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Gerstle EE, O'Connor K, Keenan KG, Slavens BA, Cobb SC. The influence of women's age and fall history on foot and lower limb kinematics during transition step descent. J Biomech 2024; 166:112056. [PMID: 38513399 DOI: 10.1016/j.jbiomech.2024.112056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
Falls are a major public health concern, with older women being at the greatest risk to experience a fall. Step descent increases the likelihood of a fall injury, yet the influence of age and fall history on lower extremity kinematics have not been extensively studied. The purpose of this study was to examine lower extremity and foot kinematics of women with and without a fall history during single step descent. Hip, knee, and foot kinematics of young women (n = 15, age = 22.6 ± 3.2 years), older women with no recent falls (n = 15, age = 71.6 ± 4.4 years), and older women with a fall history (n = 15, age = 71.5 ± 5.0 years) as they descended a 17 cm step were examined. Differences in initial contact angles and ROM during landing were examined with between group MANOVA tests. Distal foot initial contact angles were not significant between groups. For range of motion, both older groups went through greater hip extension (p = 0.003, partial η2 = 0.25), but less hip adduction (p = 0.002, partial η2 = 0.27) and less lateral midfoot dorsiflexion (p = 0.001, partial η2 = 0.28) than the younger women. The older fall group had reduced knee flexion (p = 0.004, partial η2 = 0.23) than the younger group, and the older non-fallers slightly plantarflexed at the medial midfoot (p = 0.005, partial η2 = 0.23) while the young women dorsiflexed. Thelanding phase ROMdifferences exhibited by the older adult groupsmayincrease the likelihood of a misstep, which may result in a fall.
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Affiliation(s)
- Emily E Gerstle
- Human Motion Laboratory, University of Scranton, 800 Linden Street, Scranton, PA 18510, United States.
| | - Kristian O'Connor
- Musculoskeletal Injury Biomechanics Laboratory, University of Wisconsin-Milwaukee, Enderis Hall, PO Box 413, Milwaukee, WI 53201, United States.
| | - Kevin G Keenan
- Neuromuscular Control Laboratory, University of Wisconsin-Milwaukee, Enderis Hall, PO Box 413, Milwaukee, WI 53201, United States.
| | - Brooke A Slavens
- Mobility Laboratory, University of Wisconsin-Milwaukee, Innovation Campus Accelerator, Room 140, 1225 Discovery Parkway, Wauwatosa, WI 53226, United States.
| | - Stephen C Cobb
- Foot & Ankle Biomechanics Laboratory, University of Wisconsin-Milwaukee, Enderis Hall, PO Box 413, Milwaukee, WI 53201, United States.
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Júlio CE, Antonialli FC, Nascimento TMD, Sá KA, Barton GJ, Lucareli PRG. The Movement Deviation Profile Can Differentiate Faller and Non-Faller Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:1651-1658. [PMID: 37279546 DOI: 10.1093/gerona/glad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The World Health Organization considers falls the second leading cause of death by accidental injury worldwide and one of the most frequent complications in older adults during activities of daily living. Several tasks related to fall risk have been individually assessed describing kinematic changes in older adults. The study proposal was to identify which functional task differentiates faller and non-faller older adults using the movement deviation profile (MDP). METHODS This cross-sectional study recruited 68 older adults aged ≥60 years by convenience sampling. Older adults were divided into 2 groups: with and without a history of falls (34 older adults in each group). The MDP analyzed the 3-dimensional angular kinematics data of tasks (ie, gait, walking turn, stair ascent and descent, sit-to-stand, and stand-to-sit), and the Z score of the mean MDP identified which task presented the greatest difference between fallers and non-fallers. A multivariate analysis with Bonferroni post hoc verified the interaction between groups considering angular kinematic data and the cycle time of the task. Statistical significance was set at 5% (p < .05). RESULTS Z score of the MDPmean showed an interaction between groups (λ = 0.67, F = 5.085, p < .0001). Fallers differed significantly from non-fallers in all tasks and the greatest difference was in stair descent (Z score = 0.89). The time to complete each task was not different between groups. CONCLUSIONS The MDP distinguished older adult fallers from non-fallers. The stair descent task should be highlighted because it presented the greatest difference between groups.
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Affiliation(s)
- Cíntia Elord Júlio
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Fernanda Colella Antonialli
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Tamara Medeiros do Nascimento
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Karina Araújo Sá
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Gábor József Barton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Paulo Roberto Garcia Lucareli
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, SP, Brazil
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Chai Y, Chen J, Hou M, Zheng J, Liu L, Chen Y, Fu S, Ma Y, Hong T, Wang X. Gait strategies for individuals with knee osteoarthritis when transitioning between floor and stair walking. Front Physiol 2023; 14:1026299. [PMID: 36760532 PMCID: PMC9904770 DOI: 10.3389/fphys.2023.1026299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023] Open
Abstract
Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs. Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D). Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion (p = 0.01) decreased, hip flexion (p = 0.02) and trunk lateral tilt (p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side (p = 0.003) and pelvic rotation (p = 0.03) increased, while hip abduction of the swing leg (p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis. Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.
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Affiliation(s)
- Yatai Chai
- Fujian University of Traditional Chinese Medicine, Fuzhou, China,Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jian Chen
- Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Meijin Hou
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China
| | - Jiaqi Zheng
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lu Liu
- Fujian University of Traditional Chinese Medicine, Fuzhou, China,Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yongkang Chen
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengxing Fu
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China
| | - Ye Ma
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China,Faculty of Sports Sciences, Research Academy of Grand Health, Ningbo University, Ningbo, China
| | | | - Xiangbin Wang
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China,Rehabilitation Department of the Affiliated 3rd Peoples’ Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China,*Correspondence: Xiangbin Wang,
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The Effect of Age and Fall History on Lower Extremity Neuromuscular Function During Descent of a Single Transition Step. J Aging Phys Act 2022; 31:249-256. [PMID: 36068074 DOI: 10.1123/japa.2021-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/01/2022] [Accepted: 07/12/2022] [Indexed: 01/12/2023]
Abstract
Despite the higher injury rate of falls on steps versus level ground, few studies have examined the influence of age and fall history on step descent. The purpose of this study was to determine the lead and trail limb neuromuscular function (peak joint moments and powers, electromyographic activity) differences between young females (n = 15) and older females with (n = 15) and without (n = 15) a fall history while descending a single step. Trail limb moments and powers did not differ between groups. Lead limb sagittal plane powers at the hip and knee were greater in the young adults. Electromyographic co-activation levels (knee and ankle) were not significantly different between groups. However, peroneal activation was greater in the older groups, which may have assisted in stabilizing the ankle joint in lieu of increased co-activation at the ankle. These results demonstrate consideration of step descent is important in working with older women at risk of falls.
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