Age related adaptations in postural control after balance perturbations by simulating a ‘near fall’

The aim of this study is to gain insight into factors that indicate an improved postural control. Therefore adults aged between 20 and 90 will perform reaching tasks while at the same time a fall is simulated in a controlled virtual environment (CAREN). The fall will be simulated by applying either mechanical, visual or cognitive perturbations. The findings will be used to develop a virtual environment (VE) to evaluate balance recovery reactions.

Falls are one of the greatest concerns among the elderly, because the incidents are high and they lead to severe consequences. The extent of the problem will continue to expand as the number of older people is expected to increase dramatically over the next few decades. An important risk factor for falls in the elderly is an impaired postural control, which is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. A growing number of studies show the potential of video games incorporating training (exergames) to improve postural control. However, scarce evidence is available that these interventions actually contribute to a decrease in fall risk. Finding indicators for improved postural control are needed in order to be able to validate fall risk interventions. By studying age related postural adaptations to perturbations that challenge balance in a controlled environment like CAREN (Computer Assisted Rehabilitation Environment) insight into these indicators can be gained. Eventually these findings can be used for validating an exergaming training intervention in terms of reducing fall risk by improving postural control.
The main objective of the present study is to gain insight into factors that indicate an improved postural control by evaluating balance recovery (in terms of centre of mass (CoM) and centre of pressure (CoP)) of both young and older adults during a reaching task while exposed to perturbations of physical, visual or cognitive factors, causing a near fall.

Data from VICON (Motion capture system) and force plates will be collected during the experimental trials. The NRBT and the IPEQ will be completed before the experimental trials start.

Both young and older participants will perform multiple target-directed weight shifting movements, i.e. reaching tasks, in three simulated fall risk situations which are divided in three experiments. The experiments will be conducted in the CAREN (Computer Assisted Rehabilitation Environment) lab. In the first experiment mechanical perturbations will be created by sudden platform translations with different velocity profiles during the performance of multiple reaching tasks. In the second experiment visual surround manipulations will be applied by projecting optic flow patterns on a large screen in front of the subjects during the performance of multiple reaching tasks. In the third experiment participants will perform a continuous cognitive demanding dual task during the performance of multiple reaching tasks