Elsevier

Gait & Posture

Volume 80, July 2020, Pages 68-73
Gait & Posture

Full length article
Head orientation and gait stability in young adults, dancers and older adults

https://doi.org/10.1016/j.gaitpost.2020.05.035Get rights and content

Highlights

  • Older adults showed less stable gait and the shortest steps with greater variability.

  • Dancers weren`t more stable walking under head orientation changes than young adults.

  • Yaw head motion made gait more unstable than control, up and down gaze all in groups.

Abstract

Background

Control of body orientation requires head motion detection by the vestibular system and small changes with respect to the gravitational acceleration vector could cause destabilization.

Research question

We aimed to compare the effects of different head orientations on gait stability in young adults, dancers and older adults.

Methods

Three groups of 10 subjects were evaluated, the first composed of young adults (aged 18–30 years), the second composed of young healthy dancers under high performance dance training (aged 18–30 years), and the third group composed of community-dwelling older adults (aged 65–80 years). Participants walked on a treadmill at their preferred speed in four distinct head orientation conditions for four minutes each: control (neutral orientation); dynamic yaw (following a target over 45° bilaterally); up (15° neck extension), and down (40° neck flexion). Foot and trunk kinematic data were acquired using a 3D motion capture system and the gait pattern was assessed by basic gait parameters (step length, stride width and corresponding variability) and gait stability (local divergence exponents and margins of stability). Main effects of conditions and groups, as well as their interaction effects, were evaluated by repeated-measures analysis of variance.

Results

Interactions of group and head orientation were found for both step length and stride width variability; main effects of head orientation were found for all evaluated parameters and main effects of group were found for step length and its variability and local divergence exponents in all directions.

Significance

As expected, the older adults group showed less stable gait (higher local divergence exponent), the shortest step length and greater step length variability. However, contrary to expectation, the dancers were not more stable. The yaw condition was the most challenging for all groups and the down condition seemed to be least challenging.

Introduction

During gait, the human body exhibits inverted pendulum like characteristics, so that minor changes in body orientation with respect to the gravitational acceleration vector can cause destabilization. Gait stability has been defined as the ability to maintain a stable walking, defined as a walking pattern that does not lead to falls despite such perturbations [[1], [2], [3]]. Since intrinsic or environmental perturbations are always present, the neuromuscular system must counteract these perturbations to maintain a stable gait pattern.

To control upright posture, humans rely on multimodal integration of sensory information [[4], [5], [6]]. The vestibular system likely contributes to this control by monitoring body orientation with respect to gravity through detection of motion of the head-in-space [7]. During normal walking, we actively dissociate our head movement from trunk movement [8], and use a head-in-space stabilization strategy [[9], [10], [11]], presumably to provide a reliable reference for vestibular and visual information. In daily life, we frequently change head orientation, for instance when performing a visual search during walking, when preparing to cross a street, or when shopping to look for a product in the supermarket or the store windows. In addition, many dual tasks in daily life constrain head orientation, for example when we are speaking on the phone or reading from a screen while walking.

It has been reported that older adults exhibit lower head and pelvis accelerations than young adults [12] demonstrating differences in the way they control head motion to achieve head stabilization during locomotion [[12], [13], [14]]. Besides, aging of the vestibular system may impair the ability to detect changes in head acceleration [15]. This would suggest that gait stability in older adults may be differently affected by changes in head orientation than in young adults.

Specific training may also affect the use of sensory information for balance control and hence the effect of head movement on gait stability. For example, dancers have been shown to differ from non-trained subjects in terms of sensory use for balance control [16]. Dance training imposes high balance demands while whole-body movements are synchronized to external events such as musical beats and visual cues [17]. Furthermore, dance training has been shown to cause changes in responses to vestibular input, such as suppressed nystagmus after repetitive stimuli, suppression of the vestibulo-ocular reflex, and an increased resistance to vertigo. These effects have been associated with structural brain adaptations [[18], [19], [20], [21]]. This suggests that the gait stability in dancers might be less affected by changes in head orientation than in non-trained controls and that dance training could help to improve treatment for chronic dizziness.

A 6-months dance training was shown to increase local dynamic stability in older adults [22]. If interactions of head movement and orientation with age and dance training are confirmed, our results would indicate the potential of dance training to counter age-related problems to maintain gait stability with constrained head orientation or while moving the head.

The aim of this study was to compare the effects of different head orientations on gait stability between young adults, young adult dancers and older adults. Considering the motor and sensory deterioration associated with aging [23], we hypothesized that the older adults would be less stable and more affected by changes in head orientation. Since dancers have been shown to have better postural control compared to non-trained young subjects [24], we hypothesized that the dancers would present a better gait stability and would be less affected by changes in head orientation.

Section snippets

Subjects

Three groups of 10 participants were enrolled in the study: 1) 10 healthy and active young adults aged between 18 and 30 years (24.8 ± 2.39 years; 67.42 ± 16.05 kg; 1.71 ± 0.11 m (mean ± sd)) recruited from the university community; 2) 10 dancers, aged between 18 and 30 years (23.8 ± 3.19 years; 62.7 ± 13.87 kg; 1.68 ± 0.08 m), who engaged in regular high performance training of both ballet and other contemporary dance with an average experience of 7.2 ± 3.67 years and daily dance training of

Results

The PWS differed between the groups (F(2,27) = 6.26; p = 0.006; η2 = 0.317). The young adults walked significantly faster (1.33 ± 0.14 m/s) than the old adults (1.05 ± 0.12 m/s) (p < 0.01). The dancers showed PWS of 1.24 ± 0.24 m/s, which was not significantly different from the two other groups.

Discussion

The aim of this study was to compare the effects of different head orientations on gait stability between young adults, young dancers and older adults. The head orientation conditions and groups showed only small differences in gait characteristics analyzed. The older adults showed a less stable gait pattern and shorter steps than young adults and dancers. Surprisingly, the dancers were not more stable than the young adults.

As expected, the older adults evaluated in this study exhibited lower

Conclusions

The different head orientations slightly affected the gait pattern of all groups, where the “yaw” condition was the most challenging and the “down” condition was the least challenging for gait stability. Older adults were less stable and adopted a smaller step length, but with greater variability,but they were similarly affected by changes in head orientation as young adults. Dancers did not show a more stable response to head orientations changes than young controls, suggesting that dance

Declaration of Competing Interest

The authors have no conflict of interest to declare.

Acknowledgements

The authors are grateful to Brazilian government agencies CAPES and CNPq. RMM was funded by CAPES (PDSE 19/2016). SMB was funded by a VIDI grant (016.Vidi.178.014) from the Dutch Organisation for Scientific Research (NWO).

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