Age-Related Changes in Postural Stability in Response to Varying Surface Instability in Young and Middle-Aged Adults

As individuals transition into middle age, subtle declines in postural control may occur due to gradual reductions in neuromuscular control. The current study aimed to examine the effect of age on bipedal postural control across three support surfaces with varying degrees of instability: a firm surface, a foam pad, and a multiaxial balance board. The effect of surface stability was also assessed. Postural accelerations were recorded using a tri-axial accelerometer placed over the lumbar spine (L5) in 24 young female adults (23.9 ± 5.3 years) and 24 middle-aged female adults (51.4 ± 5.9 years). Sample entropy (SampEn) was used to analyze the complexity of postural control by measuring the regularity of postural acceleration. The main results show significant age-related differences in the mediolateral and anteroposterior acceleration directions (p ≤ 0.012). Young adults exhibit more irregular fluctuations in postural acceleration (high SampEn), reflecting greater efficiency or automaticity in postural control compared to middle-aged adults. Increased surface instability also progressively decreases SampEn in the mediolateral direction (p < 0.001), reflecting less automaticity with increased instability. However, no interaction effects are observed. These findings imply that incorporating balance training on unstable surfaces might help middle-aged adults maintain postural control and prevent future falls.