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Age-related Differences in Ankle-joint Proprioception and Postural Balance in Women: Proprioception of Force Versus Position

  • Kim, Seo-hyun (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Yi, Chung-hwi (Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University) ;
  • Lim, Jin-seok (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Lim, One-bin (Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University)
  • Received : 2022.01.17
  • Accepted : 2022.02.24
  • Published : 2022.05.20

Abstract

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

Keywords

Acknowledgement

This work was supported by the National Research Fondation of Korea (NRF) grant funded by the Korea goverment (MSIT) (No.2021R1F1A104792911).

References

  1. Burns ER, Stevens JA, Lee R. The direct costs of fatal and nonfatal falls among older adults - United States. J Safety Res 2016;58:99-103. https://doi.org/10.1016/j.jsr.2016.05.001
  2. Mahoney JE. Immobility and falls. Clin Geriatr Med 1998;14(4):699-726. https://doi.org/10.1016/S0749-0690(18)30087-9
  3. Centers for Disease Control and Prevention (CDC). Fatalities and injuries from falls among older adults--United States, 1993-2003 and 2001-2005. MMWR Morb Mortal Wkly Rep 2006;55(45):1221-4. Erratum in: MMWR Morb Mortal Wkly Rep 2006;55(48):1303.
  4. Melzer I, Kurz I, Oddsson LI. A retrospective analysis of balance control parameters in elderly fallers and non-fallers. Clin Biomech (Bristol, Avon) 2010;25(10):984-8. https://doi.org/10.1016/j.clinbiomech.2010.07.007
  5. Johansson J, Nordstrom A, Gustafson Y, Westling G, Nordstrom P. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age Ageing 2017;46(6):964-70. https://doi.org/10.1093/ageing/afx083
  6. Sattin RW. Falls among older persons: a public health perspective. Annu Rev Public Health 1992;13:489-508. https://doi.org/10.1146/annurev.pu.13.050192.002421
  7. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010;21(5):658-68. https://doi.org/10.1097/EDE.0b013e3181e89905
  8. Cho CY, Kamen G. Detecting balance deficits in frequent fallers using clinical and quantitative evaluation tools. J Am Geriatr Soc 1998;46(4):426-30. https://doi.org/10.1111/j.1532-5415.1998.tb02461.x
  9. Aoyagi K, Ross PD, Davis JW, Wasnich RD, Hayashi T, Takemoto T. Falls among community-dwelling elderly in Japan. J Bone Miner Res 1998;13(9):1468-74. https://doi.org/10.1359/jbmr.1998.13.9.1468
  10. Johansson R, Magnusson M. Human postural dynamics. Crit Rev Biomed Eng 1991;18(6):413-37.
  11. Fitzpatrick R, McCloskey DI. Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. J Physiol 1994;478(Pt 1):173-86. https://doi.org/10.1113/jphysiol.1994.sp020240
  12. Fitzpatrick R, Burke D, Gandevia SC. Task-dependent reflex responses and movement illusions evoked by galvanic vestibular stimulation in standing humans. J Physiol 1994;478(Pt 2):363-72. https://doi.org/10.1113/jphysiol.1994.sp020257
  13. Goble DJ, Coxon JP, Wenderoth N, Van Impe A, Swinnen SP. Proprioceptive sensibility in the elderly: degeneration, functional consequences and plastic-adaptive processes. Neurosci Biobehav Rev 2009;33(3):271-8. https://doi.org/10.1016/j.neubiorev.2008.08.012
  14. Wiesmeier IK, Dalin D, Maurer C. Elderly use proprioception rather than visual and vestibular cues for postural motor control. Front Aging Neurosci 2015;7:97.
  15. Lord SR, Rogers MW, Howland A, Fitzpatrick R. Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc 1999;47(9):1077-81. https://doi.org/10.1111/j.1532-5415.1999.tb05230.x
  16. Chen X, Qu X. Age-related differences in the relationships between lower-limb joint proprioception and postural balance. Hum Factors 2019;61(5):702-11. https://doi.org/10.1177/0018720818795064
  17. Craig CE, Goble DJ, Doumas M. Proprioceptive acuity predicts muscle co-contraction of the tibialis anterior and gastrocnemius medialis in older adults' dynamic postural control. Neuroscience 2016;322:251-61. https://doi.org/10.1016/j.neuroscience.2016.02.036
  18. Suetterlin KJ, Sayer AA. Proprioception: where are we now? A commentary on clinical assessment, changes across the life course, functional implications and future interventions. Age Ageing 2014;43(3):313-8. https://doi.org/10.1093/ageing/aft174
  19. Kim S, Lee K, Lim O, Yi C. The effects of augmented somatosensory feedback on postural sway and muscle co-contraction in different sensory conditions. Phys Ther Korea 2020;27(2):126-32. https://doi.org/10.12674/ptk.2020.27.2.126
  20. Robbins S, Waked E, McClaran J. Proprioception and stability: foot position awareness as a function of age and footwear. Age Ageing 1995;24(1):67-72. https://doi.org/10.1093/ageing/24.1.67
  21. Thelen DG, Brockmiller C, Ashton-Miller JA, Schultz AB, Alexander NB. Thresholds for sensing foot dorsi- and plantarflexion during upright stance: effects of age and velocity. J Gerontol A Biol Sci Med Sci 1998;53(1):M33-8.
  22. Siong KH, Kwan MM, Lord SR, Lam AK, Tsang WW, Cheong AM. Fall risk in Chinese community-dwelling older adults: a physiological profile assessment study. Geriatr Gerontol Int 2016;16(2):259-65. https://doi.org/10.1111/ggi.12463
  23. Ribeiro F, Oliveira J. Aging effects on joint proprioception: the role of physical activity in proprioception preservation. Eur Rev Aging Phys Act 2007;4:71-6. https://doi.org/10.1007/s11556-007-0026-x
  24. Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med 2008;27(3):353-70, vii. https://doi.org/10.1016/j.csm.2008.03.006
  25. Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Train 2002;37(1):80-4.
  26. Bernier JN, Perrin DH. Effect of coordination training on proprioception of the functionally unstable ankle. J Orthop Sports Phys Ther 1998;27(4):264-75. https://doi.org/10.2519/jospt.1998.27.4.264
  27. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train 2002;37(1):71-9.
  28. Jerosch J, Prymka M. Proprioception and joint stability. Knee Surg Sports Traumatol Arthrosc 1996;4(3):171-9. https://doi.org/10.1007/BF01577413
  29. Kim CY, Choi JD, Kim HD. No correlation between joint position sense and force sense for measuring ankle proprioception in subjects with healthy and functional ankle instability. Clin Biomech (Bristol, Avon) 2014;29(9):977-83. https://doi.org/10.1016/j.clinbiomech.2014.08.017
  30. Garcia LC, Alcantara CC, Santos GL, Moncao JVA, Russo TL. Cryotherapy reduces muscle spasticity but does not affect proprioception in ischemic stroke: a randomized sham-controlled crossover study. Am J Phys Med Rehabil 2019;98(1):51-7. https://doi.org/10.1097/PHM.0000000000001024
  31. Hijmans JM, Geertzen JH, Dijkstra PU, Postema K. A systematic review of the effects of shoes and other ankle or foot appliances on balance in older people and people with peripheral nervous system disorders. Gait Posture 2007;25(2):316-23. https://doi.org/10.1016/j.gaitpost.2006.03.010
  32. You SH. Joint position sense in elderly fallers: a preliminary investigation of the validity and reliability of the SENSERite measure. Arch Phys Med Rehabil 2005;86(2):346-52. https://doi.org/10.1016/j.apmr.2004.01.035
  33. Deshpande N, Simonsick E, Metter EJ, Ko S, Ferrucci L, Studenski S. Ankle proprioceptive acuity is associated with objective as well as self-report measures of balance, mobility, and physical function. Age (Dordr) 2016;38(3):53. https://doi.org/10.1007/s11357-016-9918-x
  34. Song Q, Zhang X, Mao M, Sun W, Zhang C, Chen Y, et al. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. J Sport Health Sci 2021;10(5):585-93. https://doi.org/10.1016/j.jshs.2021.07.005
  35. Henry M, Baudry S. Age-related changes in leg proprioception: implications for postural control. J Neurophysiol 2019;122(2):525-38. https://doi.org/10.1152/jn.00067.2019
  36. Di Giulio I, Maganaris CN, Baltzopoulos V, Loram ID. The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture. J Physiol 2009;587(Pt 10):2399-416. https://doi.org/10.1113/jphysiol.2009.168690
  37. Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans Biomed Eng 1996;43(9):956-66. https://doi.org/10.1109/10.532130
  38. Skelton DA. Effects of physical activity on postural stability. Age Ageing 2001;30 Suppl 4:33-9. https://doi.org/10.1093/ageing/30.suppl_4.33