# Before the Fall: Anticipatory Brain Roles in Reactive Balance Control

> **NIH NIH R21** · UTAH STATE UNIVERSITY · 2020 · $107,853

## Abstract

PROJECT SUMMARY
There is a fundamental gap in understanding how the cerebral cortex contributes to balance control. Accumulating
evidence reveals a strong link between cognitive decline and increased prevalence of falls indicating that the brain plays a
meaningful role in controlling balance. However, beyond recognizing this correlation, there remains little mechanistic
understanding of what the brain actually does to avoid a fall. This knowledge gap is striking since higher brain processes
may offer powerful mechanisms to avoid falls in the cluttered and choice-demanding situations we encounter in daily life.
The long-term goal of the proposed research is to understand how higher brain processes help us prevent falls in the
complex environments we face every day, and how this changes with age. One important but untested way the brain may
help avoid falls is by preparing balance recovery actions by viewing objects in our surroundings. Such a mechanism may
help overcome the conflicting motor demands of speed and contextual adaptation, even when a loss of stability is
unexpected. The control of balance serves as a critical foundation for autonomy and an active lifestyle. As advances in
medical care have prolonged life expectancy, the need to preserve mobility and maintain independence has become an
increasing priority for the healthcare system. Falls become more commonplace as we get older and the potential for any
given fall leading to serious harm, long term disability or even death increases as we age. The objective in this application
is to determine if cortical motor output is modified when viewing objects that may be useful to recover balance and thus
avoid a fall. The central hypothesis is that viewing a safety handle will facilitate the motor cortical hand representation
relative to conditions where the handle is blocked. Furthermore, the successful ability to navigate the hand to establish a
new support base, and thus avoid a fall, will correlate with this pre-set. It is predicted that older adults will show an
impaired ability to appropriately modulate motor cortical activity based on visual cues when compared with young adults
and this will result in behavioral deficits. The rationale for the proposed research comes from studies in animals and
humans demonstrating that viewing objects can potentiate action, a concept known as `affordances.' Advance priming of
postural recovery reactions may help us avoid falls, especially in complex response environments where some actions are
afforded while others are blocked, and this may occur even before detecting a loss of balance. The hypothesis will be
tested by pursuing two specific aims: 1) To determine if motor cortical activity is facilitated by viewing a safety handle
and, if so, how this changes with age and 2) To determine if the pre-Supplementary Motor Area of the brain influences
motor cortical activity in conflict resolution of compensatory balance actions. This approach is innovative be...

## Key facts

- **NIH application ID:** 9850190
- **Project number:** 5R21AG061688-02
- **Recipient organization:** UTAH STATE UNIVERSITY
- **Principal Investigator:** David A Bolton
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $107,853
- **Award type:** 5
- **Project period:** 2019-01-15 → 2021-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850190

## Citation

> US National Institutes of Health, RePORTER application 9850190, Before the Fall: Anticipatory Brain Roles in Reactive Balance Control (5R21AG061688-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9850190. Licensed CC0.

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