Effects of step length, age, and fall history on hip and knee kinetics and knee co-contraction during the maximum step length test

Abstract

Background-Maximum step length is a brief clinical test involving stepping out and back as far as possible with the arms folded across the chest. This test has been shown to predict fall risk, but the biomechanics of this test are not fully understood. Knee and hip kinetics (moments and powers) are greater for longer steps and for younger subjects, but younger subjects also step farther.Methods-To separate effects of step length, age, and fall history on joint kinetics; 14 healthy younger, 14 older non-fallers, and 11 older fallers (27(5), 72(5), 75(6) years respectively) all stepped to the same relative target distances of 20-80% of their height. Knee and hip kinetics and knee co-contraction were calculated.Findings-Hip and knee kinetics and knee co-contraction all increased with step length, but older non-fallers and fallers utilized greater stepping hip and less stepping knee extensor kinetics. Fallers had greater stepping knee co-contraction than non-fallers. Stance knee co-contraction of non-fallers was similar to young for shorter steps and similar to fallers for longer steps.Interpretation-Age had minimal effects and fall history had no effects on joint kinetics of steps to similar distances. Effects of age and fall history on knee co-contraction may contribute to agerelated kinetic differences and shorter maximal step lengths of older non-fallers and fallers, but step length correlated with every variable tested. Thus, declines in maximum step length could indicate declines in hip and knee extensor kinetics and impaired performance on similar tasks like recovering from a trip.

Feasibility of Cognitive-Motor Exergames in Geriatric Inpatient Rehabilitation: A Pilot Randomized Controlled Study

“…In older adults, this stepping capacity is frequently reduced: their reactive steps are shorter ( Luchies et al, 1994 ) and they tend to collide the swing foot with the stance leg ( Maki et al, 2000 ). Moreover, in fallers, the maximum step length ( Cho et al, 2004 ; Schulz et al, 2013 ) and volitional stepping speed ( Melzer et al, 2007 ) is reduced compared to non-fallers. As a result, if stepping capacity is decreased, the risk for falls increases ( Okubo et al, 2017 , 2021 ).…”

Older Fallers and Non-fallers’ Neuromuscular and Kinematic Alterations in Reactive Balance Control: Indicators of Balance Decline or Compensation?

“…Interestingly, our ndings differ from a prior study that reported no differences in postural sway timing or amplitude between fallers and non-fallers following lateral shoulder-impact perturbations, 18 suggesting that different body segment perturbations may elicit distinct reactive balance control strategies. Additionally, while previous research linked greater cocontraction to more joint stability and poorer balance control, 42,43 this study has observed that older fallers even with poorer balance performance than non-fallers (lower Mini-BEST scores) were able to reduce agonist-antagonist co-contractions of lower-limb muscles and achieve larger knee/hip exion for a suspensory strategy. On top of them, this study has observed fallers with the longer activation durations of ankle dorsi exor and hip abductor together with the longer ankle dorsi exion duration than non-fallers, which may be necessary for maintaining a knee bending posture during the suspensory strategy.…”

Effects of Chemotherapy-Induced-Peripheral-Neuropathy on Spatiotemporal Gait Parameters and Fall Risk in Cancer Patients After the Completion of Chemotherapy Drug Treatment

“…Thus researchers have used the Maximum Step Length (MSL) test which assesses both dynamic balance and leg strength. Clinically, a decrease in the MSL test is associated with an increase decade of life and performance on clinical assessments that are used to predict falls; as MSL decrease, fall risk increases (Cho et al, 2004;Lindermann et al, 2003;Schulz et al, 2013).…”