Development of a new instrument for evaluating leg motions using acceleration sensors (II)

ObjectiveThe purpose of this study was to investigate the characteristics of the average acceleration of elderly people during walking.MethodThe subject cohort comprised nine men and 21 women aged ≥63 years. Subjects walked a 10-m straight course (walk test) which required stepping over six obstacles (hurdle walk test). The average acceleration was calculated from the accelerograms. Functional reach test scores and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, fall risk assessment, fall experience within the last year, and carelessness were used as standard indices to estimate the dynamic postural movement and fall risk.ResultsThe average acceleration during the walk test was not significantly correlated with the standard indices. The average accelerations at the lumbar and knee positions clustered with fall experience and carelessness, while those at the ankle and toe positions clustered with the hurdle walk test, TMIG index of competence, and fall risk assessment. Between the high- and low-risk groups classified by the conventional indices, there was a significant difference in the average acceleration at some measurement positions. The receiver operating characteristic analysis showed the possibility to discriminate the high-risk group according to the standard indices with average acceleration.ConclusionsThe average acceleration during walking may be a composite index that encompasses standard indices and discriminate the high-risk group. As such, it may be a useful tool to estimate the dynamic postural movement and fall risk at all measurement positions.

[1]  R L Kirby,et al.  The influence of foot position on standing balance. , 1987, Journal of biomechanics.

[2]  W. Phillips,et al.  “Muscular Fitness”—Easing the Burden of Disability for Elderly Adults , 1995 .

[3]  J. Cavanaugh,et al.  Kinematic characterization of standing reach: comparison of younger vs. older subjects. , 1999, Clinical biomechanics.

[4]  R. Tideiksaar Falls and instability in the elderly. , 1993, NeuroRehabilitation.

[5]  H. Shimada,et al.  Specific effects of balance and gait exercises on physical function among the frail elderly , 2003, Clinical rehabilitation.

[6]  Markku Kauppinen,et al.  Maximal Isometric Muscle Strength and Socioeconomic Status, Health, and Physical Activity in 75-Year-Old Persons , 1994 .

[7]  Murray Mp,et al.  Center of gravity, center of pressure, and supportive forces during human activities. , 1967 .

[8]  S. Yasumura,et al.  Rate of falls and the correlates among elderly people living in an urban community in Japan. , 1994, Age and ageing.

[9]  D. Krebs,et al.  Functional reach: does it really measure dynamic balance? , 1999, Archives of physical medicine and rehabilitation.

[10]  B. Lateur,et al.  The Importance of Skeletal Muscle Strength to Physical Function in Older Adults , 1991, Annals of Behavioral Medicine.

[11]  S. Lord,et al.  Physiological factors associated with injurious falls in older people living in the community. , 1992, Gerontology.

[12]  F. Ando,et al.  Frequencies and circumstances of falls in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). , 2000, Journal of epidemiology.

[13]  J. Knottnerus,et al.  A risk model for the prediction of recurrent falls in community-dwelling elderly: a prospective cohort study. , 2002, Journal of clinical epidemiology.

[14]  B. Maki,et al.  Aging and Postural Control , 1990, Journal of the American Geriatrics Society.

[15]  S. Brauer,et al.  A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[16]  I. Morioka,et al.  Development of new instrument for evaluating leg motions using acceleration sensors , 2007, Environmental health and preventive medicine.

[17]  S. Studenski,et al.  Functional reach: a new clinical measure of balance. , 1990, Journal of gerontology.

[18]  Erika Jonsson,et al.  Does the functional reach test reflect stability limits in elderly people? , 2003, Journal of rehabilitation medicine.

[19]  S. Kuno,et al.  A Comparison of Estimation Models of Physical Fitness Age for Elderly People using the Japan Fitness Test , 2006 .

[20]  L. Rubenstein,et al.  The epidemiology of falls and syncope. , 2002, Clinics in geriatric medicine.

[21]  Takeshi Miyakawa,et al.  A Measurement of a Walk Movement Using a Portable Three Dimensional Accelerometer : Evaluation of Influence of Aging by Acceleration , 2002 .

[22]  A Thorstensson,et al.  The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip , 1995, Scandinavian journal of medicine & science in sports.

[23]  A. Kimura,et al.  Relation between macro-EMG and muscle Uber conduction velocity. , 1995, Electromyography and clinical neurophysiology.

[24]  U S Nayak,et al.  Balance in elderly patients: the "get-up and go" test. , 1986, Archives of physical medicine and rehabilitation.

[25]  C. Ring,et al.  Balance function in elderly people who have and who have not fallen. , 1988, Archives of physical medicine and rehabilitation.

[26]  T. Tamura,et al.  Classification of walking pattern using acceleration waveform in elderly people , 2000, Proceedings of the 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (Cat. No.00CH37143).

[27]  M. Tinetti,et al.  The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. , 1995, JAMA.

[28]  Rachael D. Seidler,et al.  The effects of short term balance training on the postural control of older adults , 1997 .

[29]  P. Holliday,et al.  The relationship of postural sway in standing to the incidence of falls in geriatric subjects. , 1982, Age and ageing.

[30]  K. Aoyagi,et al.  Calcaneus Bone Mineral Density is Lower Among Men and Women with Lower Physical Performance , 2000, Calcified Tissue International.

[31]  K Takahashi,et al.  Different changes of quantity due to aging in the psoas major and quadriceps femoris muscles in women. , 2005, Journal of musculoskeletal & neuronal interactions.

[32]  H Nagasaki,et al.  A physical fitness model of older adults , 1995, Aging.

[33]  S. Studenski,et al.  Functional reach: predictive validity in a sample of elderly male veterans. , 1992, Journal of gerontology.

[34]  R. Baumgartner,et al.  Fear of falling and restriction of mobility in elderly fallers. , 1997, Age and ageing.

[35]  F. Horak Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? , 2006, Age and ageing.

[36]  Fall risk characteristics of the elderly in an exercise class. , 2008, Journal of physiological anthropology.

[37]  B. Brouwer,et al.  Balance, Muscle Strength, and Fear of Falling in Older Adults , 2003, Experimental aging research.

[38]  H. Kinoshita,et al.  Age-related differences in postural control in humans in response to a sudden deceleration generated by postural disturbance , 2001, European Journal of Applied Physiology.

[39]  H. Yamada,et al.  The Sensitivity of the Japan Fitness Test in Elderly People to Assess the Effects of Aging , 2006 .

[40]  A. Young Exercise physiology in geriatric practice. , 2009, Acta medica Scandinavica. Supplementum.

[41]  K. Nakazato,et al.  Measurement of competence: reliability and validity of the TMIG Index of Competence. , 1991, Archives of gerontology and geriatrics.

[42]  L. Lipsitz,et al.  Leg extensor power and functional performance in very old men and women. , 1992, Clinical science.

[43]  R. Newton,et al.  Use of the Berg Balance Test to predict falls in elderly persons. , 1996, Physical therapy.

[44]  Toshiyo Tamura,et al.  An ambulatory fall monitor for the elderly , 2000, Proceedings of the 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (Cat. No.00CH37143).

[45]  Circumstances of injurious falls leading to medical care among elderly people living in a rural community. , 1996, Archives of gerontology and geriatrics.

[46]  Relationships between physical activity, ADL capability and fall risk in community-dwelling Japanese elderly population , 2007, Environmental health and preventive medicine.

[47]  Yasuhiro Fukui,et al.  Assessment of gait parameter in hemiplegic patients by accelerometry , 2000, Proceedings of the 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (Cat. No.00CH37143).