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Updated: Apr 12, 2026

A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance

A Modified Lean and Release Technique to Emphasize Response Inhibition and Action Selection in Reactive Balance

Published on: March 19, 2020

Age-Related Associations between Reactive-Balance Stepping Responses, Self-Induced Stepping, and Gray-Matter Volume.

Inbal Paran¹, Moti Salti², Hadas Nachmani³

¹Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, inbalparan@gmail.com.

|April 10, 2026

Summary

Older adults show impaired balance control due to reduced gray matter volume in specific brain regions. Reactive stepping deficits link to prefrontal and cortical areas, while proactive stepping links to cerebellar regions, suggesting distinct neural bases.

Keywords:

Balance recovery Falls Older adults Proactive balance Structural MRI

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Area of Science:

Neuroscience
Biomechanics
Gerontology

Background:

Distinguishing age-related neural correlates of reactive and proactive balance control is crucial.
Reactive stepping involves rapid responses to instability, while proactive stepping requires anticipatory adjustments.
Understanding structural neural differences in balance control across age groups remains limited.

Purpose of the Study:

To investigate correlations between cortical and sub-cortical gray matter volume and reactive/proactive stepping responses in older and young adults.
To determine if reactive and proactive stepping exhibit distinct structural neural correlates (gray matter volume).

Main Methods:

Structural MRI brain scans were performed on 26 older and 9 young adults.
Reactive stepping kinematics and self-induced stepping variables were measured using motion capture and ground reaction forces.
Age-related differences and partial correlations between gray matter volume and stepping variables were analyzed.

Main Results:

Older adults exhibited age-related impairments in both reactive and proactive stepping, with significantly smaller gray matter volume across most brain regions (p≤0.003).
Reduced gray matter in prefrontal, cortical, putamen, and amygdala regions correlated with deficits in reactive stepping (longer recovery, lower thresholds).
Impaired self-induced (proactive) stepping (longer preparation/step durations) correlated with lower gray matter volume in precentral, cerebellar, and amygdala regions.

Conclusions:

Age-related reactive stepping deficits are linked to lower gray matter volume in prefrontal, cortical, putamen, and amygdala.
Age-related self-induced stepping impairments are associated with reduced gray matter in precentral, cerebellar, and amygdala.
Findings suggest distinct neural substrates for reactive and proactive balance control, warranting further research into potential interventions.