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

Abstract

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.

Variabilidade E Confiabilidade Dos Parâmetros Cinemáticos Da Marcha De Idosos Após Um Tropeço Controlado: Estudo Preliminar

“…The mean walking speed (1.18±0.14 m/s), stride time (1.06±0.08 s) and stride length (1.25±0.08 m) are comparable to those reported by Hollman and colleagues 28 for women of similar age (1.16±0.20 m/s; 1.06±0.13 s; 1.23±0.17 m). These results are also similar to the group that experienced a previous fall due to tripping (1.19±0.20 m/s; 1.06±0.08 s; 1.26±0.17 m) 22 . The findings of Wright and colleagues 22 showed no differences in gait kinematics when non-fallers were compared to individuals with a fall history, irrespective of the cause of the event (i.e., trip or slip).…”

“…There are several indications that these populations differ with respect to their ability to recover from a trip 21 , in which older adults are less able to regain balance and, therefore, more vulnerable to falls 20 . Although Wright and colleagues 22 showed that previous experience of falling did not result in gait pattern changes, others have reported a more cautious pattern due to fear of tripping and falling 23 , which may occur within and between sessions. Older adults tend to be more susceptible to fear of falling than their young counterparts 23 .…”

Muscle Spindles and Locomotor Control-An Unrecognized Falls Determinant?

“…All phases of the gait cycle, including stance and swing, plus inter limb coordination appear to be influenced by the length, velocity and stretch sensitivity of spindle afferents, Since defects in this process may explain the presence of a heightened fall risk in individual's with neuromuscular deficiencies and others [66,67] , as well as why walking trajectories of fallers who have tripped are more extensive than those who have slipped [68] , this paper examined what we know about muscle spindle activity in the context of locomotion for purposes of advancing our understanding of the nature of falls injuries among older adults and others. Although the current hypothesis has not been put to any adequate test, the available data do imply that an improved understanding of the link between muscle afferents, and their behavior as this affects locomotor activity can potentially help to predict who is at risk, and explain why exercise can reduce falls injuries in some cases, but not others.…”

Tripping Elicits Earlier and Larger Deviations in Linear Head Acceleration Compared to Slipping

“…After repeating this for a minimum of 20 walking trials, six of the participants were unexpectedly slipped, while the other six were unexpectedly tripped, during a randomly selected trial. Each participant was slipped or tripped only once because previous research has shown that gait characteristics are altered following exposure to a slip or a trip [26–28]. Exposing a participant to both a slip or trip would significantly influence gait characteristics, and likely head acceleration, for the second perturbation.…”