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Vermette MJ, Prince F, Bherer L, Messier J. Concentrating to avoid falling: interaction between peripheral sensory and central attentional demands during a postural stability limit task in sedentary seniors. GeroScience 2024; 46:1181-1200. [PMID: 37482601 PMCID: PMC10828328 DOI: 10.1007/s11357-023-00860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/25/2023] [Indexed: 07/25/2023] Open
Abstract
Evidence suggests falls and postural instabilities among seniors are attributed to a decline in both the processing of afferent signals (e.g., proprioceptive, vestibular) and attentional resources. We investigated the interaction between the non-visual and attentional demands of postural control in sedentary seniors. Old and young adults performed a postural stability limit task involving a maximal voluntary leaning movement with and without vision as well as a cognitive-attentional subtraction task. These tasks were performed alone (single-task) or simultaneously (dual-task) to vary the sensory-attentional demands. The functional limits of stability were quantified as the maximum center of pressure excursion during voluntary leaning. Seniors showed significantly smaller limits of postural stability compared to young adults in all sensory-attentional conditions. However, surprisingly, both groups of subjects reduced their stability limits by a similar amount when vision was removed. Furthermore, they similarly decreased their anterior-posterior stability limits when concurrently performing the postural and the cognitive-attentional tasks with vision. The overall average cognitive performance of young adults was higher than seniors and was only slightly affected during dual-tasking. In contrast, older adults markedly degraded their cognitive performance from the single- to the dual-task situations, especially when vision was unavailable. Thus, their dual-task costs were higher than those of young adults and increased in the eyes-closed condition, when postural control relied more heavily on non-visual sensory signals. Our findings provide the first evidence that as posture approaches its stability limits, sedentary seniors allot increasingly large cognitive attentional resources to process critical sensory inputs.
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Affiliation(s)
- Marie Julie Vermette
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
| | - François Prince
- Département de Chirurgie, Faculté de Médecine, Université de Montréal, CP6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Louis Bherer
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
- Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut de Cardiologie de Montréal, Montréal, QC, Canada
| | - Julie Messier
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada.
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Sertic JVL, Fall N, Konczak J. A Physically Active Lifestyle Can Protect against Age-Related Decline in Ankle Proprioception. J Mot Behav 2023; 56:305-314. [PMID: 38097196 DOI: 10.1080/00222895.2023.2293003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/04/2023] [Indexed: 03/22/2024]
Abstract
This study examined whether physically active middle-aged (50-64 years) and older adults (65-80 years) demonstrate age-related ankle proprioceptive decline relative to younger counterparts. Empirical data indicate that ankle proprioception declines with aging and such sensory decline negatively affects balance. Using a passive motion apparatus, we employed a psychophysical forced-choice paradigm in which the ankle was passively plantarflexed to a reference position (15° or 25°) and a comparison position that was always smaller than the reference. Subsequently, participants indicated which position was more plantarflexed. As outcome measures of ankle position sense acuity, a just-noticeable-difference (JND) threshold and the uncertainty area (UA) were derived from the psychometric stimulus-response difference function for each participant. The JND threshold is a measure of proprioceptive bias and UA constitutes a measure of precision. The main results are: First, at the 15° reference, most middle-aged (74%) and older adults (71%) had thresholds within the range of the young adults. The respective median JND threshold of young adults was statistically lower when compared to both older groups. Second, no differences between age groups were observed at the 25° reference. Third, no age-related differences were found for UA at either reference. These data indicate that physically active aging adults may be spared from age-related decline in ankle position sense and that age-related differences emerge for small ankle displacements. The findings underscore the importance of remaining active during aging.
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Affiliation(s)
- Jacquelyn V L Sertic
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, USA
| | - Nicole Fall
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, USA
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Wenzel TA, Hunt NL, Holcomb AE, Fitzpatrick CK, Brown TN. Surface, but Not Age, Impacts Lower Limb Joint Work during Walking and Stair Ascent. J Funct Morphol Kinesiol 2023; 8:145. [PMID: 37873904 PMCID: PMC10594440 DOI: 10.3390/jfmk8040145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
Older adults often suffer an accidental fall when navigating challenging surfaces during common locomotor tasks, such as walking and ascending stairs. This study examined the effect of slick and uneven surfaces on lower limb joint work in older and younger adults while walking and ascending stairs. Fifteen young (18-25 years) and 12 older (>65 years) adults had stance phase positive limb and joint work quantified during walking and stair ascent tasks on a normal, slick, and uneven surface, which was then submitted to a two-way mixed model ANOVA for analysis. The stair ascent required greater limb, and hip, knee, and ankle work than walking (all p < 0.001), with participants producing greater hip and knee work during both the walk and stair ascent (both p < 0.001). Surface, but not age, impacted positive limb work. Participants increased limb (p < 0.001), hip (p = 0.010), and knee (p < 0.001) positive work when walking over the challenging surfaces, and increased hip (p = 0.015), knee (p < 0.001), and ankle (p = 0.010) work when ascending stairs with challenging surfaces. Traversing a challenging surface during both walking and stair ascent tasks required greater work production from the large proximal hip and knee musculature, which may increase the likelihood of an accidental fall in older adults.
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Affiliation(s)
- Thomas A. Wenzel
- Department of Kinesiology, Boise State University, Boise, ID 83725, USA; (T.A.W.); (N.L.H.)
| | - Nicholas L. Hunt
- Department of Kinesiology, Boise State University, Boise, ID 83725, USA; (T.A.W.); (N.L.H.)
| | - Amy E. Holcomb
- Department of Mechanical and Biomedical Engineering, Boise State University, Boise, ID 83725, USA; (A.E.H.)
| | - Clare K. Fitzpatrick
- Department of Mechanical and Biomedical Engineering, Boise State University, Boise, ID 83725, USA; (A.E.H.)
| | - Tyler N. Brown
- Department of Kinesiology, Boise State University, Boise, ID 83725, USA; (T.A.W.); (N.L.H.)
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Shi X, Ganderton C, Tirosh O, Adams R, Ei-Ansary D, Han J. Test-retest reliability of ankle range of motion, proprioception, and balance for symptom and gender effects in individuals with chronic ankle instability. Musculoskelet Sci Pract 2023; 66:102809. [PMID: 37354602 DOI: 10.1016/j.msksp.2023.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To determine the reliability of the commonly used musculoskeletal assessments in individuals with chronic ankle instability (CAI). DESIGN Within and between-days test-retest reliability. SETTING University laboratory. PARTICIPANTS Twenty-four individuals with unilateral CAI. METHOD For both sides, ankle dorsiflexion range of motion (DFROM) was assessed by a goniometer and weight-bearing lunge test (WBLT), proprioception by the active movement extent discrimination apparatus (AMEDA), and balance by the Star Excursion Balance Test with anterior (SEBTA), posteromedial (SEBTPM) and posterolateral (SEBTPL) components. All measures were taken at enrollment, after 30 min and one week later. RESULTS For the asymptomatic side, all assessments demonstrated good to excellent reliability, with ICCs (3,1) between 0.8 and 0.96. On the symptomatic side, WBLT, SEBTA and SEBTPM showed excellent reliability, with ICCs (3,1) above 0.90, while SEBTPL, goniometer and AMEDA showed moderate reliability, with the 95% CI of the ICCs (3,1) crossing 0.5. Three-way repeated measures ANOVA showed a side main effect, with asymptomatic worse, for WBLT (F = 16.9, p < 0.001) and SEBTA (F = 5.4, p = 0.03); an overall improving time main effect for SEBTPL (F = 6.9, p = 0.02). Neither a gender main effect nor any interaction effect was found. CONCLUSIONS WBLT, SEBTA and SEBTPM can be strongly recommended for measuring ankle dorsiflexion mobility and dynamic balance for both sides of individuals with unilateral CAI, while only WBLT can be used for side-to-side comparison. The application of a goniometer to measure DFROM, SEBTPL or AMEDA should be done cautiously for this specific cohort, considering their poor to good reliability for the symptomatic side.
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Affiliation(s)
- Xiaojian Shi
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China.
| | - Charlotte Ganderton
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Oren Tirosh
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia
| | - Doa Ei-Ansary
- School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China; Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia.
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Han J, Yang Z, Witchalls J, Ganderton C, Adams R, Waddington G. Ankle Inversion Proprioception Impairment in Persons with Chronic Ankle Instability Is Task-Specific. Percept Mot Skills 2022; 129:1736-1748. [PMID: 36113161 DOI: 10.1177/00315125221125608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While investigators have often compared ankle proprioception between groups with and without chronic ankle instability (CAI), findings have been inconsistent. Possibly this is because ankle proprioceptive impairment in this population is task-specific. Thus, we aimed to compare ankle inversion proprioception in individuals with and without CAI in two task conditions: (i) when standing (not challenging) and (ii) when on a step-down landing (minimally-challenging). Ankle inversion proprioception was measured in both conditions for 38 recreational sport player volunteers with CAI (n = 19) and without CAI (n = 19). We used the Active Movement Extent Discrimination Apparatus (AMEDA) for the standing condition and the Ankle Inversion Discrimination Apparatus-Landing (AIDAL) for step-down landing. From analysis of variance (ANOVA) tests, CAI and non-CAI participants performed equally well on the AMEDA when standing; but the CAI group performed significantly worse than the non-CAI group on the AIDAL step-down landing task (p = 0.03). Within the non-CAI group, the AIDAL proprioceptive scores, as area under the receiver operating characteristics curve (AUC), were significantly higher than their AMEDA AUC scores (p = 0.03), while there was no significant difference between AIDAL and AMEDA AUC scores in the CAI group. Cumberland Ankle Instability Tool CAIT scores were significantly correlated with AIDAL scores (Spearman's rho = 0.391, p = 0.015), but not with the AMEDA scores; and there was no significant correlation between the AIDAL and AMEDA scores. Thus, an ankle inversion proprioceptive deficit was evident for persons with CAI on the step-down AIDAL, and in a dose-response way, but not evident on the standing AMEDA, suggesting that ankle proprioceptive impairment is task-specific. Selected proprioceptive tests must present some minimal degree of challenge to the ankle joint in a functional task in order to differentiate CAI from non-CAI participants.
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Affiliation(s)
- Jia Han
- College of Rehabilitation Sciences, 191610Shanghai University of Medicine and Health Sciences, Shanghai, China.,Research Institute for Sport and Exercise, 2234University of Canberra, Canberra, ACT, Australia.,Faculty of Health, Arts and Design, 444935Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Zonghan Yang
- Department of Physiotherapy, 85084University of Melbourne, Melbourne, VIC, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, 2234University of Canberra, Canberra, ACT, Australia
| | - Charlotte Ganderton
- Faculty of Health, Arts and Design, 444935Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, 2234University of Canberra, Canberra, ACT, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, 2234University of Canberra, Canberra, ACT, Australia
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