Abstract
Forty-seven percent of falling accidents in older adults are caused by tripping over obstacles. Understanding what strategies are involved in obstacle negotiation in older adults could reduce fall risks. There is a paucity of research investigating how healthy adults negotiate multiple obstacles, which may better reflect the complexity of the real environment. The presence of a second obstacle has induced mixed results in the obstacle negotiation of healthy older adults with the interval between obstacles two steps apart. This study extended the knowledge to understand what strategies healthy younger and older adults used to step over two obstacles placed at three-step-length apart. Twenty healthy subjects performed 2 tasks: level ground walking and stepping over two obstacles. The height of each obstacle was set at 10% of subjects’ leg height. We found that aging significantly increased the toe clearance in leading and trailing legs when stepping over the obstacles at a three-step-length interval. Toe clearance was higher while stepping over the second obstacle than the first one in older adults. These results had two-fold meanings: the three-step-length interval was long enough to trigger the adjustment of the obstacle negotiation strategy, and aging led older adults to use conservative negotiation strategies.
Highlights
The age-related effect on “single” obstacle negotiation has been well documented[6,7,8,9,10,11,12,13]
No failure of obstacle negotiation or fall was observed in this study in either the young or the older adult group
We investigated the strategies involved in multiple obstacle negotiation in both healthy young and older adults when obstacles were placed three-step-length apart
Summary
The age-related effect on “single” obstacle negotiation has been well documented[6,7,8,9,10,11,12,13]. Large hip rotation angles help an older adult elevate the leg high enough to step over the obstacle[6,7,14] These changes of gait kinematics in older adults might be due to the deterioration of sensory (visual, proprioceptive, and vestibular) systems[12,13,15], and the reduction of muscle strength[16]. Changes in the environment, and the adjustment of future actions using proprioceptive feedback from the trailing leg[19] These functions can be reduced in older adults due to the deterioration of the prefrontal cortex[20], which is involved in decision making and the controlling and planning of complex cognitive behavior. Older adults need more time to negotiate the obstacles than young adults This deterioration of executive function has been related to the reductions in step length[21]. The somatosensory sensory system plays a crucial role in transferring the height and shape information from the leading to the trailing leg[19]
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