Muscle contributions to recovery from forward loss of balance by stepping.

The purpose of this study was to determine the muscular contributions to the stepping phase of recovery from forward loss of balance in 5 young and 5 older adults that were able to recover balance in a single step, and 5 older adults that required multiple steps. Forward loss of balance was achieved by releasing participants from a static forward lean angle. All participants were instructed to attempt to recover balance by taking a rapid single step. A scalable anatomical model consisting of 36 degrees-of-freedom was used to compute kinematics and joint moments from motion capture and force plate data. Forces for 94 muscle actuators were computed using static optimisation and induced acceleration analysis was used to compute individual muscle contributions to net lumbar spine joint, and stepping side hip joint and knee joint accelerations during recovery. Older adults that required multiple recovery steps used a significantly shorter and faster initial recovery step and adopted significantly more trunk flexion throughout recovery compared to the older single steppers. Older multiple steppers also produced significantly more force in the stance side hamstrings, which resulted in significantly higher hamstring induced flexion accelerations at the lumbar spine and extension accelerations at the hip. However since the net joint lumbar spine and hip accelerations remained similar between older multiple steppers and older single steppers, we suggest that the recovery strategy adopted by older multiple steppers was less efficient as well as less effective than for older single steppers.

[1]  Tim W. Dorn,et al.  Estimates of muscle function in human gait depend on how foot-ground contact is modelled , 2012, Computer methods in biomechanics and biomedical engineering.

[2]  Ajay Seth,et al.  Muscle contributions to propulsion and support during running. , 2010, Journal of biomechanics.

[3]  Marcus G. Pandy,et al.  A computationally efficient method for assessing muscle function during human locomotion , 2011 .

[4]  Neil J Cronin,et al.  Decreased lower limb muscle recruitment contributes to the inability of older adults to recover with a single step following a forward loss of balance. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[5]  J Duysens,et al.  Stumbling over obstacles in older adults compared to young adults. , 2005, Journal of neurophysiology.

[6]  R. Barrett,et al.  Neuromechanical properties of the triceps surae in young and older adults , 2013, Experimental Gerontology.

[7]  Mark W Rogers,et al.  One step, two steps, three steps more ... Directional vulnerability to falls in community-dwelling older people. , 2013, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  M. Madigan,et al.  Age-related differences in peak joint torques during the support phase of single-step recovery from a forward fall. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  Neil J Cronin,et al.  Lower limb muscle moments and power during recovery from forward loss of balance in male and female single and multiple steppers. , 2012, Clinical biomechanics.

[10]  T. M. Owings,et al.  Lower extremity strength plays only a small role in determining the maximum recoverable lean angle in older adults. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  David G Lloyd,et al.  Repeatability of gait data using a functional hip joint centre and a mean helical knee axis. , 2003, Journal of biomechanics.

[12]  Lida Mademli,et al.  Age-related deficit in dynamic stability control after forward falls is affected by muscle strength and tendon stiffness. , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[13]  Neil J Cronin,et al.  Lower limb muscle weakness predicts use of a multiple- versus single-step strategy to recover from forward loss of balance in older adults. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  Maarten F. Bobbert,et al.  Control of support limb muscles in recovery after tripping in young and older subjects , 2004, Experimental Brain Research.

[15]  Richard R Neptune,et al.  Biomechanics and muscle coordination of human walking. Part I: introduction to concepts, power transfer, dynamics and simulations. , 2002, Gait & posture.

[16]  M. Bobbert,et al.  Push-off reactions in recovery after tripping discriminate young subjects, older non-fallers and older fallers. , 2005, Gait & posture.

[17]  Karen L Troy,et al.  Trunk kinematics and fall risk of older adults: translating biomechanical results to the clinic. , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[18]  John K. De Witt,et al.  Determination of toe-off event time during treadmill locomotion using kinematic data. , 2010 .

[19]  Ayman Habib,et al.  OpenSim: Open-Source Software to Create and Analyze Dynamic Simulations of Movement , 2007, IEEE Transactions on Biomedical Engineering.

[20]  Christopher P. Carty,et al.  Mechanisms of Adaptation from a Multiple to a Single Step Recovery Strategy following Repeated Exposure to Forward Loss of Balance in Older Adults , 2012, PloS one.

[21]  T. M. Owings,et al.  Mechanisms of failed recovery following postural perturbations on a motorized treadmill mimic those associated with an actual forward trip. , 2001, Clinical biomechanics.

[22]  Christopher P Carty,et al.  Recovery from forward loss of balance in young and older adults using the stepping strategy. , 2011, Gait & posture.

[23]  Noah J Rosenblatt,et al.  The discriminant capabilities of stability measures, trunk kinematics, and step kinematics in classifying successful and failed compensatory stepping responses by young adults. , 2012, Journal of biomechanics.

[24]  Adamantios Arampatzis,et al.  Adaptive feedback potential in dynamic stability during disturbed walking in the elderly. , 2011, Journal of biomechanics.

[25]  Adamantios Arampatzis,et al.  Adaptational responses in dynamic stability during disturbed walking in the elderly. , 2010, Journal of biomechanics.

[26]  Neil J Cronin,et al.  Adaptive recovery responses to repeated forward loss of balance in older adults. , 2012, Journal of biomechanics.

[27]  Laura A. Wojcik,et al.  Age differences in using a rapid step to regain balance during a forward fall. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[28]  Mark W Rogers,et al.  Lateral balance factors predict future falls in community-living older adults. , 2008, Archives of physical medicine and rehabilitation.

[29]  Feng Yang,et al.  Learning to resist gait-slip falls: long-term retention in community-dwelling older adults. , 2012, Archives of physical medicine and rehabilitation.

[30]  Yi-Chung Pai,et al.  Inoculation against falls: rapid adaptation by young and older adults to slips during daily activities. , 2010, Archives of physical medicine and rehabilitation.

[31]  A. Arampatzis,et al.  Deficits in the way to achieve balance related to mechanisms of dynamic stability control in the elderly. , 2008, Journal of biomechanics.

[32]  D G Lloyd,et al.  Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: implications for ACL injury risk. , 2012, Journal of biomechanics.