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. 2024 May 27;9(2):94.
doi: 10.3390/jfmk9020094.

Erosion of Stumble Correction Evoked with Superficial Peroneal Nerve Stimulation in Older Adults during Walking

Ryan Brodie  1   2   3 , Marc Klimstra  1   2   3 , Drew Commandeur  1   2 , Sandra Hundza  1   2   4
Affiliations

Erosion of Stumble Correction Evoked with Superficial Peroneal Nerve Stimulation in Older Adults during Walking

Ryan Brodie et al. J Funct Morphol Kinesiol. .

Abstract

In healthy young adults, electrical stimulation of the superficial peroneal cutaneous nerve (SPn) innervating the dorsum of the foot has been shown to elicit functionally relevant reflexes during walking that are similar to those evoked by mechanical perturbation to the dorsum of the foot during walking and are referred to as stumble corrective (obstacle avoidance) responses. Though age-related differences in reflexes induced by mechanical perturbation have been studied, toe clearance has not been measured. Further, age-related differences in reflexes evoked by electrical stimulation of SPn have yet to be determined. Thus, the purpose of this study was to characterize age-related differences between healthy young adults and older adults with no history of falls in stumble correction responses evoked by electrical stimulation of the SPn at the ankle during walking. Toe clearance relative to the walking surface along with joint displacement and angular velocity at the ankle and knee and EMG of the tibialis anterior, medial gastrocnemius, biceps femoris and vastus lateralis were measured. The combined background and reflex toe clearance was reduced in the older adults compared with the young in mid-early swing (p = 0.011). These age-related differences likely increase fall risk in the older adult cohort. Further, age-related changes were seen in joint kinematics and EMG in older adults compared with the young such as decreased amplitude of the plantarflexion reflex in early swing in older adults (p < 0.05). These altered reflexes reflect the degradation of the stumble corrective response in older adults.

Keywords: aging; falling; older adults; peroneal nerve stimulation; reflexes; stumble correction; tripping.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Toe clearance group means for OLD and YOUNG across the gait cycle for (a) reflex (subtracted (perturbed minus unperturbed), (b) background (unperturbed) and (c) background + reflex (subtracted plus unperturbed). * indicates significant difference between group difference at that bin. p < 0.05 level.
Figure 2
Figure 2
Ankle reflex (subtracted (perturbed minus unperturbed)) group means for kinematics and EMG for OLD and YOUNG across the gait cycle for (a) displacement (deg), (b) angular velocity (deg/sec), (c) MG %max EMG, and (d) TA %max EMG. EMG values are represented as the average cumulative reflex EMG after 125 ms (ACRE125) and are normalized to peak background muscle activation throughout the gait cycle for each subject. * indicates significant difference between group difference at that bin. p < 0.05 level.
Figure 3
Figure 3
Knee reflex (subtracted (perturbed minus unperturbed)) group means for kinematics and EMG for OLD and YOUNG across the gait cycle for (a) displacement (deg), (b) angular velocity (deg/sec), (c) BF %max EMG, and (d) VL %max EMG. EMG values are represented as the average cumulative reflex EMG after 125 ms (ACRE125) and are normalized to peak background muscle activation throughout the gait cycle for each subject.
Figure 4
Figure 4
Ankle background (unperturbed) group means for kinematic and EMG for OLD and YOUNG across the gait cycle for (a) displacement (deg), (b) angular velocity (deg/sec), (c) MG %max EMG, and (d) TA %max EMG. EMG values are represented as the average cumulative reflex EMG after 125 ms (ACRE125) and are normalized to peak background muscle activation throughout the gait cycle for each subject. * indicates significant difference between group difference at that bin. p < 0.05 level.
Figure 5
Figure 5
Knee background (unperturbed) group means for kinematic and EMG for OLD and YOUNG across the gait cycle for (a) displacement (deg), (b) angular velocity (deg/sec), (c) BF %max EMG, and (d) VL %max EMG. EMG values are represented as the average cumulative reflex EMG after 125 ms (ACRE125) and are normalized to peak background muscle activation throughout the gait cycle for each subject. * indicates significant difference between group difference at that bin. p < 0.05 level.
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