Brain-motor behavior coupling during walking while negotiating obstacle: A systematic review.
Zuhal Abasiyanik, Felipe Balistieri Santinelli, Tetsu Morozumi et al.
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In 30 seconds
This systematic review examined cortical activity alongside gait during obstacle negotiation in adults, using a brain–motor behavior framework. It included 13 studies (n = 649) of people with Parkinson’s disease or stroke, older adults, and young adults; eligible studies used concurrent functional near-infrared spectroscopy and gait assessment. Increased prefrontal cortex activation accompanied by impaired gait was common in Parkinson’s disease, stroke, and older adults, consistent with neural inefficiency. In healthy young and older adults, increased activation with preserved gait suggested compensation. Some studies found gait deterioration without increased activation, indicating possible capacity limitation.
Key findings
- Across 13 studies (n = 649), increased prefrontal activation with impaired gait was common in participants with Parkinson’s disease, stroke, and older age.
- Healthy young and older adults sometimes showed increased prefrontal activation while maintaining gait performance, consistent with neural compensation.
- Some studies reported gait deterioration without a corresponding change in cortical activation, suggesting capacity limitation under demanding conditions.
- Unanticipated obstacles and dual-task conditions were associated with further increases in prefrontal activation.
Why it matters
Obstacle negotiation draws on executive and motor resources, and the review links cortical activation patterns with whether gait is maintained or deteriorates. This framework may help interpret mobility challenges across neurological and ageing populations, while highlighting that greater activation is not necessarily evidence of better performance. Task demands and available neural reserve appear relevant to adaptive walking.
What to keep in mind
The review included only 13 studies, and most assessed prefrontal activity; the authors identify the need to investigate additional cortical regions. Methodological factors also influenced findings.