Cortical activity during walking and balance tasks in older adults and in people with Parkinson's disease: A structured review. (July 2018)

• Record Type: Journal Article
• Authors: Stuart, Samuel; Vitorio, Rodrigo; Morris, Rosie; Martini, Douglas N.; Fino, Peter C.; Mancini, Martina
• Is Part Of: Maturitas. Volume 113(2018)
• Page Start: 53
• Page End: 72
• Publication Date: 2018-07
• Subjects: Functional near infrared spectroscopy (fNIRS) -- Electroencephalography (EEG) -- Cortical activity -- Walking -- Balance -- Older adults -- Parkinson's disease; Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2018.04.011
• Languages: English
• ISSNs: 0378-5122

Abstract

Highlights: The paper reviews the literature on cortical activity during walking and balance in older adults and Parkinson's disease. A lack of standardized data collection, processing, definition of cortical regions of interest and outcomes has been reported. Overall, cortical activity increases during walking and balance tasks in older adults and further in Parkinson's disease. Recommendations are provided to aid cortical activity protocols during walking and balance tasks. Abstract: An emerging body of literature has examined cortical activity during walking and balance tasks in older adults and in people with Parkinson's disease, specifically using functional near infrared spectroscopy (fNIRS) or electroencephalography (EEG). This review provides an overview of this developing area, and examines the disease-specific mechanisms underlying walking or balance deficits. Medline, PubMed, PsychInfo and Scopus databases were searched. Articles that described cortical activity during walking and balance tasks in older adults and in those with PD were screened by the reviewers. Thirty-seven full-text articles were included for review, following an initial yield of 566 studies. This review summarizes study findings, where increased cortical activity appears to be required for older adults and further for participants with PD to perform walking and balance tasks, but specific activation patterns vary with the demands of the particular task. Studies attributed cortical activation to compensatory mechanisms for underlying age- or PD-related deficits in automatic movement control. However, a lack of standardization within the reviewed studies was evident from the wide range of study protocols, instruments, regions of interest, outcomes and interpretation of outcomes that were reported. Unstandardized data collection, processing and reporting limited the clinical relevance and interpretation of study findings. Future work to standardize approaches to the measurement of cortical activity during walking and balance tasks in older adults and people with PD with fNIRS and EEG systems is needed, which will allow direct comparison of results and ensure robust data collection/reporting. Based on the reviewed articles we provide clinical and future research recommendations.