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Human movement is optimized to Earth's gravity and based on highly complex interactions between sensory and neuro-muscular systems. Yet, humans are able to adapt—at least partially—to extreme environments upon and beyond Earth's surface. With upcoming Lunar Gateway and Artemis missions, it is crucial to increase our understanding of the impact of hypogravity—i.e., reduced vertical loading—on physiological and sensory-motor performances to improve countermeasure programs, and define crewmember's readiness to perform mission critical tasks. Several methodologies designed to reduce vertical loading are used to simulate hypogravity on Earth, including body weight support (BWS) devices. Countering gravity and offloading the human body is also used in various rehabilitation scenarios to improve motor recovery in neurological and orthopedic impairments. Thus, BWS-devices have the potential of advancing theory and practice of both space exploration and terrestrial rehabilitation by improving our understanding of physiological and sensory-motor adaptations to reduced vertical loading and sensory input. However, lack of standardization of BWS-related research protocols and reporting hinders the exchange of key findings and new advancements in both areas. The aim of this introduction paper is to review the role of BWS in understanding human movement in simulated hypogravity and the use of BWS in terrestrial rehabilitation, and to identify relevant research areas contributing to the optimization of human spaceflight and terrestrial rehabilitation. One of the main aims of this research topic is to facilitate standardization of hypogravity-related research protocols and outcome reporting, aimed at optimizing knowledge transfer between space research and BWS-related rehabilitation sciences.

Background: Balance impairment is a frequent cause of morbidity and mortality in people with Parkinson’s disease (PD). As opposed to the effects of appendicular motor symptoms, the effects of Levodopa on balance impairment in idiopathic PD are less clear. Objective: To review the literature on the effects of oral Levodopa on clinical balance test performance, posturography, step initiation, and responses to perturbation in people with idiopathic PD (PwPD). Methods: A systematic search of three scientific databases (Pubmed, Embase, and Web of Science) was conducted in accordance with PRISMA guidelines. For the pilot meta-analysis, standardized mean differences with 95% confidence intervals were calculated using an inverse variance random effects model. Data not suitable for implementation in the meta-analysis (missing means or standard deviations, and non-independent outcomes) were analyzed narratively. Results: A total of 2772 unique studies were retrieved, of which 18 met the eligibility criteria and were analyzed, including data of 710 idiopathic PwPD. Levodopa had a significant positive effect on the Berg Balance Scale, the Push and Release test, and jerk and frequency parameters during posturography. In contrast, some significant negative effects on velocity-based sway parameters were found during posturography and step initiation. However, Levodopa had no significant effect on most step initiation- and all perturbation parameters. Conclusion: The effects of Levodopa on balance in PwPD vary depending on the outcome parameters and patient inclusion criteria. A systematic approach with well-defined outcome parameters, and prespecified, sensitive and reliable tests is needed in future studies to unravel the effects of oral Levodopa on balance.

Objective Falls can be highly debilitating and have an important negative impact on the quality of life of patients with Parkinson's disease (PD). The aim of this systematic review and meta-analysis is to provide an up-to-date overview of the prevalence of ≥1 fall and ≥2 falls in idiopathic PD. Data Sources MEDLINE, Web of Science, Embase and Cinahl databases were systematically searched until 04 July 2022 for prospective studies reporting fall prevalence in persons with idiopathic PD. Methods Pooled prevalence rates with 95% confidence intervals (CIs) were computed using random-effects models. Heterogeneity among studies was assessed using the I2 statistic. Results A total of 54 studies (7546 participants) were included, and random-effects meta-analysis yielded a pooled proportional fall rate of 0.48 (95% CI [0.43–0.52], I2 = 93%, 46 studies, 6874 participants) for classification 1 (≥1 fall) and a pooled proportional fall rate of 0.32 (95% CI [0.27–0.37], I2 = 78%, 31 studies, 5672 participants) for classification 2 (≥2 falls). Subgroup analysis on the classification of falls, and length and method of monitoring falls did not reveal significant differences and did not reduce between-study variability. Conclusion Pooled estimates suggest that one in two persons with PD fall at least once, and one in three fall at least twice within the registered time period. Substantial variability remains after pooling fall prevalence rates according to the length and method of monitoring. Therefore, no recommendations can be made concerning these methodological aspects. Future research on falls in PD is encouraged to implement best practice recommendations to monitor and report fall data.

In an attempt to counteract microgravity-induced deconditioning during spaceflight, exercise has been performed in various forms on the International Space Station (ISS). Despite significant consumption of time and resources by daily exercise, including around one third of astronauts’ energy expenditure, deconditioning—to variable extents—are observed. However, in future Artemis/Lunar Gateway missions, greater constraints will mean that the current high volume and diversity of ISS in-flight exercise will be impractical. Thus, investigating both more effective and efficient multi-systems countermeasure approaches taking into account the novel mission profiles and the associated health and safety risks will be required, while also reducing resource requirements. One potential approach is to reduce mission exercise volume by the introduction of exercise-free periods, or “exercise holidays”. Thus, we hypothesise that by evaluating the ‘recovery’ of the no-intervention control group of head-down-tilt bed rest (HDTBR) campaigns of differing durations, we may be able to define the relationship between unloading duration and the dynamics of functional recovery—of interest to future spaceflight operations within and beyond Low Earth Orbit (LEO)—including preliminary evaluation of the concept of exercise holidays. Hence, the aim of this literature study is to collect and investigate the post-HDTBR recovery dynamics of current operationally relevant anthropometric outcomes and physiological systems (skeletal, muscular, and cardiovascular) of the passive control groups of HDTBR campaigns, mimicking a period of ‘exercise holidays’, thereby providing a preliminary evaluation of the concept of ‘exercise holidays’ for spaceflight, within and beyond LEO. The main findings were that, although a high degree of paucity and inconsistency of reported recovery data is present within the 18 included studies, data suggests that recovery of current operationally relevant outcomes following HDTBR without exercise—and even without targeted rehabilitation during the recovery period—could be timely and does not lead to persistent decrements differing from those experienced following spaceflight. Thus, evaluation of potential exercise holidays concepts within future HDTBR campaigns is warranted, filling current knowledge gaps prior to its potential implementation in human spaceflight exploration missions.

IMPORTANCE People with bilateral vestibulopathy experience severe balance and mobility issues. Fear and anxiety are associated with reduced activity, which can further affect balance and fall risk. Understanding and intervening on falls in this population is essential. The aims of this narrative review are to provide an overview of the current knowledge and applied methods on fall incidence, causes, and injuries in bilateral vestibulopathy. OBSERVATIONS Eleven articles reporting falls incidence in people with bilateral vestibulopathy were deemed eligible, including 3 prospective and 8 retrospective studies, with a total of 359 participants, of whom 149 (42%) fell during the assessed period. When reported, the most common perceived causes of falls were loss of balance, darkness, and uneven ground. Information on sustained injuries was limited, with bruises and scrapes being the most common, and only 4 fractures were reported. As most studies included falls as a secondary, descriptive outcome measure, fall data obtained using best practice guidelines were lacking. Only 6 studies reported their definition of a fall, of which 2 studies explicitly reported the way participants were asked about their fall status. Only 3 studies performed a prospective daily fall assessment using monthly fall diaries (a recommended practice), whereas the remaining studies retrospectively collected fall-related data through questionnaires or interviews. While most studies reported the number of people who did and did not fall, the number of total falls in individual studies was lacking. CONCLUSIONS AND RELEVANCE The findings from this review suggest that falls in people with bilateral vestibulopathy are common but remain an understudied consequence of the disease. Larger prospective studies that follow best practice guidelines for fall data collection with the aim of obtaining and reporting fall data are required to improve current fall risk assessments and interventions in bilateral vestibulopathy.

Background Exposure to prolonged periods in microgravity is associated with deconditioning of the musculoskeletal system due to chronic changes in mechanical stimulation. Given astronauts will operate on the Lunar surface for extended periods of time, it is critical to quantify both external (e.g., ground reaction forces) and internal (e.g., joint reaction forces) loads of relevant movements performed during Lunar missions. Such knowledge is key to predict musculoskeletal deconditioning and determine appropriate exercise countermeasures associated with extended exposure to hypogravity. Objectives The aim of this paper is to define an experimental protocol and methodology suitable to estimate in high-fidelity hypogravity conditions the lower limb internal joint reaction forces. State-of-the-art movement kinetics, kinematics, muscle activation and muscle-tendon unit behaviour during locomotor and plyometric movements will be collected and used as inputs (Objective 1), with musculoskeletal modelling and an optimisation framework used to estimate lower limb internal joint loading (Objective 2). Methods Twenty-six healthy participants will be recruited for this cross-sectional study. Participants will walk, skip and run, at speeds ranging between 0.56–3.6 m/s, and perform plyometric movement trials at each gravity level (1, 0.7, 0.5, 0.38, 0.27 and 0.16g) in a randomized order. Through the collection of state-of-the-art kinetics, kinematics, muscle activation and muscle-tendon behaviour, a musculoskeletal modelling framework will be used to estimate lower limb joint reaction forces via tracking simulations. Conclusion The results of this study will provide first estimations of internal musculoskeletal loads associated with human movement performed in a range of hypogravity levels. Thus, our unique data will be a key step towards modelling the musculoskeletal deconditioning associated with long term habitation on the Lunar surface, and thereby aiding the design of Lunar exercise countermeasures and mitigation strategies.

BACKGROUND: Trunk training after stroke is an effective method for improving trunk control, standing balance and mobility. The SWEAT2 study attempts to discover the underlying mechanisms leading to the observed mobility carry-over effects after trunk training. AIM: A secondary analysis investigating the effect of trunk training on muscle activation patterns, muscle synergies and motor unit recruitment of trunk and lower limbs muscles, aimed to provide new insights in gait recovery after stroke. DESIGN: Randomized controlled trial. SETTING: Monocentric study performed in the RevArte Rehabilitation Hospital (Antwerp, Belgium). POPULATION: Forty-five adults diagnosed with first stroke within five months, of which 39 completed treatment and were included in the analysis. METHODS: Participants received 16 hours of additional trunk training (N.=19) or cognitive training (N.=20) over the course of four weeks (1 hour, 4 times a week). They were assessed by an instrumented gait analysis with electromyography of trunk and lower limb muscles. Outcome measures were linear integrated normalized envelopes of the electromyography signal, the amount and composition of muscle synergies calculated by nonnegative matrix factorization and motor unit recruitment calculated, by mean center wavelet frequencies. Multivariate analysis with post-hoc analysis and statistical parametric mapping of the continuous curves were performed. RESULTS: No significant differences were found in muscle activation patterns and the amount of muscle synergies. In 42% of the subjects, trunk training resulted in an additional muscle synergy activating trunk muscles in isolation, as compared to 5% in the control group. Motor unit recruitment of the of trunk musculature showed decreased fast-twitch motor recruitment in the erector spinae muscle after trunk training: for the hemiplegic (t[37]=2.44, P=0.021) and non-hemiplegic erector spinae muscle (t[37]=2.36, P=0.024). CONCLUSIONS: Trunk training improves selective control and endurance of trunk musculature after sub-acute stroke. CLINICAL REHABILITATION IMPACT: What is new to the actual clinical rehabilitation knowledge is that: trunk training does not alter muscle activation patterns or the amount of muscle synergies over time; a decrease in fast-twitch motor recruitment in the erector spinae muscle was found during walking after trunk training; trunk training seems to increase the fatigue-resistance of the back muscles and enables more isolated activation.

Patients with bilateral vestibulopathy (BVP) present with unsteadiness during standing and walking, limiting their activities of daily life and, more importantly, resulting in an increased risk of falling. In BVP patients, falls are considered as one of the major complications, with patients having a 31-fold increased risk of falling compared to healthy subjects. Thus, highlighting objective measures that can easily and accurately assess the risk of falling in BVP patients is an important step in reducing the incidence of falls and the accompanying burdens. Therefore, this study investigated the interrelations between demographic characteristics, vestibular function, questionnaires on self-perceived handicap and balance confidence, clinical balance measures, gait variables, and fall status in 27 BVP patients. Based on the history of falls in the preceding 12 months, the patients were subdivided in a “faller” or “non-faller” group. Results on the different outcome measures were compared between the “faller” and “non-faller” subgroups using Pearson's chi-square test in the case of categorical data; for continuous data, Mann–WhitneyUtest was used. Performances on the clinical balance measures were comparable between fallers and non-fallers, indicating that, independent from fall status, the BVP patients present with an increased risk of falling. However, fallers tended to report a worse self-perceived handicap and confidence during performing activities of daily life. Spatiotemporal parameters of gait did not differ between fallers and non-fallers during walking at slow, preferred, or fast walking speed. These results may thus imply that, when aiming to distinguish fallers from non-fallers, the BVP patients' beliefs concerning their capabilities may be more important than the moderately or severely affected physical performance within a clinical setting. Outcome measures addressing the self-efficacy and fear of falling in BVP patients should therefore be incorporated in future research to investigate whether these are indeed able to distinguish fallers form non-fallers. Additionally, information regarding physical activity could provide valuable insights on the contextual information influencing behavior and falls in BVP.

Background Benign paroxysmal positional vertigo (BPPV) can lead to an increased fall risk in older adults. Therefore, we examined the influence of age on the effectiveness of canalith-repositioning procedures (CRPs) for the treatment of BPPV. Methods Pubmed, Web of Science, and the bibliographies of selected articles were searched for studies conducted before September 2020 that examined the effectiveness of treatments for BPPV in various age groups. Meta-analyses were performed to compare treatment effectiveness and recurrence rates for younger and older adults. Odds ratios were calculated in a random-effects model. Mean differences were calculated using a fixed-effects model. A significance level of p < 0.05 (95% confidence interval) was set. The risk of bias and the methodological quality of all included articles were examined. Results Forty-five studies were retrieved after full-text screening, of which 29 studies were included for a qualitative review. The remaining 16 studies were eligible for inclusion in the meta-analysis (3267 participants with BPPV). The success rate of a single CRP was higher in the younger group (72.5% vs. 67%, p < 0.001). An average of 1.4 and 1.5 CRPs was needed for complete recovery in the younger and older groups, respectively (p = 0.02). However, global treatment success did not differ between these groups (97.5% vs. 94.6%, p = 0.41). The recurrence rate was higher in the older population (23.2% vs. 18.6%, p = 0.007). Conclusions Although more CRPs are needed, the rate of complete recovery in older adults is similar to that observed in younger adults.

Objective: Describe the relationship between the Activities-Specific Balance Confidence (ABC) scale and Dizziness Handicap Inventory (DHI) with balance performance, as well as fall status in patients with peripheral vestibular disorders. Study Design: Retrospective. Setting: Outpatient balance clinic, tertiary referral center. Patients: Data from 97 patients (age: 54.8 +/- 12.3 yrs; 48 women) with dizziness or imbalance symptoms of peripheral vestibular origin were used for analysis. Intervention(s): / Main Outcome Measure(s): ABC-scores, DHI-scores, static and dynamic balance tests, and fall status of the past 4 weeks, 2 months, and 6 months before the time of measurement were collected. Spearman's rho correlations, chi(2) with post-hoc testing, and Kruskal-Wallis with post-hoc Mann-Whitney U test results were interpreted. Results: The ABC- and DHI-scores show moderate correlations with static balance (ABC: r = 0.44; DHI: r = -0.34) and dynamic balance tests (ABC: r = [-0.47;0.56]; DHI: r = [-0.48;0.39]) and a strong inverse correlation with each other (ABC: 70 +/- 25; DHI: 33 +/- 26; r = -0.84). Related to fall status, weak correlations were found (ABC: r = [-0.29;-0.21]; DHI: r = [0.29;0.33]). Additional results show that subjects in the low-level functioning (ABC) or severe self-perceived disability (DHI) categories have a poorer balance assessed by standing balance, Timed-Up-and-Go and Functional Gait Assessment and are more likely to have experienced multiple falls. Conclusions: The ABC-scale and DHI showed a strong convergent validity, additionally the ABC-scale showed a better concurrent validity with balance performances and the DHI with fall history. In general, patients with peripheral vestibular impairments reporting a lower self-confidence or a more severe self-perceived disability show worse balance performances and a higher fall incidence.

Objective Trunk training after stroke is an effective method for improving mobility, yet underlying associations leading to the observed mobility carryover effects are unknown. The purposes of this study were to investigate the effectiveness of trunk training for gait and trunk kinematics and to find explanatory variables for the mobility carryover effects. Methods This study was an assessor-masked, randomized controlled trial. Participants received either additional trunk training (n = 19) or cognitive training (n = 20) after subacute stroke. Outcome measures were the Tinetti Performance-Oriented Mobility Assessment (POMA), the Trunk Impairment Scale, spatiotemporal gait parameters, center-of-mass excursions, and trunk and lower limb kinematics during walking. Multivariate analysis with post hoc analysis was performed to observe treatment effects. Correlation and an exploratory regression analysis were used to examine associations with the mobility carryover effects. Results Significant improvements after trunk training, compared with the findings for the control group, were found for the Trunk Impairment Scale, Tinetti POMA, walking speed, step length, step width, horizontal/vertical center-of-mass excursions, and trunk kinematics. No significant differences were observed in lower limb kinematics. Anteroposterior excursions of the trunk were associated with 30% of the variability in the mobility carryover effects. Conclusions Carryover effects of trunk control were present during ambulation. Decreased anteroposterior movements of the thorax were the main variable explaining higher scores on the Tinetti POMA Gait subscale. However, the implementation and generalizability of this treatment approach in a clinical setting are laborious and limited, necessitating further research. Impact Trunk training is an effective strategy for improving mobility after stroke. Regaining trunk control should be considered an important treatment goal early after stroke to adequately prepare patients for walking.

ObjectivesTo identify predictive factors for falls in patients with bilateral vestibulopathy (BV). Specific variables contributing to the general work-up of a vestibular patient were compared between BV patients experiencing falls and those who did not.DesignProspective multi-centric cohort study.SettingDepartment of Otorhinolaryngology & Head and Neck Surgery at two tertiary referral centers: Antwerp University Hospital and Maastricht University Medical Center.ParticipantsIn total, 119 BV patients were included. BV diagnosis was defined in accordance with the diagnostic BV criteria, established by the Barany Society in 2017.Main outcome measuresPatients were divided into fallers and non-fallers, depending on the experience of one or more falls in the preceding 12 months. Residual vestibular function on caloric testing, rotatory chair testing, video head impulse test (vHIT) and cervical vestibular evoked myogenic potentials (cVEMP) was evaluated as a predictive factor for falls. Furthermore, hearing function (speech perception in noise (SPIN)), sound localization performance, etiology, disease duration, sport practice, scores on the Dizziness Handicap Inventory (DHI) and the Oscillopsia Severity Questionnaire (OSQ) were compared between fallers and non-fallers.ResultsForty-five (39%) patients reported falls. In a sub-analysis in the patients recruited at UZA (n = 69), 20% experienced three or more falls and three patients (4%) suffered from severe fall-related injuries. The DHI score and the OSQ score were significantly higher in fallers. Residual vestibular function, SPIN, sound localization performance, etiology, disease duration, age and sport practice did not differ between fallers and non-fallers.ConclusionsFalls and (severe) fall-related injuries are frequent among BV patients. A DHI score > 47 and an OSQ score > 27.5 might be indicative for BV patients at risk for falls, with a sensitivity of 70% and specificity of 60%. Residual vestibular function captured by single vestibular tests (vHIT, calorics, rotatory chair, cVEMP) or by overall vestibular function defined as the number of impaired vestibular sensors are not suitable to distinguish fallers and non-fallers in a BV population.

OBJECTIVES: The objective of this study was two-fold: (1) To evaluate the impact of the physiological aging process on somatosensory, vestibular, and balance functions, and (2) To examine the extent to which age and somatosensory and vestibular functions can predict balance performance. MATERIALS and METHODS: In this cross-sectional study, 141 asymptomatic subjects were assessed for touch pressure thresholds ( TPT) with Semmes-Weinstein monofilaments (SWF), vibration thresholds (VT) with a neurothesiometer (NT) and a Rydel-Seiffer tuning fork 128Hz (RSTF). Horizontal vestibulo-ocular reflexes (HVOR gain and asymmetry) were assessed using the video Head Impulse Test (vHIT). A modified version of the Romberg test was used to assess standing balance and the Timed Up and Go test (TUG) and tandem gait (TG) to evaluate dynamic balance. RESULTS: Significant age effects were found for TPT, VT, and balance but not for HVOR gain or asymmetry. Standing balance was explained for 47.2% by age, metatarsal 1 (MT1) (NT), and heel (SWF). The variance in TUG performance was explained for 47.0% by age, metatarsal 5 (MT5) (SWF), and medial malleolus (MM) (NT). Finally, the variance in TG performance was predicted for 43.1% by age, MT1 (NT), HVOR gain, and heel (SWF). CONCLUSION: Among asymptomatic adult population, both somatosensation and balance performance deteriorate with aging. In contrast, HVOR remains rather constant with age, which is possibly explained by the process of vestibular adaptation. Furthermore, this study provides evidence that the VT, TPT, HVOR gain, and age partly predict balance performance. Still, further research is needed, especially with bigger samples in decades 8 and 9. This project is granted by STIMPRO internal funding of the University of Antwerp. Johnson, C (corresponding author), Univ Antwerp, Dept Rehabil Sci & Physiotherapy, Antwerp, Belgium. charlotte.johnson@uantwerpen.be

Introduction Bilateral vestibulopathy (BVP) can affect visual acuity in dynamic conditions, like walking. This can be assessed by testing Dynamic Visual Acuity (DVA) on a treadmill at different walking speeds. Apart from BVP, age itself might influence DVA and the ability to complete the test. The objective of this study was to investigate whether DVA tested while walking, and the drop-out rate (the inability to complete all walking speeds of the test) are significantly influenced by age in BVP-patients and healthy subjects. Methods Forty-four BVP-patients (20 male, mean age 59 years) and 63 healthy subjects (27 male, mean age 46 years) performed the DVA test on a treadmill at 0 (static condition), 2, 4 and 6 km/h (dynamic conditions). The dynamic visual acuity loss was calculated as the difference between visual acuity in the static condition and visual acuity in each walking condition. The dependency of the drop-out rate and dynamic visual acuity loss on BVP and age was investigated at all walking speeds, as well as the dependency of dynamic visual acuity loss on speed. Results Age and BVP significantly increased the drop-out rate (p ≤ 0.038). A significantly higher dynamic visual acuity loss was found at all speeds in BVP-patients compared to healthy subjects (p p ≤ 0.036). Conclusion DVA tested while walking on a treadmill, is one of the few “close to reality” functional outcome measures of vestibular function in the vertical plane. It is able to demonstrate significant loss of DVA in bilateral vestibulopathy patients. However, since bilateral vestibulopathy and age significantly increase the drop-out rate at faster walking speeds, it is recommended to use age-matched controls. Furthermore, it could be considered to use an individual “preferred” walking speed and to limit maximum walking speed in older subjects when testing DVA on a treadmill.

BACKGROUND: Trunk function and lower limb strength seem to be the primary predictors for functional independence in acute stroke patients. Gaining a better understanding of their relationship during walking aids in the identification of intrinsic trunk control deficits and underlying lower limb deficits resulting in compensatory trunk movements. METHODS: Fifty-seven subjects with stroke and 57 age- and gender-matched subjects without disability were included. Participants underwent an instrumented gait analysis with a standard total body Plug-In-Gait model, a clinical examination of the lower limbs based on range of motion, strength, muscle tone and several clinical assessment scales such as the Trunk Impairment Scale, Tinetti test and Functional Ambulation Categories. Spatiotemporal parameters and joint angular time profiles were compared between healthy adults and stroke survivors with severe and mild to moderate lower limb impairments. Spm1d was used to compare the joint angular time profiles between groups. FINDINGS: Truncal deviations are present during hemiplegic walking, sub-acute stroke survivors walked with increased thoracic tilt, a neutral frontal position of the pelvis during stance, a pelvic hike during swing, and a more rotated position without crossing of the midline. Patients with more severe lower limb impairments had more pronounced deficits in truncal motion. INTERPRETATION: Setting accurate rehabilitation goals is of major importance during stroke, as well as understanding the underlying mechanisms and causes of the truncal impairments. Although more compensatory trunk deviations were seen in participants with severe lower limb impairments, they should not be considered as the sole contributor of trunk impairments during walking. Results of this study suggest that intrinsic trunk deficits during walking are also present after stroke. ispartof: Clinical Biomechanics vol:75 ispartof: location:England status: published

Noisy galvanic vestibular stimulation (nGVS) can boost vestibular sensory thresholds via stochastic resonance and research on nGVS as an intervention for vestibulopathy has accelerated recently. Recent research has investigated the effects and associated mechanisms of nGVS on balance and gait. nGVS has potential as an intervention for balance and gait-related deficits in vestibulopathy, but further research into the mechanisms underlying these effects and consensus on stimulation protocols are required.

Introduction Perception of verticality is highly related to balance control in human. Head-on-body tilt

ispartof: Gait & Posture vol:65 pages:247-248

Background Aging is often associated with changes in the musculoskeletal system, peripheral and central nervous system. These age-related changes often result in mobility problems influencing gait performance. Compensatory strategies are used as a way to adapt to these physiological changes. Research question The aim of this review is to investigate the differences in spatiotemporal and gait variability measures throughout the healthy adult life. Methods This systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (no. CRD42017057720). Databases MEDLINE (Pubmed), Web of Science (Web of Knowledge), Cochrane Library and ScienceDirect were systematically searched until March 2018. Results Eighteen of the 3195 original studies met the eligibility criteria and were included in this review. The majority of studies reported spatiotemporal and gait variability measures in adults above the age of 65, followed by the young adult population, information of middle-aged adults is lacking. Spatiotemporal parameters and gait variability measures were extracted from 2112 healthy adults between 18 and 98 years old and, in general, tend to deteriorate with increasing age. Variability measures were only reported in an elderly population and show great variety between studies. Significance The findings of this review suggest that most spatiotemporal parameters significantly differ across different age groups. Elderly populations show a reduction of preferred walking speed, cadence, step and stride length, all related to a more cautious gait, while gait variability measures remain stable over time. A preliminary framework of normative reference data is provided, enabling insights into the influence of aging on spatiotemporal parameters, however spatiotemporal parameters of middle-aged adults should be investigated more thoroughly.