Falls are the leading cause of fatal and non-fatal injuries among older adults. Age-related sensory degradation may increase instability and increase the risk of slips and falls in older adults. The integration of three sensory systems (visual, proprioceptive, and vestibular systems) and the respective weighting of each are needed to maintaining balance during unexpected slip-induced falls. The visual system is often thought of as the most important sensory system in playing a major role in stabilizing posture, guiding locomotion and controlling slip response. However, previous studies have focused on the age-related effects of visual input on static postural stability. The age-related effects of visual input associated with locomotion and unexpected slip perturbations (i.e., dynamic tasks) remains unclear.

The purpose of this study is to investigate the age-related effects of visual input on multi-sensory processing during locomotion and unexpected slip perturbations. Fifteen young and fifteen old adults were recruited to participate in this study. Motion capture system, force plate, and EMG data were collected during the experiments. Various biomechanical and neuromuscular characteristics were identified to quantify the age-related effects of visual input during locomotion and unexpected slip perturbations. The results indicate that temporary loss of visual input during walking could cause individuals to adopt a more cautious gait strategy to compensate for their physical and neuronal changes as shown in increased double support time and higher co-contraction (i.e., stiffness) of the knee and ankle joints. Older adults also have higher co-contraction at the ankle joint during walking as compared with young adults.

Regarding slip-induced falls, temporary loss of visual input causes increased slip distances and response times of upper and lower limbs in both younger and older groups. In terms of kinematics, the combination of age and temporary loss of visual input influenced the perturbed limb. In terms of muscle activation patterns, temporary loss of visual input may increase the proprioceptive gain as shown in early muscle activity onset, increased muscle activation duration, and increased co-contraction at the knee joint. However, stiffness may increase the difficulty to detect a slip event and reduce flexibility and increase slip-induced falls.

Although the human body cannot fully compensate for the temporary loss of visual input, the results in this study suggest that the reweighting process increases proprioceptive gain while visual input is unavailable. These findings support the implication of future research in order to understand the potential hazards which could occur while walking and slipping with temporary loss of visual input. The results may also contribute to the design of effective interventions to improve motor learning by applied visual occlusion in slips/falls training to reduce fall risk and enhance safety. The visual occlusion paradigm may assist to increase learning encoded in intrinsic coordination, related to motor performance skill, providing the flexibility required to adapt to complex environments such as slip-induced falls.