Aging affects postural tracking of complex visual motion cues

Spatial variability and directional shifts in postural control in Parkinson's disease

Individuals with Parkinson's disease exhibit tremors, rigidity, and bradykinesia, disrupting normal movement variability and resulting in postural instability. This comprehensive study aimed to investigate the link between the temporal structure of postural sway variability and Parkinsonism by analyzing multiple datasets from young and older adults, including individuals with Parkinson's disease, across various task conditions. We used the Oriented Fractal Scaling Component Analysis (OFSCA), which identifies minimal and maximal long-range correlations within the center of pressure time series, allowing for detecting directional changes in postural sway variability. The objective was to uncover the primary directions along which individuals exerted control during the posture. The results, as anticipated, revealed that healthy adults predominantly exerted control along two orthogonal directions, closely aligned with the anteroposterior (AP) and mediolateral (ML) axes. In stark contrast, older adults and individuals with Parkinson's disease exhibited control along suborthogonal directions that notably diverged from the AP and ML axes. While older adults and those with Parkinson's disease demonstrated a similar reduction in the angle between these two control directions compared to healthy older adults, their reliance on this suborthogonal angle concerning endogenous fractal correlations exhibited significant differences from the healthy aging cohort. Importantly, individuals with Parkinson's disease did not manifest the sensitivity to destabilizing task settings observed in their healthy counterparts, affirming the distinction between Parkinson's disease and healthy aging.

Older adults and individuals with Parkinson's disease control posture along suborthogonal directions that deviate from the traditional anteroposterior and mediolateral directions

A rich and complex temporal structure of variability in postural sway characterizes healthy and adaptable postural control. However, neurodegenerative disorders such as Parkinson's disease, which often manifest as tremors, rigidity, and bradykinesia, disrupt this healthy variability. This study examined postural sway in young and older adults, including individuals with Parkinson's disease, under different upright standing conditions to investigate the potential connection between the temporal structure of variability in postural sway and Parkinsonism. A novel and innovative method called oriented fractal scaling component analysis was employed. This method involves decomposing the two-dimensional center of pressure (CoP) planar trajectories to pinpoint the directions associated with minimal and maximal temporal correlations in postural sway. As a result, it facilitates a comprehensive assessment of the directional characteristics within the temporal structure of sway variability. The results demonstrated that healthy young adults control posture along two orthogonal directions closely aligned with the traditional anatomical anteroposterior (AP) and mediolateral (ML) axes. In contrast, older adults and individuals with Parkinson's disease controlled posture along suborthogonal directions that significantly deviate from the AP and ML axes. These findings suggest that the altered temporal structure of sway variability is evident in individuals with Parkinson's disease and underlies postural deficits, surpassing what can be explained solely by the natural aging process.

Goalkeepers' plasticity during learning of a whole-body visuomotor rotation in a stable or variable environment

Postural adjustments performed in anticipation of uncertain visual events is a common sensorimotor control problem in open sport skills. In this study, we examined how expert soccer goalkeepers and non-athletes learn a whole body visuomotor rotation during postural tracking of constant and variable visual target motions. Twenty-one (21) soccer goalkeepers (18 ± 15 years, 75 ± 12 kg) and 25 age-matched non-athletes (18 ± 12 years, 75 ± 15 kg) practiced lateral weight shifting on a dual force platform while tracking the motion of a constant (11 goalkeepers and 12 non-athletes) or a variable (10 goalkeepers and 13 non-athletes) visual target with provision of online visual feedback (VF). After 40s of tracking (baseline), the visual presentation of the VF signal reversed direction relative to the participant's motion (180° visuo-motor rotation) for 60s (adaptation) and then returned to its veridical direction for another 20s (washout). During adaptation, goalkeepers reduced the spatiotemporal error to baseline levels at an earlier time block (3rd block) compared to non-athletes (6th block), but this difference was significant only for groups tracking of the constant and not the variable target motion. Only the groups tracking the constant target increased the spatiotemporal error during the 1st washout block demonstrating a significant aftereffect. It is concluded that goalkeepers adapt faster to the feedback rotation due to their prior field knowledge of relevant visuomotor transformations in anticipation of deceptive visual cues. This expertise advantage however is present only in a stable visual environment possibly because learning is compromised when tracking uncertain motion cues requiring closed loop control.HighlightsWe examined how expert goalkeepers and non-athletes adopt to a novel whole body visuomotor rotation when tracking a constantly or variably moving targetGoalkeepers adopted faster to the visuomotor rotation than non-athletesExpertise related differences were evident only for groups tracking the constant target motionGroups tracking the variable target motion did not learn the visuomotor rotation.

Keeping balance during head-free smooth pursuit: The role of aging

Standing balance is often more unstable when visually pursuing a moving target than when fixating on a stationary one. These effects are common in both young and older adults when the head is restrained during visual task performance. The present study focused on the role of head motion on standing balance during smooth pursuit as a function of age. Three predictions were tested: a) standing balance is compromised to a greater extent in older than young adults by gaze target pursuit compared to fixation, b) older adults pursue a moving target with greater and more variable head rotation than young adults, and c) greater and more variable head rotation during the smooth pursuit task is associated with greater Center of Pressure (CoP) sway. Twenty-two (22) older (age: 71.7 ± 8.1, 12 M / 10 F) and twenty-three (23) young adults (age: 23.6 ± 2.5, 12 M / 11 F) stood on a force plate while either fixating a stationary or smoothly pursuing a horizontally moving target (31.9° peak-to-peak visual angle). CoP (Bertec Balance Plate), head kinematics (Vicon Motion Analysis) and head-unconstrained gaze (Pupil Labs Invisible) were synchronously recorded. The root means square (RMS) of CoP velocity increased during smooth pursuit compared to fixation regardless of age (p < .05), while the interquartile CoP range increased only in older and not in young participants (p < .05). We also calculated the head rotation range (peak to peak cycle amplitude) of motion and variability (SD of range of motion) across the cycles of the smooth pursuit task. Older adults pursued the moving target employing more variable (p = .022) head yaw rotation than young participants although the mean range of head rotation was similar between groups (p =. 077). The amplitude and variability of head yaw rotation did not correlate with CoP sway measures. Results suggest that head-free pursuing of a moving target decreased balance to a greater extent in old than young individuals when compared to fixation. Nevertheless, postural sway during head-free smooth pursuit was not associated with the extent or variability of head rotation.

Modulation of lower limb muscles and trajectory correction in the bipedal stance during visual perturbation

The ability to actively track posture using visual targets as indicators is important for improving impairments in whole-body coordination, and accurate visual feedback on tasks is considered effective in promoting sensory-motor integration and behavioral success. In the present study, we examined inter- and intramuscular modulation between the two lower limbs in response to visual perturbation. Sixteen healthy young subjects (age: 21.3 ± 0.7 years) were asked to move their weight back and forth while tracking a visual target displayed on a monitor in front of them for 30 s. Three types of target movements were examined: a sinusoidal wave (i.e., a predictable pattern), more complex patterns (random), and no movement (stationary). Electromyography (EMG) was used to assess intra- and intermuscular coherence modulation of the plantar flexor muscles (right and left soleus and right and left medial gastrocnemius). The ability to adjust posture to follow the target signal was assessed using a stabilometer. Inter- and intramuscular coherence increased during the visual perturbation task compared to the stationary task. In addition, left-right differences in lower limb modulation were observed during the visual perturbation task. Furthermore, interlimb coherence was related to the motor accuracy of tracking. The muscles of both lower limbs cooperated in response to visual perturbation, suggesting that these muscles control visually induced anteroposterior postural sway. Since such visual perturbations promote coordination between both lower extremities, this relationship may indicate the potential for rehabilitation training to help individuals acquire and improve the motor functions necessary to efficiently and stably perform activities of daily living.

Visuomotor control dynamics of quiet standing under single and dual task conditions in younger and older adults

Visual input facilitates stable postural control; however, ageing alters visual gaze strategies and visual input processing times. Understanding the complex interaction between visual gaze behaviour and the effects of age may inform future interventions to improve postural control in older adults. The purpose of this study was to determine effects of age and dual task on gaze and postural sway dynamics, and the sway-gaze complexity coupling to explore the coupling between sensory input and motor output. Ten older and 10 younger adults performed single and dual task quiet standing while gaze behaviour and centre of mass motion were recorded. The complexity and stability of postural sway, saccade characteristics, visual input duration and complexity of gaze were calculated in addition to sway-gaze coupling quantified by cross-sample entropy. Dual tasking increased complexity and decreased stability of sway with increased gaze complexity and visual input duration, suggesting greater automaticity of sway with greater exploration of the visual field but with longer visual inputs to maintain postural stability in dual task conditions. In addition, older adults had lower complexity and stability of sway than younger adults indicating less automated and stable postural control. Older adults also demonstrated lower gaze complexity, longer visual input durations and greater sway-gaze coupling. These findings suggest older adults adopted a strategy to increase the capacity for visual information input, whilst exploring less of the visual field than younger adults.

Preparatory Knee Flexion-Extension Movements Enhance Rapid Sidestepping Performance in Collegiate Basketball Players

Lower-limb weight-bearing load distribution in stationary standing influences the timing of rapid first step initiation of importance for functional movement activities and agility performance in sports. This study investigated the effect of pre-step lower-limb loading and unloading with preparatory knee flexion-extension movements on sidestepping performance in fifteen male collegiate basketball players. Participants performed two-choice (step limb) reaction time sidestepping under two conditions: without preparatory movements before the go cue (no-prep-NP) and with continuous alternating knee extension and flexion movements (prep-P). The reaction signal was provided at the beginning of knee extension and flexion and during these movements which corresponded with the largest and smallest loading instants and the transition states between those instants. Sidestepping performance was assessed with three-dimensional kinematic data and ground reaction forces. Step initiation onset time was significantly faster by 13-15% than the NP condition when initiated in the knee flexion phase (p ≤ 0.028, r ≥ 0.70), whereas step-limb unloading interval from step initiation to step lift-off was significantly faster by 12-15% in the knee extension phase (p ≤ 0.01, r ≥ 0.74). The preparatory movements significantly shortened step lift-off by 10-12% (p ≤ 0.013, r ≥ 0.73) and step duration by 17-21% (p < 0.001, r ≥ 0.85) with 19-22% faster step velocity (p < 0.001, r ≥ 0.84), which resulted in 14-15% shorter overall time to step landing (p < 0.001, r ≥ 0.84), irrespective of the loading phases. These results indicated that lower-limb loading with pre-step knee flexion facilitated faster step initiation, while lower-limb unloading with knee extension facilitated faster step-limb unloading, both resulting in faster step lift-off. Bilateral knee flexion-extension movements as a preparatory action could be utilized by invasion sports players to facilitate reactive stepping performance for more effective movement initiation.

Standing on unstable surface challenges postural control of tracking tasks and modulates neuromuscular adjustments specific to task complexity

Understanding the modulations of motor control in the presence of perturbations in task conditions of varying complexity is a key element towards the design of effective perturbation-based balance exercise programs. In this study we investigated the effect of mechanical perturbations, induced by an unstable surface, on muscle activation and visuo-postural coupling, when actively tracking target motion cues of different complexity. Four postural tasks following a visual oscillating target of varying target complexity (periodic-sinusoidal vs. chaotic-Lorenz) and surface (stable-floor vs. unstable-foam) were performed. The electromyographic activity of the main plantarflexor and dorsiflexor muscles was captured. The coupling between sway and target was assessed through spectral analysis and the system's local dynamic stability through the short-term maximum Lyapunov exponent. We found that external perturbations increased local instability and deteriorated visuo-motor coupling. Visuo-motor deterioration was greater for the chaotic target, implying that the effect of the induced perturbations depends on target complexity. There was a modulation of the neuromotor system towards amplification of muscle activity and coactivation to compensate surface-related perturbations and to ensure robust motor control. Our findings provide evidence that, in the presence of perturbations, target complexity induces specific modulations in the neuromotor system while controlling balance and posture.

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.

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).

Center of Pressure Feedback Modulates the Entrainment of Voluntary Sway to the Motion of a Visual Target

Visually guided weight shifting is widely employed in balance rehabilitation, but the underlying visuo-motor integration process leading to balance improvement is still unclear. In this study, we investigated the role of center of pressure (CoP) feedback on the entrainment of active voluntary sway to a moving visual target and on sway’s dynamic stability as a function of target predictability. Fifteen young and healthy adult volunteers (height 175 ± 7 cm, body mass 69 ± 12 kg, age 32 ± 5 years) tracked a vertically moving visual target by shifting their body weight antero-posteriorly under two target motion and feedback conditions, namely, predictable and less predictable target motion, with or without visual CoP feedback. Results revealed lower coherence, less gain, and longer phase lag when tracking the less predictable compared to the predictable target motion. Feedback did not affect CoP-target coherence, but feedback removal resulted in greater target overshooting and a shorter phase lag when tracking the less predictable target. These adaptations did not affect the dynamic stability of voluntary sway. It was concluded that CoP feedback improves spatial perception at the cost of time delays, particularly when tracking a less predictable moving target.

Assessing age-related balance deterioration: Visual or mechanical tasks?

BACKGROUND

Mediolateral balance assessment (MELBA) comprises tracking of predictable and unpredictable targets moving at increasing frequencies, using centre-of-mass feedback. The mediolateral-balance-assessment was shown to be sensitive to subtle age-related balance deterioration. However, it has been suggested that performance during ground-level tasks can be more sensitive to balance deterioration.

METHODS

we developed a modified mediolateral-balance-assessment using tracking of surface translations with comparable waveforms (mechanical mediolateral-balance-assessment) to compare age sensitivity of the visual and mechanical mediolateral-balance-assessment, 15 older adults (68 SD 5 yr) and 12 young adults (30 SD 4 yr) performed both tasks. Phase-shift and gain between the CoM and either the visual target or the surface displacement for the visual and the mechanical mediolateral-balance-assessment, respectively, were calculated. To identify differences in tracking strategies between the visual and mechanical mediolateral-balance-assessment, phase-shift between trunk and leg angles was calculated.

FINDINGS

Overall, older adults performed worse than young across the predictable and unpredictable tracking and visual and mechanical tasks. Of all mediolateral-balance-assessment performance descriptors, a significant interaction between age and task (visual or mechanical) was only found for the mean phase-shift. Post-hoc comparisons revealed significant age differences in the visual but not in the mechanical mediolateral-balance-assessment. Significant differences in tracking strategies were found between visual and mechanical mediolateral-balance-assessment with a greater decoupling of trunk and legs during the mechanical than the visual mediolateral-balance-assessment.

INTERPRETATION

the visual mediolateral-balance-assessment was more sensitive to age-related balance deterioration than the mechanical mediolateral-balance-assessment, possibly because visual tracking elicits motor strategies that are more affected by ageing.

Patients with chronic peripheral vestibular hypofunction compared to healthy subjects exhibit differences in gaze and gait behaviour when walking on stairs and ramps

Objective

The aim of this study was to compare gaze behaviour during stair and ramp walking between patients with chronic peripheral vestibular hypofunction and healthy human subjects.

Methods

Twenty four (24) patients with chronic peripheral vestibular hypofunction (14 unilateral and 10 bilateral) and 24 healthy subjects performed stair and ramp up and down walks at self-selected speed. The walks were repeated five times. A mobile eye tracker was used to record gaze behaviour (defined as time directed to pre-defined areas) and an insole measurement device assessed gait (speed, step time, step length). During each walk gaze behaviour relative to i) detection of first transition area “First TA”, ii) detection of steps of the mid-staircase area and the handrail “Structure”, iii) detection of second transition area “Second TA”, and iv) looking elsewhere “Elsewhere” was assessed and expressed as a percentage of the walk duration. For all variables, a one-way ANOVA followed by contrast tests was conducted.

Results

Patients looked significantly longer at the “Structure” (p<0.001) and “Elsewhere” (p<0.001) while walking upstairs compared to walking downstairs (p<0.013). Patients looked significantly longer at the “Structure” (p<0.001) and “Elsewhere” (p<0.001) while walking upstairs compared to walking downstairs (p<0.013). No differences between groups were observed for the transition areas with exception of stair ascending. Patients were also slower going downstairs (p = 0.002) and presented with an increased step time (p = 0.003). Patients were walking faster up the ramp (p = 0.014) with longer step length (p = 0.008) compared to walking down the ramp (p = 0.050) with shorter step length (p = 0.024).

Conclusions

Patients with chronic peripheral vestibular hypofunction differed in time directed to pre-defined areas during stair and ramp walking and looked longer at stair and ramp areas of interest during walking compared to healthy subjects. Patients did not differ in time directed to pre-defined areas during the stair-floor transition area while going downstairs, an area where accidents may frequently occur.

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.