Postural adjustments in anticipation of predictable perturbations allow elderly fallers to achieve a balance recovery performance equivalent to elderly non-fallers |
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| Institution: | 1. Max Planck Institute of Intelligent Systems, Germany;2. School of Kinesiology, University of British Columbia, Vancouver, Canada;3. Laboratoire de Biomécanique et Mécanique des Chocs, Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France;4. Sorbonne Université, INSERM, CNRS, Institut de la Vision, France;1. Institute of Physical Education, Health, and Leisure Studies, National Cheng Kung University, Tainan, Taiwan;2. School of Kinesiology, University of Michigan, Ann Arbor, MI, USA;1. College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan;2. Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD 21201, USA;1. Human Health and Nutritional Sciences, University of Guelph, Canada;2. Schlegel-UW Research Institute for Aging, Kitchener, ON, Canada;1. BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany;2. Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstr. 175, 79117 Freiburg, Germany;1. Université Claude Bernard Lyon 1, Villeurbanne, France;2. IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, Bron, France;3. Aix Marseille Univ, CNRS, ISM, Marseille 13288, France;4. University of New South Wales, Sydney, Australia;5. Université de Toulon, La Garde 83957, France;6. Department of Physical Therapy and Human Movement Sciences, Northwestern University Medical School, Chicago, IL 60611, United States |
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| Abstract: | BackgroundIn numerous laboratory-based perturbation experiments, differences in the balance recovery performance of elderly fallers and non-fallers are moderate or absent. This performance may be affected by the subjects adjusting their initial posture in anticipation of the perturbation.Research questions: Do elderly fallers and non-fallers adjust their posture in anticipation of externally-imposed perturbations in a laboratory setting? How does this impact their balance recovery performance?Methods21 elderly non-fallers, 18 age-matched elderly fallers and 11 young adults performed both a forward waist-pull perturbation task and a Choice Stepping Reaction Time (CSRT) task. Whole-body kinematics and ground reaction forces were recorded. For each group, we evaluated the balance recovery performance in the perturbation task, change in initial center of mass (CoM) position between the CSRT and the perturbation task, and the influence of initial CoM position on task performance.ResultsThe balance recovery performance of elderly fallers was equivalent to elderly non-fallers (p > 0.5 Kolmogorov-Smirnov test). All subject groups anticipated forward perturbations by shifting their CoM backward compared to the CSRT task (young: 2.1% of lower limb length, elderly non-fallers: 2.7%, elderly fallers: 2.2%, Hodges-Lehmann estimator, p < 0.001 Mann-Whitney U). This backward shift increases the probability of resisting the traction without taking a step.SignificanceThe ability to anticipate perturbations is preserved in elderly fallers and may explain their preserved balance recovery performance in laboratory-based perturbation tasks. Therefore, future fall risk prediction studies should carefully control for this postural strategy, by interleaving perturbations of different directions for example. |
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| Keywords: | Ageing Falls Anticipatory postural adjustments Balance-biomechanics |
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