Perceptions that women are in greater need of fall prevention might impact their participation in programs. This study aimed to understand gender differences in motivating factors and experiences in ...a fall prevention program. Thirty-four adults (18 men and 16 women) aged 60 years or older participated in focus groups after 12 weeks of fall prevention exercises and education. Six main themes emerged. It might be a macho thing represented an overarching theme of why men might not participate in fall prevention as readily as women. Personal experience as a motivator, Get my balance back, and Challenges/Successes were common themes for men and women. Both genders realized the benefits of the program; however, men emphasized the importance of personal outcomes (Being part of something bigger), whereas women highlighted group outcomes (Socialization). These findings can guide the future messaging and marketing of fall prevention programs for older adults.
Highlights • Inertial sensors have many potential benefits when assessing gait in children. • The MobilityLab inertial sensor system has yet to be validated for use in children. • The system was ...accurate for temporal but not for spatial measures in children. • A corrective equation was developed to improve spatial measures in children. • MobilityLab system is valid for gait analysis in children if correction is applied.
There are different ways to add haptic input during walking which may affect walking balance. This study compared the use of two different haptic tools (rigid railing and haptic anchors) and ...investigated whether any effects on walking were the result of the added sensory input and/or the posture generated when using those tools. Data from 28 young healthy adults were collected using the Mobility Lab inertial sensor system (APDM, Oregon, USA). Participants walked with and without both haptic tools and while pretending to use both haptic tools (placebo trials), with eyes opened and eyes closed. Using the tools or pretending to use both tools decreased normalized stride velocity (
p
< .001–0.008) and peak medial–lateral (ML) trunk velocity (
p
< .001–0.001). Normalized stride velocity was slower when actually using the railing compared to placebo railing trials (
p
= .006). Using the anchors resulted in lower peak ML trunk velocity than the railing (
p
= .002). The anchors had lower peak ML trunk velocity than placebo anchors (
p
< .001), but there was no difference between railing and placebo railing (
p
> .999). These findings highlight a difference in the type of tool used to add haptic input and suggest that changes in balance control strategy resulting from using the railing are based on arm placement, where it is the posture combined with added sensory input that affects balance control strategies with the haptic anchors. These findings provide a strong framework for additional research to be conducted on the effects of haptic input on walking in populations known to have decreased walking balance.
Age-related declines in upper extremity muscle strength may affect an older adult’s ability to land and control a simulated forward fall impact. The role of individual upper extremity joints during a ...forward fall impact has not been examined. The purpose was to evaluate the age differences in upper extremity joint moment contributions during a simulated forward fall and upper extremity muscle strength in older women. A convenience sample of 68 older women (70 (8) yrs) performed three trials of a simulated forward fall. Percentage joint moments of the upper extremity were recorded. Upper extremity muscle strength was collected via handgrip, hand-held dynamometry of the shoulder and elbow and a custom multi-joint concentric and eccentric strength isokinetic dynamometer protocol. Percentage joint moment contributions differed between women in their sixties and seventies with significantly greater relative shoulder joint involvement (P =.008), coupled with lower elbow joint contributions (P =.004) in comparison to 80 year olds. An increase in each year of age was associated with a 4% increase in elbow contribution (Beta = -0.421, r2 = 17.9, P = 0.0001) and a 3.7% decrease in shoulder contribution (Beta = 0.373, r2 = 14.6, P = 0.002). Older women exhibit different landing strategies as they age. Fall injury prevention research should consider interventions focused on these differences taking into account the contributions of upper extremity strength.
Previous research has suggested that spatiotemporal step parameters differ between settings; however, it remains unclear how different settings influence walking balance control.
How do settings and ...sex influence walking balance control during walking at different speeds for young adults?
Forty-two adults (21 male (23 ± 4 years), 21 female (24 ± 5 years)) completed overground walking trials in four settings: laboratory (10 m), hallway, indoor open, and outdoor pathway (all 20 m) at three self-selected speeds (slow, preferred, fast) following verbal instructions. Participants wore 17 inertial sensors (Xsens Awinda, Movella, Henderson, NV) to capture total body kinematics. The number of included strides was matched across all conditions, with six strides included in each condition for all participants. Medial-lateral and anterior-posterior total body angular momentum range over each stride was calculated (HML range and HAP range). Setting × speed × sex mixed factorial analysis of variance with repeated measures on setting and speed were used for statistical analysis (α =.05).
Significant setting × speed interactions (p <.001) were present for both outcomes. HML range was greater in the laboratory and hallway compared to the indoor open and outdoor pathway settings for slow walking speed only. HAP range was lower in the outdoor pathway compared to all indoor settings at slow and preferred walking speeds. Differences in HAP range between settings was more pronounced at the slow speed condition. Across setting and speed conditions, HML range was greater for males compared to females.
Young adults may alter their balance control strategy depending on the setting (laboratory, indoor open and outdoor pathway), particularly at slow speeds. Researchers and clinicians are cautioned not to assume walking in laboratory settings reflects walking in all settings nor that males and females can be examined as a single group.
•Total body angular momentum (H) range impacted by setting during walking.•Anterior-posterior (AP) H range lower outdoors compared to indoors.•AP and medial-lateral (ML) H range greater in lab compared to non-lab settings.•ML H range greater for males compared to females across settings and speeds.•Setting and sex are important considerations in walking balance control assessment.
The attentional capacity required of haptic modalities while obstacle crossing may limit their effectiveness. Therefore, this study examined the attentional demands of haptic modalities during ...obstacle crossing. Nineteen healthy young adults walked across a 10 m laboratory floor within two modality blocks using either: 1) light touch on a railing, or 2) pulling haptic anchors. Randomly dispersed within these blocks were trials without added haptic input and verbal reaction time (VRT) tasks. VRT was compared across the three walking conditions. Gait characteristics, obstacle crossing stability, and obstacle toe clearance were compared across the three walking conditions (normal walking, light touch walking, anchored walking) and 2 VRT conditions (absence vs. presence). VRTs did not differ according to walking conditions (p > .05). Step length variability for the normal walking condition was significantly greater than for both the light touch and anchored walking conditions (p = .026). Toe clearance for the trail leg was less during light touch than normal walking (p = .020). The presence of the VRT resulted in greater toe clearance for both lead (p = .018) and trail limbs (F(2,34) = 8.053, p = .011). Neither haptic modality required significantly increased attentional demand; however, light touch walking results in less obstacle toe clearance. Haptic modalities likely provide greater benefit than risk to users during obstacle crossing.
Introduction
Exercise can decrease fall risk in older adults but less is known about training to reduce injury risk in the event a fall is unavoidable. The purpose of this study was to compare ...standard fall prevention exercises to novel Fall Arrest Strategy Training (FAST); exercises designed to improve upper body capacity to reduce fall-injury risk in older women.
Method
Forty women (mean age 74.5 years) participated in either Standard (n = 19) or FAST (n = 21) twice per week for 12 weeks. Both interventions included lower body strength, balance, walking practice, agility and education. FAST added exercises designed to enhance forward landing and descent control such as upper body strengthening, speed and practice of landing and descent on outstretched hands.
Results
Both FAST and Standard significantly improved strength, mobility, balance, and fall risk factors from pre to post-intervention. There was a significant time by group interaction effect for upper body response time where FAST improved but Standard did not (p = 0.038).
Discussion
FAST resulted in similar gains in factors that reduce fall risk as a standard fall prevention program; with the additional benefit of improving speed of arm protective responses; a factor that may help enhance landing position and reduce injury risks such as head impact during a forward fall.
Frequent falls while walking among individuals with incomplete spinal cord injury may suggest impairments in reactive balance control; however, reactive balance control during walking has not been ...studied in this population. The objective was to compare reactive balance control with respect to changes in margin of stability, onset of arm and heel responses, and onset and magnitude of muscle activity following an unexpected slip perturbation in individuals with incomplete spinal cord injury and able-bodied individuals.
Kinematic and electromyography data were obtained during normal walking and one unexpected slip. Changes in margin of stability following a compensatory or aborted step, onset of arms and trail heel responses, and onset and magnitude of activation of the tibialis anterior, soleus and gluteus medius were calculated. Multivariate analyses compared responses between incomplete spinal cord injury and able-bodied groups.
Data from 16 participants with incomplete spinal cord injury (all American Spinal Injury Association Impairment Scale Grade D, 8 with tetraplegia) and 13 age-and-sex matched able-bodied individuals were included. Individuals with incomplete spinal cord injury demonstrated limited ability to increase margin of stability in the lateral direction during a compensatory or aborted step, and a smaller magnitude of soleus activity compared to able-bodied individuals.
There are limitations in reactive balance control of individuals with incomplete spinal cord injury, which may be a reason for the high frequency of falls in this population. Reactive balance assessment should be included as a component of routine balance assessment and fall avoidance strategies in this population.
•Ability to react to unexpected slip is impaired after incomplete spinal cord injury.•Ability to increase sideways margin of stability using a step is limited.•Magnitude of non-slip side soleus muscle activity is smaller.•Other reactive responses are comparable to able-bodied individuals.
The objective of this study was to validate a single-spring model in predicting measured impact forces during an outstretched arm falling scenario. Using an integrated force plate, impact forces were ...assessed from 10 young adults (5 males; 5 females), falling from planted knees onto outstretched arms, from a random order of drop heights: 3, 5, 7, 10, 15, 20, and 25 cm. A single-spring model incorporating body mass, drop height plus the estimated linear stiffness of the upper extremity (hand, wrist and arm) was used to predict impact force on the hand. We used an analysis of variance linearity test to test the validity of using a linear stiffness coefficient in the model. We used linear regression to assess variance (R2) in experimental impact force predicted by the single-spring model. We derived optimum linear stiffness coefficients for male, female and sex-combined. Our results indicated that the association between experimental and predicted impact forces was linear (P < 0.05). Explain variance in experimental impact force was R2 = 0.82 for sex-combined, R2 = 0.88 for males and R2 = 0.84 for females. Optimum stiffness coefficients were 7436 N/m for sex-combined, 8989 N/m for males and 4527 N/m for females. In conclusion, a linear spring coefficient used in the single-spring model proved valid for predicting impact forces from fall heights up to 25 cm. Results also suggest the use of sex-specific spring coefficients when estimating impact force using the single-spring model. This model may improve impact force to bone strength ratios (factor-of-risk) and prediction of forearm and wrist fracture.
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