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