Effect of ageing on the ability to adapt to a visual distortion during walking

Reduced corticospinal drive and inflexible temporal adaptation during visually guided walking in older adults

Corticospinal drive during walking is reduced in older adults compared with young adults, but it is not clear how this decrease might compromise one's ability to adjust stepping, particularly during visuomotor adaptation. We hypothesize that age-related changes in corticospinal drive could predict differences in older adults' step length and step time adjustments in response to visual perturbations compared with younger adults. Healthy young (n = 21; age 18-33 yr) and older adults (n = 20; age 68-80 yr) were tested with a treadmill task, incorporating visual feedback of the foot position and stepping targets in real-time. During adaptation, the visuomotor gain was reduced on one side, causing the foot cursor and step targets to move slower on that side of the screen (i.e., split-visuomotor adaptation). Corticospinal drive was quantified by coherence between electromyographic signals in the beta-gamma frequency band (15-45 Hz). The results showed that 1) older adults adapted to visuomotor perturbations during walking, with a similar reduction in error asymmetry compared with younger adults; 2) however, older adults showed reduced adaptation in step time symmetry, despite demonstrating similar adaptation in step length asymmetry compared with younger adults; and 3) smaller overall changes in step time asymmetry was associated with reduced corticospinal drive to the tibialis anterior in the slow leg during split-visuomotor adaptation. These findings suggest that changes in corticospinal drive may affect older adults' control of step timing in response to visual challenges. This could be important for safe navigation when walking in different environments or dealing with unexpected circumstances.NEW & NOTEWORTHY Corticospinal input is essential for visually guided walking, especially when the walking pattern must be modified to accurately step on safe locations. Age-related changes in corticospinal drive are associated with inflexible step time, which necessitates different locomotor adaptation strategies in older adults.

Neural Control of Human Locomotor Adaptation: Lessons about Changes with Aging

Walking patterns are adaptable in response to different environmental demands, which requires neural input from spinal and supraspinal structures. With an increase in age, there are changes in walking adaptation and in the neural control of locomotion, but the age-related changes in the neural control of locomotor adaptation is unclear. The purpose of this narrative review is to establish a framework where the age-related changes of neural control of human locomotor adaptation can be understood in terms of reactive feedback and predictive feedforward control driven by sensory feedback during locomotion. We parse out the effects of aging on (a) reactive adaptation to split-belt walking, (b) predictive adaptation to split-belt walking, (c) reactive visuomotor adaptation, and (d) predictive visuomotor adaptation, and hypothesize that specific neural circuits are influenced differentially with age, which influence locomotor adaptation. The differences observed in the age-related changes in walking adaptation across different locomotor adaptation paradigms will be discussed in light of the age-related changes in the neural mechanisms underlying locomotion.

Predicting aperture crossing behavior from within-trial metrics of motor control reliability

Actors utilize intrinsically scaled information about their geometric and dynamic properties when perceiving their ability to pass through openings. Research about dynamic factors of affordance perception have shown that the reliability of a given movement, or the precision of one's motor control for that movement, increase the buffer space used when interacting with the environment. While previous work has assessed motor control reliability as a person-level variable (i.e., behavior is aggregated across many trials), the current study assessed how characteristics of motor control and movement reliability within a single trial impact real-time action strategies for passing through apertures. Participants walked 5 m and then passed through apertures of various widths while their motions were tracked. For each trial, we collected walking time-series data, then calculated the magnitude and complexity of the lateral sway. Assessing two behavioral measures of the buffer, we found that trial-level metrics of motor control reliability, in addition to the person-level metrics previously studied, significantly predicted the buffer on each trial. This study supports previous claims that actors pick up real-time information about their dynamic capabilities in order to perceive and act within their environment. Further, the study recommends that future affordance research consider trial-level movement data, including nonlinear analyses that inform the pattern and structure of motor control reliability.

Are Older Adults Less Embodied? A Review of Age Effects through the Lens of Embodied Cognition

Embodied cognition is a theoretical framework which posits that cognitive function is intimately intertwined with the body and physical actions. Although the field of psychology is increasingly accepting embodied cognition as a viable theory, it has rarely been employed in the gerontological literature. However, embodied cognition would appear to have explanatory power for aging research given that older adults typically manifest concurrent physical and mental changes, and that research has indicated a correlative relationship between such changes. The current paper reviews age-related changes in sensory processing, mental representation, and the action-perception relationship, exploring how each can be understood through the lens of embodied cognition. Compared to younger adults, older adults exhibit across all three domains an increased tendency to favor visual processing over bodily factors, leading to the conclusion that older adults are less embodied than young adults. We explore the significance of this finding in light of existing theoretical models of aging and argue that embodied cognition can benefit gerontological research by identifying further factors that can explain the cause of age-related declines.

Review of safety and mobility issues among older pedestrians

Although old people make up an extremely vulnerable road-user group, older pedestrians' difficulties have been studied less extensively than those of older drivers, and more knowledge of this issue is still required. The present paper reviews current knowledge of older-adult problems with the main components of pedestrian activity, i.e., walking and obstacle negotiation, wayfinding, and road crossing. Compared to younger ones, old pedestrians exhibit declining walking skills, with a walking speed decrease, less stable balance, less efficient wayfinding strategies, and a greater number of unsafe road crossing behaviors. These difficulties are linked to age-related changes in sensorial, cognitive, physical, and self-perception abilities. It is now known that visual impairment, physical frailty, and attention deficits have a major negative impact on older pedestrians' safety and mobility, whereas the roles of self-evaluation and self-regulation are still poorly understood. All these elements must be taken into consideration, not only in developing effective safety interventions targeting older pedestrians, but also in designing roads and cars. Recent initiatives are presented here and some recommendations are proposed.

How do age and nature of the motor task influence visuomotor adaptation?

Visuomotor adaptation with prism glasses is a paradigm often used to understand how the motor system responds to visual perturbations. Both reaching and walking adaptation have been documented, but not directly compared. Because the sensorimotor environment and demands are different between reaching and walking, we hypothesized that characteristics of prism adaptation, namely rates and aftereffects, would be different during walking compared to reaching. Furthermore, we aimed to determine the impact of age on motor adaptation. We studied healthy younger and older adults who performed visually guided reaching and walking tasks with and without prism glasses. We noted age effects on visuomotor adaptation, such that older adults adapted and re-adapted slower compared to younger adults, in accord with previous studies of adaptation in older adults. Interestingly, we also noted that both groups adapted slower and showed smaller aftereffects during walking prism adaptation compared to reaching. We propose that walking adaptation is slower because of the complex multi-effector and multi-sensory demands associated with walking. Altogether, these data suggest that humans can adapt various movement types but the rate and extent of adaptation is not the same across movement types nor across ages.

Influence of repeated effort induced by a 6-min walk test on postural response in older sedentary women

According to the latest recommendations, adults should exercise regularly at moderate intensity to improve aerobic fitness and body composition. However, it is unknown whether aerobic exercise at submaximal intensity has detrimental effects on balance in older sedentary adults. We explored the effects of two 6-min walk tests (6MWTs) on the postural responses in 49 sedentary women between 60 and 76 years old. We assumed that an increase in the center of pressure (COP) fluctuations or a loss in the complexity of the COP time series would be a sign of a deleterious effect on balance. We used kinematic stabilometric parameters, recurrence quantification analysis (RQA) and the central tendency measure (CTM). We refer to the measures obtained through RQA and CTM methods by dynamical measures. Repeated-measures analysis of variance showed no significant differences between the three sets of postural kinematic measures (before vs. after the first vs. after the second 6MWT). However, we observed significant differences between the three sets for the CTM measure in the antero-posterior direction (p < 0.002), RQA determinism in the medio-lateral (ML) direction (p < 0.0001), and RQA entropy in the ML direction (F = 5.93; p < 0.004).Our results indicate that the effects of moderate-intensity walking exercise on posture are not revealed by classical postural kinematic measures but only by dynamical measures. The loss of complexity in the COP time series observed after both the first and second 6MWTs may indicate presymptomatic deterioration in the postural adaptive capabilities of sedentary older women.

Aging affects the ability to use optic flow in the control of heading during locomotion

Perceived self-motion from optic flow is implicated in the control of locomotion. Aging, which affects visual perception and sensorimotor integration, may result in an inability to use optic flow to guide heading while walking. The purpose of this study was to examine whether advanced age could impact on the steering of locomotion, when changing optic flow directions were presented in an immersive virtual environment (VE). Nine young adults (21.56 +/- 3.20 years) and nine older adults (66.11 +/- 3.95 years) participated in the study. Subjects were asked to walk while viewing a VE through a head-mounted display unit (Kaiser). The VE viewed by the subjects was a large room displayed as an expanding translational optic flow, with the focus of expansion (FOE) located at neutral, 20 degrees or 40 degrees to the right or left. Their task was to walk straight with respect to the VE. Kinematic data in 3D were collected, from which the body's centre of mass (CoM) position and heading direction were calculated. Young subjects were able to make proper heading adjustments in the VE, with respect to FOE shifts, but not older individuals. Young subjects altered their CoM trajectory so that it was oriented in the direction opposite to the FOE in the physical environment and resulted in small deviation in the VE. The older adults did not adjust their locomotor patterns in response to the different flows presented and maintained similar walking trajectories across all trials. Advanced age results in an altered control of steering of locomotion in response to changing directions of optic flow. This may be related to an impaired perception and/or use of the optic flow, or due to inherent problems in sensorimotor integration.

Falls among dizzy patients in primary healthcare: an intervention study with control group

The objective of this study is to investigate whether vestibular rehabilitation can improve balance, reduce self-perceived handicap because of dizziness and, if possible, reduce falls among dizzy patients in primary healthcare. The study also finds out which of the balance measures and measure of self-perceived handicap, if any, predicted the risk of falls. The design of this study is an intervention study with control group. Fifty-eight patients, 65 years and older, with multisensory dizziness were taken as participants. The intervention group trained vestibular rehabilitation twice a week for 9 weeks. All patients were assessed at baseline and after 3 months, with four different balance measures and the Dizziness Handicap Inventory. After 6, 9 and 12 months, a follow-up by telephone was performed and, at 12 months, the patients also filled out a Dizziness Handicap Inventory questionnaire. Statistically significant differences were found between the groups between baseline and 3 months in one static balance measure and in one dynamic measure (P=0.038 and 0.044). In total, 40 falls were reported, 31 were classified as intrinsic falls, 26 of them caused by vertigo and nine falls were classified as extrinsic. No difference was found between the two groups in proportions of patients who fell. Poor ability to stand in tandem stance doubled the risk for falls. Vestibular rehabilitation can improve balance in elderly patients with multisensory dizziness. Vertigo is a common cause of falls in this group of patients and vestibular rehabilitation is a feasible treatment.

Steering behaviour can be modulated by different optic flows during walking

Optic flow is a typical pattern of visual motion that can be used to control locomotion. While the ability to discriminate translational or rotational optic flows have been extensively studied, how these flows control steering during locomotion is not known. The goal of this study was to compare the steering behaviour of subjects subjected to rotational, translational, or combined (rotational added to translational) optic flows with a focus of expansion (FOE) located to the right, left, or straight ahead. Ten healthy young subjects were instructed to walk straight in a virtual room viewed through a helmet mounted display while the location of the FOE was randomly offset. Horizontal trajectory of the body's centre of mass (CoM), as well as rotations of the head, trunk and foot were recorded in coordinates of both the physical and virtual worlds. Results show that subjects experienced a mediolateral shift in CoM opposite to the FOE location, with larger corrections being observed at more eccentric FOE locations. Head and body segment reorientations were only observed for optic flows containing a rotational component. CoM trajectory corrections in the physical world were also of small magnitude, leading to deviation errors in the virtual world. Altogether, these results suggest a profound influence of vision, especially due to the pattern of visual motion, on steering behaviours during locomotion.

Visual contribution to walking in children with Developmental Coordination Disorder

BACKGROUND

The motor co-ordination problems of children with Developmental Coordination Disorder (DCD) have been frequently associated with poor visuospatial processing. In order to extend these findings mainly based on fine motor experiments, the present study investigates the contribution of vision to the control of walking in children with DCD.

METHODS

Children with DCD (n = 12) walked at their preferred speed on a straight, firm and uncluttered walkway in a condition with normal lighting and in a dark condition. Spatiotemporal gait variables were assessed by means of a three-dimensional ProReflex camera system and compared with the gait pattern of matched, typically developing (TD) children (n = 12).

RESULTS

In normal lighting, the gait pattern of both groups was similar, with the exception of subtle differences in the temporal phasing, showing a slightly longer support phase in the children with DCD. In the dark, step frequency and step length were decreased in the children with DCD, resulting in a significantly slower walking velocity. In addition, the medio-lateral excursion of the centre of mass tended to increase in this group. In the TD children, adaptations to the spatiotemporal pattern remained absent.

CONCLUSIONS

These results suggest that children with DCD are more dependent on global visual flow information than TD children for the maintenance of balance and the control of velocity during walking. This increased dependency on visual control might be associated with a poorly developed internal sensorimotor model.