Postural stabilization from fingertip contact: I. Variations in sway attenuation, perceived stability and contact forces with aging.

In this study, we compared the ability of young (n=10, 19-32 years) and older subjects (n=35, 60-86 years) to use fingertip contact as a balance aid during quiet stance under various conditions to determine whether aging would influence contact strategies. Experimental trials (duration, 60 s) included two visual conditions (vision; no vision), three fingertip contact conditions (no touch; smooth touch; rough touch) and two support surface conditions (firm; foam). In trials with contact, participants were required to maintain a light contact with their right index fingertip on an instrumented touch-plate. Subjects were not constrained to exert minimal contact force, although they were aware that the touch-plate was not designed for physical support. From displacements of the centre of foot pressure (COP), mean sway amplitude (MSA) was computed in the anterior-posterior (COP(AP)) and medio-lateral (COP(ML)) directions. Subjective estimates of stability were also obtained by asking participants to rate perceived stability on a visual analog scale in each condition. Mean normal force (FN) and mean resultant tangential force (F(TAN)) were computed from contact force data applied on the touch plate. In both age groups, touch conditions had a substantial effect on MSA in the AP direction under both support surface conditions, with reductions averaging between 40-55% when touch was allowed. Reductions in the ML direction, though less important (8-12% on average), were nevertheless highly significant, especially in the older subjects when standing on the foam. In the two groups, vision and texture had only marginal impact on MSA computed on both support surfaces. Contrasting with sway measurements, stability ratings were highly influenced by visual conditions in both age groups. Only in conditions of deficient support (foam surface) and absent vision did the perceived effect of touch exceed that of vision. Age had a major impact, however, on contact forces deployed during trials with touch. While individuals in the young group typically produced forces of <1 N (mean FN, 0.32+/-0.15 N) to achieve postural stabilization, older subjects tended to use higher, though not too excessive, contact forces (mean FN, 1.21+/-0.75 N) under the same conditions. From these findings, we conclude that the ability to use contact cues from the fingertip as a source of sensory information to improve postural stability is largely preserved in healthy older adults. The increase in contact force deployed by older individuals to achieve postural stabilization is interpreted as a compensatory strategy to help overcome age-related loss in tactile sensation, an issue that will be further addressed in a companion paper.