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Losing touch: age-related changes in plantar skin sensitivity, lower-limb cutaneous reflex strength, and postural stability in older adults. J Neurophysiol. 2016 Aug 3:jn.00339.2016.
Age-related changes in the density, morphology, and physiology of plantar cutaneous receptors negatively impact the quality and quantity of balance-relevant information arising from the foot soles. Plantar perceptual sensitivity declines with age, and may predict postural instability; however, alteration in lower-limb cutaneous reflex strength may also explain greater instability in older adults, and has yet to be investigated. We replicated the age-related decline in sensitivity by assessing monofilament and vibrotactile (30 & 250 Hz) detection thresholds near the first metatarsal head bilaterally in healthy young and older adults. We additionally applied continuous 30 and 250 Hz vibration to drive mechanically evoked reflex responses in the Tibialis Anterior muscle, measured via surface electromyography. To investigate potential relationships between plantar sensitivity, cutaneous reflex strength, and postural stability, we performed posturography during quiet standing without vision. Anteroposterior and mediolateral postural stability decreased with age, and increases in postural sway amplitude and frequency were significantly correlated with increases in plantar detection thresholds. With 30 Hz vibration, cutaneous reflexes were observed in 95% of young adults, but only 53% of older adults, and reflex gain, coherence, and cumulant density at 30 Hz were lower in older adults. Reflexes were not observed with 250 Hz vibration, suggesting this high frequency cutaneous input is filtered-out by motoneurons innervating Tibialis Anterior. Our findings have important implications for assessing the risk of balance impairment older adults.
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