The effect of textured surfaces on postural sway and lower limb muscle activity during quiet standing in healthy young and older adults

Abstract

This thesis investigated whether different textured surfaces have a role to play in changing balance performance in healthy young and older adults. A review of the literature showed that balance may be improved by standing on surfaces, or wearing foot insoles, with texture compared to those that are smooth, possibly by providing enhanced plantar tactile stimulation. It also showed that textured footwear interventions can influence lower limb muscle activity during functional activities. However, some major gaps in current literature were identified. There was limited evidence relating to the effect of texture in older adults: a population known to show poor balance and at high risk of falling. The importance of the geometric textured pattern in changing balance had not been investigated. It was also unclear whether textured interventions altered lower limb muscle activity, as a component of sensorimotor function of balance control. The purpose of this thesis was to address these important areas of research and contribute novel evidence to the field. In two separate studies, 24 young and 50 older healthy adults conducted tests of bilateral quiet standing with eyes open and closed on two different textured surfaces and a smooth surface as control. Centre of pressure based sway variables were extracted from a force platform and lower limb muscle activity was collected using surface electromyography, over 30 seconds. Textured surfaces did not significantly alter sway variables or lower limb muscle activity in healthy young adults. Closer observation of the data tentatively suggested texture may have the capacity to alter anterior-posterior sway and centre of pressure velocity in young adults. These findings supported the aims of this thesis to explore the possibility of a textured effect in people with poor balance ability: older adults. Textured surfaces significantly changed mediolateral sway range and centre of pressure velocity in healthy older adults, in the absence of visual information. No significant changes were observed for lower limb muscle activity, between the textured conditions. Exploratory sub-group analysis for gender generated speculative data suggesting the effect of texture on balance and muscle activity may be more marked in older females. Evidence from both studies suggests that relative to control, the two textured conditions have opposite effects on postural sway. There may be an optimal textured pattern which could be therapeutically beneficial for enhancing balance performance in healthy and pathological groups. Further investigation is required.