Perturbation-Induced Protective Arm Responses: Effect of Age, Perturbation-Intensity, and Relationship with Stepping Stability: A Pilot Study

During balance recovery from slip perturbations, forward flexion (elevation) of the arms serves to counterbalance the posteriorly displaced center of mass (CoM). We aimed to investigate whether aging affects modulation of arm responses to various intensities of unpredictable slip perturbations and whether arm responses are related to compensatory stepping stability. Ten healthy young adults and ten healthy older adults participated. Participants were asked to react naturally to three randomly administered levels of slip-like surface perturbations (intensity 1 (7.75 m/s(2)), intensity 2 (12.00 m/s(2)) and intensity 3 (16.75 m/s(2)), which occurred by means of forward acceleration of the treadmill belt while standing. Kinematic data were collected using a motion capture system. Outcomes included arm elevation displacement, velocity, and margin of stability (MoS) of compensatory stepping. The results reveal no modulation of arm elevation velocity in older adults from perturbation intensity 1 to 2, whereas younger adults demonstrated progressive increases from intensity 1 to 2 to 3. At intensity 3, older adults demonstrated reduced maximal arm elevation velocity compared to younger adults (p = 0.02). The results in both groups combined reveal a positive correlation between maximal arm elevation velocity and first compensatory step MoS at intensity 3 (p = 0.01). Together, these findings indicate age-related decreases in arm response modulation and the association of arm elevation response with protective stepping stability, suggesting that fall prevention interventions may benefit from an emphasis on arm elevation velocity control in response to greater perturbation intensities.