task. We focused on learning-induced changes in finger movements and body sway and investigated the effect of practice on their coupling. Eight subjects practiced balancing a cylindrical wooden stick for 30 min a day during a 20 day learning period. Finger movements and center of pressure trajectories were recorded in every fifth practice session (4 in total) using a ten camera VICON motion capture system interfaced with two force platforms. Motor learning was quantified using average balancing trial lengths, which increased with practice and confirmed that subjects learned the task. Nonlinear time series and phase space reconstruction methods were subsequently used to investigate changes in the spatiotemporal properties of finger movements, body sway and their progressive coupling. Systematic increases in subsystem coupling were observed despite reduced autocorrelation and differences in the temporal properties of center of pressure and finger trajectories. The average duration of these coupled trajectories increased systematically across the learning period. In short, the abrupt transition between coupled and decoupled subsystem dynamics suggested that stick balancing is regulated by a hierarchical control mechanism that switches from collective to independent control of the finger and center of pressure. In addition to traditional measures of motor performance, dynamical analyses revealed changes in motor subsystem organization that occurred when subjects learned a novel stick-balancing task.

The role of visual cues in the acquisition and transfer of a voluntary postural sway task

We investigated the acquisition and transfer of a visually guided voluntary postural sway (PS) task that was practiced with the provision of either continuous or end point visual cues. Forty healthy adults were randomly assigned in to one of the four groups that practiced sway using different combinations of target and performance feedback. Participants were asked to voluntarily sway in the sagittal plane at a pre-set frequency (0.23 Hz) by matching the force exerted on a dual force platform to a visual target. Baseline, post-test, transfer and retention (24h later) tests required performance of the PS task paced by a metronome. Continuous target cues resulted in greater accuracy at the peaks but at the cost of increasing movement intermittency. End-point cues on the other hand, produced more stable sway patterns but target overshooting. These adaptations differently generalized in the auditory-driven workspace, as reflected by more stable sway patterns for the groups practicing with end target cues and an enhancement of the ankle stiffening strategy for the groups practicing with continuous targets. It is suggested that the types of visual cues available during visually driven PS have a strong influence not only on the acquisition of this task but also on its generalization to the audio-motor workspace.

Adaptation and reintegration of proprioceptive information in young and older adults' postural control

We investigated age-related changes in adaptation and sensory reintegration in postural control without vision. In two sessions, participants adapted their posture to sway reference and to reverse sway reference conditions, the former reducing (near eliminating) and the latter enhancing (near doubling) proprioceptive information for posture by means of support-surface rotations in proportion to body sway. Participants stood on a stable platform for 3 min (baseline) followed by 18 min of sway reference or reverse sway reference (adaptation) and finally again on a stable platform for 3 min (reintegration). Results showed that when inaccurate proprioception was introduced, anterior-posterior (AP) sway path length increased in comparable levels in the two age groups. During adaptation, young and older adults reduced postural sway at the same rate. On restoration of the stable platform in the reintegration phase, a sizeable aftereffect of increased AP path length was observed in both groups, which was greater in magnitude and duration for older adults. In line with linear feedback models of postural control, spectral analyses showed that this aftereffect differed between the two platform conditions. In the sway-referenced condition, a switch from low- to high-frequency COP sway marked the transition from reduced to normal proprioceptive information. The opposite switch was observed in the reverse sway referenced condition. Our findings illustrate age-related slowing in participants' postural control adjustments to sudden changes in environmental conditions. Over and above differences in postural control, our results implicate sensory reweighting as a specific mechanism highly sensitive to age-related decline.

Effect of a 10-Week Traditional Dance Program on Static and Dynamic Balance Control in Elderly Adults

This preliminary study examined the effect of a 10-wk traditional Greek dance program on static and dynamic balance indices in healthy elderly adults. Twenty-six community-dwelling older adults were randomly assigned to either an intervention group who took supervised Greek traditional dance classes for 10 wk (1 hr, 2 sessions/week,n= 14), or a control group (n= 12). Balance was assessed pre- and postintervention by recording the center-of-pressure (COP) variations and trunk kinematics during performance of the Sharpened-Romberg test, 1-leg (OL) stance, and dynamic weight shifting (WS). After practice, the dance group significantly decreased COP displacement and trunk sway in OL stance. A significant increase in the range of trunk rotation was noted during performance of dynamic WS in the sagittal and frontal planes. These findings support the use of traditional dance as an effective means of physical activity for improving static and dynamic balance control in the elderly.

Visual feedback training improves postural adjustments associated with moving obstacle avoidance in elderly women

The study examined the impact of visually guided weight shifting (WS) practice on the postural adjustments evoked by elderly women when avoiding collision with a moving obstacle while standing. Fifty-six healthy elderly women (70.9+/-5.7 years, 87.5+/-9.6 kg) were randomly assigned into one of three groups: a group that completed 12 sessions (25 min, 3s/week) of WS practice in the Anterior/Posterior direction (A/P group, n=20), a group that performed the same practice in the medio/lateral direction (M/L group, n=20) and a control group (n=16). Pre- and post-training, participants were tested in a moving obstacle avoidance task. As a result of practice, postural response onset shifted closer to the time of collision with the obstacle. Side-to-side WS resulted in a reduction of the M/L sway amplitude and an increase of the trunk's velocity during avoidance. It is concluded that visually guided WS practice enhances elderly's ability for on-line visuo-motor processing when avoiding collision eliminating reliance on anticipatory scaling. Specifying the direction of WS seems to be critical for optimizing the transfer of training adaptations.