Deficit or compensation in sensorimotor control of balance?

Musculoskeletal injuries, neurological conditions or simply healthy ageing can severely disrupt human balance, increasing fall risk and healthcare costs. Research traditionally follows a normative approach, comparing patients to healthy adults to identify deficits. However, this overlooks the adaptive nature of motor control: altered balance or gait may represent compensatory strategies rather than mere dysfunctions. To disambiguate what corresponds to a balance deficit or a compensation, we compare the neural control of balance during ageing, after maladaptation to a musculoskeletal injury (in chronic ankle instability) and during skill learning (in gymnasts performing handstands). We use motion capture and modelling to identify how the nervous system integrates sensory information and coordinates motor contractions during standing and walking. Our goal is to identify adaptive changes in neural control which may serve as targets for the rehabilitation of balance impairments.