The involvement of ankle muscles in maintaining balance in the upright posture is higher in elderly fallers

The purpose of this study was to determine whether the mechanical contribution of ankle muscles in the upright stance differed among young adults (YA) (n = 10, age: ~ 24.3), elderly non-fallers (ENF) (n = 12, age: ~ 77.3) and elderly fallers (EF) (n = 20, age: ~ 80.7). Torque and electromyographic (EMG) activity were recorded on the triceps surae and tibialis anterior during maximum and submaximum contractions in the seated position. EMG activity was also recorded in subjects standing still. Plantar flexor (PF) and dorsal flexor (DF) torques generated in the upright posture were estimated from the torque-EMG relationship obtained during submaximum contractions in the seated position. Center of pressure (CoP) displacement was measured to quantify postural stability. Results showed that, in upright standing, EF generated greater ankle muscle relative torque (i.e. PF + DF torque in the upright stance/PF + DF during maximum isometric torque) than non-fallers (i.e. ENF, YA). The greater involvement of ankle muscles in EF was associated with higher CoP displacement. PF + DF torque in the upright stance was no different among the groups, but PF + DF torque during maximum effort was impaired in older groups compared with YA and was lower in EF than ENF. These results suggest that the postural stability impairment observed with aging is highly related to ankle muscle weakness.