Centre of mass control is reduced in older people when descending stairs at an increased riser height

Foster, Richard J.; Maganaris, Constantinos N.; Reeves, Neil D.; Buckley, John

doi:10.1016/j.gaitpost.2019.08.004

Cited by 13 publications

(5 citation statements)

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“…Therefore, it is expected that both groups would be at an increased fall risk, and by the same mechanisms, on stairs with inconsistent rise heights. However, it is likely that the consequences will be more severe for the older adults who may not be able to control their CoM as well as younger adults (Foster et al, 2019) as they do not have adequate strength reserves to recover should they lose balance (Pijnappels et al, 2008;Reeves et al, 2008). It previously been reported that poor lighting conditions (Kim, 2009;Thomas et al, 2020) and dual-tasking such as talking on the phone (Di Giulio et al, 2020) can further compromise Figure 6.…”

Section: Discussionmentioning

confidence: 99%

Negotiating stairs with an inconsistent riser: Implications for stepping safety

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Negotiating stairs with an inconsistent riser: Implications for stepping safety

et al. 2020

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“…Although stair fall risk is notably heightened for an older adult largely due to age related factors such as reduced vision or musculoskeletal function [2], stairs falls occur across the lifespan [3] and are a broad societal issue. Many factors can affect stair fall risk including frailty, risky behaviour (such as carrying objects on stairs) and poor vision [2], but several previous reports demonstrate the importance of the built environment and in particular stair dimensions in dynamic balance control and the circumstance of stair falls [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Using a stair horizontal-vertical illusion to increase foot clearance over an inconsistently taller stair-riser

et al. 2021

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Introduction Stair falls can be caused by inconsistent stair dimensions. During ascent, inconsistently taller stair risers lead to reduced foot clearances as the inconsistency goes unnoticed. A stair horizontal-vertical illusion increases perceived riser heights and foot clearance and could offset reduced foot clearances over inconsistently taller risers, though this might impact other stair safety measures. Method Twelve participants (age: 22 (3) years) ascended a seven-step staircase under three conditions: i) all steps consistent in riser height (consistent), ii) a 1cm increase in step 5 riser height (inconsistent) and iii) a 1cm increase in step 5 riser height, superimposed with a stair horizontal-vertical illusion (illusion). Vertical foot clearance, foot overhang, and margins of stability were assessed over step 4, 5 and 6. Perceived riser height due to the illusion was determined through a computer perception test. A One-Way Repeated Measures ANOVA compared biomechanical variables between conditions. A One Sample t test compared perceived riser height to the true height. Results Over the inconsistent step 5, foot clearance reduced by 0.8cm compared to consistent. Illusion increased foot clearance by 1.1cm and decreased foot overhang by 4% compared to inconsistent. On step 4 the illusion led to more anterior instability compared to inconsistent. Illusion and inconsistent led to more mediolateral stability compared to consistent. The illusion increased perceived riser height by 12%. Discussion Foot clearance reductions over inconsistently taller risers can be offset by a stair horizontal-vertical illusion. Additional benefits included a safer foot overhang and unaffected stability over the inconsistent riser. Changes to step 4 stability might have resulted from leaning forward to look at the step 5 illusion. The stair horizontal-vertical illusion could be a practical solution for inconsistently taller stair risers, where a rebuild is usually the only solution.

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“…Most research on this parameter derives from biomechanics analysis in runners, but it is also known that older people for example display a lower landing acceleration, e.g., while descending stairs. This is believed to be a compensation mechanism for the poorer balance control, which is achieved by increased "stiffening" at knee and ankle of the stance leg [17]. We believe that this phenomenon may underlie the particular walking pattern, which in few of our patients results in a clinically evident cautious-seeming, heel-based gait, as if they were "walking on eggshells".…”

Section: Discussionmentioning

confidence: 74%

Instrumented gait analysis defines the walking signature of CACNA1A disorders

et al. 2021

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Background Gait disturbances are a frequent symptom in CACNA1A disorders. Even though, data about their severity and progression are lacking and no CACNA1A-specific scale or assessment for gait is available. Methods We applied a gait assessment protocol in 20 ambulatory patients with genetically confirmed CACNA1A disorders and 39 matched healthy controls. An instrumented gait analysis (IGA) was performed by means of wearable sensors in basal condition and after a treadmill/cycloergometer challenge in selected cases. Results CACNA1A patients displayed lower gait speed, shorter steps with increased step length variability, a reduced landing acceleration as well as a reduced range of ankle motion compared to controls. Furthermore, gait-width in patients with episodic CACNA1A disorders was narrower as compared to controls. In one patient experiencing mild episodic symptoms after the treadmill challenge, the IGA was able to detect a deterioration over all gait parameters. Conclusions In CACNA1A patients, the IGA with wearable sensors unravels specific gait signatures which are not detectable at naked eye. These features (narrow-based gait, lower landing acceleration) distinguish these patients from other ataxic disorders and may be target of focused rehabilitative interventions. IGA can potentially be applied to monitor the neurological fluctuations associated with CACNA1A disorders.

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Centre of mass control is reduced in older people when descending stairs at an increased riser height

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Cited by 13 publications

References 25 publications

Negotiating stairs with an inconsistent riser: Implications for stepping safety

Negotiating stairs with an inconsistent riser: Implications for stepping safety

Using a stair horizontal-vertical illusion to increase foot clearance over an inconsistently taller stair-riser

Instrumented gait analysis defines the walking signature of CACNA1A disorders

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