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Lifespan Development > Lecture 19: Age-related changes to balance and gait > Flashcards

Lecture 19: Age-related changes to balance and gait Flashcards

1
Q

Age-Related slowing exists for:

A
  1. reaction time

2. movement rime

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2
Q

reaction time becomes ___ to initiate

A

slower

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3
Q

movement time has a ___ duration

A

prolonged (longer execution times)

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4
Q

the greater the complexity of the movement, the more likely ____ increases in older vs younger adults

A

reaction time increases

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5
Q

Musculoskeletal/Biomechanical constraints

A
  • strength (force production) at ankles, hips, trunks, UE

- ROM (kinematic degrees of freedom) at neck, trunk, knees, ankles

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6
Q

stability limitations

A

the boundary of the base of support within which the center of mass sways
-combining strength, ROM, foot size, and structure to maintain the CM within the BOS

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7
Q

___ stability limits are reported to be decreased in older adults

A

functional

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8
Q

Romberg =

A

feet together

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9
Q

Sharpened Romberg EO =

A

tandem stnace

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10
Q

Standing one-leg test results

A

age 60-69 mean: 27s
age 70-79 mean: 17.2s
age 80-89 mean: 8.5s

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11
Q

Younger adult postural sway

A

more up and down (A/P) direction compared to older adult

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12
Q

Non-faller vs faller postural sway

A
  • general increased sway with BoS configuration and age
  • Notice ML COP amplitude in adults who fall compared AP amplitude
  • Older adults who fall sway disproportionately in the ML direction compared to their same age counter-parts who don’t have a history of falls that sway in a more AP direction & younger-adults
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13
Q

Older adults tend to stand more ___

A

asymmetrical

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14
Q

older adults exhibited a statistically significant increase in asymmetry under an ___ condition

A

eyes-closed

  • the difference is also significantly greater than that observed in younger-adults
  • how functional is this? ; probably not a lot
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15
Q

Postural sway summary (older adults)

A
  • increased amounts of postural sway are linked to increase risk of falling
  • increased sway in ML direction may be special to increased risk of falling, poorer performance on balance scales and age-related disease
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16
Q

postural control implies an ability to maintain:

A

balance during:

  1. voluntary movements (proactive) and
  2. in response to an external perturbation (reactive)
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17
Q

A movement before movement

A

Well in advance
“get stable before movement”
-example: going to gran a railing before climbing stairs (widens base of support, dont need to activate all muscles needed)

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18
Q

Anticipatory postural adjustments (APAs)

A

-anticipate voluntary movement
-precede voluntary movement
- a couple of milliseconds
Examples:
-arm
-trunk bend; posterior muscles of the leg & back fire before the anterior deltoid when it comes to reaching
-step

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19
Q

autonomic postural responses

A

corrective postural response or protective postural response

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20
Q

What is needed to initiate a voluntary step?

A
  • an APA is needed
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21
Q

Step initiation in older adults

A
  1. increased reaction time
  2. greater difference (increaase) in weight transfer time in older vs younger adults
  3. directional differences
  4. greater weight transfer time poses a greater challenge to rapid stepping than reaction time alone
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22
Q

Over-simplified view of the hierarchy of postural responses

A
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23
Q

corrective vs protective change is BOS strategy

A

corrective: not changing BOS
Protective: BOS changes

24
Q

Older adults step more than younger adults

A

-older adults (fallers) step at lower perturbation and take multiple steps

25
Q

Pardoxically, older adults very step very fast

A

liftoff times in OA are as fast (nonfallers) or faster (fallers) than YA following external mechanical perturbation

26
Q

what makes older adults step faster?

A

-theres no APA when you get pulled off balance

27
Q

how is the faster step moving differently?

A

-move steps higher frequency at termination because stance is not stable at termination

28
Q

Older Adult fallers’ stepping responses are different

A

Fallers: lateral foot placement

non-fallers/young adults: medial foot placement

29
Q

lateral stepping in response to lateral perturbation (younger adults)

A

-lateral step with direction of perturbation

30
Q

lateral stepping in response to lateral perturbation (older adults)

A
  • cross over step (B)
  • medial step with contralateral (unloaded side first)
  • more common in OA w/ history of falls
31
Q

Lateral Stepping in Response to Perturbation (summary)

A

When pulled, a side-step is more common in younger adults. But a
crossover step can happen without incident. Older adults often use a
crossover step but there is an increase in limb collision during a crossover
step. This increases the likelihood of falling. Older adult fallers tend
towards a medial step with the unloaded LE first. This usually means that
multiple steps are needed to regain balance and the older adult may be
unstable at step termination.

32
Q

Posterior stepping tresholds

A
  • older adults who reported a fall had significantly reduced posterior stepping force thresholds
  • at home falls (fallers) were associated with reduced posterior and lateral force thresholds
33
Q

automatic postural responses (protective stepping) summary

A

Protective stepping is different in older adults

  • initiate a protective step as fast or faster than younger adults
  • take multiple steps
  • more laterally-directed steps when pulled forward
  • latter issues more likely to occur in older adults who have a history of falling
  • cross-over or medial step (with unloaded leg) for lateral perturbations in older adults. the medial then lateral step seems to be used a lot by older persons who fall
34
Q

visual changes in older adult

A

reduced acuity, contrast sensitivity, depth perception, dark adaptation

35
Q

vestibular changes in older adult

A

-progressive loss of labyrinthine hair cells, vestibular ganglion cells, and nerve fibers

36
Q

somato-sensation changes in older adulthood

A

reduced propioception, touch sensitivity, two-point discrimination, and vibration sense

37
Q

fancy way to challenge balance by altering sensory orientation/use

A

sway-referencing

-forcing the vestibular system to be tested

38
Q

Postural sway by “sensory” condition

A
39
Q

Effectors (neuromusculoskeletal machinery) age associated changes

A
  • unlikely that typical-age related changes in the effector system will immobilize a person
  • Effector changes: strength decline, tissue property of tendons and ligaments, mass distribution, body posture due to skeletal changes, muscle properties like fatigability

-effector changes may influence distance traveled, time it takes to travel, and types of terrains that can be traveled

40
Q

safe walking speed is

A

1.2 m/s

41
Q

walking speed you need to get across a busy street safely

A

1.2-1.4 m/s

42
Q

older adults have ___ gait speed

A

decreased

43
Q

older adults tend to have ___ stride lengths and ___ time in double limb supprt

A
  • shorter stride lengths

- increased time in double-leg support

44
Q

kinematics and kinetics of older adult (gait)

A
  1. generally less ROM at pelvis, hip, knee ankle
    *2. PF less power (PF push off problem)
    *3. Less hip extension is particularly common
    - later part of stance phase –> less push off –> reduced propulsive power –>
    slower gait
45
Q

comfortable gait speed 60-69

A

1.24m/s

46
Q

comfortable gait speed 70-79

A

1.25m/s

47
Q

comfortable gait speed 80-89

A

0.82 m/s

48
Q

comfortable gait speed 90-101

A

0.71m/s

49
Q

older adults have more ___ head movement (less rhythmical) especially over irregular terrain

A

more variable head movement

50
Q

Stride width tends to be __ in older adults

A
  • greater
  • variability is also greater
  • too much or too litle step-wish variability is associated with falls; association doesn’t exist for older adults who walked <1 m/s
51
Q

stride to stride variability may be due to

A

choosing a more cautious gait

  • slower walking is associated with greater variability anyway (regardless of age)
  • age associated changes in variability may be accounted for by loss of strength or ROM. Thus, the problem may be due to a loss of something rather than simply due to aging
52
Q

stability during self-imposed (internal) perturbations: head turning while walking

A

older adults may limit isolated movmeent of the head suggesting a modified motor pattern for head turning

53
Q

older adults require __ to regain balance during perturbed walking, yet:

A

more steps
-older adults are capable of reactively adapting their gait to improve their stability following repeated gait perturbations (similar to Younger adults)

54
Q

which is more critical for balance recovery during walking: rate of torque development or available strength

A

rate of torque production; however, magnitude and rate of development of muscle activity in older adults is lower than younger adults

55
Q

Selecting an avoidance strategy

A
  • is well preserved
  • younger adults transition from going over to going around
  • older adults more variable, and given the choice, tend to go around instead of over
56
Q

older adults have greater difficulty modulating step length to an environmental cue when the cue is given within one step duration ahead

A

may be harder to shorten step than lengthen step for older adults

57
Q

Dual task increases ___

A

obstacle contact

Lifespan Development (12 decks)

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