Preventing <scp>T</scp>rip‐<scp>R</scp>elated <scp>F</scp>alls by <scp>C</scp>ommunity‐<scp>D</scp>welling <scp>A</scp>dults: <scp>A P</scp>rospective <scp>S</scp>tudy

Rosenblatt, Noah J.; Marone, Jane R.; Grabiner, Mark D.

doi:10.1111/jgs.12428

Cited by 74 publications

(90 citation statements)

References 6 publications

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“…However, the extent to which this translates to increased safety in the community depends, in part, on the scope of the problem of trip-related falls by people with TTAs. Although trip-related falls are the leading fall-cause for nondisabled older adults [3,[8][9][10], and one that is amenable to intervention [38], similar results have yet to be established in people with TTAs.…”

Section: Discussionmentioning

confidence: 91%

Active dorsiflexing prostheses may reduce trip-related fall risk in people with transtibial amputation

et al. 2014

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Abstract-People with amputation are at increased risk of falling compared with age-matched, nondisabled individuals. This may partly reflect amputation-related changes to minimum toe clearance (MTC) that could increase the incidence of trips and fall risk. This study determined the contribution of an active dorsiflexing prosthesis to MTC. We hypothesized that regardless of speed or incline the active dorsiflexion qualities of the ProprioFoot would significantly increase MTC and decrease the likelihood of tripping. Eight people with transtibial amputation walked on a treadmill with their current foot at two grades and three velocities, then repeated the protocol after 4 wk of accommodation with the ProprioFoot. A mixed-model, repeated-measures analysis of variance was used to compare MTC. Curves representing the likelihood of tripping were derived from the MTC distributions and a multiple regression was used to determine the relative contributions of hip, knee, and ankle angles to MTC. Regardless of condition, MTC was approximately 70% larger with the ProprioFoot (p < 0.001) and the likelihood of tripping was reduced. Regression analysis revealed that MTC with the ProprioFoot was sensitive to all three angles, with sensitivity of hip and ankle being greater. Overall, the ProprioFoot may increase user safety by decreasing the likelihood of tripping and thus the pursuant likelihood of a fall.

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Section: Discussionmentioning

confidence: 91%

Active dorsiflexing prostheses may reduce trip-related fall risk in people with transtibial amputation

et al. 2014

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“…Three PBT studies have been carried out with healthy, community‐dwelling older adults that prospectively monitored falls and included a control group 19, 31, 32. Rosenblatt et al .…”

Section: Resultsmentioning

confidence: 99%

“…During the 1‐year follow up, the control group ( n = 80) experienced 31 likely preventable trip‐related falls (i.e. compensatory stepping was possible), compared with a significantly lower 17 likely preventable trip‐related falls in the intervention group 32. Pai et al .…”

Section: Resultsmentioning

confidence: 99%

“…In the studies discussed above, two studies applied perturbations that caused a loss of balance in the backward direction 31, 33. Another study applied only perturbations leading to a forward loss of balance,32 whereas three studies applied perturbations in both directions 34, 35, 36. Although the impact of perturbation direction on falls incidence or types of falls experienced is not known, there is evidence to suggest that adaptation to perturbations in one direction might not transfer and benefit reactive balance control in another direction 27, 38.…”

Section: Resultsmentioning

confidence: 99%

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Perturbation‐based balance training for falls reduction among older adults: Current evidence and implications for clinical practice

Gerards

McCrum

Mansfield

et al. 2017

Geriatrics Gerontology Int

207

151

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Falls are a leading cause of injury, hospitalization and even death among older adults. Although various strength and balance exercise interventions have shown moderate reductions in falls incidence among healthy older adults, no significant falls incidence improvements have been consistently seen in frail older adults or in patient groups with an increased falls risk (e.g. people with Parkinson's disease and stroke). This might be due to a lack of task specificity of previous exercise interventions to the recovery actions required to prevent a fall. Perturbation‐based balance training (PBT) is an emerging task‐specific intervention that aims to improve reactive balance control after destabilizing perturbations in a safe and controlled environment. Although early studies were carried out predominantly in research laboratory settings, work in clinical settings with various patient groups has been proliferating. A systematic search of recent PBT studies showed a significant reduction of falls incidence among healthy older adults and certain patient groups (e.g. people with Parkinson's disease and stroke), with clinically relevant reductions in frail older adults. The most practical methods in clinical settings might be treadmill‐based systems and therapist‐applied perturbations, and PBT that incorporates multiple perturbation types and directions might be of most benefit. Although more controlled studies with long‐term follow‐up periods are required to better elucidate the effects of PBT on falls incidence, PBT appears to be a feasible and effective approach to falls reduction among older adults in clinical settings. Geriatr Gerontol Int 2017; 17: 2294–2303..

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“…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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Preventing Trip‐Related Falls by Community‐Dwelling Adults: A Prospective Study

Cited by 74 publications

References 6 publications

Active dorsiflexing prostheses may reduce trip-related fall risk in people with transtibial amputation

Active dorsiflexing prostheses may reduce trip-related fall risk in people with transtibial amputation

Perturbation‐based balance training for falls reduction among older adults: Current evidence and implications for clinical practice

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

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