Neuroscience of Posture and Gait Control: Mechanisms, Influencing Factors and Cognitive-Motor Retraining

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Background

High levels of sedentary behavior in the 2Ist century have been linked to numerous adverse health outcomes, including psychomotor disturbances, cardiovascular disease, metabolic syndrome, and fall risk. Loss of mobility is associated with many of these disturbances and adds to morbidity in these populations. The diversity of these outcomes emphasizes the complicated and often bi-directional relationship between balance and gait control and adverse health effects. Motor control rests on continuous updating of an internal model of the body’s position based on multisensory feedback and is modulated by cognitive control processes to produce adaptive motor behaviors. This internal representation is used to forward motor commands controlling the body’s position in space and should be considered in adaptation to environmental constraints, physical training, neurorehabilitation, and clinical assessments.

Mobility limitations are common with cognitive and affective disorders and with increasing age, affecting ~35% of adults over 70 years of age and the majority of those over 85. In pathological aging, mobility loss and associated cognitive and affective disturbances are exacerbated. Reduced gait speed is highly associated with increased fall risk, dependency and mortality. Accumulating evidence indicates that postural instability, reduced gait speed and fall risk are associated with poorer cognitive function. Although the precise neural mechanisms underlying cognitive-motor declines in normal and pathological aging, substantial evidence points to an increased reliance on top-down cognitive control of motor networks thought to compensate for reductions in automatic motor processing. Because posture and gait control are mediated by both higher “controlled” and lower “automatic” levels of processing, it is critical to improve our understanding of the interrelations between the neurocognitive control systems active in posture stability and gait. Furthermore, it is becoming increasingly important to include the modulatory effects of affective, autonomic, metabolic and cardiovascular dysfunction in affected individuals.

An improved understanding of the neurocognitive processes controlling posture and gait and the potential modulatory actions of comorbid affective or metabolic dysfunction is needed to address the current and future needs of aging adults in whom motor and cognitive functions have been impaired. This information is essential to fulfill the promise of neuromodulatory methodologies in the rehabilitation setting.

A major goal of this Research Topic is to gather empirical and theoretic studies of central and peripheral mechanisms of posture and gait control, including modulatory effects of affective, autonomic and metabolic comorbidities of those mechanisms, in healthy and pathological aging. Another focus is to provide state-of-the-art studies concerning the neurobiological mechanisms by which motor controls systems interact with cognitive control systems to generate the joint expression of motor and cognitive slowing seen in normal and pathological aging. To achieve these goals, we welcome contributions investigating the neural pathways and networks involved in the control of posture, gait, and the intersection of gait slowing and cognitive decline in healthy and pathologically aging adults. Recognizing the systemic nature of gait and posture, contributions addressing the relationship between cognitive-motor decline and affective, sensory autonomic and/or metabolic dysfunctions are also encouraged.

We welcome original research or review articles focusing on studies of central and peripheral mechanisms of balance and gait control and the effective interactions between these networks and those of cognitive control. Submitted manuscript should focus on the following:
• The interaction of affective, autonomic and cognitive processing for task-specific optimality of balance equilibrium.
• Studies of postural performance under cognitive load
• The linkage between reduced gait speed and cognitive function in both healthy and pathological aging
• Validation of new technologies for assessing postural deficits in individuals with cognitive, autonomic and affective disorders
• Neuromodulatory methods for improved balance or motor control and the impact on cognitive processing
• Development of biofeedback technologies for postural or gait rehabilitation

Keywords: Balance, neurophysiological feedback loops in posture control, cognitive functions, affective status, attentional investment, biofeedback, rehabilitation, training

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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