Compensatory Stepping: The Biomechanics of a Preferred Response Among Older Adults (original) (raw)
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Age-related changes in balance control system: initiation of stepping
Clinical Biomechanics, 1993
The balance control system of a group of healthy and fit, young and elderly subjects was studied during the initiation of stepping in one of three directions: forward, sideways, and backwards in response to a light cue. The performance of these movements requires shifting support from two to one foot, moving the centre of mass outside the initial base of support and creating a new support configuration. By recording and analysing the vertical ground reaction force beneath the subject's stepping foot, we were able to examine the two phases prior to limb lift-off for stepping: reaction time and weight transfer time. Both reaction time and weight transfer time increased with age: The elderly subjects had a proportionately larger increase in weight transfer time compared to the reaction time. The peak force generated showed an age by stepping direction effect: the elderly had a significantly lower peak force for the forwards stepping compared to the younger subjects. The larger increase in weight transfer results in a slower stepping response. Since a stepping task is often recruited to avoid a fall, the increase in response execution time can have undesirable consequences.
Older adults can improve compensatory stepping with repeated postural perturbations
Frontiers in Aging Neuroscience, 2015
The ability to respond quickly and accurately to an external perturbation with a stepping response is critical to avoid falls and this ability is impaired in older, compared to young adults. However, little is known about whether young and older adults improve compensatory stepping responses similarly with practice. This study compares the extent to which young and older adults can improve, retain, and generalize postural compensatory steps in response to external perturbations. Centre of mass displacement, step characteristics and lower leg muscle activation latencies were measured during one training session of compensatory stepping in response to large surface translations in 13 young and 12 older adults. Retention was tested 24 h later. Older adults decreased their center of mass displacements over repeated exposure to large surface translations in both the anterior and posterior directions and retained these improvements. In contrast, young adults only showed adaptation and retention of forward stepping responses. Neither group was able to generalize improvements in stepping responses across directions. These results suggest step training may be beneficial for older adults, however additional, multidirectional training may be necessary to facilitate generalization of postural stepping responses for any direction of a slip or trip.
BMC Geriatrics
Introduction The inability to recover from unexpected lateral loss of balance may be particularly relevant to the problem of falling. Aim We aimed to explore whether different kinematic patterns and strategies occur in the first recovery step in single-step trials in which a single step was required to recover from a fall, and in multiple-step trials in which more than one step was required to recover from a fall. In addition, in the multiple-step trials, we examined kinematic patterns of balance recovery where extra steps were needed to recover balance. Methods Eighty-four older adults (79.3 ± 5.2 years) were exposed to unannounced right/left perturbations in standing that were gradually increased to trigger a recovery stepping response. We performed a kinematic analysis of the first recovery step of all single-step and multiple-step trials for each participant and of total balance recovery in the multiple-step trial. Results Kinematic patterns and strategies of the first recovery ...
2021
Introduction—The inability to recover from unexpected lateral loss of balance may be particularly relevant to the problem of falls.Aim—We aimed to explore whether different kinematic patterns and strategies occur in the first recovery step in single-step trials when single step was required to recover from fall and in the multiple-step trials, when more than one step were required to recover from fall. In addition, in the multiple-step trials we examined kinematic patterns of balance recovery where extra steps were needed to recover balance. Methods—Eighty-four older adults (79.3±5.2 years) were exposed to announced right/left perturbations in standing that were gradually increased to trigger a recovery stepping response. We performed kinematic analysis of the first recovery step of all single-step and multiple-step trials for each participant and of total balance recovery in the multiple-step trial.Results—Kinematic patterns and strategies of the first recovery step in the single-s...
Age-dependent differences in lateral balance recovery through protective stepping
Clinical Biomechanics, 2005
Background. Aging appears to present particular problems for lateral balance stability related to falls. Protective stepping is a common strategy for maintaining balance that may be impaired with aging due to changes in neuromusculoskeletal factors. This study assessed the response patterns, kinematics, and single support hip abduction torque during lateral protective stepping for balance recovery in healthy young and elderly adults.
Biomechanical Analysis of Older Adults Stepping Up: A Method of Evaluating Balance
Journal of Aging and Physical Activity, 2008
The aim of this study was to analyze differences in biomechanical parameters between elderly and control participants when stepping up, to evaluate control of balance. Eleven control and 14 elderly participants performed a step from an initial static posture onto a 7-cm-high force plate. For the spontaneous-velocity condition, elderly participants performed a slower progression velocity than control participants. Elderly participants spent proportionally more time in stance phase, with a corresponding decrease in swing phase, than the control participants, irrespective of movement velocity. In contrast, at spontaneous velocity the parameters related to ground-reaction force (GRF) showed that anteroposterior and mediolateral forces at toe-off of the support limb and the slope of vertical force during weight transfer were significantly smaller for the elderly than for control participants. These GRF parameters depended on the stepping-up velocity. The elderly develop a spatiotemporal ...
Differences in balance control between healthy younger and older adults during steady-state walking
Journal of Biomechanics, 2021
Each year approximately one third of older adults fall and experience extensive musculoskeletal injuries and functional disabilities. An important element in maintaining dynamic balance is the regulation of whole-body angular momentum, which is achieved by proper foot placement with respect to the body center-of-mass as well as generation of appropriate ground reaction forces. Analyzing these quantities in younger and older adults may provide insight into differences in their underlying mechanics for maintaining dynamic balance. This study examined three-dimensional whole-body angular momentum in 13 healthy older (71.8 ± 8.3 years) and 9 younger (23.2 ± 2.8 years) adults walking at their self-selected and fastest-comfortable speeds. The older adults had a significantly higher range of frontal-plane angular momentum compared to the younger adults at both speeds, suggesting poorer mediolateral balance control. This difference was related to the older adults having a wider foot placement with respect to the body center-of-mass, which when combined with the vertical ground reaction force, created a higher destabilizing external moment during single-limb stance that acts to rotate the body towards the contralateral swing leg. To counteract this destabilizing moment, the older adults generated a higher hip abduction moment. There were no differences in the range of sagittal-and transverse-plane angular momentum between age groups at either speed. These results suggest that control of dynamic balance in the frontal-plane is more challenging than in the sagittal-plane for older adults and highlight the importance of proper weight transfer mechanisms and hip abductor force production for maintaining mediolateral balance during walking.
Applied Ergonomics, 2016
Always cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the TSpace version (original manuscript or accepted manuscript) because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page. Age-related differences in dynamic balance control during stair descent and effect of varying step geometry Novak AC a , Komisar V a,b , Maki BE a,b,c,d , Fernie GR a,b,c,d
Kinematic and kinetic characteristics of stepping over a 10-cm-high obstacle in older adults
Aino Journal, 2010
The purpose of this research was to clarify the common responses shared by a high-falldown-risk group of older adults and develop an exercise-learning program to prevent falls. [Subjects] Thirty-four subjects were chosen from those who use the daycare program of a nursing home at least once a week. [Methods] All subjects were categorized in longer or shorter-MSL groups. Ninety-second stepping from two force plates to a 10-cmhigh box was executed under three conditions. The locus length of the COP, toe-obstacle distance, and step length were used as experimental data. [Results] The coefficient between the MSL and COP was from 0.69 to 0.73. The shorter-MSL group showed smaller COP movements in the A-P direction and a smaller toe-obstacle distance between the single stepping and stepping with the visual task and between the single stepping and stepping with the auditory task. No significant difference was noted in the step length between the two groups. [Conclusion] The shorter-MSL group was easily affected by the dual-task, suggesting that the shorter-MSL group has a high risk of falling when negotiating obstacles. Stepping exercise with the dual-task using the COP movements as a feedback index may be useful for older adults who have a smaller MSL.
Triggering of protective stepping for the control of human balance: age and contextual dependence
Cognitive brain …, 2003
Human stepping is a commonly executed control strategy for maintaining standing balance in the natural environment. Aging changes in the initiation triggering of both voluntary (longer latency) and perturbation-induced (shorter latency) stepping are associated with falling, and are a complex function of altered sensorimotor, neuromuscular, and cognitive system factors. The aim of this study was to determine the effect of contextual uncertainty about balance stability on the triggering of protective stepping in young and older individuals. Subjects initiated forward stepping during simple reaction time and waist-pull perturbation conditions with and without contextual uncertainty about balance stability. The results showed that, regardless of age, the initiation timing for triggering both voluntary and induced stepping was delayed substantially (100-300 ms) by the presence of balance uncertainty, and that age-associated timing differences were exacerbated with contextual uncertainty. The initiation timing of the first step liftoff for perturbation-induced stepping did not reflect entirely an immediate necessity or last resort strategy to balance instability determined directly by specific sensory input, but rather a decision to step. Moreover, the time to liftoff onset for perturbation-induced stepping was similar for the old and young with contextual certainty, and occurred 130 ms earlier for the old than for the young when balance stability was uncertain. Overall, we concluded that older individuals can retain a residual capacity to sustain stationary standing stability as a function of the prevailing task conditions, and that the reduced timing threshold with age may involve a pre-selected strategy triggered earlier by non-specific event-related sensory input rather than specific movement-related information.