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.

Highlights

  • About 30% of “fall on same level” injuries contributed to losing 31 or more workdays in 2009 (Bureau of Labor Statistics US Department of Labor, 2009)

  • Injuries caused by slip, trips, and falls have increased by 10% from 2013 to 2014 (Bureau of Labor Statistics US Department of Labor, 2015)

  • Four synergies considered to be enough to account for variability of the normal walking and slipping data (Figure 4) as they successfully reconstructed more than 75% of the original pooled data (VAF ≥ 0.75) and addition of an extra synergy did not contribute in reconstruction of more than 5% of the original data (Figure 4; Chvatal and Ting, 2013; Eskandari et al, 2016)

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Summary

Introduction

About 30% of “fall on same level” injuries contributed to losing 31 or more workdays in 2009 (Bureau of Labor Statistics US Department of Labor, 2009). During 2012, occupational injuries related to slips, trips, and falls resulted in a direct cost of over $16 billion in the USA (Liberty Mutual Research Institute for Safety, 2014). Slipping, tripping, and stumbling were the main causes of 64% of all falls in the US (Courtney et al, 2001). Slipping was reported to be the main contributor to fall initiation (Courtney et al, 2001; Gao and Abeysekera, 2004; Di Pilla, 2009). Injuries caused by slip, trips, and falls have increased by 10% from 2013 to 2014 (Bureau of Labor Statistics US Department of Labor, 2015). Considering the prevalence and the increasing trend of fall-related injuries coupled with slipping being the main cause of falling, understanding the slip recovery process is of paramount importance in fall prevention

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