Objective: Pain and fatigue are highly prevalent debilitating symptoms in Parkinson’s disease (PD), however, their relationship with physical performance, fear of falling (FOF) and falls is not cle...
Falls in older adults are leading causes of fatal and non-fatal injuries, negatively impacting quality of life among those in this demographic. Most elderly falls occur due to unrecoverable limb collapse during balance control in the single-limb support (SLS) phase. To understand why older adults are more susceptible to falls than younger adults, we investigated age-related differences in lower limb kinematics, kinetics, and muscle synergy patterns during SLS, as well as their relationship to postural control strategies. Thirteen older and thirteen younger healthy adults were compared during the SLS phase of balance recovery following an unexpected surface drop perturbation. Compared to younger adults, older adults demonstrated (1) greater trunk flexion, (2) increased hip extension torque and reduced hip abduction torque of the perturbed leg, and (3) higher postural sway. Trunk flexion was correlated with a delayed latency to the start of lateral-to-medial displacement of center of mass from the perturbation onset. The group-specific muscle synergy revealed that older adults exhibited prominent activation of the hip extensors, while younger adults showed prominent activation of the hip abductors. These findings provide insights into targeted balance rehabilitation and indicate ways to improve postural stability and reduce falls in older adults.
The objective of this study was to examine age-related differences in arm and trunk responses during first and repeated step induced balance perturbations. Young and older adults received 10 trials of unpredictable lateral platform translations. Outcomes included maximum arm and trunk displacement within 1 s of perturbation and at first foot lift off (FFLO), arm and neck muscle activity as recorded using electromyography (EMG), initial step type, balance confidence, and percentage of harness-assisted trials. Compared to young adults, older adults demonstrated greater arm and trunk angular displacements during the first trial, which were present at FFLO and negatively associated with balance confidence. Unlike young adults, recovery steps in older adults were directed towards the fall with a narrowed base of support. Over repeated trials, rapid habituation of first-trial responses of bilateral arm and trunk displacement and EMG amplitude was demonstrated in young adults, but was absent or limited in older adults. Older adults also relied more on harness assistance during balance recovery. Exaggerated arm and trunk responses to sudden lateral balance perturbations in older adults appear to influence step type and balance recovery. Associations of these persistently amplified movements with an increased reliance on harness assistance suggest that training to reduce these deficits could have positive effects in older adults with and without neurological disorders.
Pain in Parkinson’s disease (PD) is a highly prevalent non-motor symptom occurring in this population. The King’s PD Pain Scale (KPPS) was developed to assess pain in people with PD. This study aim... Pain is a highly prevalent non-motor symptom of Parkinson’s disease (PD) that is often overlooked.The King’s PD Pain Scale (KPPS) is specially designed to assess pain localization, intensity, and f...