Retention and generalizability of balance recovery response adaptations from trip-perturbations across the adult lifespan

For human locomotion, varying environments require adjustments of the motor system. We asked whether age affects gait balance recovery adaptation, its retention over months and the transfer of adaptation to an untrained reactive balance task. Healthy adults (26 young, 27 middle-aged and 25 older; average ages 24, 52 and 72 years respectively) completed two tasks. The primary task involved treadmill walking: either unperturbed (control; n=39) or subject to unexpected trip perturbations (training; n=39). A single trip perturbation was repeated after a 14-week retention period. The secondary transfer task, before and after treadmill walking, involved sudden loss of balance in a lean-and-release protocol. For both tasks the anteroposterior margin of stability (MoS) was calculated at foot touchdown. For the first (i.e. novel) trip, older adults required one more recovery step ( P=0.03) to regain positive MoS compared to younger, but not middle-aged, adults. However, over several trip perturbations, all age groups increased their MoS for the first recovery step to a similar extent (up to 70%), and retained improvements over 14 weeks, though a decay over time was found for older adults ( P=0.002; middle-aged showing a tendency for decay: P=0.076). Thus, although adaptability in reactive gait stability control remains effective across the adult lifespan, retention of adaptations over time appears diminished with aging. Despite these robust adaptations, the perturbation training group did not show superior improvements in the transfer task compared to aged-matched controls (no differences in MoS changes), suggesting that generalizability of acquired fall-resisting skills from gait-perturbation training may be limited.