THE UNDERLYING MECHANISMS OF AGE-DIFFERENCES IN

THE REACTIVE LEG DROP

Mitchel A. Magrini , Alejandra Barrera-Curiel , Ryan M Thiele , Jesus Hernamdez Sarabia , Ryan J
1 1 2 1

Colquhoun , Patrick M. Tomko , Nathanial D.M. Jenkins , Jason M. DeFreitas

1 1 1 1

Applied Neuromuscular Physiology Laboratory, Oklahoma State University

1

2
Department of Food, Nutrition, Dietetics and Health, Kansas State University
Abstract
The reactive leg drop (RLD) is a test designed to assess the
rapid sensory-motor integration necessary to recover from a
slip and avoid a fall. The lowest drop angle from the RLD has
been shown to be sensitive to age, but the underlying
mechanisms for this are still unknown. Purpose: The purpose
Introduction Results
Balance and fall recovery has been shown to be a complex and coordinated < Significant group differences in drop angle (p =
integration of both sensory and motor function (1, 2, 3). It has been suggested that,
Young
(p = 0.0006)
Older
0.0006) were observed. Both subcomponents of
during a balance perturbation, a fall is unavoidable after 145 ms after the initiation of 38° the RLD: EMD (YA: 127.9 ± 22.8 ms, OA: 160
a slip (4). Therefore, the ability to respond to a balance perturbation quickly and 69° ±24.9 ms; p = 0.0004), and SRT (OA: 140 ± 59.3
efficiently is essential for balance recovery in the older adult population (5). A ms, YA: 94.9 ± 28.6 ms; p = 0.0006), showed
simple, novel fall-risk assessment called the reactive leg drop has recently been
200
significant differences between YA and OA. *
180 180
160

proposed to mimic the rapid sensorimotor integration necessary to recover from a 160
*
160

of this study was to examine the various subcomponents of a sudden slip (6). Magrini et al. (6) found that older adults performed significantly
140

140
worse than their younger counterparts in the reactive leg drop assessment. Further,
140
120

RLD to elucidate the underlying mechanisms of age

Sensory Recovery time (ms)

120
the authors found that the drop angle was significantly associated with other 100
120

differences. Methods: Fourteen older adults (OA: mean 74 yr)

VL EMD (ms)
proprioceptive assessments, suggesting that the reactive leg drop was both age
100 100
80

and 15 young adults (YA: mean 24 yr) participated in a sensitive and dependent on proprioceptive function. However, the authors did not 80 80

60
examine the specific underlying physiological mechanisms that may determine 60 60

familiarization session followed immediately by a testing reactive leg drop performance. Therefore, the purpose of this study was to examine 40 40
40

session. For the RLDs, each participant was seated with their the underlying mechanisms of the reactive leg drop. 20 20
20

leg passively raised to full extension and supported by an 0

0 100 200 300 400 500 600 700 800 0 Younger Older
0 Younger Older

elastic band held by the investigator. Each participant was

asked to perform the Jendrassik maneuver with the upper body
while the eyes were closed. Once their leg was relaxed, the
researcher would then abruptly release the band allowing the
lower leg to free-fall. The participants were instructed to kick
up to full extension as fast as possible once they felt the lower
leg falling. Drop angle, measured with an electro-goniometer
secured to the knee, was assessed from the difference in angle
between the start position and the lowest point achieved prior
to kicking back up. Surface EMG was recorded from the vastus
lateralis (VL) muscle during the RLDs. The RLDs were
divided into 2 subcomponents: 1.) Sensory Response Time
(SRT), calculated from the start of the drop (as shown in the
goniometer signal) to the onset of VL EMG; and 2.)
Electromechanical Delay (EMD), measured as the time
between the onset of VL EMG to the time point when the leg
started to move back up (i.e. onset of concentric portion).
Separate independent t-tests with a Bonferoni correction (alpha
was p ≤ 0.016) were used to analyze the differences between
YA and OA. Results: As expected, there were significant
group differences in drop angle (p = 0.0006). Interestingly,
Methods
Fourteen older adults (OA: mean 74 yr) and 15
Conclusions
young adults (YA: mean 24 yr) participated in a
The aim of this study was to examine the sensory and motor
familiarization session followed immediately by
subcomponents of a RLD to elucidate the underlying mechanisms of
a testing session. For the RLDs, each participant
was seated with their leg passively raised to full age differences. In agreement with previous research (6), OAs
achieved a significantly larger knee angle compared to the YA.
extension and supported by an elastic band held
Additionally, both SRT and EMD were significantly longer in the
by the investigator. Each participant was asked to
perform the Jendrassik maneuver with the upper OA compared to the YA. These results suggest that both SRT and
body while the eyes were closed. Once their leg was relaxed, the EMD were underlying mechanisms of RLD performance. Sensory
researcher would then abruptly release the band allowing the lower leg to and motor integration and function is essential to efficiently and
free-fall. The participants were instructed to kick up to full extension as accurately react to a sudden balance perturbation to avoid a fall. This
fast as possible once they felt the lower leg falling. Drop angle, measured study demonstrates that sensory (i.e., SRT) and motor (i.e., EMD)
with an electro-goniometer secured to the knee, was assessed from the subcomponents of the RLD are significantly different between YA
difference in angle between the start position and the lowest point and OA. As such, both variables may separately play significant
achieved prior to kicking back
roles in slip recovery and fall avoidance. The ability to accurately
up. Surface EMG was recorded
assess sensorimotor integration may aid clinicians, practitioners, and
from the vastus lateralis (VL)
researchers in further understanding the effects of age on
muscle during the RLDs. The
SRT
RLDs were divided into 2
sensorimotor integration which may lead to improved sensorimotor
EMD
interventions reducing fall risk.
Drop Time
subcomponents: 1.) Sensory
Response Time (SRT),
Knee Angle (°) B
Recovery Time

calculated from the start of the

both subcomponents of the RLD: EMD (OA: 127.9 ± 22.8 ms, drop (as shown in the References
YA: 160 ±24.9 ms; p = 0.0004), and SRT (OA: 140 ± 59.3 ms, goniometer signal) to the onset
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