Biomechanics of slips and falls in the elderly: Effects of restricted arm motion on recovery strategies
Year: 2013
Type: dissertation
Abstract: Slip and fall accidents pose a serious threat to elderly individuals. Several \nresearchers, over the past few decades, have successfully quantified different gait \nparameters pertaining to the biomechanics of slips and falls to help reduce the incidence \nof slip and fall accidents in the elderly. However, a comprehensive understanding of mechanisms including strategies used by the elderly for recovery during a slippery perturbation under different arm restriction conditions is still lacking. This research study investigated gait patterns in young and elderly individuals, in terms of proactive \nand reactive strategies that individuals used to reduce their likelihood of a fall related \ninjury during a slippery perturbation under different arm restriction conditions. In \naddition to the gait parameters, the strength capabilities of the lower extremities of young \nand elderly individuals were also explored. Lastly, a logistic regression equation was \ndeveloped to predict falls and recoveries. \nThe study did help identify successful strategies used for recovery under different \narm restriction conditions. In addition, unsuccessful reactive movements that resulted in \nfalls were also pointed out. Proactive strategies identified including reduced step length, \nwalking velocity, heel contact velocity and foot floor angle were used by both younger \nand older individuals when they knew the floor was slippery. Reduced step length, foot \nfloor angle and walking velocity were also noted when one or two arms of individuals \nwere restricted. In terms of age, more elderly individuals fell when compared to younger \nindividuals. Several other variables including average sliding heel velocity, peak sliding \nheel deceleration and separation between whole body center of mass and sliding heel also \nshowed differences for age. Significant differences were noted not only between older \nand younger individuals but also between fallers and non-fallers in terms of the recovery effort. Variables including average sliding heel velocity, maximum and minimum differences between the upper body center of mass (UBCOM) and the lower body center of mass (LBCOM) showed differences between fallers and non-fallers. In terms of arm restriction, both young and older individuals showed significant differences in maximum \nwrist velocities for the different arm restriction conditions. Differences in maximum \nvelocities between the WBCOM and heel when comparing the no-arm and two-arm restriction, and also the no-arm and one-arm conditions were also found. In terms of strength, knee and ankle torques were found to be significantly higher for younger individuals when compared to elderly individuals. The leg collapse that was observed which resulted in falls was an additional indicator of poor strength in the elderly. The primary contribution to elderly gait literature and the biomechanics of slips \nand falls through this study was the development of a novel method through the exploration of UBCOM-LBCOM dynamics during recovery effort from a slippery \nperturbation under different arm restriction conditions. In terms of findings, the study did show that individuals were able to recover better when their arms were not restricted. \nThe study did also show that the elder fallers were unable to ‘catch up’ by moving their \ntrunk (and UBCOM) quickly to keep up with the sliding heel (and the LBCOM. On the other hand, younger non-fallers were able to have a higher difference in velocities \nbetween the UBCOM and LBCOM, and still ‘catch up’ successfully. Thus, the study of UBCOM-LBCOM dynamics might be useful in better understanding elderly slips and \nfalls.
Author: Aditya Jayadas
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funder: Texas Tech University
OpenAlex ID: W2275880978