Walking adaptability for targeted fall-risk assessments

Geerse, Daphne J.; Roerdink, Melvyn; Marinus, Johan; Hilten, Jacobus J. van

doi:10.1016/j.gaitpost.2019.02.013

Cited by 37 publications

(56 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…How the proposed relation between adaptability to repeated perturbations, locomotor system health and falls risk presents in daily-life remains unclear, and should be studied further. Additionally, there are many ways that walking adaptability can be assessed, and it is currently unclear if the method of assessment is critical (Geerse et al, 2019 ). Further research on walking adaptability in various tasks, including repeated external perturbations such as slips or trips, in older fallers and non-fallers, could help address this gap in knowledge.…”

Section: Discussionmentioning

confidence: 99%

Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults

Gerards

Meijer

Karamanidis

et al. 2021

Front. Sports Act. Living

View full text Add to dashboard Cite

Given that falls most commonly occur during walking due to unexpected balance perturbations like trips and slips, walking-based balance assessment including walking stability and adaptability to such perturbations could be beneficial for fall risk assessment in older adults. This cross-sectional study reanalyzed data from two larger studies conducted with the same walking protocol. Participants completed unperturbed walking trials at speeds of 0.4 m/s up to 1.8 m/s in 0.2 m/s steps. Ten unannounced treadmill belt acceleration perturbations were then applied while participants walked at equivalent stability, assessed using the margins of stability. Retrospective (12 months) falls incidence was collected to divide participants into people with and without a history of falls. Twenty older adults (mean age 70.2 ± 2.9 years) were included in this analysis; eight people with one or more recent falls and 12 people without, closely matched by sex, age and height. No significant differences were found in unperturbed walking parameters or their variability. Overall perturbation-recovery step behavior differed slightly (not statistically significant) between the groups after the first perturbation and differences became more pronounced and significant after repetition of perturbations. The No-Falls group significantly reduced the number of recovery steps needed across the trials, whereas the Falls group did not show these improvements. People with a previous fall tended to have slightly delayed and more variable recovery responses after perturbation compared to non-fallers. Non-fallers demonstrate more signs of adaptability to repeated perturbations. Adaptability may give a broader indication of the ability of the locomotor system to respond and improve responses to sudden walking perturbations than unperturbed walking variability or recovery to a single novel perturbation. Adaptability may thus be a more useful marker of falls history in older adults and should be considered in further research.

show abstract

Section: Discussionmentioning

confidence: 99%

Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults

Gerards

Meijer

Karamanidis

et al. 2021

Front. Sports Act. Living

View full text Add to dashboard Cite

show abstract

“…In walking, it is important to be able to adapt to environmental circumstances, including the ability to avoid obstacles. Currently, walking-adaptability training is done with real obstacles or with 2D projections onto the walking surface [50][51][52][53][54][55]. Compared to 2D projections, the HoloLens offers the possibility to go beyond 2D by presenting 3D holographic obstacles.…”

Section: A Look Into the Future: Applications Of Mixed-reality Technomentioning

confidence: 99%

Avoiding 3D Obstacles in Mixed Reality: Does It Differ from Negotiating Real Obstacles?

Coolen

Beek

Geerse

et al. 2020

Sensors

Self Cite

View full text Add to dashboard Cite

Mixed-reality technologies are evolving rapidly, allowing for gradually more realistic interaction with digital content while moving freely in real-world environments. In this study, we examined the suitability of the Microsoft HoloLens mixed-reality headset for creating locomotor interactions in real-world environments enriched with 3D holographic obstacles. In Experiment 1, we compared the obstacle-avoidance maneuvers of 12 participants stepping over either real or holographic obstacles of different heights and depths. Participants’ avoidance maneuvers were recorded with three spatially and temporally integrated Kinect v2 sensors. Similar to real obstacles, holographic obstacles elicited obstacle-avoidance maneuvers that scaled with obstacle dimensions. However, with holographic obstacles, some participants showed dissimilar trail or lead foot obstacle-avoidance maneuvers compared to real obstacles: they either consistently failed to raise their trail foot or crossed the obstacle with extreme lead-foot margins. In Experiment 2, we examined the efficacy of mixed-reality video feedback in altering such dissimilar avoidance maneuvers. Participants quickly adjusted their trail-foot crossing height and gradually lowered extreme lead-foot crossing heights in the course of mixed-reality video feedback trials, and these improvements were largely retained in subsequent trials without feedback. Participant-specific differences in real and holographic obstacle avoidance notwithstanding, the present results suggest that 3D holographic obstacles supplemented with mixed-reality video feedback may be used for studying and perhaps also training 3D obstacle avoidance.

show abstract

“…Reduced walking speed has also been tied to incidence of falls (Abellan Van Kan et al, 2009;Verghese et al, 2009;Middleton et al, 2016;Geerse et al, 2019) and fear of falling (Callisaya and Verghese, 2018;Geerse et al, 2019;van Schooten et al, 2019) in older adults. Slowed gait speed is a common characteristic of aging (Himann et al, 1988;Nigg and Skleryk, 1988;Bohannon, 1997;Jerome et al, 2015).…”

Section: Walking Speedmentioning

confidence: 99%

Interactions Between Different Age-Related Factors Affecting Balance Control in Walking

Reimann

Ramadan

Fettrow

et al. 2020

Front. Sports Act. Living

View full text Add to dashboard Cite

Maintaining balance during walking is a continuous sensorimotor control problem. Throughout the movement, the central nervous system has to collect sensory data about the current state of the body in space, use this information to detect possible threats to balance and adapt the movement pattern to ensure stability. Failure of this sensorimotor loop can lead to dire consequences in the form of falls, injury and death. Such failures tend to become more prevalent as people get older. While research has established a number of factors associated with higher risk of falls, we know relatively little about age-related changes of the underlying sensorimotor control loop and how such changes are related to empirically established risk factors. This paper approaches the problem of age-related fall risk from a neural control perspective. We begin by summarizing recent empirical findings about the neural control laws mapping sensory input to motor output for balance control during walking. These findings were established in young, neurotypical study populations and establish a baseline of sensorimotor control of balance. We then review correlates for deteriorating balance control in older adults, of muscle weakness, slow walking, cognitive decline, and increased visual dependency. While empirical associations between these factors and fall risk have been established reasonably well, we know relatively little about the underlying causal relationships. Establishing such causal relationships is hard, because the different factors all co-vary with age and are difficult to isolate empirically. One option to analyze the role of an individual factor for balance control is to use computational models of walking comprising all levels of the sensorimotor control loop. We introduce one such model that generates walking movement patterns from a short list of spinal reflex modules with limited supraspinal modulation for balance. We show how this model can be used to simulate empirical studies, and how comparison between the model and empirical results can indicate gaps in our current understanding of balance control. We also show how different aspects of aging can be added to this model to study their effect on balance control in isolation.

show abstract

Walking adaptability for targeted fall-risk assessments

Cited by 37 publications

References 33 publications

Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults

Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults

Avoiding 3D Obstacles in Mixed Reality: Does It Differ from Negotiating Real Obstacles?

Interactions Between Different Age-Related Factors Affecting Balance Control in Walking

Contact Info

Product

Resources

About