Lower-Extremity Intra-Joint Coordination and Its Variability between Fallers and Non-Fallers during Gait

Abstract

Falling is one of the most common causes of hip fracture and death in older adults. A comparison of the biomechanics of the gait in fallers and non-fallers older adults, especially joint coordination and coordination variability, enables the understanding of mechanisms that underpin falling. Therefore, we compared lower-extremity intra-joint coordination and its variability between fallers and non-fallers older adults during gait. A total of 26 older adults, comprising 13 fallers, took part in this study. The participants walked barefoot at a self-selected speed on a 10-m walkway. Gait kinematics in the dominant leg during 10 cycles were captured with 10 motion tracking cameras at a sampling rate of 100 Hz. Spatiotemporal gait parameters, namely, cadence, walking speed, double support time, stride time, width, and length, as well as intra-joint coordination and coordination variability in the sagittal plane were compared between the two groups. Results showed that fallers walked with significant lower cadence, walking speed, and stride length but greater double support and stride time than non-fallers. Significant differences in the ankle-to-knee, knee-to-hip, and ankle-to-hip coordination patterns between fallers and non-fallers and less coordination variability in fallers compared to non-fallers in some instants of the gait cycles were observed. The differences in spatiotemporal gait parameters in fallers compared to non-fallers may indicate an adaptation resulting from decreased efficiency to decrease the risk of falling. Moreover, the differences in segment coordination and its variability may indicate an inconsistency in neuromuscular control. It may also indicate reduced ability to control the motion of the leg in preparation for foot contact with the ground and the knee and ankle motions during loading response. Finally, such differences may show less control in generating power during the push-off phase in fallers.

Lower-extremity inter-joint coordination variability in active individuals with transtibial amputation and healthy males during gait

“…5 ). Previous studies reported lower coordination variability in the lower extremity joints in the sagittal plane during the stance phase of gait in fallers than in non-fallers 37 . Then less coordination variability in joint coupling indicates a lower degree of freedom and less capability to adapt to perturbations during gait and increases the fall risk of TTAs.…”

Analysis of technical characteristics of typical lower limb balance movements in Tai Chi: a cross-sectional study based on AnyBody bone muscle modeling

“…The professional group can better stimulate the knee joint by intensifying the training of straightening the balance leg, which shows a greater joint torque during balance leg movement. Sadeghi et al (2021) study concluded that the knee joint plays a supporting role in lower limb movements, and with the support ability of the knee joint, the balance of the lower limb can be better maintained. Therefore, the balancing movements in Tai Chi positively impact the training of the supporting ability of the knee joint, and when practicing leg stirrup balancing, attention should be devoted to the straightening of the balancing leg to obtain better training effects.…”

Gait Biomechanical Parameters Related to Falls in the Elderly: A Systematic Review

“…Cadence was evaluated in 22 studies that compared fallers with non-fallers. Among these, six studies reported the fallers' cadence was lower [25,32,39,45,68,98]. Although another 10 studies observed lower values of cadence in fallers, no statistically significant difference was yielded [30,31,36,55,61,86,89,94,100,102].…”

“…Gait speed was the parameter most analyzed, namely in 50 studies that compared fallers and non-fallers. Regarding these studies, 29 reported the fallers' gait speed was lower than nonfallers [14,23,[25][26][27][30][31][32]34,37,39,43,[48][49][50][55][56][57]60,63,68,75,84,85,91,93,98,100,102]. Although another 17 studies observed lower values of gait speed in fallers, no statistically significant differences were yielded [22,24,28,36,58,[60][61][62]66,76,[80][81][82]86,89,91,94].…”

“…Stride or step length was analyzed in 39 studies that compared fallers and nonfallers. Nineteen studies reported the fallers' stride or step length was lower [23,25,30,[32][33][34][35]39,43,51,53,56,67,84,85,91,94,98,100]. Although another 13 studies observed lower values of stride or step length in fallers, no statistically significant difference was yielded [21,22,24,31,36,44,61,63,66,77,80,81,102].…”