Age-related changes in balance control system: initiation of stepping

Patla, Aftab E.; Frank, James S.; Winter, David; Rietdyk, Shirley; Prentice, Stephen D.; Prasad, S.

doi:10.1016/0268-0033(93)90012-7

Cited by 93 publications

(88 citation statements)

References 10 publications

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“…There appears to be little difference between healthy young and healthy older women in the kinematics of these rapid steps, either voluntary or involuntary (19,20). What may differ between the old and young, in both voluntary and involuntary stepping, is that the older adults utilize a longer period of time prior to lift-off for response planning, for reaction time, and for preliminary postural adjustments (such as additional weight shifting) (12,(20)(21)(22)(23). Thus, the MSL and RST group differences in the present study may reflect aspects of initiation and preparation for stepping, rather than only the step taking itself.…”

Section: Discussionmentioning

confidence: 99%

“…Other sources of RST variability may occur in the method of presenting the stimulus to initiate the step. Some studies use a light cue (23,24), and others have used a gentle waist pull (19) to get the subject to initiate a voluntary step. The method chosen here-a verbal command-seemed more clinically applicable than using a complicated light array (requiring three directions for each leg) or the apparatus necessary to generate a waist pull (again in three directions for each leg).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Clinical Measure of Maximal and Rapid Stepping in Older Women

Medell

Alexander

2000

The Journals of Gerontology Series A: Biological Sciences and M

146

110

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Background. In older adults, clinical measures have been used to assess fall risk based on the ability to maintain stance or to complete a functional task. However, in an impending fall situation, a stepping response is often used when strategies to maintain stance are inadequate. We examined how maximal and rapid stepping performance might differ among healthy young, healthy older, and balance-impaired older adults, and how this stepping performance related to other measures of balance and fall risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Clinical Measure of Maximal and Rapid Stepping in Older Women

Medell

Alexander

2000

The Journals of Gerontology Series A: Biological Sciences and M

146

110

View full text Add to dashboard Cite

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“…(Elble et al 1996) Furthermore, older adults with balance impairments have greater step initiation times compared with older adults without balance impairments. (Medell and Alexander 2000;Lord and Fitzpatrick 2001) The time to make a step increases further when there is uncertainty about the direction of the step, (Patla et al 1993;Lord and Fitzpatrick 2001;Luchies et al 2002;Rogers et al 2003) suggesting that central nervous system (i.e. skeletomotor circuit) resources are required to select an appropriate motor response.…”

Section: Discussionmentioning

confidence: 99%

Delays in auditory-cued step initiation are related to increased volume of white matter hyperintensities in older adults

et al. 2008

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An increased volume of white matter hyperintensities (WMH) on MRI has been associated with mobility impairments in older adults. The objective of this preliminary study was to investigate the relationship between the volume of WMH and delays in auditory-cued step initiation. Eight subjects aged 75-83 y participated. The WMH volume in the corticospinal tracts and anterior thalamic radiations were summed. Subjects performed an auditory-cued stepping task that included two simple reaction time (SRT) trials and three choice reaction time (CRT) trials. SRT trials required subjects to step as quickly as possible with the right foot from a symmetric standing position to a single target position in response to an auditory stimulus. For the CRT trials, subjects stepped as quickly as possible to one of two possible locations, depending on the auditory stimulus. The time from the stimulus onset to the reaction time of the anticipatory postural adjustment (APA RT ) and liftoff (LO) of the right foot was computed for each stimulus. The mean APA RT and LO were greater for the CRT steps compared with the SRT steps to the same location. Increases in WMH were significantly associated with larger APA RT and LO during both SRT and CRT for both target locations. These data suggest that increased volume of WMH is associated with greater central processing time during voluntary step initiation, and highlight a possible mechanism that can help to explain how damage to white matter tracts affects mobility in older adults.

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“…It has been determined that the prolonged time taken to transfer body weight off the stepping foot is actually of greater importance than the delays seen in reaction time for initiating the task itself. [86][87][88] It is unclear why older adults generally take longer to perform the postural adjustment for lateral weight transfer during tasks such as step initiation. It may be partially attributable to changes in the torque-generating capacity of muscles important in accelerating the body's COM laterally, namely the hip abductors.…”

Section: Dynamic Balancementioning

confidence: 99%