Perturbation walking effects on prefrontal cortical activation and walking performance in older women with and without osteoarthritis: a FNIRS study

Abstract

Introduction: Perturbation walking (PW) has been shown to improve gait, however its effect on the cortical control of gait might provide insights on neural mechanisms underlying falls in adults with osteoarthritis. The objective of this study is to investigate the effect of PW on prefrontal cortical (PFC) activation in older women with (OA) and without osteoarthritis (HOA). We hypothesized that there would be an increase in PFC activation during PW relative to comfortable walking (CW) and higher increase in PFC activation during PW in HOA compared to OA.

Methods: Twenty community-dwelling older women (66.7 ± 5.41 years old) walked on an instrumented treadmill that provided perturbations at pseudo-random intervals between 5-25 s using a counterbalanced design. Functional Near Infrared Spectroscopy was used to quantify PFC oxygenated hemoglobin (HbO₂) and deoxyhemoglobin (Hb) levels, while standing prior to the task as a baseline. A linear mixed effects model was conducted to investigate the effects of cohort (HOA vs OA), task (PW vs CW), and their interaction on HbO₂ (μM) and Hb (μM) levels.

Results: HbO₂ and Hb levels differed significantly between CW and PW tasks for both cohorts (P < 0.001) and demonstrated significant task by cohort interaction (P < 0.05). In addition, we found changes in walking performance (stride time, stride length, stride width and stance time) during and after PW. Spearman correlation demonstrated a strong association between increased stance time, increased body mass index and decreased PFC activation during PW. No other significant results were found.

Discussion: This study found increase in PFC activation during PW and gait adaptation after a short bout of PW in HOA and OA. This increase in PFC activation was higher in HOA compared to OA, particularly during PW tasks, and was consistent with theory of limitations in mobility affecting neural activation in older adults. Further work remains to examine how pain, obesity, and mobility impacts cortical control in older adults with and without osteoarthritis.

Keywords: functional near infrared spectroscopy; gait; osteoarthiritis; prefrontal cortex; walking.

FIGURE 1

(Left) mean hemoglobin (Hb02) and (Right) mean deoxyhemoglobin (Hb) activation during comfortable walking (CW1, CW2) and perturbation walking tasks (PW1, PW2) in healthy older adults (HOA) and older adults with osteoarthritis (QA). ***p < 0.001, **p < 0.01.

FIGURE 2

Mean stride time, stride length, stance time, and stride width during comfortable walking (CW1, CW2) and perturbation walking tasks (PW1, PW2) in healthy older adults (HOA) and older adults with osteoarthritis (OA). **p < 0.01, *p < 0.05.