Concurrent supra-postural auditory-hand coordination task affects postural control: Using sonification to explore environmental complexity in factors affecting fall risk

Clinical screening tests for balance and mobility often fall short of predicting fall risk. Cognitive distractors and unpredictable external stimuli, common in busy natural environments, contribute to this risk, especially in older adults. Less is known about the effects of upper sensory-motor coordination, such as coordinating one's hand with an external stimulus. We combined movement sonification and affordable inertial motion sensors to develop a task for the precise measurement and manipulation of full-body interaction with stimuli in the environment. In a double-task design, we studied how a supra-postural activity affected quiet stance. The supra-postural task consisted of rhythmic synchronization with a repetitive auditory stimulus. The stimulus was attentionally demanding because it was being modulated continuously. The participant's hand movement was sonified in real time, and their goal was to synchronize their hand movement with the stimulus. In the unpredictable condition, the tempo changed at random points in the trial. A separate sensor recorded postural fluctuations. Young healthy adults were compared to older adult (OA) participants without known risk of falling. The results supported the hypothesis that supra-postural coordination would entrain postural control. The effect was stronger in OAs, supporting the idea that diminished reserve capacities reduce the ability to isolate postural control from sensory-motor and cognitive activity.