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Abstract
We have previously identified three balance mechanisms that young healthy adults use to maintain balance while walking. The three mechanisms are: (1) The lateral ankle mechanism, an active modulation of ankle inversion/eversion in stance; (2) The foot placement mechanism, an active shift of the swing foot placement; and (3) The push-off mechanism, an active modulation of the ankle plantarflexion angle during double stance. Here we seek to determine whether there are changes in neural control of balance when walking at different cadences and speeds. Twenty-one healthy young adults walked on a self-paced treadmill while immersed in a 3D virtual reality cave, and periodically received balance perturbations (bipolar galvanic vestibular stimulation) eliciting a perceived fall to the side. Subjects were instructed to match two cadences specified by a metronome, 110 bpm (High) and 80 bpm (Low), which in this experiment, led to faster and slower gait speeds, respectively. The results indicate that subjects altered the use of the balance mechanisms at different cadences. The lateral ankle mechanism was used more in the Low condition, while the foot placement mechanism was used more in the High condition. There was no difference in the use of the push-off mechanism between cadence conditions. These results suggest that neural control of balance is altered when gait characteristics, such as cadence change, suggesting a flexible balance response that is sensitive to the constraints of the gait cycle. We speculate that the use of the balance mechanisms may be a factor resulting in well-known characteristics of gait in populations with compromised balance control, such as slower gait speed in older adults or higher cadence in people with Parkinson's disease.
Highlights
There is an ongoing debate about whether or not walking slower is more stable (Bruijn et al, 2009)
The center of mass (CoM) deviation peaks in the third single stance phase following the onset of the perturbation for the Low condition, and peaks in the fourth single stance phase following the onset of the perturbation for the High condition
The results indicate that all three previously identified balance mechanisms are used to respond to the perceived fall, but the majority of the balance response is shifted to the lateral ankle mechanism when walking with a low cadence
Summary
There is an ongoing debate about whether or not walking slower is more stable (Bruijn et al, 2009). We know certain patient populations reduce their gait speed and increase their cadence (Himann et al, 1988; Lauretani et al, 2003; Buckley et al, 2018; Duan-Porter et al, 2019), but is the motivation to improve stability? We do not intend to justify whether walking slower or faster leads to more or less stability, here we are interested in how the neural control of balance in the medial-lateral direction changes at different cadences. Humans can adopt different combinations of step length and cadence to walk at a certain speed (Ardestani et al, 2016), creating a complex relationship when fixing a specific gait parameter. The interplay between the adjustment of these anteriorposterior gait parameters and the control of balance in the medial-lateral direction is not well-understood
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