Balance task difficulty affects postural sway and cortical activity in healthy adolescents

Electroencephalographic (EEG) research indicates changes in adults' low frequency bands of frontoparietal brain areas executing different balance tasks with increasing postural demands. However, this issue is unsolved for adolescents when performing the same balance task with increasing difficulty. Therefore, we examined the effects of a progressively increasing balance task difficulty on balance performance and brain activity in adolescents. Thirteen healthy adolescents aged 16-17 year performed tests in bipedal upright stance on a balance board with six progressively increasing levels of task difficulty. Postural sway and cortical activity were recorded simultaneously using a pressure sensitive measuring system and EEG. The power spectrum was analyzed for theta (4-7 Hz) and alpha-2 (10-12 Hz) frequency bands in pre-defined frontal, central, and parietal clusters of electrocortical sources. Repeated measures analysis of variance (rmANOVA) showed a significant main effect of task difficulty for postural sway (p < 0.001; d = 6.36). Concomitantly, the power spectrum changed in frontal, bilateral central, and bilateral parietal clusters. RmANOVAs revealed significant main effects of task difficulty for theta band power in the frontal (p < 0.001, d = 1.80) and both central clusters (left: p < 0.001, d = 1.49; right: p < 0.001, d = 1.42) as well as for alpha-2 band power in both parietal clusters (left: p < 0.001, d = 1.39; right: p < 0.001, d = 1.05) and in the central right cluster (p = 0.005, d = 0.92). Increases in theta band power (frontal, central) and decreases in alpha-2 power (central, parietal) with increasing balance task difficulty may reflect increased attentional processes and/or error monitoring as well as increased sensory information processing due to increasing postural demands. In general, our findings are mostly in agreement with studies conducted in adults. Similar to adult studies, our data with adolescents indicated the involvement of frontoparietal brain areas in the regulation of postural control. In addition, we detected that activity of selected brain areas (e.g., bilateral central) changed with increasing postural demands.