Muscle Spindles and Locomotor Control-An Unrecognized Falls Determinant in the Elderly?

Abstract

Ray Marks

Historically, evidence muscle spindles might be involved in locomotion was provided by their presence in four-footed animal antigravity muscles associated with posture and locomotion and later shown to be present in all muscles involved in locomotion, including human locomotor and other muscles. In unraveling the complexity of the muscle spindle and its role in human locomotor control it appeared their dysfunction could underpin one explanation for falls that lead to high disability in older adult populations, especially those suffering from muscle atrophy and declining neural control. Herein, after reviewing most of the available evidence linking muscle spindles to normal human locomotion and its control, it appears increasing research evidence points to a possible key role for muscle spindles degeneration or dysfunction in acute as well as secondary falls related injuries and events. We conclude periodic muscle reflex testing of vulnerable older adults may reduce falls risk and emergency room visits. In addition, further benefits may accrue if fallers in the emergency room are examined to establish any ongoing need for sensorimotor rehabilitation and joint protection.

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