Long-Term Retention of Gait Stability Improvements

Abstract

Evidence of long-term modification of behavior—in particular, gait alterations in response to repeated exposure to slips—within the locomotor-balance control system is limited. The purpose of this study was to examine whether improvements in fall-resisting behavior as reflected by improvements in gait stability could be retained on a long-term basis. Eight healthy young subjects were exposed to a block of repeated slip trials during a single acquisition session consisting of five repeated slip exposures; the same subjects were then re-tested using the same protocol at a minimum of 12 mo later. Pre- and postslip gait stability for all slip trials was measured at touchdown (slipping limb) and liftoff (contralateral limb) based on the center of mass state (i.e., its instantaneous position and velocity) relative to the base of support (BOS) and the predicted thresholds for backward loss of balance. In the acquisition session, subjects were able to increase pre- and postslip stability, which significantly correlated with a decrease in the incidence of balance loss from 100% (1st slip) to 0% (5th slip). All subjects exhibited a similar balance loss on the first slip of the follow-up session. Nonetheless, subjects were able to retain the acquired preslip stability with feedforward control on the first slip but not the postslip stability related to the reactive response. Also, the subjects demonstrated a faster re-acquisition, with only one balance loss on the second slip of the follow-up session, as compared with seven balance losses on the acquisition session. Such rapid improvements were achieved by the significantly greater increase in post- compared with preslip stability; this increase was for the most part, a consequence of reductions in slip intensity (i.e., the peak BOS velocity). We concluded that a single acquisition session could only produce limited long-term retainable effects within the locomotor-balance control system. It appeared, however, that the CNS was still primed to more rapidly update its internal representation of gait stability during re-acquisition.