[Purpose] Tripping is a frequent cause of falls among aging adults. Appropriate limb
movements while negotiating obstacles are critical to trip avoidance. The aim of our study
was to investigate the mechanics of obstacle crossing in older adults at low or high risk
of falling. [Subjects and Methods] Twenty community-dwelling adults aged ≥55 years, were
evaluated with the Tinetti Balance and Gait scale and classified as being at high or low
risk of falling. Between-group comparisons of kinematics were evaluated for obstacle
heights of 10%, 20%, and 30% of leg length. [Results] The high-risk group demonstrated
greater toe-obstacle clearance of the leading leg. Increasing obstacle height led to
increased maximal toe-obstacle clearance, toe-obstacle distance, and shortened swing phase
of the leading limb. Adaptation of clearance height was greater for the trailing leg.
Individuals at high risk of falling demonstrated less symmetry between the leading and
trailing legs and a narrower step width, features that increase the likelihood of
tripping. [Conclusion] Kinematic parameters of obstacle clearance, including the symmetry
index described in our study, could provide clinicians with a quick screening tool to
identify patients at risk of falling and to evaluate outcomes of training programs.
The aim of this study was to clarify the effects of general anesthesia (GA) on joint range of motion (ROM) in children with spastic cerebral palsy (SCP). Eighty-four SCP cases (mean age 8.4 years) admitted for first corrective surgery were retrospectively reviewed. Lower limb ROM were measured 1 day before operation and immediately after GA. Contracture of hip, knee, and ankle joints decreased significantly after GA, with + 11.1° (39.5%) for the hip abduction angle, −3.7° (18.0%) for the Thomas test, −15.0° (19.1%) for the popliteal angle, + 6.6° (39.8%) and 7.0° (109%) for ankle dorsiflexion with knee flexion and extension, respectively (all P < 0.001). These changes were correlated positively to pre-GA contracture and body weight, negatively to age, but independent of preoperative functional level, geographic classification of SCP, or modified Ashworth scale. On the basis of these findings, routine post-GA reassessments of joint ROM before corrective surgeries were recommended for pediatric SCP cases.
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