Modifiable performance domain risk-factors associated with slip-related falls

Troy, Karen L.; Donovan, Stephanie; Marone, Jane R.; Bareither, Mary Lou; Grabiner, Mark D.

doi:10.1016/j.gaitpost.2008.02.008

Cited by 39 publications

(43 citation statements)

References 21 publications

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“…A more anteriorly positioned COM at this phase of the gait cycle would therefore be expected to be beneficial for this recovery strategy. However, when walking on a slippery surface, the placement of the recovery foot posterior to the COM was not translated into a successful recovery from a slip at heel strike 22 . This may be due to recovery responses differing between slips initiated by a slipping platform and those by a slippery surface, with slips due to the surface thought to be more representative of those that occur in the community 23 .…”

Section: Discussionmentioning

confidence: 99%

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

et al. 2015

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Studying the relationships between centre of mass (COM) and centre of pressure (COP) during walking has been shown to be useful in determining movement stability. The aim of the current study was to compare COM-COP separation measures during walking between groups of older adults with no history of falling, and a history of falling due to tripping or slipping. Any differences between individuals who have fallen due to a slip and those who have fallen due to a trip in measures of dynamic balance could potentially indicate differences in the mechanisms responsible for falls. Forty older adults were allocated into groups based on their self-reported fall history during walking. The non-faller group had not experienced a fall in at least the previous year. Participants who had experienced a fall were split into two groups based on whether a trip or slip resulted in the fall(s). A Vicon system was used to collect full body kinematic trajectories. Two force platforms were used to measure ground reaction forces. The COM was significantly further ahead of the COP at heel strike for the trip (14.3±2.7cm) and slip (15.3±1.1cm) groups compared to the nonfallers (12.0±2.7cm). COM was significantly further behind the COP at foot flat for the slip group (-14.9±3.6cm) compared to the non-faller group (-10.3±3.9cm). At mid-swing, the COM of the trip group was ahead of the COP (0.9±1.6cm), whereas for the slip group the COM was behind the COP (-1.2±2.2cm). These results show identifiable differences in dynamic balance control of walking between older adults with a history of tripping or slipping and non-fallers.

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Section: Discussionmentioning

confidence: 99%

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

et al. 2015

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“…The ability to control balance is a critical condition for minimizing the risk of falls [38]. The skills necessary to recover from the treadmill-induced postural disturbances such as resisting trunk rotation and quickly executing long steps [6,32,43] are the same skills required to recover from trips [35] and slips [48]. The focus of the rehabilitation program was to increase the ability of the subjects to respond to large postural perturbations and perform the recovery steps necessary to avoid a fall.…”

Section: Discussionmentioning

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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“…However the trunk, due to its large relative mass, also has the potential to substantially influence the position and velocity of the body's CoM and hence the MoS. Trunk kinematics have been reported to discriminate between fallers and non-fallers during recovery from trip [19,20] and slip [21] perturbations (see Grabiner et al [2] for review). For example, older fallers exhibit greater trunk flexion than aged-matched nonfallers during recovery from an induced trip [20].…”

Section: Introductionmentioning

confidence: 99%

Recovery from forward loss of balance in young and older adults using the stepping strategy

2011

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Modifiable performance domain risk-factors associated with slip-related falls

Cited by 39 publications

References 21 publications

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

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

Recovery from forward loss of balance in young and older adults using the stepping strategy

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