Consider SCM for Gait in older people.!!!

We know that we have 3 systems that keep us upright against the gravitational plane: 1) The visual system 2) The vestibular system 3) The proprioceptive system. As we grow, we seem to become more dependent upon the visual system to maintain stability of the head. Older people seem to be less stable than younger ones, When it comes to head stability consideration.

Method: This study compare the neuromechanical mechanisms of head stability in younger and geriatric woman during gait initiation, a time when we employ the visual system for things like balance and foot placement. The visual system is a king in this case and trumps are other systems. The system represent whatever it need to to keep the eyes level with the horizon.

They used a  stereophotogrammetric system to measure angular displacement and acceleration and surface emg (no, not the best) to look at activation latencies of neck (particularly the SCM), trunk and pelvic muscles. Older women had higher variability in angular displacement of the head (possibly they may have age related breakdown of the vestibular system?), decreased ability to attenuate accelerations in the saggital plane, and increased SCM activation latencies.

Closing thoughts..….

Make sure Geriatric patient have:

– Better functioning joints, muscles & proprioception.

You could help them by:

– You can manipulating and mobilizing joints which have pathomechanics problem.
– You can improving muscular function through endurance and strength based exercises of the neck as well as core & other modalities you can use.
-Concentrate on more proprioceptive based exercises, especially ones which incorporate the head, like head repositioning exercises,
– Encourage them to engage in proprioceptive heavy activities, works the axial extensors.

Check SCM strength in older people when they have gait issue still future research is generate an understanding of why Mediolateral dynamic stability declines during gait initiation in older females.

References:

Maslivec A, Bampouras T, Dewhurst S, Vannozzi G, Macaluso A, Laudani L.  Mechanisms of head stability during gait initiation in young and older women: A neuro-mechanical analysis.
J Electromyogr Kinesiol. 2017 Nov 23;38:103-110. doi: 10.1016/j.jelekin.2017.11.010.