Abstract
BackgroundIn understanding how the human body perceives and responds to small slip-like motions, information on how one senses the slip is essential. The effect of aging and plantar sensory loss on detection of a slip can also be studied. Using psychophysical procedures, acceleration detection thresholds of small lateral whole-body perturbations were measured for healthy young adults (HYA), healthy older adults (HOA) and older adults with diabetic neuropathy (DOA). It was hypothesized that young adults would require smaller accelerations than HOA's and DOA's to detect perturbations at a given displacement.MethodsAcceleration detection thresholds to whole-body lateral perturbations of 1, 2, 4, 8, and 16 mm were measured for HYAs, HOAs, and DOAs using psychophysical procedures including a two-alternative forced choice protocol. Based on the subject's detection of the previous trial, the acceleration magnitude of the subsequent trial was increased or decreased according to the parameter estimation by sequential testing methodology. This stair-stepping procedure allowed acceleration thresholds to be measured for each displacement.ResultsResults indicate that for lateral displacements of 1 and 2 mm, HOAs and DOAs have significantly higher acceleration detection thresholds than young adults. At displacements of 8 and 16 mm, no differences in threshold were found among groups or between the two perturbation distances. The relationship between the acceleration threshold and perturbation displacement is of particular interest. Peak acceleration thresholds of approximately 10 mm/s2 were found at displacements of 2, 4, 8, and 16 mm for HYAs; at displacements of 4, 8, and 16 mm for HOAs; and at displacements of 8 and 16 mm for DOAs. Thus, 2, 4, and 8 mm appear to be critical breakpoints for HYAs, HOAs, and DOAs respectively, where the psychometric curve deviated from a negative power law relationship. These critical breakpoints likely indicate a change in the physiology of the system as it responds to the stimuli.ConclusionAs a function of age, the displacement at which the group deviates from a negative power law relationship increases from 2 mm to 4 mm. Additionally, the displacement at which subjects with peripheral sensory deficits deviate from the negative power law relations increases to 8 mm. These increases as a function of age and peripheral sensory loss may help explain the mechanism of falls in the elderly and diabetic populations.
Highlights
Standing balance is a task that relies on the integration of sensory systems including somatosensory tactile and joint receptors as well as visual and vestibular systems
The critical point in acceleration threshold occurs at 2 mm for healthy young adults (HYA), 4 mm for healthy older adults (HOA), and 8 mm for diabetic neuropathy (DOA)
The acceleration detection thresholds to lateral perturbations measured here are significantly different between young adults, healthy older adults, and diabetic older adults at small (1 and 2 mm) displacements
Summary
Standing balance is a task that relies on the integration of sensory systems including somatosensory tactile and joint receptors as well as visual and vestibular systems. The normal and abnormal functioning of human sensory or control systems can be studied physiologically with large perturbations that are guaranteed to elicit a response; or psychophysically with peri-threshold stimuli that are at the level of sensitivity that barely reach perception. A subject with "scale" his/her response to a stimulus depending on the total amount of energy in the stimulus [2] Since both the duration and intensity of a stimulus contribute to the total energy, detection thresholds often exhibit a "trading relationship" between time and intensity. Acceleration detection thresholds of small lateral whole-body perturbations were measured for healthy young adults (HYA), healthy older adults (HOA) and older adults with diabetic neuropathy (DOA). It was hypothesized that young adults would require smaller accelerations than HOA's and DOA's to detect perturbations at a given displacement
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