We have previously described two recovery strategies after perturbations of gait during treadmill walking. Fit older subjects more frequently used the strategy that appeared less stable than did the young (Bruce et al, 2000). We have now compared recovery strategies in elderly subjects who had recently fallen with those who had not. Subjects were 24 women, mean age 74.2 (sd 3.4) years. All had fallen at least once in the last four years and had participated in exercise tailored to improve balance and gait. The ‘fallers’ group was those 16 subjects who had fallen one or more times in the previous year. The study had RNOHT ethical committee approval; subjects gave written informed consent following Helsinki guidelines. Subjects wore a safety harness and walked on a PowerJog GX100 treadmill at their own comfortable walking pace, which was the same for each group. Kinematics were recorded by the CODA mpx30 motion analysis system using 16 LED markers. At the beginning of swing phase during randomly selected strides CODA triggered the perturbations, applied by cords attached to each foot. The perturbations were not large enough to cause loss of balance. We obtained 44 gait perturbations (each the average of 6 trials) from the fallers and 19 from the non-fallers. Each subject adopted a consistent strategy in response to perturbation (Bruce et al, 2000). The timing of lifting of the un-tripped leg immediately after the perturbation was delayed in a gretaer proportion of the fallers (14/44 fallers vs 1/19 non-fallers, Chi squared, p=0.023). Fallers took longer to return to their normal pattern of foot placement after perturbation (p<0.05, unpaired t-test). Both groups showed increased flexion of the trunk immediately following the perturbation (by approximately 2 degrees). This lasted longer (approx. 0.25 sec) in the fallers than in the non-fallers and they then tended to overcompensate (p<0.01, unpaired t-test). After a minor gait perturbation older people who fall persistently have a less stable response and are slower to recover.
King's College London (2005) J Physiol 565P, PC11
Communications: Responses to the perturbation of the leg during walking on a treadmill in elderly women fallers and non-fallers
Bruce, Stuart ; Skelton, Dawn ; Gentles, Helen ; Christopher, Tony ; Rosenberg, Martin ; Woledge, Roger ;
1. Conquest Hospital, St Leonards-on-Sea, United Kingdom. 2. UCL Institute of Human Performance, RNOHT, Stanmore, United Kingdom. 3. School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, United Kingdom. 4. Centre for Applied Biomedical Research, School of Biomedical Sciences, King's College London, London, United Kingdom.
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Where applicable, experiments conform with Society ethical requirements.