Lateral Stability During Forward-Induced Stepping for Dynamic Balance Recovery in Young and Older Adults

Rogers, Mark W.; Hedman, Lois Deming; Johnson, Matthew L.; Cain, Thomas D.; Hanke, Timothy

doi:10.1093/gerona/56.9.m589

Cited by 137 publications

(105 citation statements)

References 27 publications

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“…This review has shown that balance evaluations are very different, both in protocols and in measurement methods, and that direct comparisons among studies and data interpretation are extremely limited. Many experimental protocols indicated that increased postural sway in older adults is well documented and research findings highlighted a correlation between postural sway and increased risk of falling not only on a static board (Baloh et al 1994;Benjuya et al 2004;Billot et al 2010;Fernie et al 1982;Hasselkus & Shambes 1975;Kang et al 2009;Lajoie et al 2002;Lord et al 1994;Maki et al 1994;Melzer et al 2004;Stel et al 2003), but also on an unstable board (Nardone et al 1994;Nardone et al 2000;Woollacott & Shumway-Cook 1990;Wolfson et al 1994;Rogers et al 2001). All Medial lateral sway in both the conditions (eyes open and closed) was found to be a distinguishing variable between older "fallers" and "non-fallers" in both static and dynamic narrow stance condition .…”

Section: Discussionmentioning

confidence: 99%

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The contribution of postural balance analysis in older adult fallers: A narrative review

Pizzigalli

Cremasco

Mulasso

et al. 2016

Journal of Bodywork and Movement Therapies

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Section: Discussionmentioning

confidence: 99%

“…Thus the loss of lateral postural control in fallers could be explained by an asymmetric muscle strength loss in their lower limbs. Good lateral postural control is essential for a protective role in response to destabilizing events (Rogers et al 2001).…”

Section: Distinguishing Characteristics Of Older "Fallers" and "Non-fmentioning

confidence: 99%

The contribution of postural balance analysis in older adult fallers: A narrative review

Pizzigalli

Cremasco

Mulasso

et al. 2016

Journal of Bodywork and Movement Therapies

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“…Failed compensatory steps have been observed in 45% of older adult falls in the free-living environment [17]. Although compensatory stepping is impaired with older age [13,24,26,33,39], it is a modifiable skill that improves with practice [4,11,40,46]. A task-specific fall prevention training program has been developed based on compensatory step training that has successfully reduced trip-related falls by the elderly after laboratory-induced trips [11] and prospectively reported trip-related falls that occur in the community [41].…”

Section: Introductionmentioning

confidence: 99%

Task-specific Fall Prevention Training Is Effective for Warfighters With Transtibial Amputations

Kaufman

Wyatt

Sessoms

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Key factors limiting patients with lower extremity amputations to achieve maximal functional capabilities are falls and fear of falling. A task-specific fall prevention training program has successfully reduced prospectively recorded trip-related falls that occur in the community by the elderly. However, this program has not been tested in amputees. Questions/purposes In a cohort of unilateral transtibial amputees, we aimed to assess effectiveness of a falls prevention training program by (1) quantifying improvements in trunk control; (2) measuring responses to a standardized perturbation; and (3) demonstrating retention at 3 and 6 months after training. Second, we collected patientreported outcomes for balance confidence and falls control. Methods Fourteen male military service members (26 ± 3 years) with unilateral transtibial amputations and who had been walking without an assistive device for a median of 10 months (range, 2-106 months) were recruited to participate in this prospective cohort study. The training program used a microprocessor-controlled treadmill designed to deliver task-specific postural perturbations that simulated a trip. The training consisted of six 30-minute sessions delivered over a 2-week period, during which task difficulty, including perturbation magnitude, increased as the patient's ability progressed. Training effectiveness was assessed using a perturbation test in an This study was funded by the Department of Defense Grant Number W81X-WH-11-2-0058 (Log No. DM090896) and the Navy Bureau of Medicine and Surgery, Wounded, Ill, and Injured Program. Approved for public release; distribution is unlimited. This research was conducted in compliance with all applicable federal regulations governing the protection of human subjects (protocol NMCSD.2001.003 and Protocol NHRC.2001.0031). The institution of one or more of the authors (MDG) has a patent on technology (ActiveStep TM ; Symbex, Lebanon, NH, USA) noted in this manuscript. One of the authors (MDG) is an inventor of the ActiveStep TM system but has no conflicts of interest to declare with regard to the present study. The views expressed are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government. Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® immersive virtual environment. The key outcome variables were peak trunk flexion and velocity, because trunk kinematics at the recovery step have been shown to be a determinant of fall likelihood. The patient-reported outcomes were also collected using questionnaires. The effectiveness of the rehabilitation program was also assessed by collecting data before perturbation training and comparing the key outcome parameters with those measured immediately after perturbation training (0 months) as well as both 3 and 6 months posttraining. Results Mean trunk flexion angle and velocity significantly improved after participating in the ...

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“…Alternatively, reduced toe clearance may also be related to the significant reduction in mediolateral (ML) center of mass (COM)-center of pressure (COP) separation determined for older adults, which results in reduction in sideways momentum of the body 22) . Without adequate sideways momentum of the body more energy would have been required to lift the swing leg sufficiently to clear the obstacle edge, because elevation of the swing leg occurs with a sideways tilting motion of the body 23) . Older adults appeared to adopt a stability-oriented strategy to minimize the risk of ML instability by reducing toe clearance of the trailing leg.…”

Section: Discussionmentioning

confidence: 99%

Effects of Illumination on Toe Clearance and Gait Parameters of Older Adults when Stepping over an Obstacle: a Pilot Study

Cho

Ryu

et al. 2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate how older adults adjust gait patterns when stepping over a ground-based obstacle under two different lighting conditions. [Subjects] A total of 10 communitydwelling healthy older adults (mean age, 67.9 ± 2.12 years; age range, 65-72 years) were enrolled in this study.[Methods] All participants stood quietly in a self-selected foot position on the floor. Each participant was then instructed to step over a 10 cm high wooden obstacle under two illumination conditions (1 and 200 lx) at a selfselected pace with the right leg in response to the verbal cue "GO", and continued walking with the left leg on a 5 m pathway. Toe clearances and step parameters were measured using an eight-camera motion analysis system.[Results] Under the low lighting condition, toe clearance of the trailing leg was significantly lower than under the normal lighting condition. However, no significant differences were observed in toe clearance of the lead leg, step velocity, stride length, step length, cadence, or swing/stance duration between the normal and low lighting conditions.[Conclusion] Older adults reduce toe clearance of the trailing leg under low lighting conditions while stepping over an obstacle, which places them at greater risk of falling.

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Lateral Stability During Forward-Induced Stepping for Dynamic Balance Recovery in Young and Older Adults

Cited by 137 publications

References 27 publications

The contribution of postural balance analysis in older adult fallers: A narrative review

The contribution of postural balance analysis in older adult fallers: A narrative review

Task-specific Fall Prevention Training Is Effective for Warfighters With Transtibial Amputations

Effects of Illumination on Toe Clearance and Gait Parameters of Older Adults when Stepping over an Obstacle: a Pilot Study

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