Neuromuscular control of gait stability in older adults is adapted to environmental demands but not improved after standing balance training

Abstract

Balance training aims to improve balance and transfer acquired skills to real-life tasks and conditions. How older adults adapt gait control to different conditions, and whether these adaptations are altered by balance training remains unclear. We investigated adaptations in neuromuscular control of gait in twenty-two older adults (72.6 {+/-} 4.2 years) between normal (NW) and narrow-base walking (NBW), and the effects of a standing balance training program shown to enhance unipedal balance control in the same participants. At baseline, after one session and after 3-weeks of training, kinematics and EMG of NW and NBW on a treadmill were measured. Gait parameters and temporal activation profiles of five synergies extracted from 11 muscles were compared between time-points and gait conditions. No effects of balance training or interactions between training and walking condition on gait parameters or synergies were found. Trunk center of mass (CoM) displacement and velocity (vCoM), and the local divergence exponent (LDE), were lower in NBW compared to NW. For synergies associated with stance of the non-dominant leg and weight acceptance of the dominant leg, full width at half maximum (FWHM) of the activation profiles was smaller in NBW compared to NW. For the synergy associated with non-dominant heel strike, FWHM was greater in NBW compared to NW. The Center of Activation (CoA) of the activation profile associated with dominant leg stance occurred earlier in NBW compared to NW. CoAs of activation profile associated with non-dominant stance and non-dominant and dominant heel strikes were delayed in NBW compared to NW. The adaptations of synergies to NBW can be interpreted as related to a more cautious weight transfer to the new stance leg and enhanced control over CoM movement in the stance phase. However, control of mediolateral gait stability and these adaptations were not affected by balance training.