Young and Older Adults Exhibit Proactive and Reactive Adaptations to Repeated Slip Exposure

Pavol, Michael J.; Runtz, Eileen F.; Pai, Yi–Chung

doi:10.1093/gerona/59.5.m494

Cited by 77 publications

(121 citation statements)

References 32 publications

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“…In terms of practical application of these research findings, previous research has suggested that older adults can benefit from training sessions to avoid falling from a trip 29 or slip 30 . In young adults, trip training resulted in adjustments to the COM position and velocity both proactively and reactively 18 .…”

Section: Discussionmentioning

confidence: 83%

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

et al. 2015

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Studying the relationships between centre of mass (COM) and centre of pressure (COP) during walking has been shown to be useful in determining movement stability. The aim of the current study was to compare COM-COP separation measures during walking between groups of older adults with no history of falling, and a history of falling due to tripping or slipping. Any differences between individuals who have fallen due to a slip and those who have fallen due to a trip in measures of dynamic balance could potentially indicate differences in the mechanisms responsible for falls. Forty older adults were allocated into groups based on their self-reported fall history during walking. The non-faller group had not experienced a fall in at least the previous year. Participants who had experienced a fall were split into two groups based on whether a trip or slip resulted in the fall(s). A Vicon system was used to collect full body kinematic trajectories. Two force platforms were used to measure ground reaction forces. The COM was significantly further ahead of the COP at heel strike for the trip (14.3±2.7cm) and slip (15.3±1.1cm) groups compared to the nonfallers (12.0±2.7cm). COM was significantly further behind the COP at foot flat for the slip group (-14.9±3.6cm) compared to the non-faller group (-10.3±3.9cm). At mid-swing, the COM of the trip group was ahead of the COP (0.9±1.6cm), whereas for the slip group the COM was behind the COP (-1.2±2.2cm). These results show identifiable differences in dynamic balance control of walking between older adults with a history of tripping or slipping and non-fallers.

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Section: Discussionmentioning

confidence: 83%

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

et al. 2015

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“…walking or transferring from standing to sitting), and rarely occur during quiet standing 1, 54, 55. Therefore, perturbations should be applied during tasks, such as walking,33, 34 weight shifting39, 56 and rising from a chair 57. Falls can also occur in varied environmental circumstances that pose sensory and mechanical challenges to balance control (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…in the dark/dim light or in the presence of obstacles that impede stepping), and can occur when the individual is distracted. Therefore, PBT programs should consider adding sensory, environmental and cognitive challenges during training to help to promote generalizability of improved reactive balance control to realistic situations 39, 57…”

Section: Resultsmentioning

confidence: 99%

Perturbation‐based balance training for falls reduction among older adults: Current evidence and implications for clinical practice

Gerards

McCrum

Mansfield

et al. 2017

Geriatrics Gerontology Int

198

151

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Falls are a leading cause of injury, hospitalization and even death among older adults. Although various strength and balance exercise interventions have shown moderate reductions in falls incidence among healthy older adults, no significant falls incidence improvements have been consistently seen in frail older adults or in patient groups with an increased falls risk (e.g. people with Parkinson's disease and stroke). This might be due to a lack of task specificity of previous exercise interventions to the recovery actions required to prevent a fall. Perturbation‐based balance training (PBT) is an emerging task‐specific intervention that aims to improve reactive balance control after destabilizing perturbations in a safe and controlled environment. Although early studies were carried out predominantly in research laboratory settings, work in clinical settings with various patient groups has been proliferating. A systematic search of recent PBT studies showed a significant reduction of falls incidence among healthy older adults and certain patient groups (e.g. people with Parkinson's disease and stroke), with clinically relevant reductions in frail older adults. The most practical methods in clinical settings might be treadmill‐based systems and therapist‐applied perturbations, and PBT that incorporates multiple perturbation types and directions might be of most benefit. Although more controlled studies with long‐term follow‐up periods are required to better elucidate the effects of PBT on falls incidence, PBT appears to be a feasible and effective approach to falls reduction among older adults in clinical settings. Geriatr Gerontol Int 2017; 17: 2294–2303..

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“…In this research, we investigated only muscle responses to clarify ways of adaptation. However, there is the possibility that elderly subjects can adapt by feedforward control to compensate for repeated perturbations-for example, changing the center of mass (COM) location and the movement of upper limbs, as has been shown in several reports [9][10][11][18][19][20] . In addition, we think that change of head movement occurred.…”

Section: Discussionmentioning

confidence: 99%

“…Healthy older adults appeared fully capable of learning to recover better from, or adjusting to, repeated exposures to perturbations during a sit-to-stand task [9][10][11] . Smith et al 12) examined whether a difference exists between muscle responses of older fallers and those of nonfallers during repeated dorsi-flexion perturbations to standing.…”

Section: Introductionmentioning

confidence: 99%

Motor Adaptation during Slip-Perturbed Gait in Older Adults

et al. 2008

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Abstract.[Purpose] The purpose of this study was to investigate adaptations to slip perturbations using a customized separated-belt treadmill in older adults.[Subjects] Forty-five healthy older subjects participated in this study.[Methods] Participants were requested to continue to walk against 20 slip perturbations during a 5-minute period. The magnitudes of the reactive responses were evaluated with the use of a tri-axial accelerometer attached to the subject's pelvis. Also, the latency to the onset of EMG activity and the magnitude of EMG activity were measured using surface electrodes placed on both sides of the erector spinae, rectus abdominis, biceps femoris, vastus medialis (VM), gastrocnemius medialis (GM), and tibialis anterior muscles.[Results] The magnitude of the reactive response in the second half of the perturbed walk was significantly more decreased than during the first half (p < 0.01). Decreases in the magnitude of EMG were also observed from VM and GM muscles (p < 0.01, p < 0.05, respectively), but the latency of each of the muscles was unchanged. [Conclusion] In conclusion, adaptations that may have contributed to the prevention of falls occurred in older adults. These adaptations might have been accomplished by a change in magnitude of muscle activity rather than by a change in timing.

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Young and Older Adults Exhibit Proactive and Reactive Adaptations to Repeated Slip Exposure

Abstract: Young and older adults rapidly learned to avoid falling through similar proactive and reactive adaptations that persisted in the short term. Both proactive and reactive adaptations should be targeted in interventions to reduce older adult fall incidence.

Cited by 77 publications

References 32 publications

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip

Perturbation‐based balance training for falls reduction among older adults: Current evidence and implications for clinical practice

Motor Adaptation during Slip-Perturbed Gait in Older Adults

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