Motor readiness and joint torque production in lower limbs of older women fallers and non-fallers

Crozara, Luciano Fernandes; Morcelli, Mary Hellen; Marques, Nise Ribeiro; Hallal, Camilla Zamfolini; Spinoso, Déborah Hebling; Neto, Antônio Francisco de Almeida; Cardozo, Adalgiso Coscrato; Gonçalves, Mauro

doi:10.1016/j.jelekin.2013.04.016

Cited by 40 publications

(45 citation statements)

References 35 publications

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“…A decrease in rate of force development has been reported to be an important contributor to declining muscle function in older men (Thompson, Ryan, Sobolewski, Conchola, & Cramer, 2013) and a risk factor for falls in older women (Crozara et al, 2013). Although few previous studies have examined accelerometerderived measures of jerk, in one recent study maximum jerk was found to show expected improvements in response to training during a sit-to-stand activity in older people (Regterschot et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts

Hannam¹,

Deere²,

Worrall³

et al. 2016

Journal of Aging and Physical Activity

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The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (-0.53; -0.77, -0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (-0.39; -0.63, -0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.

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Section: Discussionmentioning

confidence: 99%

Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts

Hannam¹,

Deere²,

Worrall³

et al. 2016

Journal of Aging and Physical Activity

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“…2). A slower speed of strength generation has been shown to be a limiting factor to balance recovery during challenges to balance while standing on one leg, a movement similar to the weight acceptance phase of stair negotiation tasks (12,13,26). Therefore the decreased speed of strength generation observed in patients with neuropathy is expected to reduce their capability to adapt to a perturbation in balance and may therefore limit the speed at which the stairwalking tasks can be performed safely by patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore it is of importance to reduce any marked unsteadiness to prevent a fall occurring on stairs. Patients with diabetic neuropathy display slower joint strength generation when balance is challenged while standing on one leg (12,13). This may have implications during the single leg stance phases of walking up and down stairs and could therefore explain the increased chance of falling in this population.…”

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confidence: 99%

Contributory Factors to Unsteadiness During Walking Up and Down Stairs in Patients With Diabetic Peripheral Neuropathy

et al. 2014

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OBJECTIVEAlthough patients with diabetic peripheral neuropathy (DPN) are more likely to fall than age-matched controls, the underlying causative factors are not yet fully understood. This study examines the effects of diabetes and neuropathy on strength generation and muscle activation patterns during walking up and down stairs, with implications for fall risk. RESEARCH DESIGN AND METHODSSixty-three participants (21 patients with DPN, 21 diabetic controls, and 21 healthy controls) were examined while walking up and down a custom-built staircase. The speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles were analyzed. RESULTSPatients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P < 0.05). During ascent, the ankle and knee extensor muscles were activated significantly later by patients with neuropathy and took longer to reach peak activation (P < 0.05). During descent, neuropathic patients activated the ankle extensors significantly earlier, and the ankle and knee extensors took significantly longer to reach peak activation (P < 0.05). CONCLUSIONSPatients with DPN are slower at generating strength at the ankle and knee than control participants during walking up and down stairs. These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling. Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk.Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes, affecting up to 50% of older patients (1,2). It is characterized by sensory loss in the lower limbs, altered sense of joint position, and impaired muscular function, which can result in alterations to gait (1-5). Patients with neuropathy are five times more likely to fall than age-matched controls, with over half of patients reporting at least one fall per year (6,7). Falls while walking down stairs account for 60% of all fall-related deaths, making this activity 10 times more hazardous than level-ground walking (8).

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“…The older participants were divided into two groups: elderly fallers (n = 20) and elderly non-fallers (n = 24) based on whether the participant had fallen or not in the year before the evaluation. Similar to previous research [1,15,16], a fall was considered an unintentional event in which the subject ended on the ground and was investigated through a survey developed specifically for this study. Table 1 shows the descriptive characteristics of the sample.…”

Section: Subjectsmentioning

confidence: 99%

Neuromuscular performance in the hip joint of elderly fallers and non-fallers

et al. 2015

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Motor readiness and joint torque production in lower limbs of older women fallers and non-fallers

Cited by 40 publications

References 35 publications

Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts

Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts

Contributory Factors to Unsteadiness During Walking Up and Down Stairs in Patients With Diabetic Peripheral Neuropathy

Neuromuscular performance in the hip joint of elderly fallers and non-fallers

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