An optimal level of variability enables us to interact adaptively and safely to a continuously changing environment, where often our movements must be adjusted in a matter of milliseconds. A large body of research exists that demonstrates natural variability in healthy gait (along with variability in other, healthy biological signals such as heart rate) and a loss of this variability in aging and injury, as well as in a variety of neurodegenerative and physiological disorders. We submit that this field of research is now in pressing need of an innovative “next step” that goes beyond the many descriptive studies that characterize levels of variability in various patient populations. We need to devise novel therapies that will harness the existing knowledge on biological variability and create new possibilities for those in the grip of disease. We also propose that the nature of the specific physiological limitation present in the neuromuscular apparatus may be less important in the physiological complexity framework than the control mechanisms adopted by the older individual in the coordination of the available degrees of freedom. The theoretical underpinnings of this framework suggest that interventions designed to restore healthy system dynamics may optimize functional improvements in older adults. We submit that interventions based on the restoration of optimal variability and movement complexity could potentially be applied across a range of diseases or dysfunctions as it addresses the adaptability and coordination of available degrees of freedom, regardless of the internal constraints of the individual.
Stergiou and Kent are with the Center for Research in Human Movement Variability, Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE. Stergiou is also with the College of Public Health, University of Nebraska Medical Center, Omaha, NE. McGrath is with the School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.