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Rasmussen CM, Mun S, Ouattas A, Walski A, Curtze C, Hunt NH. Curvilinear walking elevates fall risk and modulates slip and compensatory step attributes after unconstrained human slips. J Exp Biol 2024; 227:jeb246700. [PMID: 38456285 PMCID: PMC11006391 DOI: 10.1242/jeb.246700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
While much attention has been paid to understanding slip-related falls in humans, little has been focused on curvilinear paths despite their prevalence, distinct biomechanical demands and increased slipping threat. We determined the mechanics, compensatory stepping reactions and fall risk associated with slips during fixed-speed walking across ranges of path curvature, slipped foot and slip onset phase contexts possible in the community, which builds upon previous work by examining speed-independent effects of curvilinear walking. Twenty-one participants experienced 15 unconstrained slips induced by a wearable friction-reducing device as motion capture and harness load cell data were recorded. Falls were most likely after early stance slips to the inside foot and increased at tighter curvatures. Slip distance and peak velocity decreased as slips began later in stance phase, did not differ between feet, and accelerated on tighter paths. Slipping foot directions relative to heading transitioned from anterior (forward) to posterior (backward) as slips began later in stance, were ipsilateral (toward the slipping foot side) and contralateral (toward the opposite side) for the outside and inside foot, respectively, and became increasingly ipsilateral/contralateral on tighter curvatures. Compensatory steps were placed anteriorly and ipsilaterally after outside and inside foot slips, respectively, and lengthened at later onset phases for outside foot slips only. Our findings illustrate slip magnitude and fall risk relationships that suggest slip direction may influence the balance threat posed by a slip, imply that walking speed may modify slip likelihood, and indicate the most destabilizing curved walking contexts to target in future perturbation-based balance training approaches.
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Affiliation(s)
- Corbin M. Rasmussen
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Seongwoo Mun
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Abderrahman Ouattas
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Andrew Walski
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Carolin Curtze
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Nathaniel H. Hunt
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA
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Beschorner KE, Nasarwanji M, Deschler C, Hemler SL. Prospective validity assessment of a friction prediction model based on tread outsole features of slip-resistant shoes. Appl Ergon 2024; 114:104110. [PMID: 37595332 PMCID: PMC10847959 DOI: 10.1016/j.apergo.2023.104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/20/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023]
Abstract
Shoe outsole design strongly influences slip and fall risk. Certain tread features that can be readily measured have been shown to predict friction performance. This research aimed to replicate those findings and quantify their ability to predict slipping. Participants (n = 34) were exposed to a low friction oil-coated floor surface, while wearing slip-resistant shoes. The coefficient of friction (COF) of each shoe were predicted based on tread surface area, the presence of a bevel, and hardness. The COF was measured, and the slip outcome was determined. Predicted and measured COF were correlated, and measured COF was a sensitive predictor of slip outcome. The relationship of predicted COF on slip outcome was weaker than anticipated and was not statistically significant. This study partially confirmed the ability of previous regression equations to predict COF. However, the effect size was weaker than previously reported and predicted COF was not sensitive for predicting slips.
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Affiliation(s)
- Kurt E Beschorner
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara St., Pittsburgh, PA, 15213, USA.
| | - Mahiyar Nasarwanji
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara St., Pittsburgh, PA, 15213, USA
| | - Chris Deschler
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara St., Pittsburgh, PA, 15213, USA
| | - Sarah L Hemler
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara St., Pittsburgh, PA, 15213, USA
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3
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Hennah C, Doumas M. Dual-task walking on real-world surfaces: Adaptive changes in walking speed, step width and step height in young and older adults. Exp Gerontol 2023; 177:112200. [PMID: 37160198 DOI: 10.1016/j.exger.2023.112200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Age-related changes in dual-task walking are well established, but research in this topic is based on evidence from laboratory rather than real-world studies. We investigated how dual-task walking on real-world surfaces affects young and older adults' gait characteristics and cognitive resource allocation. METHOD Sixteen young (aged 19-35, 12 female) and fifteen older adults (aged 70-85, 7 female) with no major neurological or musculoskeletal disorders walked at a self-selected speed on forty-metre outdoor paths that had asphalt or grass surface. They walked with or without a cognitive task (counting backwards). Cognitive task difficulty was individually adjusted at 80 % accuracy. Participants performed the three tasks in Single Task (ST Asphalt, ST Grass, ST Cognitive) and Dual Task context (DT Asphalt-Cognitive, DT Grass-Cognitive). RESULTS The two groups showed similar dual task effects in cognition and walking speed, both of which were slower when dual-task walking. Older adults' steps were wider overall but only young adults widened their step width when dual-task walking on grass compared to asphalt. Similarly, young adults' step height increased from single to dual-task walking when on grass, where older adults' did not. DISCUSSION The lack of adaptation of step width and height when dual-task walking may leave older adults vulnerable to tripping or falling in common real-world conditions, such as while walking on grass, gravel, or uneven city sidewalks. Considering this, the built environment should be made more accessible to facilitate older adults' safe walking.
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Affiliation(s)
| | - Michail Doumas
- School of Psychology, Queen's University Belfast, Belfast, UK
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Li H, Qiu X, Yang Z, Zhang Z, Wang G, Kim Y, Kim S. Effects of Cha-Cha Dance Training on the Balance Ability of the Healthy Elderly. Int J Environ Res Public Health 2022; 19:13535. [PMID: 36294115 PMCID: PMC9603652 DOI: 10.3390/ijerph192013535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Neuro-musculo-skeletal degradations with advancing age are generally accompanied with mobility problems and poor health status, contributing to impaired physical function and increased risk of falls. In an effort to diminish a fall-related risk such as unstable balance, a variety of interventions have been studied and implemented. Yet, there have been few studies to evaluate the effect of Cha-cha dance training on postural balance or balance performance of the elderly. The Cha-cha dance is composed of moderate rhythm and symmetrical movements and is easy to master and even easier for the elderly to begin. The purpose of this study was to intervene the fitness exercise through 12-week Cha-cha dance training, evaluate its impact on the balance ability of the elderly, and provide a scientific experimental basis for the elderly to participate in the Cha-cha dance exercise. Forty healthy elderly people with no difference in balance ability were randomly divided into two groups. The Cha-cha training group (CTG, n = 20) regularly participated in Cha-cha dance class, 3 times a week, 90 min each time, for a total of 12 weeks, and the control group (CONG, n = 20) did not participate in the class and engaged to their regular daily life. Dynamic and static balance were measured at pre and post intervention. Overall, the results showed that dynamic balance and static balance in CTG were significantly improved after the intervention. In addition, the results showed that the improvement was more significant in trials in left foot than right foot, and trials in closed eyes than open eyes, respectively. In conclusion, a 12-week Cha-cha dance class or program alone can be an effective intervention to improve balance of the elderly.
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Affiliation(s)
- Han Li
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea
- Department of Physical Education, Huaiyin Normal University, Huaian 223000, China
| | - Xuan Qiu
- Department of Physical Education, Yichun University, Yichun 336000, China
| | - Zhitao Yang
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea
- Department of Mechanical and Electrical Engineering, Zhoukou Normal University, Zhoukou 466000, China
| | - Zhengxiao Zhang
- Department of Physical Education, Yichun University, Yichun 336000, China
| | - Gang Wang
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea
- Department of Physical Education, Xinyang Normal University, Xinyang 464000, China
| | - Youngsuk Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea
| | - Sukwon Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea
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Ouattas A, Rasmussen CM, Hunt NH. Severity of Unconstrained Simultaneous Bilateral Slips: The Impact of Frontal Plane Feet Velocities Relative to the Center of Mass to Classify Slip-Related Falls and Recoveries. Front Public Health 2022; 10:898161. [PMID: 35899166 PMCID: PMC9309647 DOI: 10.3389/fpubh.2022.898161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
Targeted interventions to prevent slip-related falls may be informed by specific kinematic factors measured during the reactive response that accurately discriminate recoveries from falls. But reactive responses to diverse slipping conditions during unconstrained simultaneous bilateral slips, which are closely related to real-world slips, are currently unknown. It is challenging to identify these critical kinematic factors due to the wide variety of upper and lower body postural deviations that occur following the slip, which affect stability in both the sagittal and frontal planes. To explore the utility of kinematic measurements from each vertical plane to discriminate slip-related falls from recoveries, we compared the accuracy of four Linear Discriminant Analysis models informed by predetermined sagittal or frontal plane measurements from the lower body (feet velocities relative to the center of mass) or upper body (angular momentum of trunk and arms) during reactive responses after slip initiation. Unconstrained bilateral slips during over-ground walking were repeatedly administered using a wearable device to 10 younger (24.7 ± 3.2 years) and 10 older (72.4 ± 3.9 years) adults while whole-body kinematics were measured using motion capture. Falls (n = 20) and recoveries (n = 40) were classified by thresholding the dynamic tension forces measured in an overhead harness support system and verified through video observation. Frontal plane measurements of the peak feet velocities relative to the center of mass provided the best classification (classification accuracy = 73.3%), followed by sagittal plane measurements (classification accuracy = 68.3%). Measurements from the lower body resulted in higher accuracy models than those from the upper body, but the accuracy of all models was generally low compared to the null accuracy of 66.7% (i.e., predicting all trials as recoveries). Future work should investigate novel models that include potential interactions between kinematic factors. The performance of lower limb kinematics in the frontal plane in classifying slip-related falls demonstrates the importance of administering unconstrained slips and measuring kinematics outside the sagittal plane.
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Dusane S, Bhatt T. Can prior exposure to repeated non-paretic slips improve reactive responses on novel paretic slips among people with chronic stroke? Exp Brain Res 2022. [PMID: 35106605 DOI: 10.1007/s00221-021-06300-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
This study examined if people with chronic stroke (PwCS) could adapt following non-paretic overground gait-slips and whether such prior exposure to non-paretic slips could improve reactive responses on novel paretic slip. Forty-nine PwCS were randomly assigned to either adaptation group, which received eight unexpected, overground, nonparetic-side gait-slips followed by two paretic-side slips or a control group, which received two paretic-side slips. Slip outcome, recovery strategies, center of mass (CoM) state stability, post-slip stride length and slipping kinematics were analyzed. The adaptation group demonstrated fall-reduction from first to eighth non-paretic slips, along with improved stability, stride length and slipping kinematics (p < 0.05). Within the adaptation group, on comparing novel slips, paretic-side demonstrated comparable pre-slip stability (p > 0.05); however, lower post-slip stability, increased slip velocity and falls was noted (p < 0.05). There was no difference in any variables between the novel paretic slips of adaptation and control group (p > 0.01). However, there was a rapid improvement on the 2nd slip such that adaptation group demonstrated improved performance from the first to second paretic slip compared to that in the control group (p < 0.01). PwCS demonstrated immediate proactive and reactive adaptation with overground, nonparetic-side gait-slips. However, PwCS did not demonstrate any inter-limb performance gain on the paretic-side after prior nonparetic-side adaptation when exposed to a novel paretic-side slip; but they did show significant positive gains with single slip priming on the paretic-side compared to controls without prior adaptation.Clinical registry number: NCT03205527.
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Choi J, Ogawa T, Takesue S, Muraki S, Inoue Y, Abe H, Yamanoi E. Different flooring surfaces affect infants' crawling performance. Appl Ergon 2022; 98:103553. [PMID: 34428619 DOI: 10.1016/j.apergo.2021.103553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
This study assessed the influence of different types of flooring on infants' crawling motion patterns and performance. Each participating infant (range: 8.7-12.4 months) was encouraged to crawl on a tatami mat made of woven straw as well as other flooring types such as hardwood, carpet, and joint mat. Material tests were conducted to quantify the friction and shock absorption of the flooring. A three-dimensional motion capture system was used to measure spatiotemporal and kinematic variables during hands-and-knees crawling. An increased crawling rate was associated with a faster cadence of cyclic arm movements, but not with crawling stride length. Hardwood flooring had a significantly lower crawling rate and longer duration of hand-floor contact than tatami, while the crawling stride length and range of motion of joint movements were hardly affected by flooring type. The results of this study suggest a drawback of hardwood flooring in terms of infants' effective quadrupedal locomotion.
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Affiliation(s)
- Jeewon Choi
- Department of Human Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan
| | - Takeru Ogawa
- Department of Human Science, Graduate School of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan
| | - Shin Takesue
- Department of Human Science, Graduate School of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan
| | - Satoshi Muraki
- Department of Human Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan.
| | - Youki Inoue
- Ikehiko Corporation, 1052 Miyamatsu, Mizuma-gun, Fukuoka, 830-0424, Japan
| | - Hikari Abe
- Ikehiko Corporation, 1052 Miyamatsu, Mizuma-gun, Fukuoka, 830-0424, Japan
| | - Emi Yamanoi
- Mamakoya Co. Ltd., 3-17-28 Heisei, Chuo-ku, Kumamoto, 860-0833, Japan
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Griffin SC, Hemler SL, Beschorner KE. Investigating the Influence of Spatiotemporal Gait Characteristics on Shoe Wear Rate. IISE Trans Occup Ergon Hum Factors 2022. [PMID: 34781847 DOI: 10.1080/24725838.2021.2005184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OCCUPATIONAL APPLICATIONSWe investigated the association between shoe wear rate and several metrics describing an individual's spatiotemporal gait characteristics (cadence, step length, and preferred walking speed). No associations were found, indicating that alternative metrics should be investigated to predict the individualized rate at which workers wear down shoe tread.
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Affiliation(s)
- Sarah C Griffin
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah L Hemler
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kurt E Beschorner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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9
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Simpkins C, Ahn J, Yang F. Effects of anterior load carriage on gait parameters: A systematic review with meta-analysis. Appl Ergon 2022; 98:103587. [PMID: 34547577 DOI: 10.1016/j.apergo.2021.103587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
Anterior load carriage is common in occupational work and daily activities. Our primary purpose was to systematically review previous work concerning the biomechanics of walking with anterior load carriage. A secondary goal was to conduct a meta-analysis on common gait parameters relevant to front load carriage. An electronic database search yielded eight qualified articles. Meta-analyses were performed for four gait variables: stride length, heel contact velocity, required coefficient of friction, double support time. When possible, subgroup analyses by age were conducted. Results suggest that walking with front load carriage may shorten the stride length, particularly among young adults, but has small effects on the other three variables. Findings should be interpreted with caution given the limited number of studies included and small sample size per study. Future work investigating these four variables and others is needed to further our understanding of the impact of front load carriage on gait.
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Affiliation(s)
- Caroline Simpkins
- Department of Kinesiology & Health, Georgia State University, Atlanta, GA, USA
| | - Jiyun Ahn
- Department of Kinesiology & Health, Georgia State University, Atlanta, GA, USA
| | - Feng Yang
- Department of Kinesiology & Health, Georgia State University, Atlanta, GA, USA.
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Dusane S, Bhatt T. Effect of Multisession Progressive Gait-Slip Training on Fall-Resisting Skills of People with Chronic Stroke: Examining Motor Adaptation in Reactive Stability. Brain Sci 2021; 11:brainsci11070894. [PMID: 34356128 PMCID: PMC8303184 DOI: 10.3390/brainsci11070894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 01/28/2023] Open
Abstract
Background: This study examined whether a multisession gait-slip training could enhance reactive balance control and fall-resisting skills of people with chronic stroke (PwCS). Methods: A total of 11 PwCS underwent a four-week treadmill-based gait-slip training (four sessions). Pre- and post-training assessment was performed on six intensities of gait-slips (levels 1–6). Training consisted of 10 blocks of each progressively increasing intensity (four trials per block) until participants fell at >2 trials per block (fall threshold). In the next session, training began at a sub-fall threshold and progressed further. Fall outcome and threshold, number of compensatory steps, multiple stepping threshold, progression to higher intensities, pre- and post-slip center of mass (CoM), state stability, clinical measures, and treadmill walking speed were analyzed. Results: Post-training, PwCS demonstrated a reduction in falls and compensatory steps on levels 5 and 6 (p < 0.05) compared to pre-training. While an increase in pre-slip stability was limited to level 6 (p < 0.05), improvement in post-slip stability at lift-off was noted on levels 2, 3, and 5 (p < 0.05) along with improved post-slip minimum stability on levels 5 and 6 (p < 0.05). Post-training demonstrated improved fall (p < 0.05) and multiple stepping thresholds (p = 0.05). While most participants could progress to level 4 between the first and last training sessions, more participants progressed to level 6 (p < 0.05). Participants’ treadmill walking speed increased (p < 0.05); however, clinical measures remained unchanged (p > 0.05). Conclusions: Multisession, progressively increasing intensity of treadmill-based gait-slip training appears to induce significant adaptive improvement in falls, compensatory stepping, and postural stability among PwCS.
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Affiliation(s)
- Shamali Dusane
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA;
- Ph.D. Program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA;
- Correspondence: ; Tel.: +1-312-355-4443; Fax: +1-312-996-4583
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Sierra M SD, Múnera M, Provot T, Bourgain M, Cifuentes CA. Evaluation of Physical Interaction during Walker-Assisted Gait with the AGoRA Walker: Strategies Based on Virtual Mechanical Stiffness. Sensors (Basel) 2021; 21:3242. [PMID: 34067133 DOI: 10.3390/s21093242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 11/16/2022]
Abstract
Smart walkers are commonly used as potential gait assistance devices, to provide physical and cognitive assistance within rehabilitation and clinical scenarios. To understand such rehabilitation processes, several biomechanical studies have been conducted to assess human gait with passive and active walkers. Several sessions were conducted with 11 healthy volunteers to assess three interaction strategies based on passive, low and high mechanical stiffness values on the AGoRA Smart Walker. The trials were carried out in a motion analysis laboratory. Kinematic data were also collected from the smart walker sensory interface. The interaction force between users and the device was recorded. The force required under passive and low stiffness modes was 56.66% and 67.48% smaller than the high stiffness mode, respectively. An increase of 17.03% for the hip range of motion, as well as the highest trunk’s inclination, were obtained under the resistive mode, suggesting a compensating motion to exert a higher impulse force on the device. Kinematic and physical interaction data suggested that the high stiffness mode significantly affected the users’ gait pattern. Results suggested that users compensated their kinematics, tilting their trunk and lower limbs to exert higher impulse forces on the device.
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Soangra R, Shiraishi M, Beuttler R, Gwerder M, Boyd L, Muthukumar V, Trabia M, Aminian A, Grant-beuttler M. Foot Contact Dynamics and Fall Risk among Children Diagnosed with Idiopathic Toe Walking. Applied Sciences 2021; 11:2862. [DOI: 10.3390/app11062862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children that are diagnosed with Idiopathic Toe walking (cITW) are characterized by persistent toe-to-toe contacts. The objective of this study was to explore whether typical foot contact dynamics during walking predisposes cITW to a higher risk of falling. Twenty cITW and age-matched controls performed typical and toe walking trials. The gait parameters related to foot contact dynamics, vertical force impulses during stance, slip, and trip risk were compared for both groups. We found that cITW manifest less stable gait and produced significantly higher force impulses during push-off. Additionally, we found that cITW had a higher slip-initiation risk that was associated with higher foot contact horizontal and vertical velocities in addition to lower transitional acceleration of center of mass. We found that cITW exhibited a higher trip risk with toe clearance being significantly lower when compared to healthy counterparts. This study allowed for a quantitative description of foot contact dynamics and delineated typical from toe walking among cITW. Overall, the results indicate that cITW are less stable during typical walking and are prone to a higher risk of slip and trip-like falls.
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13
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Soangra R, Lockhart T. Smartphone-Based Prediction Model for Postoperative Cardiac Surgery Outcomes Using Preoperative Gait and Posture Measures. Sensors (Basel) 2021; 21:s21051704. [PMID: 33801240 PMCID: PMC7958120 DOI: 10.3390/s21051704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022]
Abstract
Gait speed assessment increases the predictive value of mortality and morbidity following older adults' cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were recruited for this study. As per the Society of Thoracic Surgeons (STS) recommendation guidelines, eight of the cardiovascular disease (CVD) patients were classified as frail (prone to adverse outcomes with gait speed ≤0.833 m/s) and the remaining eight patients as non-frail (gait speed >0.833 m/s). Treating physicians and patients were blinded to gait and posture assessment results not to influence the decision to proceed with surgery or postoperative management. Follow-ups regarding patient outcomes were continued until patients were discharged or transferred from the hospital, at which time data regarding outcomes were extracted from the records. In the preoperative setting, patients performed the 5-m walk and stand still for 30 s in the clinic while wearing a mobile phone with a customized app "Lockhart Monitor" available at iOS App Store. Systematic evaluations of different gait and posture measures identified a subset of smartphone measures most sensitive to differences in two groups (frail versus non-frail) with adverse postoperative outcomes (morbidity/mortality). A regression model based on these smartphone measures tested positive on five CVD patients. Thus, clinical settings can readily utilize mobile technology, and the proposed regression model can predict adverse postoperative outcomes such as morbidity or mortality events.
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Affiliation(s)
- Rahul Soangra
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA;
- Fowler School of Engineering, Chapman University, Orange, CA 92866, USA
| | - Thurmon Lockhart
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA
- Correspondence: ; Tel.: +1-540-257-3058
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Dusane S, Gangwani R, Patel P, Bhatt T. Does stroke-induced sensorimotor impairment and perturbation intensity affect gait-slip outcomes? J Biomech 2021; 118:110255. [PMID: 33581438 DOI: 10.1016/j.jbiomech.2021.110255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 12/29/2022]
Abstract
People with chronic stroke (PwCS) demonstrate similar gait-slip fall-risk on both paretic and non-paretic side. Compensatory stepping and slipping limb control are crucial to reduce gait-slip fall-risk. Given the unpredictable intensities of real-life perturbations, this study aimed to determine whether recovery from paretic or non-paretic slips vary as a function of perturbation intensity among PwCS. Forty-four PwCS were assigned to non-paretic low intensity slip, non-paretic high intensity slip, paretic low intensity slip, or paretic high intensity slip group. Participants were subjected to a novel overground gait-slip with a distance of 24 cm (low) or 45 cm (high), under either limb. Recovery strategies, center of mass (CoM) state stability and slipping kinematics were analyzed. Both non-paretic high and low intensity groups demonstrated similar percentage of aborted and recovery stepping, however, paretic high intensity group demonstrated greater aborted stepping (p > 0.05). Both high and low intensity paretic slip groups demonstrated reduced post-slip CoM stability relative to the non-paretic slip groups (p < 0.05). Slip displacement was greater in paretic high group compared with non-paretic high group (p < 0.05). Greater slip displacement at higher intensity was noted only in paretic slip group (p < 0.05). The slip velocity was faster in paretic groups compared to non-paretic slip groups (p < 0.05). Paretic slips showed lower stability at both intensities associated with difficulty in modulating slipping kinematics and resorting to an increased aborted stepping strategy compared to non-paretic slip. These findings are suggestive of developing balance interventions for improving both compensatory non-paretic limb stepping and reactive control of slipping paretic limb for fall-risk reduction.
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Affiliation(s)
- Shamali Dusane
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA; Ph.D. program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612 USA
| | - Rachana Gangwani
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA; MS program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA
| | - Prakruti Patel
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL 60612, USA.
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Wang S, Wang Y, Pai YCC, Wang E, Bhatt T. Which Are the Key Kinematic and Kinetic Components to Distinguish Recovery Strategies for Overground Slips Among Community-Dwelling Older Adults? J Appl Biomech 2020; 36:217-227. [PMID: 32492653 PMCID: PMC8344101 DOI: 10.1123/jab.2019-0285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/20/2020] [Accepted: 04/07/2020] [Indexed: 12/23/2022]
Abstract
Slip outcomes are categorized as either a backward loss of balance (LOB) or a no loss of balance (no-LOB) in which an individual does not take a backward step to regain their stability. LOB includes falls and nonfalls, while no-LOB includes skate overs and walkovers. Researchers are uncertain about which factors determine slip outcomes and at which critical instants they do so. The purpose of the study was to investigate factors affecting slip outcomes in proactive and early reactive phases by analyzing 136 slip trials from 68 participants (age: 72.2 [5.3] y, female: 22). Segment angles and average joint moments in the sagittal plane of the slipping limb were compared for different slip outcomes. The results showed that knee flexor, hip extensor, and plantar flexor moments were significantly larger for no-LOB than for LOB in the midproactive phase, leading to smaller shank-ground and foot-ground angles at the slip onset, based on forward dynamics. In the early reactive phase, the hip extensor and plantar flexor moments were larger for no-LOB than for LOB, and all segment angles were smaller for no-LOB. Our findings indicate that the shank angle and knee moment were the major determinants of slip outcomes in both proactive and reactive phases.
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Pacheco TBF, de Medeiros CSP, de Oliveira VHB, Vieira ER, de Cavalcanti FAC. Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis. Syst Rev 2020; 9:163. [PMID: 32682439 PMCID: PMC7368979 DOI: 10.1186/s13643-020-01421-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/06/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Exergaming is a fun, engaging, and interactive form of exercising that may help overcome some of the traditional exercise barriers and help improve adherence on the part of older adults, providing therapeutic applications for balance recovery and functional mobility. The purpose of this systematic review is to summarize the effects of exergames on mobility and balance in older adults. METHODS The PRISMA guidelines for systematic reviews were followed. The following databases were searched from inception to August 2019: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, CINAHL, and INSPEC. We selected randomized controlled trials that assessed the effects of exergames on balance or mobility of older adults without neurological conditions, in comparison to no intervention or health education. Two review authors independently screened the trials' titles and abstracts and identified trials for inclusion according to the eligibility criteria. An almost perfect agreement between the authors was observed with respect to interrater reliability of trial selection (kappa = 0.84; P < 0.001). We performed descriptive analysis of the quantitative data to summarize the evidence. Meta-analysis was carried out using RevMan. A random effects model was used to compute the pooled prevalence with 95% confidence intervals. RESULTS After screening 822 records, 12 trials comparing exergames with no intervention were included. A total of 1520 older adults participated in the studies, with a mean age of 76 ± 6 years for the experimental group and 76 ± 5 years for the control group. Quantitative synthesis showed significant improvements in balance and mobility based on the center of pressure sway (SMD = - 0.89; 95%CI = - 1.26 to - 0.51; P = 0.0001; I2 = 58%), Berg Balance Scale (MD = 2.15; 95%CI = 1.77 to 2.56; P = 0.0001; I2 = 96%), and on Timed Up and Go test (MD = - 2.48; 95%CI = - 3.83 to - 1.12; P = 0.0003; I2 = 0). CONCLUSIONS Exergames improved balance and mobility in older adults without neurological disorders and motivate patients to keep performing balance exercises. High quality studies with standardized assessment protocols are necessary to improve the strength of the evidence.
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Affiliation(s)
- T B F Pacheco
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
| | - C S P de Medeiros
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - V H B de Oliveira
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - E R Vieira
- Department of Physical Therapy, Florida International University (FIU), Miami, USA
| | - F A C de Cavalcanti
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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Dörr S, Schlecht M, Chatzitomaris A, Weisser G, Lucke-Paulig L, Friedl A, Joachim R, Lobmann R. Predictive Effect of Inflammatory Response and Foot Ulcer
Localization on Outcome in Younger and Older Individuals with Infected Diabetic
Foot Syndrome. Exp Clin Endocrinol Diabetes 2020; 129:878-886. [DOI: 10.1055/a-1149-8989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractThe diabetic foot syndrome (DFS) is the most important cause for non-traumatic
major amputation in adult individuals and actually one of the most frightening
events in diabetics’ life. Despite the often protracted treatment of
infected DFS at the end patients are often confronted with amputation. We
investigated 352 individuals with infected DFS in two age separated-groups.
Older individuals presented with significant worse renal function and lower
HbA1c on day of admittance. Most detected ulcers involved the plantar sides of
the metatarsal heads (MTH) and the toes. We saw an age-dependent translocation
of foot ulcers from plantar and hindfoot to the forefoot and toes. In average
every third wound provoked amputation, in the majority (94%) minor
amputations, only 1.9% major amputations occurred. Lesions of the
5th toe or its MTH and interdigital or interphalangeal joint
ulcers led to amputation in more than 60%. Worse renal function and WBC
above 11 tsd/µl were linked with higher amputation risk. But in
particular current scoring systems like SINBAD or Wagner-Armstrong scale and
thus finally clinician’s assessment of the wound situation gave a
substantial hint for subsequent amputation – regardless of age.
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Affiliation(s)
- Stefan Dörr
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Michael Schlecht
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Apostolos Chatzitomaris
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Gregor Weisser
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Lara Lucke-Paulig
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Alexander Friedl
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Regina Joachim
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
| | - Ralf Lobmann
- Departments of Endocrinology, Diabetology and Geriatrics, Stuttgart
General Hospital, Bad Cannstatt, Germany
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Li J, Goerlandt F, Li KW. Slip and Fall Incidents at Work: A Visual Analytics Analysis of the Research Domain. Int J Environ Res Public Health 2019; 16:ijerph16244972. [PMID: 31817818 PMCID: PMC6950497 DOI: 10.3390/ijerph16244972] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/24/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023]
Abstract
Slip and fall incidents at work remain an important class of injury and fatality causing mechanisms. An extensive body of safety research has accumulated on this topic. This article presents an analysis of this research domain. Two bibliometric visualization tools are applied: VOSviewer and HistCite. Samples of 618 slip and fall related articles are obtained from the Web of Science database. Networks of institutions, authors, terms, and chronological citation relationships are established. Collaboration and research activities of the slip and fall research community show that most contributors are from the United States, with the (now closed) Liberty Mutual Research Institute for Safety the most influential research organization. The results of a term clustering analysis show that the slip and fall research can be grouped into three sub-domains: epidemiology, gait/biomechanics, and tribology. Of these, early research focused mainly on tribology, whereas research on gait/biomechanics and epidemiological studies are relatively more recent. Psychological aspects of slip and fall incident occurrence represent a relatively under-investigated research topic, in which future contributions may provide new insights and safety improvements. Better linking of this research domain with other principles and methods in safety science, such as safety management and resilience, may also present valuable future development paths.
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Affiliation(s)
- Jie Li
- Department of Safety Science and Engineering, School of Ocean Science and Engineering, Shanghai Maritime University, Pudong New Area, Shanghai 201306, China
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Floris Goerlandt
- Dalhousie University, Department of Industrial Engineering, Halifax, Nova Scotia B3H 4R2,UK
| | - Kai Way Li
- Department of Industrial Management, Chung Hua University, Hsin-Chu 30012, Taiwan
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Aprigliano F, Monaco V, Tropea P, Martelli D, Vitiello N, Micera S. Effectiveness of a Robot-Mediated Strategy While Counteracting Multidirectional Slippages. ROBOTICA 2019; 37:2119-31. [DOI: 10.1017/s0263574719000626] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryThis study investigates the effectiveness of a robot-mediated strategy aimed at promoting balance recovery after multidirectional slippages. Six older adults were asked to manage anteroposterior and mediolateral slippages while donning an active pelvis orthosis (APO). The APO was set up either to assist volunteers during balance loss or to be transparent. The margin of stability, in sagittal and frontal planes, was the main metric to assess the effectiveness of balance recovery. Results showed that the assistive strategy is effective at promoting balance recovery in the sagittal plane, for both perturbing paradigms; however, it is not effective at controlling stability in the frontal plane.
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Nouredanesh M, Gordt K, Schwenk M, Tung J. Automated Detection of Multidirectional Compensatory Balance Reactions: A Step Towards Tracking Naturally Occurring Near Falls. IEEE Trans Neural Syst Rehabil Eng 2019; 28:478-487. [PMID: 31794400 DOI: 10.1109/tnsre.2019.2956487] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Falls are the leading cause of fatal and non-fatal injuries among seniors with serious and costly consequences. Laboratory evidence supports the view that impaired ability to execute compensatory balance reactions (CBRs) or near-falls is linked to an increased risk of falling. Therefore, as an alternative to the commonly used fall risk assessment methods examining spatial-temporal parameters of gait, this study focuses on the development of machine learning-based models to detect multidirectional CBRs using wearable inertial measurement units (IMUs). Random forest models were developed based upon the data captured by five wearable IMUs to 1) detect CBRs during normal gait, and 2) identify the type of CBR (eight different classes). A perturbation treadmill (PT) was employed to systematically elicit CBRs (i.e. PT-CBRs) during walking in different directions (e.g slip-like, trip-like, and medio-lateral) and amplitudes (e.g., low-, high-amplitude). We hypothesized that these PT-CBRs could simulate naturally-occurring CBRs (N-CBRs). Proof-of-concept testing in 9 young, healthy adults demonstrated accuracies of 96.60% and 80.64% for the PT-CBR detection and type identification models, respectively. Performance of the detection model was tested against a published dataset (IMUFD) simulating N-CBRs, including the most common types observed in older adults in long-term care facilities, which achieved sensitivity of 100%, but poor specificity. Adding normal gait data from IMUFD for training improved specificity, indicating treadmill walking alone is insufficient exemplar data. Perturbation treadmill combined with overground walking data is a suitable paradigm to collect training datasets of involuntary CBR events. These findings suggest that accurate detection of naturally-occurring CBRs is feasible, and supports further investigation of implementing a wearable sensor system to track naturally-occurring CBRs as a novel means of fall risk assessment.
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Gosine P, Komisar V, Novak AC. Characterizing the demands of backward balance loss and fall recovery during stair descent to prevent injury. Appl Ergon 2019; 81:102900. [PMID: 31422249 DOI: 10.1016/j.apergo.2019.102900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
Understanding the demands of balance recovery on stairs is important for developing strategies to prevent falls on stairs. This study characterized recovery strategies and whole-body movement following unexpected backward balance loss during stair descent in twelve young adults. Following balance loss, peak downward COM velocity was approximately double that experienced during non-perturbation stair descent. Participants used several balance recovery strategies: harness reliance (n = 1), no grasping reaction (n = 3), and grasping some environmental feature (n = 8). Of the five participants who used the handrail, four demonstrated grasping errors. Peak resultant handrail forces ranged from 24.2N to 238.3N. The results highlight the challenge of balance recovery during stair descent, showing that some people will use any available surface to arrest a fall. Our findings serve as a benchmark to understand the impact of stair-related interventions on fall recovery.
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Affiliation(s)
- Philippa Gosine
- KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street - Room 407, Toronto, Ontario, M5S 3G9, Canada
| | - Vicki Komisar
- KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada
| | - Alison C Novak
- KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W8, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue - Room 160, Toronto, Ontario, M5G 1V7, Canada.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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
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Abstract
BACKGROUND Most fall intervention studies attempted to improve the mobility, range of motion of upper and lower extremities, or all major muscle strengths. Yet, there has been little effort to identify movements or actions that may be mainly responsible for recovering from a slipping. It was imperative to link lower extremity kinematics in conjunction with the functional anatomy of lower extremity muscles during forward heel-slipping to identify what muscles should have been activated substantially if a person would have recovered from forward heel-slipping. OBJECTIVE The present study investigated lower extremity movements, such as the ankle, knee, and hip rotations, which could contribute to falls from forward heel-slipping. Determining changes in positions of foot, shank, and thigh during slipping would provide information to develop the optimal training regimen or interventions that may be effective for improving a chance to recover from the postural disturbance. METHODS Twenty healthy adults (24-68 years old) participated in this experiment. Among twenty participants, only eight participants' data were analyzed in this study. The 3D position data were used to compute the sagittal foot, shank, and thigh angles and frontal thigh angle. RESULTS The study results indicated that, during the period of slipping, the angles of the segments of the slipping leg were different from that of the foot, shank, and thigh when walking ordinarily over the dry surface in the present study. CONCLUSIONS The characteristics or differences in the angular kinematics of lower extremity during unexpected slips in the present study demonstrate possible causes for slip-induced falls.
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Affiliation(s)
- Sukwon Kim
- Department of Physical Education, College of Education, Chonbuk National University, Jeonju, Korea
| | - Kyung-Sook Joo
- Department of Nursing Science, U1 University, Yeongdong-gun, Chungcheongbuk-do, Korea
| | - Jian Liu
- Division of Safety Technology, Marshall University, Huntington, WV, USA
| | - Jee-Hoon Sohn
- Department of Physical Education, College of Cultural Convergence, Jeonju University, Jeonju, Korea
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Beschorner KE, Iraqi A, Redfern MS, Cham R, Li Y. Predicting slips based on the STM 603 whole-footwear tribometer under different coefficient of friction testing conditions. Ergonomics 2019; 62:668-681. [PMID: 30638144 PMCID: PMC7365591 DOI: 10.1080/00140139.2019.1567828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/02/2019] [Indexed: 05/06/2023]
Abstract
Assessing footwear slip-resistance is critical to preventing slip and fall accidents. The STM 603 (SATRA Technology) is commonly used to assess footwear friction but its ability to predict human slips while walking is unclear. This study assessed this apparatus' ability to predict slips across footwear designs and to determine if modifying the test parameters alters predictions. The available coefficient of friction (ACOF) was measured with the device for nine different footwear designs using 12 testing conditions with varying vertical force, speed and shoe angle. The occurrence of slipping and the required coefficient of friction was quantified from human gait data including 124 exposures to liquid contaminants. ACOF values varied across the test conditions leading to different slip prediction models. Generally, a steeper shoe angle (13°) and higher vertical forces (400 or 500 N) modestly improved predictions of slipping. This study can potentially guide improvements in predictive test conditions for this device. Practitioner Summary: Frictional measures by the STM603 (SATRA Technology) were able to predict human slips under liquid contaminant conditions. Test parameters did have an influence on the measurements. An increased shoe-floor testing angle resulted in better slip predictions than test methods specified in the ASTM F2913 standard.
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Affiliation(s)
- Kurt E. Beschorner
- Department of Bioengineering, University of Pittsburgh, Benedum Hall 302, 3700 O’Hara St., Pittsburgh, PA 15261
| | - Arian Iraqi
- Department of Bioengineering, University of Pittsburgh, Benedum Hall 302, 3700 O’Hara St., Pittsburgh, PA 15261
| | - Mark S. Redfern
- Department of Bioengineering, University of Pittsburgh, Benedum Hall 302, 3700 O’Hara St., Pittsburgh, PA 15261
| | - Rakié Cham
- Department of Bioengineering, University of Pittsburgh, Benedum Hall 302, 3700 O’Hara St., Pittsburgh, PA 15261
- Department of Physical Therapy, University of Pittsburgh
| | - Yue Li
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue
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Huntley AH, Rajachandrakumar R, Schinkel-Ivy A, Mansfield A. Characterizing slip-like responses during gait using an entire support surface perturbation: Comparisons to previously established slip methods. Gait Posture 2019; 69:130-135. [PMID: 30708096 DOI: 10.1016/j.gaitpost.2019.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The characteristics of experimentally induced slips (low-friction surfaces and non-motorized platforms) in laboratory settings are influenced by participant gait velocity, contact surface area, and level of friction between the foot and surface. However, motorized platforms that could account for these factors during slip-like paradigms have not been extensively used. RESEARCH QUESTION How does slip-like perturbations evoked via a motorized platform change gait characteristics and postural stability during overground walking? METHODS Ten healthy young adults performed 4 overground, self-paced walking trials, with the 4th trial including an unexpected forward support surface translation at heel-strike during steady state walking. Kinematic and kinetic data were collected, with step characteristics (time, distance, velocity) and postural stability calculated to compare between normal gait and slip-like trials. Slip foot characteristics were also determined. RESULTS Peak slipping foot velocity variability was considerably smaller compared to previously reported low-friction and non-motorized perturbations. The centre of mass was shifted more posteriorly (thus in a less stable location) by the end of the platform acceleration phase compared to the same time point post-heel strike during normal gait trials. Participants successfully responded to every slip-like perturbation by significantly increasing step time, decreasing step distance, and decreasing step velocity. SIGNIFICANCE Our results demonstrate the repeatability and consistency of a motorized support surface paradigm to induce slip-like perturbations. Furthermore, stability and step characteristic results confirm posterior shifts in stability and appropriate stepping responses, mimicking how participants would react if responding to a real world slip.
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Affiliation(s)
- Andrew H Huntley
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, Ontario, M5G 2A2, Canada.
| | - Roshanth Rajachandrakumar
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, Ontario, M5G 2A2, Canada
| | - Alison Schinkel-Ivy
- School of Physical and Health Education, Nipissing University, 100 College Drive, North Bay, Ontario, P1B 8L7, Canada
| | - Avril Mansfield
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, Ontario, M5G 2A2, Canada; Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, Ontario, M5G 1V7, Canada
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Yamaguchi T, Masani K. Effects of age-related changes in step length and step width on the required coefficient of friction during straight walking. Gait Posture 2019; 69:195-201. [PMID: 30772623 DOI: 10.1016/j.gaitpost.2019.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/11/2018] [Accepted: 02/07/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Slipping is one of the leading causes of falls among older adults. Older adults are considered to walk with a small anteroposterior (AP) component and a large mediolateral (ML) component of the required coefficient of friction (RCOF) owing to a short step length and a wide step width, respectively. However, limited information is available. RESEARCH QUESTION What are the effects of aging on the resultant RCOF (RCOFres) and its ML (RCOFML) and AP (RCOFAP) components during straight walking? METHODS We used the kinetic and kinematic data of 188 participants aged 20-77 years from a publicly available database (National Institute of Advanced Industrial Science and Technology Gait Database 2015). The participants were divided into the following three groups: young group (n = 56; age range, 20-34 years), middle-aged group (n = 50; age range, 35-64 years), and old group (n = 82; age range, 65-77 years). RESULTS The RCOFres and RCOFAP were lower in the old group than in the other groups, indicating a lower slip risk in this group. However, the RCOFML was higher and the step width was greater in the old group than in the other groups. The higher RCOFML and lower RCOFAP in the old group might be associated with slips in a more lateral direction. SIGNIFICANCE Our findings suggest that older adults have a high risk of slipping in a more lateral direction. Shoes with high-slip resistance in the lateral direction are recommended to prevent hazardous lateral slips among older adults.
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Affiliation(s)
- Takeshi Yamaguchi
- Graduate School of Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi, 980-8579, Japan; Graduate School of Biomedical Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi, 980-8579, Japan.
| | - Kei Masani
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
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Lockhart TE, Frames CW, Soangra R, Lieberman A. Effects of Obesity and Fall Risk on Gait and Posture of Community-Dwelling Older Adults. Int J Progn Health Manag 2019; 10:019. [PMID: 32257579 PMCID: PMC7111245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Epidemiological studies link increased fall risk to obesity in older adults, but the mechanism through which obesity increases falls and fall risks is unknown. This study investigates if obesity (Body Mass Index: BMI>30 kg/m2) influenced gait and standing postural characteristics of community dwelling older adults leading to increased risk of falls. One hundred healthy older adults (age 74.0±7.6 years, range of 56-90 years) living independently in a community participated in this study. Participants' history of falls over the previous two years was recorded, with emphasis on frequency and characteristics of falls. Participants with at least two falls in the prior year were classified as fallers. Each individual was assessed for postural stability during quiet stance and gait stability during 10 meters walking. Fall risk parameters of postural sway (COP area, velocity, path-length) were measured utilizing a standard forceplate coupled with an accelerometer affixed at the sternum. Additionally, parameters of gait stability (walking velocity, double support time, and double support time variability) were assessed utilizing an accelerometer affixed at the participant's sternum. Gait and postural stability analyses indicate that obese older adults who fell have significantly altered gait pattern (longer double support time and greater variability) exhibiting a loss of automaticity in walking and, postural instability as compared to their counterparts (i.e., higher sway area and path length, and higher sway velocity) further increasing the risk of a fall given a perturbation. Body weight/BMI is a risk factor for falls in older adults as measured by gait and postural stability parameters.
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Affiliation(s)
- Thurmon E Lockhart
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ,85281, USA
| | - Christopher W Frames
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ,85281, USA
- Barrow Neurological Institute, Phoenix, AZ, USA
| | - Rahul Soangra
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA,92618, USA
- Fowler School of Engineering, Chapman University, Orange, CA, 92866, USA
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Wang Y, Bhatt T, Liu X, Wang S, Lee A, Wang E, Pai YCC. Can treadmill-slip perturbation training reduce immediate risk of over-ground-slip induced fall among community-dwelling older adults? J Biomech 2018; 84:58-66. [PMID: 30616984 DOI: 10.1016/j.jbiomech.2018.12.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine any potential falls-resistance benefits that might arise from treadmill-slip-perturbation training. One hundred sixty-six healthy community-dwelling older adults were randomly assigned to either the treadmill-slip-training group (Tt) or the treadmill-control group (Tc). Tt received 40 slip-like perturbations during treadmill walking. Tc received unperturbed treadmill walking for 30 min. Following their treadmill session, both groups were exposed to a novel slip during over-ground walking. Their responses to this novel slip were also compared to previously collected data from participants who received either over-ground-slip training (Ot) with 24 slips or over-ground walking (Oc) with no training before experiencing their novel over-ground slip. Fall rates and both proactive (pre-slip) and reactive (post-slip) stability were assessed and compared for the novel over-ground slip in groups Tt, Tc, and Oc, as well as for the 24th slip in Ot. Results showed Tt had fewer falls than Tc (9.6% versus 43.8%, p < 0.001) but more falls than Ot (9.6% versus 0%, p < 0.001). Tt also had greater proactive and reactive stability than Tc (Tt > Tc, p < 0.01), however, Tt's stabilities were lower than those of Ot (p < 0.01). There was no difference in fall-rate or reactive stability between Tc and Oc, though treadmill walking did improve the proactive stability control of the latter. While the treadmill-slip-training protocol could immediately reduce the numbers of falls from a novel laboratory-reproduced slip, such improvements were far less than that from the motor adaptation to the over-ground-slip-training protocol.
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Affiliation(s)
- Yiru Wang
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA; PhD Program in Rehabilitation Science, College of Applied Health and Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Xuan Liu
- Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, USA
| | - Shuaijie Wang
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Anna Lee
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA; PhD Program in Rehabilitation Science, College of Applied Health and Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Edward Wang
- Department of Biomedical and Health Information Sciences, College of Applied Health and Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Yi-Chung Clive Pai
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA.
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Abstract
Monitoring human gait is essential to quantify gait issues associated with fall-prone individuals as well as other gait-related movement disorders. Being portable and cost-effective, ambulatory gait analysis using inertial sensors is considered a promising alternative to traditional laboratory-based approach. The current study aimed to provide a method for predicting the spatio-temporal gait parameters using the wrist-worn inertial sensors. Eight young adults were involved in a laboratory study. Optical motion analysis system and force-plates were used for the assessment of baseline gait parameters. Spatio-temporal features of an Inertial Measurement Unit (IMU) on the wrist were analyzed. Multi-variate correlation analyses were performed to develop gait parameter prediction models. The results indicated that gait stride time was strongly correlated with peak-to-peak duration of wrist gyroscope signal in the anterio-posterior direction. Meanwhile, gait stride length was successfully predicted using a combination model of peak resultant wrist acceleration and peak sagittal wrist angle. In conclusion, current study provided the evidence that the wrist-worn inertial sensors are capable of estimating spatio-temporal gait parameters. This finding paves the foundation for developing a wrist-worn gait monitor with high user compliance.
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Affiliation(s)
- JIAN LIU
- Division of Applied Science & Technology, Marshall University, Huntington, WV, USA
| | - THURMON LOCKHART
- School of Biological and Health Systems Engineering, Ira A/Fulton Schools of Engineering, Arizona State University, Tempe, AZ, USA
| | - SUKWON KIM
- Department of Physical Education, College of Education, Chonbuk National University, Jeonju, South Korea
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Abstract
BACKGROUND: Dancesport is a popular activity among older adults who look for fun and fitness in Korea. Studies reported positive sociological and psychological effects of dancesport. But, little studies were performed to evaluate the effects of dancesport on balance performances. OBJECTIVE: The objective of the present study was to evaluate the effects of dancesport for 15 weeks on walking balance and standing balance of older adults. METHODS: Older adults regularly participated in the dancesport program 3 times a week for 15 weeks. The program included Rumba, Cha-cha-cha, and Jive. They exercised the prescribed dancesport at intermediate level for 50–60 mins for each time. A total 22 reflective markers were placed on the anatomical landmarks and 8 cameras were used to measure 3-D positions of participants. Also, center of pressure (COP) data were measured to analyze standing balance using a ground reaction board at 1200 Hz for 30 seconds. One-way analysis of variance (ANOVA) was performed to test the effects of 15 weeks of dancesport on walking balance and standing balance. RESULTS: The results suggested that, after 15 weeks of dancesport participation, older adults’ walking balance (48.3 ± 20.3 cm2 vs 38.2 ± 18.2 cm2) and standing balance (COP area: 189.4 ± 85.4 mm2 vs 103.5 ± 55.4mm2, COP distance: 84.2 ± 34.4 cm vs 76.5 ± 21.4 cm) were significantly improved. CONCLUSION: Performing dancesport would require moving center of mass rapidly and frequently while maintaining posture. This may result in improving walking balance and standing balance in the present study. The study concluded that dancesport would be an effective exercise method in enhancing postural stability of older adults.
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Affiliation(s)
- Jeehoon Sohn
- Department of Physical Education, College of Cultural Industry, Arts, and Sports, Jeonju University, Jeonju, Korea
| | - Sung-Ha Park
- Industrial and Systems Engineering, Hannam University, Daejeon, Korea
| | - Sukwon Kim
- Department of Physical Education, College of Education, Research Institute of Physical Education, Chonbuk National University, Jeonju, Korea
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Baghdadi A, Megahed FM, Esfahani ET, Cavuoto LA. A machine learning approach to detect changes in gait parameters following a fatiguing occupational task. Ergonomics 2018; 61:1116-1129. [PMID: 29452575 DOI: 10.1080/00140139.2018.1442936] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 02/13/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study is to provide a method for classifying non-fatigued vs. fatigued states following manual material handling. A method of template matching pattern recognition for feature extraction ($1 Recognizer) along with the support vector machine model for classification were applied on the kinematics of gait cycles segmented by our stepwise search-based segmentation algorithm. A single inertial measurement unit on the ankle was used, providing a minimally intrusive and inexpensive tool for monitoring. The classifier distinguished between states using distance-based scores from the recogniser and the step duration. The results of fatigue detection showed an accuracy of 90% across data from 20 recruited subjects. This method utilises the minimum amount of data and features from only one low-cost sensor to reliably classify the state of fatigue induced by a realistic manufacturing task using a simple machine learning algorithm that can be extended to real-time fatigue monitoring as a future technology to be employed in the manufacturing facilities. Practitioner Summary: We examined the use of a wearable sensor for the detection of fatigue-related changes in gait based on a simulated manual material handling task. Classification based on foot acceleration and position trajectories resulted in 90% accuracy. This method provides a practical framework for predicting realistic levels of fatigue.
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Affiliation(s)
- Amir Baghdadi
- a Department of Industrial and Systems Engineering , University at Buffalo, The State University of New York , Buffalo , NY , USA
- b Department of Mechanical and Aerospace Engineering , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Fadel M Megahed
- c Farmer School of Business , Miami University , Oxford , OH , USA
| | - Ehsan T Esfahani
- b Department of Mechanical and Aerospace Engineering , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Lora A Cavuoto
- a Department of Industrial and Systems Engineering , University at Buffalo, The State University of New York , Buffalo , NY , USA
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Abstract
Is there a neuromuscular basis for falls? If so, it may provide new insight into falls and their assessment and treatment. We hypothesized that falls and recoveries from a laboratory-induced slip would be characterized by differences in multimuscle coordination patterns. Using muscle synergy analysis, we identified different multimuscle coordination patterns between older adults who fell and those who recovered from a laboratory-induced "feet-forward" slip. Participants who fell recruited fewer muscle synergies than participants who recovered. This suggests that a fall may result from recruitment of an inadequate number of muscle synergies to produce the necessary mechanical functions required to maintain balance. Participants who fell also recruited different muscle synergies, including one with high levels of coactivity consistent with a startle-like response. These differences in multimuscle coordination between slip outcomes were not accompanied by differences in slip difficulty or gait kinematics before or during the slip response. The differences in neuromuscular control may therefore reflect differences in sensorimotor control rather than kinematic constraints imposed by the slip, or the musculoskeletal system. Further research is required to test the robustness of these results and their interpretation with respect to additional mechanical variables (e.g., joint torques, ground reaction forces), responses to other fall types (e.g., trips), and within rather than between individuals. NEW & NOTEWORTHY Do falls and recoveries possess distinct neuromuscular features? We identified differences in neuromuscular control between older adults who fell and those who recovered from a "feet-forward" slip. Differences in neuromuscular control were not accompanied by differences in gait or slip kinematics before or during the slip response, suggesting differences in sensorimotor control rather than kinematics dictated the observed differences in neuromuscular control. An analysis of additional mechanical variables is required to confirm this interpretation.
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Affiliation(s)
- Andrew Sawers
- Department of Kinesiology, University of Illinois at Chicago , Chicago, Illinois
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, Illinois
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Iraqi A, Cham R, Redfern MS, Beschorner KE. Coefficient of friction testing parameters influence the prediction of human slips. Appl Ergon 2018; 70:118-126. [PMID: 29866300 PMCID: PMC5991488 DOI: 10.1016/j.apergo.2018.02.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/08/2018] [Accepted: 02/17/2018] [Indexed: 05/20/2023]
Abstract
Measuring the available coefficient of friction (ACOF) of a shoe-floor interface is influenced by the choice of normal force, shoe-floor angle and sliding speed. The purpose of this study was to quantify the quality of slip prediction models based on ACOF values measured across different testing conditions. A dynamic ACOF measurement device that tests entire footwear specimens (Portable Slip Simulator) was used. The ACOF was measured for nine different footwear-contaminant combinations with two levels of normal force, sliding speed and shoe-floor angle. These footwear-contaminant combinations were also used in human gait studies to quantify the required coefficient of friction (RCOF) and slip outcomes. The results showed that test conditions significantly influenced ACOF. The condition that best predicted slip risk during the gait studies was 250 N normal force, 17° shoe-floor angle, 0.5 m/s sliding speed. These findings can inform footwear slip-resistance measurement methods to improve design and prevent slips.
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Affiliation(s)
- Arian Iraqi
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Rakié Cham
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Mark S Redfern
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Kurt E Beschorner
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
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Miodonska Z, Stepien P, Badura P, Choroba B, Kawa J, Derejczyk J, Pietka E. Inertial data-based gait metrics correspondence to Tinetti Test and Berg Balance Scale assessments. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2018.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Iraqi A, Cham R, Redfern MS, Vidic NS, Beschorner KE. Kinematics and kinetics of the shoe during human slips. J Biomech 2018; 74:57-63. [PMID: 29759653 PMCID: PMC5987760 DOI: 10.1016/j.jbiomech.2018.04.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/31/2018] [Accepted: 04/14/2018] [Indexed: 10/17/2022]
Abstract
This paper quantified the heel kinematics and kinetics during human slips with the goal of guiding available coefficient of friction (ACOF) testing methods for footwear and flooring. These values were then compared to the testing parameters recommended for measuring shoe-floor ACOF. Kinematic and kinetic data of thirty-nine subjects who experienced a slip incident were pooled from four similar human slipping studies for this secondary analysis. Vertical ground reaction force (VGRF), center of pressure (COP), shoe-floor angle, side-slip angle, sliding speed and contact time were quantified at slip start (SS) and at the time of peak sliding speed (PSS). Statistical comparisons were used to test if any discrepancies exist between the state of slipping foot and current ACOF testing parameters. The main findings were that the VGRF (26.7 %BW, 179.4 N), shoe-floor angle (22.1°) and contact time (0.02 s) at SS were significantly different from the recommended ACOF testing parameters. Instead, the testing parameters are mostly consistent with the state of the shoe at PSS. We argue that changing the footwear testing parameters to conditions at SS is more appropriate for relating ACOF to conditions of actual slips, including lower vertical forces, larger shoe-floor angles and shorter contact duration.
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Affiliation(s)
- Arian Iraqi
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Rakié Cham
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Mark S Redfern
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Natasa S Vidic
- Department of Industrial Engineering, University of Pittsburgh, Benedum Engineering Hall #1025, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
| | - Kurt E Beschorner
- Department of Bioengineering, University of Pittsburgh, Benedum Engineering Hall #302, 3700 O'Hara St., Pittsburgh, PA 15261, United States.
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36
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Soangra R, Lockhart TE. Inertial Sensor-Based Variables Are Indicators of Frailty and Adverse Post-Operative Outcomes in Cardiovascular Disease Patients. Sensors (Basel) 2018; 18:E1792. [PMID: 29865245 DOI: 10.3390/s18061792] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one's gait speed is not completely associated with one's risk of falls, gait speed is a quick robust measure to classify frail/non-frail CVD patients and undoubtedly frail individuals are more prone to falls. Thus, this study examines the effects of inertial sensor-based quick movement variability characteristics in identifying CVD patients likely to have an adverse post-operative outcome. This study establishes a relationship with gait and postural predictor variables with patient's post-operative adverse outcomes. Accordingly, inertial sensors embedded inside smartphones are indispensable for the assessment of elderly patients in clinical environments and may be necessary for quick objective assessment. Sixteen elderly CVD patients (Age 76.1 ± 3.6 years) who were scheduled for cardiac surgery the next day were recruited for this study. Based on STS recommendation guidelines, eight of the CVD patients were classified as frail (prone to adverse outcomes with gait speed ≤ 0.833 m/s) and the other eight patients as non-frail (gait speed > 0.833 m/s). Smartphone-derived walking velocity was found to be significantly lower in frail patients than that in non-frail patients (p < 0.01). Mean Center of Pressure (COP) radius (p < 0.01), COP Area (p < 0.01), COP path length (p < 0.05) and mean COP velocity (p < 0.05) were found to be significantly higher in frail patients than that in the non-frail patient group. Nonlinear variability measures such as sample entropy were significantly lower in frail participants in anterior-posterior (p < 0.01) and resultant sway direction (p < 0.01) than in the non-frail group. This study identified numerous postural and movement variability parameters that offer insights into predictive inertial sensor-based variables and post-operative adverse outcomes among CVD patients. In future, smartphone-based clinical measurement systems could serve as a clinical decision support system for assessing patients quickly in the perioperative period.
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Mansouri MB, Vivaldi NA, Donnelly CJ, Robinson MA, Vanrenterghem J, Reinbolt JA. Synthesis of Subject-Specific Human Balance Responses Using a Task-Level Neuromuscular Control Platform. IEEE Trans Neural Syst Rehabil Eng 2018; 26:865-873. [PMID: 29641391 DOI: 10.1109/tnsre.2018.2808878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Many activities of daily living require a high level of neuromuscular coordination and balance control to avoid falls. Complex musculoskeletal models paired with detailed neuromuscular simulations complement experimental studies and uncover principles of coordinated and uncoordinated movements. Here, we created a closed-loop forward dynamic simulation framework that utilizes a detailed musculoskeletal model (19 degrees of freedom, and 92 muscles) to synthesize human balance responses after support-surface perturbation. In addition, surrogate response models of task-level experimental kinematics from two healthy subjects were provided as inputs to our closed-loop simulations to inform the design of the task-level controller. The predicted muscle activations and the resulting synthesized subject joint angles showed good conformity with the average of experimental trials. The simulated whole-body center of mass displacements, generated from a single kinematics trial per perturbation direction, were on average, within 7 mm (anterior perturbations) and 13 mm (posterior perturbations) of experimental displacements. Our results confirmed how a complex subject-specific movement can be reconstructed by sequencing and prioritizing multiple task-level commands to achieve desired movements. By combining the multidisciplinary approaches of robotics and biomechanics, the platform demonstrated here offers great potential for studying human movement control and subject-specific outcome prediction.
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Chang WR, Chang CC. Relationship among several measurements of slipperiness obtained in a laboratory environment. Appl Ergon 2018; 68:117-124. [PMID: 29409624 DOI: 10.1016/j.apergo.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 11/05/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Abstract
Multiple sensing mechanisms could be used in forming responses to avoid slips, but previous studies, correlating only two parameters, revealed a limited picture of this complex system. In this study, the participants walked as fast as possible without a slip under 15 conditions of different degrees of slipperiness. The relationships among various response parameters, including perceived slipperiness rating, utilized coefficient of friction (UCOF), slipmeter measurement and kinematic parameters, were evaluated. The results showed that the UCOF, perceived rating and heel angle had higher adjusted R2 values as dependent variables in the multiple linear regressions with the remaining variables in the final pool as independent variables. Although each variable in the final data pool could reflect some measurement of slipperiness, these three variables are more inclusive than others in representing the other variables and were bigger predictors of other variables, so they could be better candidates for measurements of slipperiness.
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Affiliation(s)
- Wen-Ruey Chang
- Chang WR Falls Prevention, LLC, Arlington, VA 22203, USA.
| | - Chien-Chi Chang
- Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan, ROC
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Chang WR, Xu X. Identification of heel strike under a slippery condition. Appl Ergon 2018; 66:32-40. [PMID: 28958428 DOI: 10.1016/j.apergo.2017.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 07/14/2017] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
Kinematics at heel strike instant (HSI) has been used to quantify slip severity. However, methods to identify HSI remain ambiguous and have not been evaluated under slippery conditions. A glass force plate was used to observe the contact interface between shoe and floor under slippery conditions. HSIs identified from the video captured beneath the force plate and from the force plate and kinematics were compared. The results showed that HSIs identified with the video were closer to those identified with the normal force threshold (NFT) (9.0 ms ± 5.5 ms) than were most of those identified with kinematics. Slips with a longer distance travelled between NFT HSI and video HSI had a larger heel horizontal velocity (>0.8 m/s) and a smaller foot angular velocity (<100deg/s) at the NFT instant, and were still part of the forward swing. The results show that improved methods are needed over NFT to identify HSI, especially under slippery conditions.
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Affiliation(s)
- Wen-Ruey Chang
- Chang WR Falls Prevention, LLC, Arlington, VA 22209, USA.
| | - Xu Xu
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC 27695, USA
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Patel PJ, Bhatt T. Fall risk during opposing stance perturbations among healthy adults and chronic stroke survivors. Exp Brain Res 2018; 236:619-28. [PMID: 29279981 DOI: 10.1007/s00221-017-5138-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
Studies examining recovery from SLIPS and TRIPS indicate higher incidence of falls during SLIPS than TRIPS however, differences in the recovery mechanisms during these opposing perturbations have not been examined. We therefore aimed to compare the reactive balance responses contributing to fall risk during SLIPS and TRIPS at comparable perturbation intensity among community-dwelling healthy adults and chronic stroke survivors. Younger adults (N = 11), age-matched adults (N = 11) and chronic stroke survivors (N = 12) were exposed to a single SLIP and TRIP through a motorized treadmill (16 m/s2, 0.20 m). Center of mass (COM) state stability was measured by recording COM position and velocity relative to base of support, i.e., Ḋ COM/BOS and Ẋ COM/BOS, respectively. Trunk and compensatory step kinematics were also recorded. During SLIPS, the incidence of falls among stroke survivors was greater than healthy adults (53.83% vs. 0%), however not for TRIPS. All groups showed higher change in postural stability from liftoff to touchdown during TRIPS than SLIPS. Among healthy adults higher change in Ḋ COM/BOS during TRIPS was accompanied by the ability to control trunk flexion at step touchdown and lower peak trunk velocity as compared with SLIPS, with no significant differences in compensatory step length between the perturbations (p > 0.05). Chronic stroke survivors increased compensatory step length during TRIPS versus SLIPS (p < 0.05) contributing to greater stability change. They were unable to control trunk excursion and peak trunk velocity as compared with the healthy adults leading to lower stability than healthy younger and age-matched adults during SLIPS and lower stability than younger adults during TRIPS. Difficulty in trunk control during SLIPS among all individuals and compensatory step length among stroke survivors emphasizes higher fall risk for SLIPS than TRIPS among these populations.
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Oliveira CF, Vieira ER, Machado Sousa FM, Vilas-Boas JP. Kinematic Changes during Prolonged Fast-Walking in Old and Young Adults. Front Med (Lausanne) 2017; 4:207. [PMID: 29218309 PMCID: PMC5703830 DOI: 10.3389/fmed.2017.00207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/06/2017] [Indexed: 11/13/2022] Open
Abstract
Walking biomechanics is known to be influenced by speed. However, most of the research examining the effects of walking speed and gait characteristics has been conducted after a fast-walking task, neglecting the changes that may occur during the task. The aim of the present study was to determine the impact of fast-walking over time on kinematics in young and old adults. Twenty-seven young adults (26.6 ± 6.0 years) and 23 old adults (71.0 ± 5.6 years) walked at 70% of their maximum heart rate for 20 min or until exhaustion, and the effects of fast-walking on temporospatial parameters and on angular kinematics were analyzed during the activity. During the protocol, both age-groups increased step-width variability. Significant effects of time were found for the ankle and hip at toe off for the older group. For the younger group, only the ankle angle at heel strike changed over time. For both groups, fast-walking induced changes in the coordination among the lower-limb angles that were more prominent during the swing phase of the gait. In conclusion, lower-limb kinematics changes in young adults were compatible with early signs of fatigue. The increased step-width variability in older adults may indicate an augmented risk of falling. Changes in the lower-limb walking kinematics of old adults suggest that the adjustments for weight acceptance and body propulsion were restricted to the hip and ankle joints. The kinematic changes among the lower-limb joint angles during the swing phase may compromise the quality of gait. These findings provide a foundation for future studies in the assessment of the risk of falls in older adults associated with walking at a faster pace.
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Affiliation(s)
- Camila Fonseca Oliveira
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL, United States
| | - Filipa Manuel Machado Sousa
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - João Paulo Vilas-Boas
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
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42
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Abstract
Falls impose significant negative impacts to the US population and economy. A significant number of falls may be prevented via appropriate slip-responses since a strong relation exists between slips and falls. More importantly, as severe slips are more prone to result in a fall, identifying severe slippers along with the responsible factors for their adverse motor control and severe slipping should be the highest priority in fall prevention process. Previous studies have suggested that muscle synergies may be building blocks of the central nervous system in controlling motor tasks. Muscle synergies observed during slipping (‘post-slip-initiation synergies’ or ‘just briefly,’ ‘slipping muscle synergies’), may represent the fundamental blocks of the neural control during slipping. Hence, studying the differences in slipping muscle synergies of mild and severe slippers can potentially reveal the differences in their neural control and subsequently, indicate the responsible factors for the adverse post-slip response in severe slippers. Even though the slipping muscle synergies have been investigated before, it still remains unclear on how the slip severity is associated with the slipping muscle synergies. More importantly, muscle synergies can be interpreted not only as neural blocks but also as physical sub-tasks of the main motor task. Hence, studying the differences of slipping synergies of mild and severe slippers would reveal the discrepancies in sub-tasks of their post-slip response. These discrepancies help pinpoint the malfunctioning sub-function associated with inadequate motor response seen in severe slippers. Twenty healthy subjects were recruited and underwent an unexpected slip (to extract their slipping synergies). Subjects were classified into mild and severe slippers based on their Peak Heel Speed. An independent t-test revealed several significant inter-group differences for muscle synergies of mild and severe slippers indicating differences in their neural control of slipping. A forward dynamic simulation was utilized to reveal the functionality of each synergy. Decomposition of slipping into sub-tasks (synergies), and finding the malfunctioning sub-task in severe slippers is important as it results in a novel targeted motor-rehabilitation technique that only aims to re-establish the impaired sub-task responsible for the adverse motor-response in severe slippers.
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Affiliation(s)
- Mohammad Moein Nazifi
- Human Rehabilitation Group, Department of Mechanical Engineering, Texas A&M University, College Station, TX, United States
| | - Kurt E Beschorner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Industrial Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Pilwon Hur
- Human Rehabilitation Group, Department of Mechanical Engineering, Texas A&M University, College Station, TX, United States
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Choi WJ, Robinovitch SN, Ross SA, Phan J, Cipriani D. Effect of neck flexor muscle activation on impact velocity of the head during backward falls in young adults. Clin Biomech (Bristol, Avon) 2017; 49:28-33. [PMID: 28843128 DOI: 10.1016/j.clinbiomech.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/12/2017] [Accepted: 08/15/2017] [Indexed: 02/07/2023]
Abstract
Falls are a common cause of traumatic brain injuries (TBI) across the lifespan. A proposed but untested hypothesis is that neck muscle activation influences impact severity and risk for TBI during a fall. We conducted backward falling experiments to test whether activation of the neck flexor muscles facilitates the avoidance of head impact, and reduces impact velocity if the head contacts the ground. Young adults (n=8) fell from standing onto a 30cm thick gymnastics mat while wearing a helmet. Participants were instructed to fall backward and (a) prevent their head from impacting the mat ("no head impact" trials); (b) allow their head to impact the mat, but with minimal impact severity ("soft impact" trials); and (c) allow their head to impact the mat, while inhibiting efforts to reduce impact severity ("hard impact" trials). Trial type associated with peak magnitude of electromyographic activity of the sternocleidomastoid (SCM) muscles (p<0.017), and with the vertical and horizontal velocity of the head at impact (p<0.001). Peak SCM activations, expressed as percent maximal voluntary isometric contraction (%MVIC), averaged 75.3, 67.5, and 44.5%MVIC in "no head impact", "soft impact", and "hard impact" trials, respectively. When compared to "soft impact" trials, vertical impact velocities in "hard impact" trials averaged 87% greater (3.23 versus 1.73m/s) and horizontal velocities averaged 83% greater (2.74 versus 1.50m/s). For every 10% increase in SCM %MVIC, vertical impact velocity decreased 0.24m/s and horizontal velocity decreased 0.22m/s. We conclude that SCM activation contributes to the prevention and modulation of head impact severity during backward falls.
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Affiliation(s)
- W J Choi
- Injury Prevention and Biomechanics Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Kangwon-do, South Korea.
| | - S N Robinovitch
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - S A Ross
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - J Phan
- Department of Physical Therapy, Chapman University, Irvine, CA, USA
| | - D Cipriani
- Department of Physical Therapy, Center for Graduate Studies, West Coast University, Los Angeles, CA, USA
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44
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Lee K, Lee YW. Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial. J Phys Ther Sci 2017; 29:1590-1595. [PMID: 28931994 PMCID: PMC5599827 DOI: 10.1589/jpts.29.1590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/08/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, Kyungdong University, Republic of Korea
| | - Yong Woo Lee
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
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45
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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. Appl Ergon 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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Kleiner A, Galli M, Franceschini M, De Pandis MF, Stocchi F, Albertini G, de Barros RML. The coefficient of friction in Parkinson's disease gait. Funct Neurol 2017; 32:17-22. [PMID: 28380319 PMCID: PMC5505525 DOI: 10.11138/fneur/2017.32.1.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to characterize the coefficient of friction (COF) curves of patients with Parkinson's disease (PD) during barefoot gait and to evaluate the relationships between this variable and functional scales. Twenty-two subjects with PD (ON phase of levodopa) and 22 healthy subjects participated in this study. The participants walked barefoot along a pathway that went over two force plates embedded in the floor of the data collection room. The instantaneous COF was calculated as the ratio between the horizontal and vertical components of the ground reaction forces. Two-sample t-tests applied to every 1% of the support phase of the COF curve were used to compare the groups and to identify the phases in which the two groups were different. Specifically, three COF areas were computed: Area 1 (for the loading response phase), Area 2 (for the midstance phase) and Area 3 (for the terminal stance phase). Pearson's tests were applied to assess the associations between the COF curve areas and the clinical scales. The subjects with PD exhibited lower COF values during the loading response and terminal stance phases and higher COF values during the mid-stance phase compared with the control group. A strong positive correlation was observed between Area 1 and the Timed Up and Go Test (90.3%). In conclusion, the patients' COFs exhibited patterns that were different from those of the control group. Moreover, during the loading response phase, these differences were well-correlated with the Timed Up and Go Test scale data; Timed Up and Go Test data can be used to identify the risk of falls among PD patients.
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Affiliation(s)
- Ana Kleiner
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
- “Motion analysis Lab”, IRCCS San Raffaele Pisana, Rome, Italy
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Vieira MF, Rodrigues FB, de Sá e Souza GS, Magnani RM, Lehnen GC, Andrade AO. Linear and Nonlinear Gait Features in Older Adults Walking on Inclined Surfaces at Different Speeds. Ann Biomed Eng 2017; 45:1560-1571. [DOI: 10.1007/s10439-017-1820-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/10/2017] [Indexed: 11/30/2022]
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48
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Nazifi MM, Yoon HU, Beschorner K, Hur P. Shared and Task-Specific Muscle Synergies during Normal Walking and Slipping. Front Hum Neurosci 2017; 11:40. [PMID: 28220067 PMCID: PMC5292600 DOI: 10.3389/fnhum.2017.00040] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/19/2017] [Indexed: 11/13/2022] Open
Abstract
Falling accidents are costly due to their prevalence in the workplace. Slipping has been known to be the main cause of falling. Understanding the motor response used to regain balance after slipping is crucial to developing intervention strategies for effective recovery. Interestingly, studies on spinalized animals and studies on animals subjected to electrical microstimulation have provided major evidence that the Central Nervous System (CNS) uses motor primitives, such as muscle synergies, to control motor tasks. Muscle synergies are thought to be a critical mechanism used by the CNS to control complex motor tasks by reducing the dimensional complexity of the system. Even though synergies have demonstrated potential for indicating how the body responds to balance perturbations by accounting for majority of the data set's variability, this concept has not been applied to slipping. To address this gap, data from 11 healthy young adults were collected and analyzed during both unperturbed walking and slipping. Applying an iterative non-negative matrix decomposition technique, four muscle synergies and the corresponding time-series activation coefficients were extracted. The synergies and the activation coefficients were then compared between baseline walking and slipping to determine shared vs. task-specific synergies. Correlation analyses found that among four synergies, two synergies were shared between normal walking and slipping. However, the other two synergies were task-specific. Both limbs were contributing to each of the four synergies, suggesting substantial inter-limb coordination during gait and slip. These findings stay consistent with previous unilateral studies that reported similar synergies between unperturbed and perturbed walking. Activation coefficients corresponding to the two shared synergies were similar between normal walking and slipping for the first 200 ms after heel contact and differed later in stance, suggesting the activation of muscle synergies in response to a slip. A muscle synergy approach would reveal the used sub-tasks during slipping, facilitating identification of impaired sub-tasks, and potentially leading to a purposeful rehabilitation based on damaged sub-functions.
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Affiliation(s)
- Mohammad Moein Nazifi
- Human Rehabilitation Group, Department of Mechanical Engineering, Texas A&M UniversityCollege Station, TX, USA
| | - Han Ul Yoon
- Human Rehabilitation Group, Department of Mechanical Engineering, Texas A&M UniversityCollege Station, TX, USA
| | - Kurt Beschorner
- Deparment of Bioengineering, University of PittsburghPittsburgh, PA, USA
- Deparment of Industrial Engineering, University of Wisconsin-MilwaukeeMilwaukee, WI, USA
| | - Pilwon Hur
- Human Rehabilitation Group, Department of Mechanical Engineering, Texas A&M UniversityCollege Station, TX, USA
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Soangra R, Lockhart TE. Dual-Task Does Not Increase Slip and Fall Risk in Healthy Young and Older Adults during Walking. Appl Bionics Biomech 2017; 2017:1014784. [PMID: 28255224 DOI: 10.1155/2017/1014784] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/16/2016] [Accepted: 12/28/2016] [Indexed: 12/04/2022] Open
Abstract
Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants' fall risks are modified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task walking have no destabilizing effect on gait and slip responses in healthy individuals. We also found that, during dual-tasking, healthy individuals adopted cautious gait mode (CGM) strategy that is characterized by reduced walking speed, shorter step length, increased step width, and reduced heel contact velocity and is likely to be an adaptation to minimize attentional demand and decrease slip and fall risk during limited available attentional resources. Exploring interactions between gait variability and cognitive functions while walking may lead to designing appropriate fall interventions among healthy and patient population with fall risk.
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50
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Affiliation(s)
- Devon Albert
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara Street, Room 302, Pittsburgh, PA 15271, USA
- Department of Biomedical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Brian Moyer
- Mechanical Engineering Technology Department, University of Pittsburgh–Johnstown, Johnstown, PA, USA
| | - Kurt E. Beschorner
- Department of Bioengineering, University of Pittsburgh, 3700 O'Hara Street, Room 302, Pittsburgh, PA 15271, USA
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