Fear of falling alters anticipatory postural control during cued gait initiation
Ellmers, T; Maslivec, A; Young, W
Date: 12 May 2020
Journal
Neuroscience
Publisher
Elsevier
Publisher DOI
Abstract
Fear of falling can have a profound influence on anticipatory postural control during dynamic
balance tasks (e.g., rise-to-toes and leg-raise tasks), with fearful individuals typically exhibiting
postural adjustments of smaller magnitudes prior to movement onset. However, very little is
known about how fear of falling influences the ...
Fear of falling can have a profound influence on anticipatory postural control during dynamic
balance tasks (e.g., rise-to-toes and leg-raise tasks), with fearful individuals typically exhibiting
postural adjustments of smaller magnitudes prior to movement onset. However, very little is
known about how fear of falling influences the generation of anticipatory postural adjustments
(APAs) during gait initiation; a task in which producing smaller APAs may compromise
stability. Sixteen young adults initiated gait as fast as possible following an auditory cue during
two conditions: Baseline (ground level), and Threat (fear of falling induced via a platform
raised 1.1 metres). While the magnitude and duration of APAs did not change between
conditions, participants executed steps of shorter lengths during Threat. As APAs during gait
initiation are typically proportionate to the length of the first step, the APAs during Threat are
therefore disproportionately large (given the shorter step length). We suggest that such failure
to scale the APA to the magnitude of the motor output represents a fear-related
‘overcompensation’, whereby fearful participants sought to ensure that the APA was sufficient
for ensuring that their centre of mass was positioned above the support leg prior to gait
initiation. During conditions of threat, participants also exhibited greater postural sway prior
to initiating gait (i.e., following the auditory cue) and took longer to generate the APA (i.e.,
impaired reaction). As greater reaction times during voluntary stepping is consistently
associated with increased fall-risk, we suggest this as one mechanism through which fear of
falling may reduce balance safety.
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