Proprioceptive reliance on trunk muscles for maintaining postural stability decreases in older patients with sagittal imbalance

Tadashi Ito; Yoshihito Sakai; Keitaro Kawai; Kazunori Yamazaki; Hideshi Sugiura; Yoshifumi Morita

doi:10.1016/j.gaitpost.2023.06.022

Proprioceptive reliance on trunk muscles for maintaining postural stability decreases in older patients with sagittal imbalance

Gait Posture. 2023 Sep:105:1-5. doi: 10.1016/j.gaitpost.2023.06.022. Epub 2023 Jul 4.

Authors

Tadashi Ito¹, Yoshihito Sakai², Keitaro Kawai³, Kazunori Yamazaki⁴, Hideshi Sugiura⁵, Yoshifumi Morita³

Affiliations

¹ Three-Dimensional Motion Analysis Laboratory, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan; Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan. Electronic address: sanjigen@mikawa-aoitori.jp.
² Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.
³ Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan.
⁴ Institutional Research Center, Aichi Mizuho College, Nagoya City, Aichi Prefecture 467-0867, Japan.
⁵ Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan.

PMID: 37451033
DOI: 10.1016/j.gaitpost.2023.06.022

Abstract

Background: Control of postural adjustments requires tight regulation of the spinal alignments. Sagittal imbalance may cause balance impairment and proprioceptive decline in older adults. However, the evidence on the proprioceptive mechanisms is limited, although it is known that poor proprioceptive inputs may induce spinal deformities. Thus, this study aimed to measure proprioceptive control quantifiers in older adults with sagittal imbalance to clarify the characteristic postural adjustments during proprioceptive inputs.

Research question: What are the specific proprioceptive postural adjustments required to maintain balance in older adult patients with lumbar spondylosis?

Methods: This was a cross-sectional, observational study. The participants were classified according to the sagittal vertical axis (SVA) lengths with 50 mm as the cut-off value. The pressure displacement center was determined in 36 patients without sagittal imbalance and 68 patients with sagittal imbalance during an upright stance on a balance board with eyes closed. Vibratory stimulations of 27-272 Hz were applied to the gastrocnemius (GS) and lumbar multifidus (LM) muscles to measure the relative contributions and center of pressures of different relative proprioceptive weighting ratios (RPWs) used on postural adjustments.

Results: The RPWs of older adults with sagittal imbalance were higher than that in those without sagittal imbalance (56-100 Hz; p = 0.013). Logistic regression analysis showed that older patients with sagittal imbalance had a significant ankle proprioception control of advantage (odds ratio: 1.1, 95% confidence interval: 1.01-1.1, p = 0.012).

Significance: In older patients with sagittal imbalance, the reliance on hip strategy during balance control (RPW 56-100 Hz) decreases. A quantitative assessment of postural stability during proprioceptive inputs is crucial to identify dependence on proprioception signals, including postural strategy, in older patients with sagittal imbalance. Interventions to improve proprioception can improve the postural stability and strategy of older patients with sagittal imbalance.

Keywords: Ankle strategy; Hip strategy; Postural balance; Proprioception; Sagittal imbalance.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Ankle / physiology
Cross-Sectional Studies
Humans
Muscle, Skeletal / physiology
Postural Balance* / physiology
Proprioception* / physiology