Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling

Abstract Most falls in older people are due to loss of balance during everyday locomotion, e.g., when initiating walking from sitting; sit-to-walk (STW). It has been considered that the broader stride width in walking that is seen in many people with fear of falling (FoF) does not increase stability...

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Bibliographic Details
Published in:Gait & posture 2010-04, Vol.31 (4), p.438-443
Main Authors: Åberg, Anna Cristina, Frykberg, Gunilla Elmgren, Halvorsen, Kjartan
Format: Article
Language:English
Subjects:
Acceleration
Accidental Falls
Aged
Aged, 80 and over
Case-Control Studies
Centre of mass
Evaluation
Fear
Frail elderly
Humans
Locomotion
Locomotion - physiology
MEDICIN
Medicin/Teknik
MEDICINE
Medicine/Technology
Orthopedics
Postural balance
Posture - physiology
Proprioception - physiology
Walking - physiology
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Summary:Abstract Most falls in older people are due to loss of balance during everyday locomotion, e.g., when initiating walking from sitting; sit-to-walk (STW). It has been considered that the broader stride width in walking that is seen in many people with fear of falling (FoF) does not increase stability, but could be predictive of future falls because of increased medio-lateral (ML) velocity of the body centre of mass (CoM). This study was aimed to examine step-, velocity- and stability-related parameters, focusing on ML stability, in STW performance of people with and without FoF. Ten subjects with FoF and 10 matched controls, aged ≥70 years, were included. Kinematic and kinetic data were collected in a laboratory. Stability parameters were calculated from a formula implying that the vertical projection of the CoM extrapolated by adding its velocity times a factor √ l / g (height of inverted pendulum divided by gravity) should fall within the base of support (BoS). A related spatial margin of stability (SMoS), defined as the minimum distance from the extrapolated CoM (XCoM) to the boundaries of the BoS, was also calculated. In the phase ‘seat-off–second-toe-off’, the FoF group had significantly ( p < 0.05) shorter and broader steps, lower forward but similar ML CoM velocity, and broader CoM and XCoM widths. The FoF group therefore exhibited a disproportionately large sideways velocity compared to the controls. This indicates that STW may be a hazardous transfer for older people with FoF, which should be relevant in assessment and training aimed at preventing falls.
ISSN:0966-6362
1879-2219
1879-2219
DOI:10.1016/j.gaitpost.2010.01.018