Reactive balance control in response to a perturbation requires significant kinematic and neuromuscular changes to regain stability 4, 5, and an adequate stepping response has previously been viewed as a critical factor in preventing falls 6. Similarly, for the older adults residing in long-term care, external perturbations also account for ~ 30% of falls 3. Slips account for 40% of falls in community-dwelling older adults, with this incidence becoming increasingly prevalent as individuals age 1, 2. Unexpected perturbations during gait, such as trips and slips, are the main cause of falls in heathy older adults 1. This study enhances our understanding of the neuromuscular basis of both voluntary and reactive stepping as well as the potential effect of aging on neuromuscular control during balance tasks. Our results indicate that there is a low similarity of muscle synergies between voluntary stepping and reactive stepping and that aging had a limited effect on the structure of muscle synergies. Minor differences in the synergy structure were observed for both voluntary and reactive stepping between age groups. Our results showed that fewer muscle synergies were used during reactive stepping than during voluntary stepping in both young and older adults. Using muscle synergy analysis, we extracted the muscle synergies for both voluntary and reactive stepping. Electromyography (EMG) signals during both backward voluntary stepping in response to an auditory cue and backward reactive stepping elicited by a forward slip-like treadmill perturbation during stance were recorded in ten healthy young adults and ten healthy older adults. However, the effect of aging on neuromuscular control during voluntary and reactive stepping remains unclear. It has previously been well described that both voluntary and reactive step training could improve the efficacy of reactive stepping in different populations. Reactive stepping responses are essential to prevent falls after a loss of balance.
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