Reduced trunk movement control during motor dual-tasking in older adults

Abstract

Older adults have a decreased trunk movement control which is linked to their higher fall risk. While motor/cognitive dual-tasking deteriorates balance and walking in older adults, there is limited understanding on how trunk kinematics and kinetics are affected by dual-tasking in scenarios where falls can occur. Therefore, the purpose of the study was to determine the impacts of a challenging motor dual-task, specifically obstacle avoidance during walking, on trunk and lower-body kinematics and kinetics of older adults compared to young adults. The study captured three-dimensional kinematic and kinetic data from 12 young adults and 10 older adults as they walked on a treadmill and stepped over an obstacle with both legs. The study analyzed trunk, hip, knee, and ankle angles and torques. Trunk torque was further broken down to trunk muscle torque, gravitational torque, and inertia torque. A linear mixed effects model was used to investigate the difference in each variable between the two groups. Older adults exhibited significantly increased trunk flexion angle and trunk extension muscle torque compared to young adults, with the trunk being the only segment/joint showing differences in both kinematics and kinetics. Trunk torque breakdown analysis revealed that larger trunk flexion led to a larger gravitational torque, which contributed to an increased compensatory trunk muscle torque. Moreover, older adults' less controlled trunk flexion during weight shifting from trail leg to the lead leg, necessitated a compensatory trunk deceleration during trail leg obstacle avoidance which was achieved by generating additional increase in trunk muscle torque. The study demonstrated that motor dual-tasking has the most negative effects on trunk control in older adults compared to young adults. This exposes older adults to a higher fall risk. Therefore, future work should focus on supporting trunk control during daily multi-tasking conditions where falls can occur.