Abstract
Fear of falling influences postural strategies used for balance, and is key in the maintenance of independent living and quality of life as adults age. However, there is a distinct need for methodology that aims to specifically address and prime fear under dynamic conditions, and to better determine the role of fear in movement preparation. This preliminary study investigated how fear priming influences fear of falling in young and older individuals, and assessed how changes in fear of falling map to movement behavior. Young (21.5 ± 1.7 years, n = 10) and older (58.1 ± 2.2 years) participants matched for height, weight, and sex were repeatedly exposed to four different and incrementally challenging laboratory-based slipping perturbations during a self-initiated, goal-directed step and reach task. Both younger and older cohorts showed similar heightened perceptions in fear of falling after fear priming, and changes in peak joint excursions including reduced ankle flexion, and increased lumbar flexion after fear priming. Age-related changes were only evident in total mediolateral center of mass displacement, with younger participants showing greater displacement after fear priming. Despite clear differences in preparatory muscle onsets relative to reach onset seen in older participants, muscle timings or co-contraction indices were not significantly different. Methods utilizing repeated exposure to varying increases of a slip-based postural challenge can successfully prime fear of falling in individuals, regardless of age.
Highlights
Fear of falling and movement anxiety related to postural threat have been shown to influence postural strategies used for balance, and are key factors in the maintenance of independent living and quality of life as adults age (Young and Williams, 2015)
Fear of falling manifests in an impaired and “cautious” gait strategy (Delbaere et al, 2009) yet, it is unknown whether this is solely based on fear components or is multi-dimensional in nature as comparisons are often made between individuals exhibiting low or high fear of falling (Adkin et al, 2002; Nagai et al, 2012; Uemura et al, 2012). These paradigms adopt voluntary movements toward postures affording less stability. These findings indicate that fear of falling can be characterized by a conscious prioritization of posture and minimization in center of mass (CoM) displacement
Influence of Fear Priming on State-Specific Fear of Falling
Summary
Fear of falling and movement anxiety related to postural threat have been shown to influence postural strategies used for balance, and are key factors in the maintenance of independent living and quality of life as adults age (Young and Williams, 2015). Fear Priming Influences With Age. Cleworth et al, 2012, 2016; Zaback et al, 2016), and by manipulating the expectation of an externally produced perturbation (Johnson et al, 2019). 2012, 2016; Zaback et al, 2016), and by manipulating the expectation of an externally produced perturbation (Johnson et al, 2019) From these studies, a “stiffening strategy” characterized by increases in muscle coactivation (Nagai et al, 2012) and reduced ranges of motion and velocity of movement across joints of the lower limb (Brown et al, 2002) is associated with increased postural threat, with the goal of minimizing disturbances to the center of mass (CoM) position (Carpenter et al, 2001). A number of activities, including gait and whole-body reaching, require preparatory postural adjustments across the lower limbs and trunk that drive displacement of the CoM for successful task performance (Brenière et al, 1987; Stapley et al, 1999; Leonard et al, 2009; Stamenkovic and Stapley, 2016)
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