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Height-induced postural threat influences standing balance control. However, it is unknown if minimizing individuals’ emotional response to threat moderates this relationship. This study repeatedly exposed individuals to height-induced postural threat to determine if reducing the emotional response to threat influences standing balance control. Sixty-eight young adults completed a series of standing trials at LOW (0.8 m above ground, away from edge) and HIGH (3.2 m above ground, at edge) postural threat conditions. Emotional state was assessed using self-report and electrodermal measures. Standing balance was assessed through analysis of centre of pressure (COP) movement and lower leg electromyographic activity. Individuals’ emotional response to threat was attenuated following repeated threat exposure. However, threat-induced changes in standing balance were largely preserved. When initially threatened, individuals leaned backward and demonstrated smaller amplitude and higher frequency of COP adjustments; these balance outcomes did not change following repeated threat exposure. Only high frequency COP oscillations (>1.8 Hz) and ankle muscle co-contraction showed any adaptation; regression analyses showed that these behavioural adaptations were accounted for by a combination of emotional and cognitive state changes. This suggests that some threat-induced standing balance changes are more closely linked with the emotional response to threat than others, and are therefore amendable to intervention.

Humans exhibit changes in postural control when confronted with threats to stability. This study used a prolonged threat exposure protocol to manipulate emotional state within a threatening context to determine if any threat-induced standing behaviours are employed independent of emotional state. Retention of balance adaptations was also explored. Thirty-seven adults completed a series of 90-s standing trials at two surface heights (LOW: 0.8 m above ground, away from edge; HIGH: 3.2 m above ground, at edge) on two visits 2–4 weeks apart. Psychological and autonomic state was assessed using self-report and electrodermal measures. Balance control was assessed using centre of pressure (COP) and lower limb electromyographic recordings. Upon initial threat exposure, individuals leaned backward, reduced low-frequency centre of pressure (COP) power, and increased high-frequency COP power and plantar/dorsiflexor coactivation. Following repeated exposure, the psychological and autonomic response to threat was substantially reduced, yet only high-frequency COP power and plantar/dorsiflexor coactivation habituated. Upon re-exposure after 2–4 weeks, there was partial recovery of the emotional response to threat and few standing balance adaptations were retained. This study suggests that some threat-induced standing behaviours are coupled with the psychological and autonomic state changes induced by threat, while others may reflect context-appropriate adaptations resistant to habituation.

Introduction: The ability to scale anticipatory postural adjustments (APAs) according to the predicted size of the upcoming movement is reduced with aging. While age-related changes in central set may be one reason for this effect, an individual's emotional state might also contribute to changes in anticipatory postural control. Therefore, the purpose of this study was to determine whether an altered emotional state, as elicited through postural threat, alters the scaling of APAs during a handle pull movement in young and older adults. It was hypothesized that the presence of postural threat would lead to more homogenous APAs (i.e., less scaling of APAs) across a range of pulling forces.Methods: Young (n=23) and older adults (n=16) stood on top of a force plate that was mounted to a motorized platform. From this position, participants performed a series of handle pull trials without (no threat) or with (threat) the possibility of receiving a postural perturbation in the form of an unpredictable surface translation. Handle pulls were performed at force levels between 50% and 90% of maximum force. For each trial, the magnitude and timing of the APA were quantified from center of pressure (COP) recordings as well as electromyographic (EMG) activity of the soleus and medial gastrocnemius. The scaling of APAs with respect to force exertion was then determined through regression analyses and by comparing APAs during pulls of lower versus higher force.Results and Discussion: As evidenced by their smaller slope of the regression line between various dependent measures (i.e., COP velocity, soleus EMG onset latency, and soleus EMG amplitude) and the pulled forces, older adults demonstrated less scaling of APAs than the young. However, increases in arousal, anxiety and fear of falling due to postural threat, only minimally altered the scaling of APAs. Regardless of age, the slope of the regressions for none of the measures were affected by threat while only the soleus and medial gastrocnemius EMG onsets demonstrated significant force x threat interaction effects. These results suggest that the decreased ability to scale APAs with aging is unlikely to be due to changes in emotional state.

This study investigated the influence of fear of falling or postural threat on the control of posture and movement during a voluntary rise to toes task for 12 healthy young adults. Postural threat was modified through alterations to the surface height at which individuals stood (low or high platform) and changes in step restriction (away from or at the edge of the platform) creating four levels of postural threat: LOW AWAY, LOW EDGE, HIGH AWAY and HIGH EDGE. To rise to the toes, an initial postural adjustment must destabilise the body so that it can be moved forward and elevated to a new position of support over the toes. Centre of pressure and centre of mass profiles, as well as tibialis anterior (TA), soleus (SO) and gastrocnemius (GA) muscle activity patterns were used to describe this behaviour. The results showed that the performance of the rise to toes task was significantly modified when positioned at the edge of the high platform. In this situation, the central nervous system reduced the magnitude and rate of the postural adjustments and subsequent voluntary movement. Although the duration of the movement was lengthened for this most threatening condition, the sequencing and relative timing of TA, SO and GA muscle activity was preserved. These changes in rise to toes behaviour were accompanied by evidence of increased physiological arousal and participant reports of decreased confidence, increased anxiety and decreased stability. Evidence of fear of falling effects on anticipatory postural control is clinically relevant as it may explain deficits in this control observed in individuals with balance disorders. For example, individuals with Parkinson's disease or cerebellar dysfunction demonstrate impaired performance on the rise to toes task as reflected in alterations of both the timing and magnitude of their anticipatory postural adjustments. Our findings suggest alterations in the magnitude of postural adjustments may be magnified by fear of falling while changes in the timing of postural adjustments may reflect underlying pathology.

Individuals report directing attention toward and away from multiple sources when standing under height-related postural threat, and these changes in attention focus are associated with postural control modifications. As it is unknown whether these changes generalize to other types of threat situations, this study aimed to quantify changes in attention focus and examine their relationship with postural control changes in response to a direct threat to stability. Eighty young adults stood on a force plate fixed to a translating platform. Three postural threat conditions were created by altering the expectation of, and prior experience with, a postural perturbation: no threat of perturbation, threat without perturbation experience, and threat with perturbation experience. When threatened, participants were more anxious and reported directing more attention to movement processes, threat-related stimuli, and self-regulatory strategies, and less to task-irrelevant information. Postural sway amplitude and frequency increased with threat, with greater increases in frequency and smaller increases in amplitude observed with experience. Without experience, threat-related changes in postural control were accounted for by changes in anxiety; larger changes in anxiety were related to larger changes in sway amplitude. With experience, threat-related postural control changes were accounted for by changes in attention focus; increases in attention to movement processes were related to greater forward leaning and increases in sway amplitude, while increases in attention to self-regulatory strategies were related to greater increases in sway frequency. Results suggest that relationships between threat-related changes in anxiety, attention focus, and postural control depend on the context associated with the threat.

Purpose This study examined whether spinal excitability, as measured by the soleus Hoffmann reflex (H-reflex), is scaled to the difficulty level of the dual-task being performed. Methods Twenty-two participants completed a combination of three balance task and three secondary cognitive (visuo-motor) task difficulty levels for a total of nine dual-task conditions. An additional eight participants were tested while performing the same three balance task difficulty levels on its own (i.e., single-tasking). The balance task required participants to maintain their balance on a fixed or rotating stabilometer while the visuo-motor task required participants to respond to moving targets presented on a monitor. Throughout each single- and dual-task trial, H-reflexes were elicited from the soleus. Results Although dual-task performance, as quantified by visuo-motor task accuracy as well as the root mean square of the stabilometer position and velocity, decreased by 10–34% with increasing dual-task difficulty ( p  < 0.05), no changes in the soleus H-reflex amplitude were observed between dual-task conditions ( p  = 0.483–0.758). This contrasts to when participants performed the balance task as a single-task, where the H-reflex amplitude decreased by ~25% from the easy to the hard balance task difficulty level ( p  = 0.037). Conclusions In contrast to the commonly reported finding of a reduced soleus H-reflex amplitude when individuals perform a less posturally stable task by itself, the results indicate that spinal excitability is not modulated as a function of dual-task difficulty. It is possible that when an individual’s attentional resource capacity is exceeded during dual-tasking, they become ineffective in regulating spinal excitability for balance control.

This study investigated the effects of postural set on the cortical response evoked by an external perturbation to human upright stance. Postural set was manipulated by providing either predictable or unpredictable whole body perturbations which required balance corrections to maintain upright stability. Unpredictable perturbations evoked a large negative potential (e.g., CZ: -19.9+/-5.1 microV) that was similar in timing (e.g., CZ: 98.9+/-5.5 ms) and shape to that reported in previous studies. This large negative potential was not discernable for perturbations with predictable onset timing and direction in spite of the presence of significant compensatory balance reactions. Importantly, when a surprise perturbation was presented following a series of predictable perturbations, the large negative potential occurred on this trial even though subjects expected a predictable stimulus onset. This suggests that the large negative potential was dependent on a dissociation between expected and actual stimuli rather than on a tonic central state defined by task conditions. These results suggest that cortical events may be linked to error detection that is independent of sensory or motor events associated with evoked balance reactions.

This study investigated the effects of altering the base of support (BOS) at the turn point on anticipatory locomotor adjustments during voluntary changes in travel direction in healthy young and older adults. Participants were required to walk at their preferred pace along a 3-m straight travel path and continue to walk straight ahead or turn 40° to the left or right for an additional 2-m. The starting foot and occasionally the gait starting point were adjusted so that participants had to execute the turn using a cross-over step with a narrow BOS or a lead-out step with a wide BOS. Spatial and temporal gait variables, magnitudes of angular segmental movement, and timing and sequencing of body segment reorientation were similar despite executing the turn with a narrow or wide BOS. A narrow BOS during turning generated an increased step width in the step prior to the turn for both young and older adults. Age-related changes when turning included reduced step velocity and step length for older compared to young adults. Age-related changes in the timing and sequencing of body segment reorientation prior to the turn point were also observed. A reduction in walking speed and an increase in step width just prior to the turn, combined with a delay in motion of the center of mass suggests that older adults used a more cautious combined foot placement and hip strategy to execute changes in travel direction compared to young adults. The results of this study provide insight into mobility constraints during a common locomotor task in older adults.

Objectives: Our aim was to track improvements in postural control during recovery from an acute unilateral peripheral vestibular deficit (UVL), presumably due to vestibular neuritis, and to determine if recovery rates were different for stance and gait tasks. Postural control was quantified using simple measurements of trunk sway: amplitudes of trunk sway angle and angular velocity, in the roll and pitch directions as well as task duration, were examined for a battery of stance and gait tasks. These measures were collected at the onset of the deficit and then 3 weeks and 3 months later. Study Design: A repeated-measures design was used for UVL subjects and age-matched healthy controls. Stance tasks involved standing on 1 or 2 legs with eyes open or closed. Gait tasks consisted of tandem gait, walking normally with eyes closed, or with the head rotating or head pitching, walking up and down stairs and walking over a series of low barriers. Stance and tandem gait tasks were repeated using a foam support surface instead of a normal floor. Patients: Twenty-eight patients with acute UVL were examined. Main Outcome Measures: The range of trunk sway angular displacement and angular velocity in the pitch and roll directions was measured for each task in addition to task duration. The measures were compared with those of normal subjects. Results: The amplitudes of pitch trunk sway for 2-legged stance tasks with eyes closed underwent the greatest reduction 3 weeks after UVL onset. At 3 months, trunk sway was almost normal for all 2-legged stance tasks. One-legged stance tasks with eyes open showed a similar but slower improvement. Stance time without a fall showed a very rapid improvement for 1-legged tasks but was still shorter than that of normal subjects at 3 months. Trunk sway for the simple gait tasks was within normal range at 3 months; however, task duration was still longer than normal. More complex gait tasks, such as walking 8 tandem steps on foam or walking up and down stairs, showed no improvement in trunk roll sway at 3 months. A mix of variables from mainly gait tasks best identified a balance deficit due to UVL, with complex gait tasks becoming more important for identification purposes as compensation progressed. The accuracy of UVL identification with durations alone was 75% of the accuracy with combined trunk sway and duration measures. Conclusions: These data suggest that recovery of normal trunk control during the compensation process for unilateral vestibular hypofunction is more rapid for stance tasks than gait tasks. Even at 3 months, trunk sway for complex gait tasks was not normal. Thus, trunk sway for gait tasks provides a better insight into remaining deficits in balance control of vestibular-loss patients than the sway of stance tasks.

Verbal feedback was used to alter balance efficacy to examine its effects on perceived and actual balance in young adults. Participants (N = 61) completed a stance task, were randomized to either a high or low balance efficacy or control group, and then completed the same task. The results showed that balance efficacy was manipulated as the low balance efficacy group had decreases in balance efficacy. Although verbal feedback did not alter balance efficacy in the high balance efficacy group, perceptions of stability increased for these participants. No changes in actual balance were found. The nature of verbal feedback may differentially influence balance-related cognitions during a challenging stance task in young adults. Une rétroaction verbale a été utilisée afin d'altérer l'efficacité de l'équilibre et d'examiner ses effets sur la perception de l'équilibre chez des jeunes adultes. Les participants (N = 61) ont complété une tâche de station debout, ont ensuite été assignés aléatoirement à un groupe d'efficacité de l'équilibre élevée, faible ou un groupe contrôle et ont complété la même tâche à nouveau. Les résultats ont montré que l'efficacité de l'équilibre était diminuée dans le groupe d'efficacité de l'équilibre faible. Même si la rétroaction verbale n'a pas altéré l'efficacité de l'équilibre dans le groupe d'efficacité de l'équilibre élevée, la perception de stabilité était plus élevée dans ce groupe. Aucun changement dans l'équilibre réel n'a été observé. La nature de la rétroaction verbale pourrait influencer les cognitions liées à l'équilibre durant une tâche de station debout exigeante chez les jeunes adultes.