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Updated: Oct 20, 2025
A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance
Published on: March 19, 2020
Perturbation-based balance assessment: Examining reactive balance control in older adults with mild cognitive
Lakshmi N Kannan1, Tanvi S Bhatt1
1Department of Physical Therapy, The University of Illinois at Chicago, Chicago, Illinois, USA.
Background:
Older adults with mild cognitive impairment (OAwMCI) present subtle balance and gait deficits along with subjective memory decline. Although these presentations might not affect activities of daily living (ADLs), they attribute to a two-folded increase in falls. While changes occurring in volitional balance control during ADLs have been extensively examined among OAwMCI, reactive balance control, required to recover from external perturbations, has received little attention. Therefore, this study examined reactive balance control in OAwMCI compared to their healthy counterparts.
Methods:
Fifteen older adults with mild cognitive impairment (OAwMCI), fifteen cognitively intact older adults (CIOA) (>55 years), and fifteen young adults (18-30 years) were exposed to stance perturbations at three different intensities. Behavioral outcomes postural COM state stability, step length, step initiation, and step execution were computed.
Results:
Postural COM state stability was the lowest in OAwMCI compared to CIOA and young adults, and it deteriorated at higher perturbation intensities (P < 0.001). Step length was the lowest among OAwMCI and was significantly different from young adults (P < 0.001) but not from CIOA. Unlike OAwMCI, CIOA and young adults increased their step length at higher perturbation intensities (P < 0.001). OAwMCI showed longer recovery step initiation times and shorter execution times compared to CIOA and young adults at higher perturbation intensities (P < 0.001).
Conclusion:
OAwMCI exhibit exacerbated reactive instability and are unable to modulate their responses as the threat to balance control altered. Thus, they are at a significantly higher risk of falls than their healthy counterparts.
Insights
Older adults with mild cognitive impairment (OAwMCI) have poorer reactive balance control and are unable to adjust their responses to balance threats. This significantly increases their risk of falls compared to cognitively intact individuals.
Area of Science:
- Gerontology
- Neurology
- Biomechanics
Background:
- Older adults with mild cognitive impairment (OAwMCI) exhibit subtle balance and gait deficits, increasing fall risk.
- Reactive balance control, crucial for recovering from perturbations, is understudied in OAwMCI.
- This study investigates reactive balance control in OAwMCI compared to healthy controls.
Purpose of the Study:
- To examine reactive balance control in older adults with mild cognitive impairment (OAwMCI).
- To compare reactive balance control strategies between OAwMCI, cognitively intact older adults (CIOA), and young adults.
- To identify differences in postural stability and stepping responses to perturbations.
Main Methods:
- Participants included OAwMCI, CIOA, and young adults.
- Subjects experienced stance perturbations of varying intensities.
- Behavioral outcomes measured included postural COM stability, step length, and step initiation/execution times.
Main Results:
- OAwMCI demonstrated the lowest postural COM stability, which worsened with increased perturbation intensity.
- OAwMCI had shorter step lengths than young adults and did not modulate step length with perturbation intensity, unlike controls.
- OAwMCI exhibited longer recovery step initiation times and shorter execution times at higher intensities.
Conclusions:
- OAwMCI show impaired reactive balance control and fail to adapt responses to balance threats.
- These deficits place OAwMCI at a significantly higher risk of falls.
- Findings highlight the need for interventions targeting reactive balance in OAwMCI.
