Preventing falls is important in the elderly. One reason for falling is tripping or stumbling; hence, it is important to improve the crossing motion. This study aimed to compare speed- and accuracy-oriented crossing training and establish a useful training method. To investigate the effects of crossing motion training, we conducted a randomized controlled trial. Twenty healthy elderly individuals (aged 71.7 ± 1.5 years) were randomly assigned to two groups: speed training and accuracy training groups. They practiced initiating their crossing motion faster or more accurately for 12 weeks. Using a three-dimensional motion analysis system, the data on the crossing motion was captured before and after the training period. We set four conditions (normal speed, fast, leaning stance, and leaning stance and fast) and two directions (anterior and lateral) to analyze the crossing motion. The crossing motion of the speed training group became significantly faster compared to baseline (p < 0.05); however, the accuracy of the crossing motion of the accuracy training group was not statistically significant. Speed training in this study had clear effects on crossing motion. It is surprising that crossing motion training from a normal upright stance can also improve swing speed from the leaning stance. We believe that this training is easy and useful in the elderly population.

Background: Aging is associated with a decline in both motor and sensory functions that destabilizes posture, increasing the risk of falls. Dynamic standing balance is strongly linked to fall risk in older adults. Sensory information from the soles and trunk is essential for balance control. Few studies have demonstrated the efficacy of targeted sensory training on balance improvement. Objectives: To assess vibratory sensation function in the trunk and sole using a vibration device and evaluate the effects of trunk and sole tactile sensation training on dynamic standing balance performance in older adults. Methods: In this randomized controlled trial, eighteen older adults were randomly assigned to three groups: control (n = 8, mean age 66.6 ± 3.4), trunk training (n = 5, mean age 71.0 ± 1.9), and sole training (n = 5, mean age 66.4 ± 3.6). The training lasted for 10 weeks, utilizing vibratory stimulation at 128 Hz through tuning forks for 15 min during each session, conducted three times a week. The primary outcomes were vibratory sensitivity, assessed with a belt-fitted device on the trunk and a plate equipped with vibrators on the soles, and dynamic balance, evaluated through force plate testing that measured limits of stability (LoS) in multiple directions. Results: Correct response rates for trunk vibratory stimulation significantly improved in the trunk training group (p < 0.05). The rate of two-stimuli discrimination improved in both training groups. Significant advancements in balance metrics were observed in the trunk and sole training groups when compared to the control group, especially regarding anterior–posterior tilts (p < 0.05). A positive correlation was identified between two-point vibratory discrimination and LoS test performance. Conclusions: Sensory training of the trunk and sole enhances balance performance in older adults, suggesting potential benefits for fall prevention. Future studies should assess long-term effects and explore optimal training duration with larger sample sizes.

Fall incidents are increasing every year and prevention is necessary. Preventing falls can increase the quality of life of the elderly and decrease medical costs. Stumbling and tripping are the main causes of falls and falls in the lateral direction, causing the hip fracture. This study aimed to analyze the accuracy and speed of lateral obstacle crossing in the elderly, especially from leaning posture. Twenty healthy older adults (6 men and 14 women, aged 71.7 ± 1.5 years) and 20 healthy young adults (5 men and 15 women, aged 21.4 ± 1.2 years) participated in this study. We set four conditions (normal, fast, leaning, and leaning fast), and participants crossed the obstacle laterally ten times under each condition. The crossing motion was captured using a three-dimensional analysis system. The trajectory of the foot, landed position, step time, center of gravity of the body, and moment of the lower extremity during the swing phase were calculated and compared between older and younger adults. In the leaning condition, the step time and knee moment of the elderly were significantly longer and larger than those of young adults. From the results of the trajectory of the foot and landed position in the leaning condition, motion inconsistency of the foot was found in the elderly. We believe that it is difficult for the elderly to perform the intended crossing motion and swing quickly because of aging. This inconsistency in motion is a serious cause of falls in the elderly.

The vestibulo-ocular reflex (VOR) plays an important role in controlling the gaze at a visual target. Although patients with vestibular hypofunction aim to improve their VOR function, some retain dysfunction for a long time. Previous studies have explored the effects of direct current stimulation on vestibular function; however, the effects of random noise stimulation on eye–head coordination have not previously been tested. Therefore, we aimed to clarify the effects of high frequency noisy vestibular stimulation (HF-nVS) on eye–head coordination related to VOR function. Thirteen healthy young adult participants with no serious disease took part in our study. The current amplitude and density used were 0.4 mA and 0.2 mA/cm², respectively, with a random noise frequency of 100–640 Hz. The electrodes were located on both mastoid processes. The stimulus duration and fade in/out duration were 600 and 10 s, respectively. Subjects oscillated their head horizontally, gazing at the fixation point, at 1 Hz (0.5 cycles/s) for 30 repetitions. The coordination of eye–head movements was measured by eye-tracking and a motion capture system. Peak-to-peak angles for eye and head movement and deviation of the visual line from the fixation target revealed no significant differences between HF-nVS and sham. The lag time between the eye and head movement with HF-nVS post-stimulation was significantly shorter than that of the sham. We found that HF-nVS can reduce the lag time between eye and head movement and improve coordination, contributing to a clear retinal image. This technique could be applied as a form of VOR training for patients with vestibular hypofunction.

Paired associative stimulation (PAS) increases and decreases cortical excitability in primary motor cortex (M1) neurons, depending on the spike timing-dependent plasticity, i.e., long-term potentiation (LTP)- and long-term depression (LTD)-like plasticity, respectively. However, how PAS affects the cortical circuits for the agonist and antagonist muscles of M1 is unclear. Here, we investigated the changes in the LTP- and LTD-like plasticity for agonist and antagonist muscles during PAS: 200 pairs of 0.25-Hz peripheral electric stimulation of the right median nerve at the wrist, followed by a transcranial magnetic stimulation of the left M1 with an interstimulus interval of 25 ms (PAS-25 ms) and 10 ms (PAS-10 ms). The unconditioned motor evoked potential amplitudes of the agonist muscles were larger after PAS-25 ms than after PAS-10 ms, while those of the antagonist muscles were smaller after PAS-25 ms than after PAS-10 ms. The γ-aminobutyric acid A (GABA_A)- and GABA_B-mediated cortical inhibition for the agonist and antagonist muscles were higher after PAS-25 ms than after PAS-10 ms. The cortical excitability for the agonist and antagonist muscles reciprocally and topographically increased and decreased after PAS, respectively; however, GABA_A and GABA_B-mediated cortical inhibitory functions for the agonist and antagonist muscles were less topographically decreased after PAS-10 ms. Thus, PAS-25 ms and PAS-10 ms differentially affect the LTP- and LTD-like plasticity in agonist and antagonist muscles.

Background: Accidental falls are caused by sudden perturbations, and thus, quick and well-organized stepping responses are needed. Stepping is one of the most important motions for avoiding falls in elderly patients. We sought to analyze foot motion during the volitional steps of older adults and compare it with that of younger adults. Methods: Eighteen healthy older adults (age: 70.8 ± 3.2 years) and 22 younger adults (age: 20.2 ± 0.3 years) were included in this study. The subjects crossed over a lateral obstacle 10 times, keeping the motion as consistent as possible. An infrared reflective marker, placed on the subjects’ heels, recorded motion through a three-dimensional motion analysis system. A clinical sensory test for knee proprioception was performed and the difference between the target and the actual angle of the subjects was calculated using an electrical goniometer. Results: The results of the motion analysis indicated that the trajectories of the heels in older adults were not consistent compared with that of young adults (p< 0.05). Unfortunately, the clinical sensory test and the time-series analysis of knee angle change were unable to detect a decline in the proprioceptive function of the knee. Conclusion: We believe that knee flexor muscles lack coordination in terms of eccentric contractions. This decline of coordination could cause the descending period to extend, which is the time from the top of the trajectory of the heel to the finish of the normalized motion. We also believe that the change in motion may indicate compensatory mechanisms for aging. This information can be useful for designing fall prevention exercises for the elderly population.