Dubreucq Lucie, Mereu Aurélie, Blanc Gabrielle, Filiatrault Johanne, Duclos Cyril
School of Rehabilitation, Université de Montréal, Montreal, Canada.
Exp Brain Res. 2017 May;235(5):1429-1438. doi: 10.1007/s00221-017-4902-y. Epub 2017 Feb 24.
The fear of falling can be manipulated by introducing a postural threat (e.g., an elevated support surface) during stance and gait. Under these conditions, balance parameters are altered in both young and elderly individuals. This study aimed to dissociate the physical and psychological aspects of the threat and show the impact of a verbal warning cue of imminent perturbation during gait among young and elderly healthy participants. Ten young subjects (29.4 ± 3.9 years) and ten subjects aged over 65 years (72.9 ± 3.5) participated in the study. Spatiotemporal and balance parameters were quantified during eight consecutive gait cycles using a motion analysis system and an instrumented treadmill. These parameters were compared twice in the control trial and before/after a verbal warning cue of imminent perturbation during gait ("postural threat") in perturbation trials and between groups using repeated measure ANOVAs.
The verbal cue yielded reduced step length (p = 0.008), increased step width (p = 0.049), advanced relative position of the center of mass (p = 0.016), increased stabilizing force (p = 0.003), and decreased destabilizing force (p = 0.002). This warning effect was not observed in the older participant group analyses but was found for three participants based on individual data analyses. The warning effect in younger participants was not specific to impending perturbation conditions. Most gait and balance parameters were altered in the older group (p < 0.05) versus the younger group in each condition, regardless of the warning cue. A psychological threat affects gait and balance similarly to a physical threat among young participants but not among most older participants.
在站立和行走过程中引入姿势威胁(例如升高支撑面)可操控对跌倒的恐惧。在这些情况下,年轻人和老年人的平衡参数都会改变。本研究旨在区分威胁的身体和心理方面,并展示在年轻和老年健康参与者行走过程中即将发生扰动的言语警告提示的影响。十名年轻受试者(29.4±3.9岁)和十名65岁以上的受试者(72.9±3.5岁)参与了该研究。使用运动分析系统和装有仪器的跑步机在连续八个步态周期内对时空参数和平衡参数进行量化。在对照试验中以及在扰动试验中行走过程中即将发生扰动的言语警告提示(“姿势威胁”)之前/之后,对这些参数进行了两次比较,并使用重复测量方差分析在组间进行比较。
言语提示导致步长减小(p = 0.008)、步宽增加(p = 0.049)、质心相对位置提前(p = 0.016)、稳定力增加(p = 0.003)和去稳定力减小(p = 0.002)。在老年参与者组分析中未观察到这种警告效应,但基于个体数据分析在三名参与者中发现了这种效应。年轻参与者中的警告效应并非特定于即将发生的扰动情况。在每种情况下,与年轻组相比,老年组的大多数步态和平衡参数均发生改变(p < 0.05),无论有无警告提示。心理威胁对年轻参与者的步态和平衡的影响与身体威胁相似,但对大多数老年参与者则不然。