Abstract
While perturbation training is promising in reducing fall-risk among older adults, its impact on altering their spontaneous gait pattern has not been investigated. The purpose of this study was to determine to what extent older adults' gait pattern would be affected by exposure to repeated slips. Seventy-three community-dwelling older adults (age: 72.6±5.4 years) underwent 24 repeated-slip exposure induced by unannounced unlocking and relocking of low-friction sections of a 7-m pathway upon which they walked. Full body kinematics and kinetics were recorded during the training. The gait parameters and the center of mass (COM) stability against backward balance loss were compared before and after the training. The results revealed that the training reduced fall incidence from 43.8% upon the novel slip to 0 at the end of training. After the training, subjects significantly improved gait stability by forward positioning of their COM relative to the base of support without altering gait speed. This forward COM shift resulted from a shortened step at the end of single stance and forward trunk leaning during double stance. They also adopted flat foot landing with knee flexed at touchdown (with an average change of 6.9 and 4.1 degrees, respectively). The perturbation training did alter community-dwelling older adults' spontaneous gait pattern. These changes enabled them to improve their volitional control of stability and their resistance to unpredictable and unpreventable slip-related postural disturbance.
Highlights
Falls pose a significant health threat to elderly and a serious economic burden to the society (Baker and Harvey, 1985; Tinetti, 2003)
The training significantly reduced the incidence of falls to 0% upon the final (24th) slip down from 43.8% (χ2 = 40.98, p < 0.001) upon the novel slip, which was the first exposure to the slip prior to the following repeated slips
The overall results indicated that repeated-slip exposure did alter community-dwelling older adults’ gait pattern to improve their posterior stability against postural disturbance threats during walking
Summary
Falls pose a significant health threat to elderly and a serious economic burden to the society (Baker and Harvey, 1985; Tinetti, 2003). Falls initiated by slipping account for about 25%. Backward falls from a slip frequently cause hip fracture that can have devastating consequences (Kannus et al, 1999). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain
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