Falls prediction in elderly people: A 1-year prospective study

Swanenburg, Jaap; Bruin, Eling D. de; Uebelhart, Daniel; Mulder, Theo

doi:10.1016/j.gaitpost.2009.11.013

Cited by 133 publications

(111 citation statements)

References 18 publications

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“…Since this stance is less stable in the ML direction, and ML stability is particularly critical to stance safety (Maki et al 1994;Swanenburg et al 2010), slower MT in this stance is consistent with modulation of the imagined movement plan to limit its destabilizing effect on stance. Alternatively, the semi-tandem Romberg stance may have been more demanding because of its relative ML instability (or simply less familiar in this task context given that it did not feature in the practice blocks at the start of the session), reducing the cognitive resources available to guide the arm movements.…”

Section: Discussionmentioning

confidence: 65%

Body posture modulates imagined arm movements and responds to them

Boulton

Mitra

2013

Journal of Neurophysiology

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Boulton H, Mitra S. Body posture modulates imagined arm movements and responds to them. J Neurophysiol 110: 2617-2626. First published September 18, 2013 doi:10.1152/jn.00488.2013.-Imagined movements are thought to simulate physical ones, with similar behavioral constraints and neurophysiological activation patterns and with an inhibition mechanism that suppresses movement execution. When upper body movements such as reaching with the arm are made from an upright stance, lower body and trunk muscles are also activated to maintain body posture. It is not clear to what extent parameters of imagined manual movements are sensitive to the postural adjustments their execution would necessitate, nor whether such postural responses are as effectively inhibited as the imagined movements themselves. We asked healthy young participants to imagine reaching movements of the arm while in upright stance, and we measured their self-reported movement times and postural sway during imagined movements. We manipulated mediolateral stance stability and the direction of arm movement (mediolateral or anteroposterior). Imagined arm movements were reportedly slower when subjects were standing in a mediolaterally less stable stance, and the body swayed more when arm movements were imagined in the direction of postural vulnerability. The results suggest that the postural state of the whole body, not just the involved limbs, informs trajectory planning during motor imagery and that measurable adjustments to body posture accompany imagined manual actions. It has been suggested that movement is suppressed during motor imagery by a premotor inhibitory mechanism operating at brain stem or spinal level. Any such inhibition must be incomplete because, for example, it does not eliminate autonomic arousal. Our results suggest that it also does not effectively suppress postural adjustments planned in support of imagined movements.

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Section: Discussionmentioning

confidence: 65%

Body posture modulates imagined arm movements and responds to them

Boulton

Mitra

2013

Journal of Neurophysiology

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“…for falling because of its associated impairments in judgment, gait, visual-spatial perception, and ability to recognize and avoid hazards (Swanenburg, de Bruin, Uebelhart, & Mulder, 2010;van Doorn et al, 2003).…”

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confidence: 99%

Effectiveness of Interventions to Prevent Falls in People With Alzheimer’s Disease and Related Dementias

Jensen

Padilla

2011

The American Journal of Occupational Therapy

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A systematic review was conducted to determine the effectiveness of interventions to prevent falls in people with Alzheimer’s disease (AD) and related dementias. Twelve research reports met inclusion criteria. Studies reported on three types of intervention: (1) exercise- and motor-based interventions, (2) nursing staff–directed interventions, and (3) multidisciplinary interventions. Strategies were offered as single or multifaceted intervention programs. All types of intervention resulted in benefit, although the evidence for effectiveness is tentative because of the studies’ limitations. More research is needed to better understand appropriate dosages of intervention. No evidence was found for the effectiveness of prevention programs accessed as part of occasional respite care. Occupational therapy was seldom involved in the interventions researched. Because effective fall prevention programs are embedded in people’s daily routines and encouraged participation in occupation, the contribution occupational therapy practitioners can make to the care of people with AD has yet to be fully realized.

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“…In the current study, even though provided with the option to step, older adults may have decreased trunk roll sway to reduce the likelihood that they would need to take a step to recover posture. Swanenburg and colleagues also found that older adults without a risk of falling had a wider base of support compared to older adults at risk of falling when instructed to stand in their preferred comfortable standing position [22]. In the current study, participants were instructed to stand with feet together, eliminating the potential to adopt a wider base of support to increase stability when expecting a perturbation.…”

Section: Discussionmentioning

confidence: 75%

“…Research on older adults standing at a height has revealed a stiffening strategy similar to that observed in young adults; this effect is observed most often in the forward direction or in the direction of the impending postural threat [15,16]. Research has also shown that older adults who are more susceptible to falling tend to be more unstable in the mediallateral direction [22], and are required to take a step to recover their balance more often [23]. In the current study, even though provided with the option to step, older adults may have decreased trunk roll sway to reduce the likelihood that they would need to take a step to recover posture.…”

Section: Discussionmentioning

confidence: 87%