Muscle weakness is related to slip-initiated falls among community-dwelling older adults

Ding, Li; Yang, Feng

doi:10.1016/j.jbiomech.2015.12.009

Cited by 62 publications

(59 citation statements)

References 35 publications

(48 reference statements)

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“…Specifically, the BFLH and VLAT of the leading/slip leg had significantly shorter onset latencies in subjects who recovered compared with those who fell, as much as 50 ms after the slip onset (Table 2). While previous studies have emphasized the importance of mechanical (Ferber et al 2002;Han and Yang 2015;Iqbal and Pai 2000) and muscular (Chambers and Cham 2007;Ding and Yang 2016;Lockhart and Kim 2006;Parijat et al 2015;Tang et al 1998) contributions from the knee in maintaining balance after a slip, ours is the first to demonstrate a difference in timing of these muscles between slip outcomes. The late knee flexor activity in subjects who fell may have delayed the necessary knee flexion moment (Cham and Redfern 2001;Ferber et al 2002) required to limit knee extension and return the slipping foot back toward the body (Cham and Redfern 2001;Lockhart and Kim 2006;Pai et al 2006) such that a sufficient base of support exists upon which knee extension can be applied to prevent limb collapse.…”

Section: Muscle Coordination About the Knee May Dictate Slip Outcomementioning

confidence: 42%

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

Sawers

Pai

Bhatt

et al. 2017

Journal of Neurophysiology

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A central question relevant to the prevention of falls is: How does the robust control of walking and balance break down during a fall? Previous work has focused on muscle coordination during successful balance recoveries or the kinematics and kinetics of falls. Here, for the first time, we identified differences in the spatial and temporal coordination of muscles among older adults who fell and those who recovered from an unexpected slip.

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Section: Muscle Coordination About the Knee May Dictate Slip Outcomementioning

confidence: 42%

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

Sawers

Pai

Bhatt

et al. 2017

Journal of Neurophysiology

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“…In previous studies, hip flexion [2, 14, 15], knee flexion [2, 14, 15], ankle dorsiflexion [2, 14, 16], and ankle plantar flexion ROMs [2, 14, 16] were found to be significantly associated with physical performance, but those studies did not consider hip extension or internal and external hip rotation ROMs. On the other hand, strong knee extension and flexion strength are associated with the maintenance of balance on walking [17]. Although ROM and muscle strength are considered to be important factors that influence physical performance, little information is available on the extent to which each ROM and muscle strength value is associated with the physical performance of community-dwelling older women.…”

Section: Introductionmentioning

confidence: 99%

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Jung

Yamasaki

2016

J Physiol Anthropol

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BackgroundReduced lower extremity range of motion (ROM) and muscle strength are related to functional disability in older adults who cannot perform one or more activities of daily living (ADL) independently. The purpose of this study was to determine which factors of seven lower extremity ROMs and two muscle strengths play dominant roles in the physical performance of community-dwelling older women.MethodsNinety-five community-dwelling older women (mean age ± SD, 70.7 ± 4.7 years; age range, 65–83 years) were enrolled in this study. Seven lower extremity ROMs (hip flexion, hip extension, knee flexion, internal and external hip rotation, ankle dorsiflexion, and ankle plantar flexion) and two muscle strengths (knee extension and flexion) were measured. Physical performance tests, including functional reach test (FRT), 5 m gait test, four square step test (FSST), timed up and go test (TUGT), and five times sit-to-stand test (FTSST) were performed.ResultsStepwise regression models for each of the physical performance tests revealed that hip extension ROM and knee flexion strength were important explanatory variables for FRT, FSST, and FTSST. Furthermore, ankle plantar flexion ROM and knee extension strength were significant explanatory variables for the 5 m gait test and TUGT. However, ankle dorsiflexion ROM was a significant explanatory variable for FRT alone. The amount of variance on stepwise multiple regression for the five physical performance tests ranged from 25 (FSST) to 47% (TUGT).ConclusionsHip extension, ankle dorsiflexion, and ankle plantar flexion ROMs, as well as knee extension and flexion strengths may play primary roles in the physical performance of community-dwelling older women. Further studies should assess whether specific intervention programs targeting older women may achieve improvements in lower extremity ROM and muscle strength, and thereby play an important role in the prevention of dependence on daily activities and loss of physical function, particularly focusing on hip extension, ankle dorsiflexion, and ankle plantar flexion ROMs as well as knee extension and flexion strength.

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“…Therefore, it is possible that the lower ICCs for leg flexion PT in the sarcopenic, malnourished women in the present study was a function of lower leg flexion strength. It has been suggested that the inability of older adults to express strength reliably may be a direct consequence of detrimental age‐related changes in neuromuscular function, and low leg flexion strength has been associated with greater risk of falls in older adults . Thus, although isokinetic leg flexion strength tests may exhibit lower reliability in sarcopenic, malnourished older adults, increasing leg flexion strength may be a way to enhance physical function in this population.…”

Section: Discussionmentioning

confidence: 99%

Reliability and Minimum Detectable Change for Common Clinical Physical Function Tests in Sarcopenic Men and Women

Jenkins

Cramer

2017

J American Geriatrics Society

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The ICCs and standard errors of the measurement (SEMs) generally improved with familiarization, which emphasizes the need for at least one familiarization trial for these measurements in sarcopenic, malnourished older adults. A three tier-approach to interpreting the clinical importance of statistically significant results that includes null hypothesis testing, examination and interpretation of the effect magnitude, and comparison of individual changes with the SEM and minimum detectable change of the measurements used is recommended.

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Muscle weakness is related to slip-initiated falls among community-dwelling older adults

Cited by 62 publications

References 35 publications

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

Neuromuscular responses differ between slip-induced falls and recoveries in older adults

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Reliability and Minimum Detectable Change for Common Clinical Physical Function Tests in Sarcopenic Men and Women

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