Eckardt Nils, Rosenblatt Noah J
Department of Training and Movement Science, Institute for Sport and Sports Science, University of Kassel, Germany.
Dr. William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Hum Mov Sci. 2018 Dec;62:67-80. doi: 10.1016/j.humov.2018.09.008. Epub 2018 Sep 21.
It is crucial to understand age-related degenerative processes that affect dynamic postural control and ultimately increase the risk of falling for older adults. Mediolateral stability during gait, which requires active control of foot placement, may be particularly diminished with age. Using the uncontrolled manifold-analysis (UCM), we aimed to quantify the effect of age and uneven surfaces on the ability to rely on motor equivalent control to stabilize the mediolateral trajectory of the swing limb during gait. The UCM analysis tests the extent to which all available degrees of freedom (DoF) that contribute to a task-relevant performance variable co-vary so as to stabilize, i.e., reduce the variance of, that performance variable. Within the UCM analysis, variability is partitioned into two components: "good" variance that has no effect on the performance variable, and "bad" variance, that results in a variable performance. A synergy index quantifies the relative amount of "good" variance compared to "bad" variance. Thirteen healthy younger (mean age 23 years) and 11 healthy older adults (mean age 73 years) walked across an even lab floor and a more challenging uneven surface. The UCM analysis was performed using lower extremity segment angles as the DoF that contribute to the mediolateral trajectory of the swing limb. We found that both, young and older adults were able to exploit motor flexibility to stabilize the foot trajectory regardless of walking condition, resulting in similar synergy indices. However, to counteract the age-related increase in performance destabilizing variability on the uneven surface, older adults increased "good" variability to similar degree. We conclude that increasing variability is not a sign of decreased motor control but rather an intentional strategy of the neuromuscular system to compensate for possible age-related declines in strength and balance. There is great potential to improve fall prevention programs by introducing tasks that promote, rather than limit, exploration of motor solutions to strengthen appropriate synergies.
了解与年龄相关的退行性过程至关重要,这些过程会影响动态姿势控制,并最终增加老年人跌倒的风险。步态中的内外侧稳定性需要对足部位置进行主动控制,而随着年龄的增长,这种稳定性可能会特别减弱。我们使用非受控流形分析(UCM),旨在量化年龄和不平坦表面对步态中依靠运动等效控制来稳定摆动肢体内外侧轨迹能力的影响。UCM分析测试了所有有助于任务相关性能变量的可用自由度(DoF)共同变化以稳定该性能变量(即减少其方差)的程度。在UCM分析中,变异性被分为两个部分:对性能变量没有影响的“好”方差,以及导致性能变量变化的“坏”方差。协同指数量化了“好”方差与“坏”方差的相对量。13名健康的年轻人(平均年龄23岁)和11名健康的老年人(平均年龄73岁)走过平坦的实验室地面和更具挑战性的不平坦表面。使用下肢节段角度作为有助于摆动肢体内外侧轨迹的DoF进行UCM分析。我们发现,无论行走条件如何,年轻人和老年人都能够利用运动灵活性来稳定足部轨迹,从而得到相似的协同指数。然而,为了抵消与年龄相关的不平坦表面上性能不稳定变异性的增加,老年人将“好”的变异性增加到了相似的程度。我们得出结论,变异性增加并非运动控制能力下降的标志,而是神经肌肉系统为补偿可能与年龄相关的力量和平衡下降而采取的一种有意策略。通过引入促进而非限制对运动解决方案探索以加强适当协同作用的任务,在预防跌倒计划方面有很大的改进潜力。