Abstract
Training improves balance control in older adults, but the time course and neural mechanisms underlying these improvements are unclear. We studied balance robustness and performance, H-reflex gains, paired reflex depression, and co-contraction duration in ankle muscles after one and ten training sessions in 22 older adults (+65yrs). Mediolateral balance robustness, time to balance loss in unipedal standing on a platform with decreasing rotational stiffness, improved (33%) after one session, with no further improvement after ten sessions. Balance performance, absolute mediolateral center of mass velocity, improved (18.75%) after one session in perturbed unipedal standing and (18.18%) after ten sessions in unperturbed unipedal standing. Co-contraction duration of soleus/tibialis anterior increased (16%) after ten sessions. H-reflex gain and paired reflex depression excitability did not change. H-reflex gains were lower, and soleus/tibialis anterior co-contraction duration was higher in participants with more robust balance after ten sessions, and co-contraction duration was higher in participants with better balance performance at several time-points. Changes in robustness and performance were uncorrelated with changes in co-contraction duration, H-reflex gain, or paired reflex depression. In older adults, balance robustness improved over a single session, while performance improved gradually over multiple sessions. Changes in co-contraction and excitability of ankle muscles were not exclusive causes of improved balance.
Highlights
IntroductionImpaired balance control due to aging results in falls, injuries, and loss of independence in older adults (World Health Organization, 2007)
Balance control is essential to avoid falls during daily-life activities
These results indicate a rapid improvement in balance robustness after only one session of training, with no further improvement after the subsequent nine training sessions
Summary
Impaired balance control due to aging results in falls, injuries, and loss of independence in older adults (World Health Organization, 2007). To resolve this issue, it is important to understand how balance control works and when and how it improves as a result of training. Balance training leads to improved balance performance in older adults (Muehlbauer, Gollhofer, Lesinski, Hortoba, & Granacher, 2015), observed as a reduction in mediolateral center of mass velocity during unipedal stance (Raymakers, Samson, & Verhaar, 2005). It is important to investigate the relation between improved balance control in older adults with changes in neural mechanisms at central and/or peripheral nervous system components
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