Rubega Maria, Di Marco Roberto, Zampini Marianna, Formaggio Emanuela, Menegatti Emanuele, Bonato Paolo, Masiero Stefano, Del Felice Alessandra
Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy.
Department of Information Engineering, University of Padova, Padova, IT, Italy.
Aging Brain. 2021 Apr 7;1:100013. doi: 10.1016/j.nbas.2021.100013. eCollection 2021.
Falls due to balance impairment are a major cause of injury and disability in the elderly. The study of neurophysiological correlates during static and dynamic balance tasks is an emerging area of research that could lead to novel rehabilitation strategies and reduce fall risk. This review aims to highlight key concepts and identify gaps in the current knowledge of balance control in the elderly that could be addressed by relying on surface electromyographic (EMG) and electroencephalographic (EEG) recordings. The neurophysiological hypotheses underlying balance studies in the elderly as well as the methodologies, findings, and limitations of prior work are herein addressed. The literature shows: 1) a wide heterogeneity in the experimental procedures, protocols, and analyses; 2) a paucity of studies involving the investigation of cortical activity; 3) aging-related alterations of cortical activation during balance tasks characterized by lower cortico-muscular coherence and increased allocation of attentional control to postural tasks in the elderly; and 4) EMG patterns characterized by delayed onset after perturbations, increased levels of activity, and greater levels of muscle co-activation in the elderly compared to younger adults. EMG and EEG recordings are valuable tools to monitor muscular and cortical activity during the performance of balance tasks. However, standardized protocols and analysis techniques should be agreed upon and shared by the scientific community to provide reliable and reproducible results. This will allow researchers to gain a comprehensive knowledge on the neurophysiological changes affecting static and dynamic balance in the elderly and will inform the design of rehabilitative and preventive interventions.
因平衡功能受损导致的跌倒，是老年人受伤和残疾的主要原因。研究静态和动态平衡任务期间的神经生理学关联，是一个新兴的研究领域，有望催生新的康复策略并降低跌倒风险。本综述旨在突出关键概念，并找出在老年人平衡控制的现有知识中，可通过依赖表面肌电图（EMG）和脑电图（EEG）记录来填补的空白。本文论述了老年人平衡研究背后的神经生理学假设，以及先前研究的方法、结果和局限性。文献表明：1）实验程序、方案和分析存在广泛的异质性；2）涉及皮层活动研究的匮乏；3）平衡任务期间皮层激活的衰老相关变化，其特征为老年人的皮层-肌肉协调性较低，且对姿势任务的注意力控制分配增加；4）与年轻人相比，老年人的肌电图模式表现为扰动后起始延迟、活动水平增加以及肌肉共同激活水平更高。肌电图和脑电图记录是监测平衡任务执行期间肌肉和皮层活动的宝贵工具。然而，科学界应商定并共享标准化方案和分析技术，以提供可靠且可重复的结果。这将使研究人员全面了解影响老年人静态和动态平衡的神经生理学变化，并为康复和预防干预措施的设计提供依据。
