Effects of task-specific obstacle-induced trip-perturbation training: proactive and reactive adaptation to reduce fall-risk in community-dwelling older adults

Wang, Yiru; Wang, Shuaijie; Bolton, Ryan; Kaur, Tanjeev; Bhatt, Tanvi

doi:10.1007/s40520-019-01268-6

Cited by 34 publications

(57 citation statements)

References 63 publications

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“…Combined with the results seen for overground slip perturbation training showing similar rapid improvement (i.e., "single trial effect") and plateauing of training effects after merely a few slip trials in healthy young and older adults (24), these findings support the notion that a small number of slip or trip perturbation trials are sufficient to facilitate large refinements in the locomotorbalance control system, irrespective of age. Nevertheless, whether the adaptation rate and amount, and, hence, the perturbation dose-response relationship, are comparable across the adult lifespan remains unclear and needs further investigation, and a lack of knowledge regarding the dose-response relationship in exercisebased fall prevention has been highlighted recently (4,36).…”

Section: Improving Trip-and Slip-resisting Skillsmentioning

confidence: 99%

Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters

Karamanidis

Epro

McCrum

et al. 2019

Exercise and Sport Sciences Reviews

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Section: Improving Trip-and Slip-resisting Skillsmentioning

confidence: 99%

Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters

Karamanidis

Epro

McCrum

et al. 2019

Exercise and Sport Sciences Reviews

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“…Conversely, participants would experience forward instability following a trip perturbation due to the forward shift of both COM velocity and displacement with respect to the BOS. Therefore, a faster walking speed could increase forward instability, resulting in a greater risk for trip-induced falls (Pavol et al, 2001;Wang et al, 2019b). The TUG test scores could thus have had opposing predictive effects for slip vs. trip perturbation.…”

Section: Discussionmentioning

confidence: 99%

Can Smartphone-Derived Step Data Predict Laboratory-Induced Real-Life Like Fall-Risk in Community- Dwelling Older Adults?

Wang

Gangwani

Kannan

et al. 2020

Front. Sports Act. Living

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Background: As age progresses, decline in physical function predisposes older adults to high fall-risk, especially on exposure to environmental perturbations such as slips and trips. However, there is limited evidence of association between daily community ambulation, an easily modifiable factor of physical activity (PA), and fall-risk. Smartphones, equipped with accelerometers, can quantify, and display daily ambulation-related PA simplistically in terms of number of steps. If any association between daily steps and fall-risks is established, smartphones due to its convenience and prevalence could provide health professionals with a meaningful outcome measure, in addition to existing clinical measurements, to identify older adults at high fall-risk. Objective: This study aimed to explore whether smartphone-derived step data during older adults' community ambulation alone or together with commonly used clinical fall-risk measurements could predict falls following laboratory-induced real-life like slips and trips. Relationship between step data and PA questionnaire and clinical fall-risk assessments were examined as well. Methods: Forty-nine community-dwelling older adults (age 60–90 years) completed Berg Balance Scale (BBS), Activities-specific Balance Confidence scale (ABC), Timed Up-and-Go (TUG), and Physical Activity Scale for the Elderly (PASE). One-week and 1-month smartphone steps data were retrieved. Participants' 1-year fall history was noted. All participants' fall outcomes to laboratory-induced slip-and-trip perturbations were recorded. Logistic regression was performed to identify a model that best predicts laboratory falls. Pearson correlations examined relationships between study variables. Results: A model including age, TUG, and fall history significantly predicted laboratory falls with a sensitivity of 94.3%, specificity of 58.3%, and an overall accuracy of 85.1%. Neither 1-week nor 1-month steps data could predict laboratory falls. One-month steps data significantly positively correlated with BBS ( r = 0.386, p = 0.006) and ABC ( r = 0.369, p = 0.012), and negatively correlated with fall history ( r p = −0.293, p = 0.041). Conclusion: Older participants with fall history and higher TUG scores were more likely to fall in the laboratory. No association between smartphone steps data and laboratory fall-risk was established in our study population of healthy community-dwelling older adults which calls for further studies on varied populations. Although modest, results do reveal a relationship between steps data and functional balance deficits and fear of falls.

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“…Because tripping occurs when the foot (toes) contacts the floor or floor elevation changes, many studies have investigated the effects of floor elevation changes on falling risk 19 – 21 . Despite the development of barrier-free environments with no obstacles on the floor, the number of falling accidents among older adults continues to increase.…”

Section: Introductionmentioning

confidence: 99%

Effect of foot–floor friction on the external moment about the body center of mass during shuffling gait: a pilot study

Yamaguchi

Shibata

Wada³

et al. 2021

Sci Rep

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Herein, we investigated the effect of friction between foot sole and floor on the external forward moment about the body center of mass (COM) in normal and shuffling gaits. Five young male adults walked with normal and shuffling gaits, under low- and high-friction surface conditions. The maximum external forward moment about the COM (MEFM-COM) in a normal gait appeared approximately at initial foot contact and was unaffected by floor condition. However, MEFM-COM in a shuffling gait under high-friction conditions exceeded that under low-friction conditions (p < 0.001). Therein, MEFM-COM increased with an increasing utilized coefficient of friction at initial foot contact; this effect was weaker during a normal gait. These findings indicate that increased friction between foot sole and floor might increase tripping risk during a shuffling gait, even in the absence of discrete physical obstacles.

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Effects of task-specific obstacle-induced trip-perturbation training: proactive and reactive adaptation to reduce fall-risk in community-dwelling older adults

Cited by 34 publications

References 63 publications

Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters

Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters

Can Smartphone-Derived Step Data Predict Laboratory-Induced Real-Life Like Fall-Risk in Community- Dwelling Older Adults?

Effect of foot–floor friction on the external moment about the body center of mass during shuffling gait: a pilot study

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