Trip recovery strategies following perturbations of variable duration.

Appropriately responding to mechanical perturbations during gait is critical to maintain balance and avoid falls. Tripping perturbation onset during swing phase is strongly related to the use of different recovery strategies; however, it is insufficient to fully explain how strategies are chosen. The dynamic interactions between the foot and the obstacle may further explain observed recovery strategies but the relationship between such contextual elements and strategy selection has not been explored. In this study, we investigated whether perturbation onset, duration and side could explain strategy selection for all of swing phase. We hypothesized that perturbations of longer duration would elicit lowering and delayed-lowering strategies earlier in swing phase than shorter perturbations. We developed a custom device to trip subjects multiple times while they walked on a treadmill. Seven young, healthy subjects were tripped on the left or right side at 10% to 80% of swing phase for 150 ms, 250 ms or 350 ms. Strategies were characterized by foot motion post-perturbation and identified by an automated algorithm. A multinomial logistic model was used to investigate the effect of perturbation onset, side, and the interaction between duration and onset on recovery strategy selection. Side perturbed did not affect strategy selection. Perturbation duration interacted with onset, limiting the use of elevating strategies to earlier in swing phase with longer perturbations. The choice between delayed-lowering and lowering strategies was not affected by perturbation duration. Although these variables did not fully explain strategy selection, they improved the prediction of strategy used in response to tripping perturbations throughout swing phase.

[1]  F. Prince,et al.  Symmetry and limb dominance in able-bodied gait: a review. , 2000, Gait & posture.

[2]  B. R. Umberger,et al.  A test of the functional asymmetry hypothesis in walking. , 2008, Gait & posture.

[3]  J. Duysens,et al.  Muscular responses and movement strategies during stumbling over obstacles. , 2000, Journal of neurophysiology.

[4]  Constantinos N Maganaris,et al.  Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly. , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[5]  D. Winter,et al.  Strategies for recovery from a trip in early and late swing during human walking , 2004, Experimental Brain Research.

[6]  J. Quintern,et al.  Obstruction of the swing phase during gait: phase-dependent bilateral leg muscle coordination , 1986, Brain Research.

[7]  T. M. Owings,et al.  Mechanisms leading to a fall from an induced trip in healthy older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  T. McMahon,et al.  The threshold trip duration for which recovery is no longer possible is associated with strength and reaction time. , 2001, Journal of biomechanics.

[9]  Grant Trewartha,et al.  The role of strategy selection, limb force capacity and limb positioning in successful trip recovery. , 2010, Clinical biomechanics.

[10]  Yasin Y Dhaher,et al.  Biomechanical impairments and gait adaptations post-stroke: multi-factorial associations. , 2009, Journal of biomechanics.

[11]  D. Jahnigen,et al.  Kinematics of recovery from a stumble. , 1993, Journal of gerontology.

[12]  F. V. D. van der Helm,et al.  Multiple-step strategies to recover from stumbling perturbations. , 2003, Gait & posture.

[13]  Todd A. Kuiken,et al.  The effect of perturbation onset timing and length on tripping recovery strategies , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[14]  M S Redfern,et al.  Biomechanics of trailing leg response to slipping - evidence of interlimb and intralimb coordination. , 2009, Gait & posture.

[15]  M. P. Mcguigan,et al.  The role of arm movement in early trip recovery in younger and older adults. , 2008, Gait & posture.

[16]  J. Concato,et al.  A simulation study of the number of events per variable in logistic regression analysis. , 1996, Journal of clinical epidemiology.

[17]  Alan Agresti,et al.  Categorical Data Analysis , 2003 .

[18]  A. G. Feldman,et al.  Stability of gait and interlimb coordination in older adults. , 2012, Journal of neurophysiology.

[19]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[20]  S. Simon Gait Analysis, Normal and Pathological Function. , 1993 .

[21]  M. Bobbert,et al.  Contribution of the support limb in control of angular momentum after tripping. , 2004, Journal of biomechanics.