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Lesley A Brown

Publications and source records attributed to Lesley A Brown.

11 recordsLinked to original sources
PubMed2006

The effect of anxiety on the regulation of upright standing among younger and older adults.

We tested the hypothesis that fall anxiety would differentially influence the regulation of upright standing among younger and among older adults. Fall anxiety was imposed by a manipulation of environmental context that increased the threat to postural control by introducing the potential for injurious consequences should a fall occur. Fifteen younger and 15 older adults participated in this study. Regardless of age, postural control was more conservative when fall anxiety increased, however, age did not affect how anxiety influenced the regulation of postural control. Our findings imply that the motor consequences of fall anxiety are no more pervasive for older adults than for younger adults, and that age does not alter the ability to accommodate to environmental demands that heighten fall anxiety.

Accidental Falls↗
PubMed2006

Parkinsonian deficits in sensory integration for postural control: temporal response to changes in visual input.

This study investigated the effect of Parkinson's disease (PD) on the time course for postural control following the removal and reinsertion of visual information. Twelve medicated PD patients (PD) and 12 age matched control (CTRL) subjects performed two 45-s quiet standing trials, during which visual feedback was available (0-15s), deprived (15-30s), and then restored (30-45s). The 45s test trial was divided into 5s time bins to compare the time-based effect of sensory reorganization during deprivation and reintegration. Results revealed an increase in Elliptical Sway Area (ESA) following visual deprivation for both groups; this increased ESA remained significantly higher than the baseline level for the duration of the deprivation period among PD patients and returned to baseline the level among CTRL. Despite elevated ESA at the end of visual deprivation among PD patients, neither group showed a change in ESA after visual information was restored. These results indicate a PD-associated deficit with the reorganization of sensory priorities for postural control, and may implicate the basal ganglia as being critical for integration of sensory information for postural control.

Aged↗
PubMed2006

Age-dependent differences in the time course of postural control during sensory perturbations.

BACKGROUND AND AIMS: With research demonstrating that older adults are more likely to sustain a loss of balance than younger adults, the need for an account of age-related differences in postural control is apparent. Several measures of balance reported in the literature have assessed balance using an average or summative measure over the course of a trial, typically lasting several seconds. One limitation related to these measures is the inability to assess the time-course of postural control occurring throughout the trial. To this end, the current investigation assessed the temporal changes in balance both as a function of age and sensory environment. METHODS: Postural control was assessed from 10 older adults (69.3+/-4.7 years) and 10 younger adults (22.1+/-1.7 years) over the course of fifteen seconds in three different sensory environments. The sensory manipulations involved sway-referenced rotation of the floor and/or the visual surround. RESULTS: Significant differences (p=0.001) in overall postural stability were observed between the two groups on all three sensory conditions. Additionally, time-course changes were observed between the two groups when the environment did not cause sensory conflict (sway-referenced floor or room only). However, when the environment created a situation of sensory conflict (sway-referenced floor and room) both groups followed the same time-course of postural changes. CONCLUSIONS: Interestingly, the time course of postural control for the older adults on the easiest condition was mimicked by the younger adults on a more challenging condition. However, when faced with sensory conflict there were no group differences in the time course of postural control. The findings suggest an age-related decline in the temporal control of posture in altered sensory environments.

Accidental Falls↗
PubMed2006

Motor deficits in Parkinsonian reaching: dopa-sensitivity influenced by real-world task constraint.

Parkinson's disease (PD) patients can perform many daily activities, but movement deficits are evident. Those deficits may be increased when the required movement is constrained in accuracy. Variable improvements in performance with PD medication have been demonstrated, and sensitivity to task constraint has been evident in some studies. The authors quantified both specific movement deficits and improvements for PD patients in a reaching task. PD patients (N=8) both on and off medication showed a need for greater ongoing control in movements with higher task-accuracy constraints. Increased task-accuracy constraints further compromised movement timing and structure among PD patients who were off medication, suggesting that unmedicated PD patients may typically compensate by using more conscious control of movement, resulting in increased slowing and segmentation of components when higher task accuracy is required.

Activities of Daily Living↗
PubMed2005

Age-dependent differences in the attentional demands of obstacle negotiation.

BACKGROUND: Although the attention directed to gait does increase as an impending obstacle nears, it remains unclear whether the allocation of attentional resources differs between the precrossing phase of obstacle negotiation and the crossing phase of this task. This study compared the attentional demands associated with steady-state walking and the precrossing and crossing phases of an obstacle-negotiation task between young and older adults. METHODS: Fifteen younger and 15 older adults participated in this study. Participants were required to perform a verbal reaction time task during three events: (1) steady-state unobstructed gait, (2) precrossing (the final full stride prior to obstacle crossing), and (3) obstacle crossing. RESULTS: The attention directed during precrossing exceeds that of steady-state walking for both younger and older adults. Younger adults direct more attention to gait during precrossing than they do during crossing. However, precrossing is equally attentionally demanding as crossing for older adults, and both of these events require more attention than does steady-state gait in this age group. CONCLUSIONS: The task of obstacle negotiation, from precrossing through obstacle crossing, is attentionally demanding for elderly persons, and fall risk, due to a compromised availability of attentional resources, does occur prior to obstacle crossing in this age group.

Accidental Falls↗
PubMed2004

Obstacle negotiation kinematics: age-dependent effects of postural threat.

This study investigated whether obstacle negotiation kinematics among younger (YA) and older adults (OA) are influenced by postural threat. Obstacle negotiation kinematics among YA and OA were examined under four conditions of postural threat. Seventeen older and 15 YA negotiated a fixed virtual obstacle while walking at a self-determined velocity along a 7.2 m walkway. Postural threat was manipulated by varying the width (0.60 vs. 0.15 m) and height (0.00 vs. 0.60 m) of the walkway. Increasing postural threat resulted in elevated levels of physiological arousal and altered crossing kinematics for all subjects. Specifically, crossing step length, lead limb velocity, trail limb velocity, and whole body center of mass (COM) velocity decreased and lead limb crossing height increased in the condition of greatest postural threat compared with the condition of least postural threat. Although both YA and OA altered obstacle negotiation kinematics under conditions of postural threat, the changes observed among older adults were considerably different from those of YA. In particular, OA demonstrated more marked reductions in the crossing velocity of the lead limb, trail limb, and COM than YA between the condition of least postural threat and the condition of greatest postural threat. The results of this study reveal that postural threat influences negotiation kinematics among YA and OA and illustrate that age-dependent differences exist for obstacle negotiation kinematics when postural threat increases. These findings may imply a beneficial effect of fear of falling on reducing fall probability among healthy OA.

Accidental Falls↗
PubMed2003

The allocation of attention during locomotion is altered by anxiety.

We tested the hypotheses that: (1) anxiety regarding the possibility of falling alters the attentional demands of gait; and (2) this alteration in the attentional requirements of gait occurs independently of gait pattern accommodations. Sixteen younger and 15 older adults participated in this study. Subjects walked at a self-determined velocity along a 7.2-m walkway under four conditions of postural threat; the walking conditions varied depending on the width constraints of the walkway (60 cm vs 15 cm) and the height of the walking surface (0 cm vs 60 cm). Attentional demands of locomotion in each condition of testing were assessed using the dual-task methodology, in which participants verbally responded to an auditory cue as quickly as possible while continuing to walk. Our findings revealed that: (1) participants were successful in verbally responding to the auditory cue without modifying their gait pattern; (2) reaction times increased for all subjects when walking in the condition of greatest postural threat; (3) the attentional demands for locomotion varied with the phase of the gait cycle for younger adults but not for older adults; (4) the phase-dependent effect for younger adults disappeared in the condition of greatest postural threat, while reaction time scores for older adults systematically increased; and (5) increases in reaction time persisted despite significant changes in gait kinematics. Our findings confirm that anxiety increases the attentional demands for locomotion and provide further explanation for age-dependent increases in the attentional demands of gait. Furthermore, our findings confirm that fall-related anxiety predicates an increase in the allocation of attention to locomotor control that is independent of gait pattern adjustments.

Adult↗
PubMed2002

Central set influences on gait. Age-dependent effects of postural threat.

We tested the hypothesis that anxiety regarding the potential consequences of a possible fall would alter gait patterns differently between younger and older adults. Sixteen younger and fifteen older adults participated in this study. Participants walked at a self-determined velocity along a 7.2-m walkway under 4 different conditions of postural threat; the walking conditions varied depending on the width constraints of the walkway (0.60 m vs 0.15 m) and the height of the walking surface (floor vs elevated: 0 m vs 0.60 m). Results indicated that although both younger and older adults altered their gait patterns under conditions of increased postural threat, the movement adaptations observed among older adults were substantially different to those adopted by younger adults. These age-dependent differences were strongly evidenced in the joint kinematics and the variability of the gait pattern within each condition. Our findings also indicated that when postural threat increased, the level of muscle activation throughout the gait cycle was altered in the distal musculature (gastrocnemius m. and tibialis anterior m.) among older adults only. Based on the age-related differences observed, we believe that the gait pattern alterations observed among younger and older adults reflect central set modifications to postural control that are mediated by a heightened anxiety imposed by the constraints of the testing conditions. Based on the age-dependent differences in the observed gait pattern modifications, it appears that the effects of anxiety on the control of locomotion are more pervasive for older adults than for younger adults.

Accidental Falls↗
PubMed2002

Attentional demands for static postural control after stroke.

OBJECTIVE: To assess the attentional demands associated with postural control among people who have had a stroke. DESIGN: Nonrandomized matched case-control study. SETTING: University research laboratory in Canada. PARTICIPANTS: Six individuals who had suffered a left or right cerebral ischemic attack in the past year and a sample of 6 age- and gender-matched controls. Participants in the stroke group had a mean age of 64.17+/-13.14 years; control participants had a mean age of 64.00+/-13.91 years. Mean National Institute of Health Stroke Scale scores for these patients were 7.67+/-4.92 at the time of stroke and 1.66+/-1.36 at the time of testing. None of the patients were taking medications that would alter cognitive status or balance abilities. INTERVENTION: Participants performed a verbal reaction-time test while engaged in 3 postural tasks (sitting, standing, standing with feet together). MAIN OUTCOME MEASURE: Reaction time: latency between visual stimulus and verbal response. RESULTS: Reaction times in the stroke group differed significantly in all conditions from the controls (410+/-72 ms vs 320+/-54 ms, P<.01). A significant interaction was found between group and postural task (P=.05), with reaction-time scores showing a progressive increase in postural task difficulty among participants who had suffered a stroke. Post hoc comparisons revealed that sitting reaction-time scores were significantly slower than reaction-time scores for feet together standing (P=.008) among participants in the stroke group. CONCLUSION: Individuals who have suffered a stroke showed increased attentional demands for tasks of static postural control compared with healthy, age-matched participants.

Aged↗
PubMed2002

Is the prioritization of postural control altered in conditions of postural threat in younger and older adults?

Background. The purpose of this study was to determine if the prioritization of postural control over secondary task performance is altered in younger and older adults under different conditions of postural threat. Methods. Fifteen healthy older adults (mean age = 69.53 +/- 5.78) and 15 younger adults (mean age = 22.00 +/- 2.17) performed Brooks' Spatial Letter Task (BST) while standing in four conditions of postural threat. Galvanic skin conductance (GSC) was collected to measure changes in physiological arousal. BST task duration was used to measure changes in cognitive performance, and center of pressure (COP) area was used to determine changes in postural stability across each of the testing conditions. A prioritization index was calculated based on the relative change in BST and COP across testing conditions. This measure was used to quantify changes in the relationship between postural control and secondary task performance under conditions of postural threat. Results. Measures of GSC increased in younger and older adults in response to conditions of increased postural threat. Prioritization index scores revealed that a greater number of older adults than younger adults prioritized postural control over secondary task performance under conditions of increased postural threat. Conclusions. Environmental contexts that alter postural threat may lead to modifications in the prioritization between postural control and secondary task performance among older adults. This relationship may have implications for postural control under situations that do not afford deterioration in secondary task performance.

Adult↗