Abstract
Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training program on these postural control impairments using a brain network model based on system identification techniques.Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model.Results: With balance training, the elderly subjects significantly reduced their overly large postural reactions and approximated those of younger subjects. Less significant differences between elderly and young subjects' postural control, namely larger spontaneous sway amplitudes, velocities, and frequencies, larger overall time delays and a weaker motor feedback compared to young subjects were not significantly affected by the balance training.Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits.
Highlights
Impairments of postural control result in increased rates of unintentional falls
Two subjects of the training group dropped out during the training period due to personal reasons not associated with balance training
The training and control groups were well balanced at baseline concerning age, sex, body mass, and physical activity (Table 2)
Summary
Impairments of postural control result in increased rates of unintentional falls. falls are the leading cause of injuries and subsequent deaths among people 65 years and older, and generate a fundamental financial burden to the healthcare system (Burns et al, 2016). There is general consensus that altered postural control in elderly people is determined by degradations of the sensory channels, i.e., vestibular, visual, and proprioceptive cues (Rauch et al, 2001; Goble et al, 2009; Grossniklaus et al, 2013), of the motor system (Macaluso and De Vito, 2004), and by deficits in higher-level adaptive systems (Shumway-Cook and Woollacott, 2001). It is still under debate whether, in addition, elderly’s central weighting of sensory signals is affected. It is unclear which subsystem mainly determines the degradation of postural control, given the fact that many subsystems are altered during aging
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