Balance control during stair negotiation in older adults

Lee, Heng-Ju; Chou, Li-Shan

doi:10.1016/j.jbiomech.2006.11.001

Cited by 109 publications

(71 citation statements)

References 21 publications

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“…Indeed, going up and down stairs is rated by older adults to be among the most difficult tasks in their daily life (Williamson and Fried, 1996). Falls are three times more frequent during descent than ascent (Svanström, 1974;Tinetti et al, 1988), which seems often to be explained by a decline in the ability to regulate body sway during the stair-to-floor transition when descending (Lee and Chou, 2007). In response to these changes, older adults adopt cautionary behaviors in stair cases, such as lowering their speed, watching their feet while walking, and using the handrails (Hamel and Cavanagh, 2004).…”

Section: Obstacle Negotiationmentioning

confidence: 99%

Review of safety and mobility issues among older pedestrians

Tournier

Dommès²,

Cavallo³

2016

Accident Analysis & Prevention

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a b s t r a c tAlthough old people make up an extremely vulnerable road-user group, older pedestrians' difficulties have been studied less extensively than those of older drivers, and more knowledge of this issue is still required. The present paper reviews current knowledge of older-adult problems with the main components of pedestrian activity, i.e., walking and obstacle negotiation, wayfinding, and road crossing. Compared to younger ones, old pedestrians exhibit declining walking skills, with a walking speed decrease, less stable balance, less efficient wayfinding strategies, and a greater number of unsafe road crossing behaviors. These difficulties are linked to age-related changes in sensorial, cognitive, physical, and self-perception abilities. It is now known that visual impairment, physical frailty, and attention deficits have a major negative impact on older pedestrians' safety and mobility, whereas the roles of self-evaluation and self-regulation are still poorly understood. All these elements must be taken into consideration, not only in developing effective safety interventions targeting older pedestrians, but also in designing roads and cars. Recent initiatives are presented here and some recommendations are proposed.

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Section: Obstacle Negotiationmentioning

confidence: 99%

Review of safety and mobility issues among older pedestrians

Tournier

Dommès²,

Cavallo³

2016

Accident Analysis & Prevention

View full text Add to dashboard Cite

show abstract

“…Several studies that compared the postural control of healthy young and older adults focused on the importance of dynamic balance when climbing and descending stairs 18 and during gait 19 . These studies indicated that older adults do not reduce body sway effectively during the stair-to-floor transition and that they are more careful when submitted to a faster gait due to the fear of losing their balance.…”

Section: Introductionmentioning

confidence: 99%

Comparação da oscilação postural estática na posição sentada entre jovens e idosos saudáveis

Melo¹,

Ferreira²,

Santos-Pontelli³

et al. 2009

Rev. bras. fisioter.

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“…Therefore, measurement of separation between the center of mass and center of pressure provides a superior measure, as it accounts for both postural movements (via the center of mass) and foot placements (via the center of pressure). Given the implicit relationship between increased separations of the center of mass from the center of pressure and the increase in muscular effort required to maintain upright posture, higher separations between the two represent greater challenges to balance (14,15). While a number of previous studies in other populations have used this measure (15,16), it has only been applied in a patient population with diabetes during quiet standing (17), where balance is relatively unchallenged and the risk of falling is low.…”

mentioning

confidence: 99%

Diabetic Peripheral Neuropathy Compromises Balance During Daily Activities

et al. 2015

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OBJECTIVEPatients with diabetes with peripheral neuropathy have a well-recognized increased risk of falls that may result in hospitalization. Therefore this study aimed to assess balance during the dynamic daily activities of walking on level ground and stair negotiation, where falls are most likely to occur. RESEARCH DESIGN AND METHODSGait analysis during level walking and stair negotiation was performed in 22 patients with diabetic neuropathy (DPN), 39 patients with diabetes without neuropathy (D), and 28 nondiabetic control subjects (C) using a motion analysis system and embedded force plates in a staircase and level walkway. Balance was assessed by measuring the separation between the body center of mass and center of pressure during level walking, stair ascent, and stair descent. RESULTSDPN patients demonstrated greater (P < 0.05) maximum and range of separations of their center of mass from their center of pressure in the medial-lateral plane during stair descent, stair ascent, and level walking compared with the C group, as well as increased (P < 0.05) mean separation during level walking and stair ascent. The same group also demonstrated greater (P < 0.05) maximum anterior separations (toward the staircase) during stair ascent. No differences were observed in D patients. CONCLUSIONSGreater separations of the center of mass from the center of pressure present a greater challenge to balance. Therefore, the higher medial-lateral separations found in patients with DPN will require greater muscular demands to control upright posture. This may contribute to explaining why patients with DPN are more likely to fall, with the higher separations placing them at a higher risk of experiencing a sideways fall than nondiabetic control subjects.Patients with diabetic peripheral neuropathy (DPN) have an altered gait strategy (1-3) and a fivefold increased risk of falling (4-6). Falling is a major health risk in many developed countries; for example, in the general U.K. population, over a quarter of accidents that required hospital treatment were the result of a fall (7). A fall is preceded by loss of balance, which may be recoverable in some individuals, but requires rapid responses and a high level of strength from the lower-limb muscles (8,9). Nevertheless, the more likely an individual is to lose balance, the more likely they will at some point experience a fall. Therefore, quantifying balance control

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Balance control during stair negotiation in older adults

Cited by 109 publications

References 21 publications

Review of safety and mobility issues among older pedestrians

Review of safety and mobility issues among older pedestrians

Comparação da oscilação postural estática na posição sentada entre jovens e idosos saudáveis

Diabetic Peripheral Neuropathy Compromises Balance During Daily Activities

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