Subjective stability perception is related to postural anxiety in older subjects |
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| Affiliation: | 1. Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK;2. Escuela de Fonoaudiologia, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago, Chile;3. Department of Exercise & Sport Science, International University of Health, Exercise and Sports, LUNEX University, Differdange, Luxembourg;1. Univeristy of Southern California, Los Angeles, California, United States;2. Children’s Hospital Los Angeles, Los Angeles, California, United States;1. Department of Physical Therapy & Athletic Training, PhD Program in Rehabilitation Sciences, College of Health & Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Ave., Boston, MA, United States;2. Natick Soldier Research Development and Engineering Center, 10 General Greene Ave., Natick, MA, United States;3. Department of Physical Therapy, 3 Solomont Way, Suite 5, University of Massachusetts Lowell, Lowell, MA, United States;1. Institute for Biomechanics, ETH Zürich, Switzerland;2. Zurich Bone and Joint Institute, Switzerland;3. Schulthess Klinik Zürich, Switzerland;1. Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Brazil;2. College of Kinesiology, University of Saskatchewan, Canada;3. School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil |
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| Abstract: | BackgroundUnder static conditions, the objective and subjective measures of postural stability correlate well. However, age-related changes in postural control and task-related anxiety may modify the relationship between these subjective and objective measures. Ultimately, patients’ symptoms represent subjective reports, thus understanding this relationship has clinical implications.AimsThis study investigates the relationship between subjective-objective measures of postural stability in dynamic conditions and whether this relationship is influenced by age or task-related anxiety.Methods50 healthy participants (aged 18–83 years) stood on a platform oscillating at variable amplitudes, with-without a fall-preventing harness to modulate task-related anxiety. Trunk sway path, hip velocity and foot lifts (objective measures) and subjective scores of instability and task-related anxiety were recorded.ResultsThe subjective perception of stability accurately matched objective body sway, following a logarithmic function profile (r2 = 0.72, p < 0.001). This function did not change significantly with age, harness or task presentation order. A strong relationship was observed between subjective measures of stability and task-related anxiety for all subjects (r = 0.81, p < 0.001). Task repetition reduced anxiety in the young, uncoupling anxiety changes from subjective instability, but not in the elderly who retained higher anxiety levels in line with subjective unsteadiness.DiscussionSubjects accurately rate their own instability during dynamic postural challenges, irrespective of age and actual fall risk. However, anxiety may selectively modulate the perception of instability in older subjects. The perception of stability relies upon the integration of sensory afferents but also recruits emotional-cognitive processes, particularly in older individuals. The use of a safety harness has no influence on subjective or objective postural stability. |
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| Keywords: | Postural control Older population Anxiety Perception Sway Balance |
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