Training improves balance control in older adults, but the time course and neural mechanisms underlying these improvements are unclear. We studied balance robustness and performance, H-reflex gains, paired reflex depression, and co-contraction duration in ankle muscles after one and ten training sessions in 22 older adults (+65 yrs). Mediolateral balance robustness, time to balance loss in unipedal standing on a platform with decreasing rotational stiffness, improved (33%) after one session, with no further improvement after ten sessions. Balance performance, absolute mediolateral center of mass velocity, improved (18.75%) after one session in perturbed unipedal standing and (18.18%) after ten sessions in unperturbed unipedal standing. Co-contraction duration of soleus/tibialis anterior increased (16%) after ten sessions. H-reflex gain and paired reflex depression excitability did not change. H-reflex gains were lower, and soleus/tibialis anterior co-contraction duration was higher in participants with more robust balance after ten sessions, and co-contraction duration was higher in participants with better balance performance at several time-points. Changes in robustness and performance were uncorrelated with changes in co-contraction duration, H-reflex gain, or paired reflex depression. In older adults, balance robustness improved over a single session, while performance improved gradually over multiple sessions. Changes in co-contraction and excitability of ankle muscles were not exclusive causes of improved balance.@en

With aging, the sensory, motor, and central nervous system deficiencies lead to inadequate bicycle postural control in older cyclists. Similarly, variety in riding skills leads to different bicycle postural control strategies. Cycling seems to be an automated task but keeping the bicycle stable at low speed, pedaling, and steering requires continuous physical and cognitive effort, and in long term may lead to fatigue induced by steering and stabilizing the e-bike at low forward speeds especially in older cyclists. E-bikes enables riders to cycle for langer duration and distance by reducing the physical fatigue. There is an increasing societal interest in electric bicycles where in 2021, 26. 73 billion US dollars worldwide have been invested on e-bikes and by 2027 this global market size will increase to 53.53 billion US dollars (Statista). However, with increased numbers of e-bikes, bicycle accidents due to inadequate steering and balance control by older cyclists have increased, which suggests needs for extra safety measures to maintain balance on a bicycle for challenging situation such as facing undesired disturbances or low forward speeds. We developed a prototype steering assist which aims to increase safety and improve the user experience, by reducing the steering effort and enhancing the bicycle postural control (rider-bike balance control). We investigated the potential effectiveness ofthe steering assist technology in real life challenging situations. Our present study should be considered exploratory research to find the potential effectiveness of the steering assist technology in improving the user experience and safety compared to a non-assistive e-bike. The improved bicycle postural control is validated by smaller range, variability, and rate of steering and roll trajectories when the rider is subjected to an unwanted disturbance. Improved bicycle postural control is expected based on the reduced need for compensatory behavior in the presence of assistive technology. Decreased steering effort is expected due to reduced demand for acute steering control in the anticipatory control strategy.@en

Bicycles are more difficult to control at low speeds due to the vehicle’s unstable low-speed dynamics. This issue might be exacerbated by factors such as aging, disturbances, and multi-tasking. To address this issue, we developed a prototype ‘balance assist system’ with Royal Dutch Gazelle and Bosch eBike Systems at Delft University of Technology, which includes an electric motor capable of providing additional steering torque. We implemented a speed-adaptive feedback controller to generate the additional steering torque to that of the rider. We conducted a study with 18 older and 14 younger cyclists to first examine the effect of aging, disturbances, and multi-tasking on cycling at lower forward speeds, and evaluate the effectiveness of the system in improving the stability of the rider-bicycle system while facing these challenges. The study consisted of two scenarios: a single-task scenario where participants rode the bicycle on a marked narrow straight-line track, and a multi-task scenario where participants performed a shoulder check task and followed visual cues while tracking the straight-line. We introduced handlebar disturbances using the steer motor in half of the trials in both scenarios. All trials were repeated with and without the balance assist system. We calculated the bicycle mean magnitude of roll and steering rate—as indicators of bicycle balance control and required steering actions, respectively—and the rider’s mean magnitude of lean rate with respect to the ground to investigate the effect of the balance assist system on rider’s lateral motion. Our results showed that aging, disturbances, and multi-tasking increased the roll rate, and the balance assist system was able to significantly reduce it. The effect size of the balance assist system in reducing the roll rate across all conditions was found to be larger in older cyclists, indicating a more substantial impact compared to younger cyclists. Disturbances and multi-tasking increased the steering rate, which was successfully reduced by the balance assist system. Aging did not significantly affect the steering rate. The rider’s lean rate was not significantly affected by age, disturbances, or the balance assist, indicating that the upper body plays a minor role when riders have good steering control authority. Overall, our findings suggest that lateral motion and required steering action can be affected by age, multi-tasking, and handlebar disturbances which can endanger cyclists’ safety, and the balance assist system has the potential to improve cycling safety and reduce the incidence of single-actor crashes. Further investigation on riders’ contribution to control actions is required.@en

Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.@en

Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.@en

Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.@en

This study aimed to assess modulation of lower leg muscle reflex excitability and co-contraction during unipedal balancing on compliant surfaces in young and older adults. Twenty healthy adults (ten aged 18–30 years and ten aged 65–80 years) were recruited. Soleus muscle H-reflexes were elicited by electrical stimulation of the tibial nerve, while participants stood unipedally on a robot-controlled balance platform, simulating different levels of surface compliance. In addition, electromyographic data (EMG) of soleus (SOL), tibialis anterior (TA), and peroneus longus (PL) and full-body 3D kinematic data were collected. The mean absolute center of mass velocity was determined as a measure of balance performance. Soleus H-reflex data were analyzed in terms of the amplitude related to the M wave and the background EMG activity 100 ms prior to the stimulation. The relative duration of co-contraction was calculated for soleus and tibialis anterior, as well as for peroneus longus and tibialis anterior. Center of mass velocity was significantly higher in older adults compared to young adults (p< 0.001) and increased with increasing surface compliance in both groups (p< 0.001). The soleus H-reflex gain decreased with surface compliance in young adults (p= 0.003) , while co-contraction increased (pSOL,TA=0.003andpPL,TA<0.001). Older adults did not show such modulations, but showed overall lower H-reflex gains (p< 0.001) and higher co-contraction than young adults (pSOL,TA<0.001andpPL,TA=0.002). These results suggest an overall shift in balance control from the spinal level to supraspinal levels in older adults, which also occurred in young adults when balancing at more compliant surfaces.@en