1
|
Ahn J, Ban R, Simpkins C, Yang F. Android obesity could be associated with a higher fall risk than gynoid obesity following a standing-slip: A simulation-based biomechanical analysis. J Biomech 2024; 164:111962. [PMID: 38306779 DOI: 10.1016/j.jbiomech.2024.111962] [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: 09/21/2023] [Revised: 01/13/2024] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
It is well recognized that overall obesity increases fall risk. However, it remains unknown if the obesity-induced increase in the fall risk depends upon the adipose distribution (or obesity type: android vs. gynoid). This pilot study examined the effects of fat deposition region on fall risk following a standing-slip trial in young adults with simulated android or gynoid adiposity. Appropriate external weights were attached to two groups of healthy young lean adults at either the abdomen or upper thigh region to simulate android or gynoid adiposity, respectively, with a targeted body mass index of 32 kg/m2. Under the protection of a safety harness, both groups were exposed to an identical standing-slip on a treadmill with a maximum slip distance of 0.36 m. The primary (dynamic gait stability) and secondary (latency, length, duration, and speed of the recovery step, slip distance, and trunk velocity) outcome variables on the slip trial were compared between groups. The results revealed that the android group was more unstable with a longer slip distance and a slower trunk flexion velocity than the gynoid group at the recovery foot liftoff after the slip onset. The android group initiated the recovery step later but executed the step faster than the gynoid group. Biomechanically, the android adipose tissue may be associated with a higher fall risk than the gynoid fat tissue. Our findings could provide preliminary evidence for considering fat distribution as an additional fall risk factor to identify older adults with obesity at a high fall risk.
Collapse
Affiliation(s)
- Jiyun Ahn
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Rebecca Ban
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA.
| |
Collapse
|
2
|
Nguyen NT, Christensen MS, Tracy JB, Kellaher GK, Pohlig RT, Crenshaw JR. How should the margin of stability during walking be expressed to account for body size? J Biomech 2023; 161:111835. [PMID: 37865979 PMCID: PMC10842449 DOI: 10.1016/j.jbiomech.2023.111835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 08/25/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
When expressing the margin of stability as a distance, it does not directly estimate the perturbation magnitude needed to change stability states. Additionally, it is unknown how body size may influence this measure. Therefore, we propose other expressions of stability margins, including that of an impulse, a change in center of mass velocity, and a scaled, unitless impulse. The purpose of this study was to determine the influence of body size on these margin expressions using walking data from children and adults. We anticipated that margins expressed as an impulse would have strong correlations with body mass and height, as well as large between-group differences. We predicted that scaling this impulse value would result in small correlations and between-group effect sizes. We calculated each stability margin at minimum lateral values and in the anteroposterior directions at mid-swing and foot strike. In the lateral direction, margins expressed as an impulse had strong correlations with body size (r≥0.58, p<0.01) and large between-group differences (|d|≥1.07, p<0.01). The other expressions did not have strong positive correlations (|r|≤0.20) or large between-group effects (|d|≤0.44). In the anteroposterior directions, impulse margins had strong correlations with body size (|r|≥0.83, p<0.01) and large between-group differences (|d|≥1.74, p<0.01). The scaled, unitless impulse margin was the only variable that resulted in small, non-significant differences (|r|≤0.22, p≥0.24) as well as small between-group effect sizes (|d|≤0.46, p≥0.22). We propose expressing stability margins as an impulse. If scaling is needed, we encourage using the scaled, unitless impulse.
Collapse
Affiliation(s)
- Nancy T Nguyen
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States
| | - Michael S Christensen
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States
| | - James B Tracy
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States; University of Colorado Anschutz Medical Campus, School of Medicine, Department of Physical Medicine and Rehabilitation, United States
| | - Grace K Kellaher
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States
| | - Ryan T Pohlig
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States
| | - Jeremy R Crenshaw
- University of Delaware, College of Health Sciences, Department of Kinesiology and Applied Physiology, United States.
| |
Collapse
|
3
|
Ferreira RN, Ribeiro NF, Figueiredo J, Santos CP. Provoking Artificial Slips and Trips towards Perturbation-Based Balance Training: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:9254. [PMID: 36501958 PMCID: PMC9740792 DOI: 10.3390/s22239254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Humans' balance recovery responses to gait perturbations are negatively impacted with ageing. Slip and trip events, the main causes preceding falls during walking, are likely to produce severe injuries in older adults. While traditional exercise-based interventions produce inconsistent results in reducing patients' fall rates, perturbation-based balance training (PBT) emerges as a promising task-specific solution towards fall prevention. PBT improves patients' reactive stability and fall-resisting skills through the delivery of unexpected balance perturbations. The adopted perturbation conditions play an important role towards PBT's effectiveness and the acquisition of meaningful sensor data for studying human biomechanical reactions to loss of balance (LOB) events. Hence, this narrative review aims to survey the different methods employed in the scientific literature to provoke artificial slips and trips in healthy adults during treadmill and overground walking. For each type of perturbation, a comprehensive analysis was conducted to identify trends regarding the most adopted perturbation methods, gait phase perturbed, gait speed, perturbed leg, and sensor systems used for data collection. The reliable application of artificial perturbations to mimic real-life LOB events may reduce the gap between laboratory and real-life falls and potentially lead to fall-rate reduction among the elderly community.
Collapse
Affiliation(s)
- Rafael N. Ferreira
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
| | - Nuno Ferrete Ribeiro
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
- MIT Portugal Program, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal
| | - Joana Figueiredo
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
| | - Cristina P. Santos
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
| |
Collapse
|
4
|
Holcomb AE, Hunt NL, Ivy AK, Cormier AG, Brown TN, Fitzpatrick CK. Musculoskeletal adaptation of young and older adults in response to challenging surface conditions. J Biomech 2022; 144:111270. [PMID: 36162144 PMCID: PMC9847467 DOI: 10.1016/j.jbiomech.2022.111270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/18/2022] [Accepted: 08/19/2022] [Indexed: 01/21/2023]
Abstract
Over 36 million adults over 65 years of age experience accidental falls each year. The underlying neuromechanics (whole-body function) and driving forces behind accidental falls, as well as the effects of aging on the ability of the musculoskeletal system to adapt, are poorly understood. We evaluated differences in kinematics (lower extremity joint angles and range of motion), kinetics (ground reaction force), and electromyography (muscle co-contraction), due to changes in surface conditions during gait in 14 older adults with a history of falling and 14 young adults. We investigated the impact of challenging surfaces on musculoskeletal adaptation and compared the mechanisms of adaptation between age-groups. Older adults displayed greater hip and knee flexion and range of motion during gait, reduced initial vertical loading, and 13 % greater knee muscle co-contraction during early stance compared to young adults. Across age groups, the presence of an uneven challenging surface increased lower-limb flexion compared to an even surface. On a slick surface, older adults displayed 30 % greater ankle muscle co-contraction during early stance as compared to young adults. Older adults respond to challenging surfaces differently than their younger counterparts, employing greater flexion during early stance. This study underscores the need for determining lower-limb musculoskeletal adaptation strategies during gait and assessing how these strategies change with age, risk of accidental falls, and environmental surfaces to reduce the risk of accidental falls.
Collapse
Affiliation(s)
- Amy E Holcomb
- Computational Biosciences Laboratory, Mechanical and Biomedical Engineering, Boise State University, Boise, ID, United States
| | - Nicholas L Hunt
- Center for Orthopaedic and Biomechanics Research, Kinesiology, Boise State University, Boise, ID, United States
| | - Amanda K Ivy
- Computational Biosciences Laboratory, Mechanical and Biomedical Engineering, Boise State University, Boise, ID, United States
| | - Aidan G Cormier
- Computational Biosciences Laboratory, Mechanical and Biomedical Engineering, Boise State University, Boise, ID, United States
| | - Tyler N Brown
- Center for Orthopaedic and Biomechanics Research, Kinesiology, Boise State University, Boise, ID, United States
| | - Clare K Fitzpatrick
- Computational Biosciences Laboratory, Mechanical and Biomedical Engineering, Boise State University, Boise, ID, United States.
| |
Collapse
|
5
|
Kim D, Lewis CL, Silverman AK, Gill SV. Changes in dynamic balance control in adults with obesity across walking speeds. J Biomech 2022; 144:111308. [PMID: 36150320 DOI: 10.1016/j.jbiomech.2022.111308] [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: 03/14/2022] [Revised: 08/19/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022]
Abstract
Adults with obesity have gait instability, leading to increased fall risks and decreased physical activity. Whole-body angular momentum (WBAM) is regulated over a gait cycle, essential to avoid a fall. However, how obese adults regulate WBAM during walking is unknown. The current study investigated changes in WBAM about the body's center of mass (COM) during walking in obese and non-obese adults across different walking speeds. Twenty-eight young adults with obesity and normal weight walked barefoot at a fixed walking speed (FWS, 1.25 m/s) and at five different speeds based on their preferred walking speed (PWS): 50, 75, 100, 125, and 150 % of PWS. Adults with obesity walked slower with shorter step length, wider step width, and longer double support time (p < 0.01). The ranges of frontal- and transverse-plane WBAM were greater in obese adults (p < 0.01). We also found that the range of frontal-plane WBAM did not significantly change with walking speed (p > 0.05), while the range of transverse-plane WBAM increased with walking speed (p < 0.01). The ranges of frontal- and transverse-plane WBAM increased with the mediolateral ground reaction force and mediolateral moment arm (p < 0.01), which may be most affected by lateral foot placement relative to the body's COM. Our findings suggest that controlling mediolateral stability during walking is more challenging in obese adults, independent of their slow walking speed. Understanding whole-body rotational dynamics observed in obese walking provides an insight into the biomechanical link between obesity and gait instability, which may help find a way to reduce fall risks and increase physical activity.
Collapse
Affiliation(s)
- Daekyoo Kim
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA.
| | - Cara L Lewis
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Simone V Gill
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA
| |
Collapse
|
6
|
Abdollahi M, Whitton N, Zand R, Dombovy M, Parnianpour M, Khalaf K, Rashedi E. A Systematic Review of Fall Risk Factors in Stroke Survivors: Towards Improved Assessment Platforms and Protocols. Front Bioeng Biotechnol 2022; 10:910698. [PMID: 36003532 PMCID: PMC9394703 DOI: 10.3389/fbioe.2022.910698] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background/Purpose: To prevent falling, a common incident with debilitating health consequences among stroke survivors, it is important to identify significant fall risk factors (FRFs) towards developing and implementing predictive and preventive strategies and guidelines. This review provides a systematic approach for identifying the relevant FRFs and shedding light on future directions of research. Methods: A systematic search was conducted in 5 popular research databases. Studies investigating the FRFs in the stroke community were evaluated to identify the commonality and trend of FRFs in the relevant literature. Results: twenty-seven relevant articles were reviewed and analyzed spanning the years 1995–2020. The results confirmed that the most common FRFs were age (21/27, i.e., considered in 21 out of 27 studies), gender (21/27), motion-related measures (19/27), motor function/impairment (17/27), balance-related measures (16/27), and cognitive impairment (11/27). Among these factors, motion-related measures had the highest rate of significance (i.e., 84% or 16/19). Due to the high commonality of balance/motion-related measures, we further analyzed these factors. We identified a trend reflecting that subjective tools are increasingly being replaced by simple objective measures (e.g., 10-m walk), and most recently by quantitative measures based on detailed motion analysis. Conclusion: There remains a gap for a standardized systematic approach for selecting relevant FRFs in stroke fall risk literature. This study provides an evidence-based methodology to identify the relevant risk factors, as well as their commonalities and trends. Three significant areas for future research on post stroke fall risk assessment have been identified: 1) further exploration the efficacy of quantitative detailed motion analysis; 2) implementation of inertial measurement units as a cost-effective and accessible tool in clinics and beyond; and 3) investigation of the capability of cognitive-motor dual-task paradigms and their association with FRFs.
Collapse
Affiliation(s)
- Masoud Abdollahi
- Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, United States
| | - Natalie Whitton
- Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, United States
| | - Ramin Zand
- Department of Neurology, Geisinger Neuroscience Institute, Danville, PA, United States
| | - Mary Dombovy
- Department of Rehabilitation and Neurology, Unity Hospital, Rochester, NY, United States
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Kinda Khalaf
- Department of Biomedical Engineering, Khalifa University of Science and Technology, and Health Engineering Innovation Center, Abu Dhabi, United Arab Emirates
| | - Ehsan Rashedi
- Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, United States
- *Correspondence: Ehsan Rashedi,
| |
Collapse
|
7
|
Park JH, Kim S, Nussbaum MA, Srinivasan D. Effects of back-support exoskeleton use on gait performance and stability during level walking. Gait Posture 2022; 92:181-190. [PMID: 34864386 DOI: 10.1016/j.gaitpost.2021.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Back-support exoskeletons (BSEs) are a promising intervention to mitigate physical demands at work. Although growing evidence indicates that BSEs can reduce low-back physical demands, there is limited understanding of potential unintended consequences of BSE use, including the risk of falls. RESEARCH QUESTION Does using a BSE adversely affect gait performance and stability, and are such effects dependent on specific BSE external torque characteristics? METHODS Twenty participants (10 M, 10 F) completed five level over-ground walking trials and a five-minute treadmill walking trial while wearing a BSE (backX™) with three different levels of external torque (i.e., no torque, low torque, and high torque) and in a control (no-exoskeleton) condition. Spatiotemporal gait patterns, stride-to-stride gait variability measures, required coefficient-of-friction (RCoF), and minimum foot clearance (MFC) were determined, to assess gait performance. Gait stability was quantified using the maximum Lyapunov exponent (MLE) of trunk kinematics and the margin-of-stability (MoS). RESULTS Using the backX™ with high supportive torque decreased slip risk (7% decrease in RCoF) and slightly improved trunk stability (3% decrease in MLE). However, it also decreased step length (1%), increased step width (10%) and increased gait variability (8-19%). Changes in MoS were complex: while MoS at heel strike decreased in the AP direction, it increased in the ML direction. There was a rather large decrease in MoS (26%) in the ML direction during the swing phase. SIGNIFICANCE This is the first study to quantify the effects of wearing a passive BSE with multiple supportive torque levels on gait performance and stability during level walking. Our results, showing that the external torque of the BSE may adversely affect gait step width, variability, and dynamic stability, can contribute to better design and practice guidelines to facilitate the safe adoption of BSEs in the workplace.
Collapse
Affiliation(s)
- Jang-Ho Park
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA.
| |
Collapse
|
8
|
Hirata K, Kokubun T, Miyazawa T, Hanawa H, Kubota K, Sonoo M, Fujino T, Kanemura N. Relationship Between the Walking Velocity Relative to the Slip Velocity and the Corrective Response. J Med Biol Eng 2021. [DOI: 10.1007/s40846-020-00527-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Allin LJ, Brolinson PG, Beach BM, Kim S, Nussbaum MA, Roberto KA, Madigan ML. Perturbation-based balance training targeting both slip- and trip-induced falls among older adults: a randomized controlled trial. BMC Geriatr 2020; 20:205. [PMID: 32532221 PMCID: PMC7291462 DOI: 10.1186/s12877-020-01605-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Falls are the leading cause of injuries among older adults. Perturbation-based balance training (PBT) is an innovative approach to fall prevention that aims to improve the reactive balance response following perturbations such as slipping and tripping. Many of these PBT studies have targeted reactive balance after slipping or tripping, despite both contributing to a large proportion of older adult falls. The goal of this randomized controlled trial was to evaluate the effects of PBT targeting slipping and tripping on laboratory-induced slips and trips. To build upon prior work, the present study included: 1) a control group; 2) separate training and assessment sessions; 3) PBT methods potentially more amenable for use outside the lab compared to methods employed elsewhere, and 4) individualized training for older adult participants. METHODS Thirty-four community-dwelling, healthy older adults (61-75 years) were assigned to PBT or a control intervention using minimization. Using a parallel design, reactive balance (primary outcome) and fall incidence were assessed before and after four sessions of BRT or a control intervention involving general balance exercises. Assessments involved exposing participants to an unexpected laboratory-induced slip or trip. Reactive balance and fall incidence were compared between three mutually-exclusive groups: 1) baseline participants who experienced a slip (or trip) before either intervention, 2) post-control participants who experienced a slip (or trip) after the control intervention, and 3) post-PBT participants who experienced a slip (or trip) after PBT. Neither the participants nor investigators were blinded to group assignment. RESULTS All 34 participants completed all four sessions of their assigned intervention, and all 34 participants were analyzed. Regarding slips, several measures of reactive balance were improved among post-PBT participants when compared to baseline participants or post-control participants, and fall incidence among post-PBT participants (18%) was lower than among baseline participants (80%). Regarding trips, neither reactive balance nor fall incidence differed between groups. CONCLUSIONS PBT targeting slipping and tripping improved reactive balance and fall incidence after laboratory-induced slips. Improvements were not observed after laboratory-induced trips. The disparity in efficacy between slips and trip may have resulted from differences in dosage and specificity between slip and trip training. TRIAL REGISTRATION Name of Clinical Trial Registry: clinicaltrials.gov Trial Registration number: NCT04308239. Date of Registration: March 13, 2020 (retrospectively registered).
Collapse
Affiliation(s)
- Leigh J Allin
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | | | - Briana M Beach
- Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA
| | - Sunwook Kim
- Grado Department of Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), 1145 Perry Street, Blacksburg, VA, USA
| | - Maury A Nussbaum
- Grado Department of Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), 1145 Perry Street, Blacksburg, VA, USA
| | - Karen A Roberto
- Institute for Society, Culture and Environment, Center for Gerontology, Virginia Tech, Blacksburg, VA, USA
| | - Michael L Madigan
- Grado Department of Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), 1145 Perry Street, Blacksburg, VA, USA.
| |
Collapse
|
10
|
Komisar V, McIlroy WE, Duncan CA. Individual, task, and environmental influences on balance recovery: a narrative review of the literature and implications for preventing occupational falls. IISE Trans Occup Ergon Hum Factors 2019. [DOI: 10.1080/24725838.2019.1634160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Vicki Komisar
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
| | | | - Carolyn A. Duncan
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI
| |
Collapse
|
11
|
|
12
|
MOTA JACOBA, KERR ZACHARYY, GERSTNER GENAR, GIULIANI HAYDENK, RYAN ERICD. Obesity Prevalence and Musculoskeletal Injury History in Probation Officers. Med Sci Sports Exerc 2019; 51:1860-1865. [DOI: 10.1249/mss.0000000000001996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
13
|
Mota JA, Barnette TJ, Gerstner GR, Giuliani HK, Tweedell AJ, Kleinberg CR, Thompson BJ, Pietrosimone B, Ryan ED. Relationships Between Neuromuscular Function and Functional Balance Performance in Firefighters. Sci Rep 2018; 8:15328. [PMID: 30333503 PMCID: PMC6193010 DOI: 10.1038/s41598-018-33555-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/27/2018] [Indexed: 01/02/2023] Open
Abstract
The purpose of the present study was to examine the relationships between neuromuscular function and functional balance performance in firefighters. Fifty career firefighters (35.1 ± 7.5 yr) performed isometric leg extension and flexion muscle actions to examine peak torque (PT), and absolute (aTQ) and normalized (nTQ; %PT) rapid torque variables at 50, 100, 150, and 200 ms. A performance index (PI) was determined from the functional balance assessment completion time. Partial correlations were used to examine the relationship between the PI and the maximal and rapid TQ variables for each muscle and the composite value, while controlling for demographic data related to the PI. Multiple regression analyses examined the relative contributions of the maximal and rapid aTQ variables, and demographic data on the PI. After controlling for age and %BF, the majority of the later aTQ and nTQ variables (100–200 ms) and PT were associated with the PI (r = −0.501–−0.315). Age, %BF, and aTQ100 explained 42–50% of the variance in the PI. Lower rapid strength, increased age, and poorer body composition were related to worse performance during the functional balance assessment. Strategies to improve rapid strength and %BF, especially in aging firefighters may impact dynamic balance abilities in firefighters.
Collapse
Affiliation(s)
- Jacob A Mota
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Timothy J Barnette
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gena R Gerstner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hayden K Giuliani
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew J Tweedell
- United States Army Research Laboratory, Aberdeen Proving Ground, MD, USA
| | | | - Brennan J Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
14
|
Two Novel Slip Training Methods Improve the Likelihood of Recovering Balance After a Laboratory-Induced Slip. J Appl Biomech 2018; 35:37–43. [PMID: 30080436 DOI: 10.1123/jab.2018-0076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Task-specific balance training is an approach to fall prevention that has the potential to reduce the number of slip-induced falls. However, a limitation of current task-specific training methods is that they require non-trivial financial and/or equipment resources. This pilot study evaluated the efficacy of two low-cost, low-tech methods for slip recovery training in improving balance recovery ability. The two methods were: 1) repeated unexpected slip training (UST), which involved repeated unexpected slips while walking (similar to current methods of task-specific slip recovery training); and 2) volitional slip-recovery training (VST), which involved practicing a slip recovery response after volitionally stepping to induce a slip-like perturbation. Thirty-six young adults completed one training session (UST, VST, or control), followed by one unexpected, laboratory-induced slip while walking on the following day. Compared to controls, UST and VST resulted in a higher proportion of successful balance recoveries from the laboratory-induced slips. UST improved both proactive control and the reactive stepping response after slipping, while VST improved the ability to arrest the motion of the slipping foot. Based on these preliminary results, UST and VST may provide practical, cost-effective methods for slip recovery training.
Collapse
|
15
|
Allin LJ, Nussbaum MA, Madigan ML. Feet kinematics upon slipping discriminate between recoveries and three types of slip-induced falls. ERGONOMICS 2018; 61:866-876. [PMID: 29231784 DOI: 10.1080/00140139.2017.1413212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
This study investigated the relationship between feet kinematics upon slipping while walking and the outcome of the slip. Seventy-one slips (induced by walking over an unexpectedly slippery surface) were analysed, which included 37 recoveries, 16 feet-split falls, 11 feet-forward falls and seven lateral falls. Feet kinematics differed between recoveries and three types of slip-induced falls, and a discriminant model including six measures of feet kinematics correctly predicted 87% of slip outcomes. Two potentially modifiable characteristics of the feet kinematics upon slipping that can improve the likelihood of successfully averting a fall were identified: (1) quickly arresting the motion of the slipping foot and (2) a recovery step that places the trailing toe approximately 0-10% body height anterior to the sacrum. These results may inform the development of task-specific balance training interventions that promote favourable recovery responses to slipping. Practitioner Summary: This study investigated the relationship between feet movements upon slipping and outcomes of the slip. Potentially modifiable characteristics that can reduce the likelihood of falling were: (1) quickly arresting slipping foot motion and (2) a recovery step that places the trailing toe approximately 0-10% body height anterior to the sacrum.
Collapse
Affiliation(s)
- Leigh J Allin
- a Department of Biomedical Engineering , Texas A&M University , College Station , TX , USA
| | - Maury A Nussbaum
- b Grado Department of Industrial & Systems Engineering , Virginia Tech , Blacksburg , VA , USA
| | - Michael L Madigan
- a Department of Biomedical Engineering , Texas A&M University , College Station , TX , USA
| |
Collapse
|
16
|
Arena SL, Garman CR, Nussbaum MA, Madigan ML. Required friction during overground walking is lower among obese compared to non-obese older men, but does not differ with obesity among women. APPLIED ERGONOMICS 2017; 62:77-82. [PMID: 28411741 DOI: 10.1016/j.apergo.2017.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/21/2016] [Accepted: 02/13/2017] [Indexed: 06/07/2023]
Abstract
Obesity and aging have been independently associated with altered required friction during walking, but it is unclear how these factors interact to influence the likelihood of slipping. Therefore, the purpose of this study was to determine whether there are differences related to obesity and aging on required friction during overground walking. Fourteen older non-obese, 11 older obese, 20 younger non-obese, and 20 younger obese adults completed walking trials at both a self-selected and hurried speed. When walking at a hurried speed, older obese men walked at a slower gait speed and exhibited lower frictional demands compared both to older non-obese men and to younger obese men. No differences in required friction were found between non-obese and obese younger adults. These results suggest that the increased rate of falls among obese or older adults is not likely due to a higher risk of slip initiation.
Collapse
|
17
|
Obesity and Obesity Shape Markedly Influence Spine Biomechanics: A Subject-Specific Risk Assessment Model. Ann Biomed Eng 2017; 45:2373-2382. [DOI: 10.1007/s10439-017-1868-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 06/03/2017] [Indexed: 12/15/2022]
|
18
|
Yang F, Kim J, Yang F. Effects of obesity on dynamic stability control during recovery from a treadmill-induced slip among young adults. J Biomech 2017; 53:148-153. [DOI: 10.1016/j.jbiomech.2017.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/23/2016] [Accepted: 01/13/2017] [Indexed: 12/30/2022]
|
19
|
Ghezelbash F, Shirazi-Adl A, Arjmand N, El-Ouaaid Z, Plamondon A, Meakin J. Effects of sex, age, body height and body weight on spinal loads: Sensitivity analyses in a subject-specific trunk musculoskeletal model. J Biomech 2016; 49:3492-3501. [DOI: 10.1016/j.jbiomech.2016.09.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 02/02/2023]
|