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Query: UMLS:C0241981 (loss of balance)
 452 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims of this study were to investigate which arm movements are made during trip recovery, to determine the contributions of arm movements in trip recovery and to identify differences in these contributions between younger and older adults and different recovery strategies. A group of seven older adults (65-75 years) and a group of eight younger adults (20-35 years) were examined. Participants completed a trip recovery protocol in which 3-D kinematic and kinetic data were collected for recovery movements following unexpected trips during locomotion. In younger adults, arm movements were associated with an elevated body centre of mass (CM) position during recovery. Arm movements also served to reduce the angular momentum in the direction of the trip by 13% between trip stimulus and recovery foot contact in 'elevating' recovery strategies. Arm movements in older adults contributed an additional 3% to the destabilising angular momentum during 'elevating' recoveries. It was concluded that older adults exhibit a more 'protective' recovery strategy (to limit injury resulting from fall impacts following loss of balance) and younger adults exhibit a more 'preventive' strategy (to prevent loss of balance).
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PMID:The role of arm movement in early trip recovery in younger and older adults. 1756 98

Recent epidemiological studies have shown that there is a clear need for efforts to prevent non-traffic occupational injuries among truck drivers. The objective of the present study was to establish the hazard scenarios for truck drivers during loading/unloading through analyses of text descriptions of accident processes. Focus was on accidents that were primarily related to movement/operation on and around the truck, which are particular to truck drivers. Special emphasis was placed on falls from heights, as this was shown to be the most frequent type of accident and a major cause of fractures among truck drivers. Analyses of text descriptions of 136 accidents, including 63 cases of fall from height, collected in one company over a period of three years, revealed that: (a) the major triggering factors for falls from heights on and around the truck were stepping off the edge at height (33.3%), wrong footing (27.0%), and loss of balance/control of wagon (15.9%); (b) the major triggering factors for accidents on and around the truck in general were slip/trip (44.1%) and defect/malfunction (14.7%). The present study identified four target areas for improving prevention of occupational accidents of truck drivers in connection with movement/operation on and around trucks during loading/unloading: (1) improvement of the procedures for unloading to reduce the risk of fall from the back-hatch lift, (2) improvements of shoes and housekeeping to reduce the risk of slip/trip, (3) improvement of truck maintenance, and (4) reconciliation of views on causes of accidents between employers and truck drivers as a first step for a dialogue for improving safety in the goods-transport branch.
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PMID:Hazard scenarios of truck drivers' occupational accidents on and around trucks during loading and unloading. 1988 40

The reasons for higher fall risk of people with osteoarthritis (OA) compared to people without OA are not known. It is possible that following a loss of balance OA may negatively affect the recovery stepping response. Stepping responses have not been reported for people with knee OA. Here, we compared recovery step kinematics following laboratory-induced trip and following a large treadmill-delivered perturbation simulating a trip between a group of women with and without self-reported knee OA. We hypothesized that knee OA would significantly impair recovery step kinematics compared to those of a control group. Following the laboratory-induced trip, step length and trunk flexion velocity at recovery step completion of women with OA were significantly impaired and more so for the women who fell. Following the treadmill-delivered perturbation, the recovery step kinematics of women with OA were not significantly impaired. For both perturbations, the women who fell had significantly impaired recovery step kinematics compared to those who did not fall, regardless of OA. The results are consistent with previous work on healthy middle aged and older women and suggest that the same biomechanical risk factors for trip-related falls are shared by middle age and older women regardless of the presence of knee OA. The results support the need to determine whether training protocols which have been shown to improve recovery step kinematics and reduce prospective falls by healthy older women can have similar outcomes for people with knee OA.
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PMID:Knee osteoarthritis negatively affects the recovery step following large forward-directed postural perturbations. 2694 35

Most falls occur after a loss of balance following an unexpected perturbation such as a slip or a trip. Greater understanding of how humans control and maintain stability during perturbed walking may help to develop appropriate fall prevention programs. The aim of this study was to examine changes in spatiotemporal gait and stability parameters in response to sudden mechanical perturbations in medio-lateral (ML) and anterior-posterior (AP) direction during treadmill walking. Moreover, we aimed to evaluate which parameters are most representative to quantify postural recovery responses. Ten healthy adults (mean = 26.4, SD = 4.1 years) walked on a treadmill that provided unexpected discrete ML and AP surface horizontal perturbations. Participants walked under no perturbation (normal walking), and under left, right, forward, and backward sudden mechanical perturbation conditions. Gait parameters were computed including stride length (SL), step width (SW), and cadence, as well as dynamic stability in AP- (MoS-AP) and ML- (MoS-ML) directions. Gait and stability parameters were quantified by means, variability, and extreme values. Overall, participants walked with a shorter stride length, a wider step width, and a higher cadence during perturbed walking, but despite this, the effect of perturbations on means of SW and MoS-ML was not statistically significant. These effects were found to be significantly greater when the perturbations were applied toward the ML-direction. Variabilities, as well as extremes of gait-related parameters, showed strong responses to the perturbations. The higher variability as a response to perturbations might be an indicator of instability and fall risk, on the same note, an adaptation strategy and beneficial to recover balance. Parameters identified in this study may represent useful indicators of locomotor adaptation to successfully compensate sudden mechanical perturbation during walking. The potential association of the extracted parameters with fall risk needs to be determined in fall-prone populations.
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PMID:The effects of unexpected mechanical perturbations during treadmill walking on spatiotemporal gait parameters, and the dynamic stability measures by which to quantify postural response. 2967 58

For human locomotion, varying environments require adjustments of the motor system. We asked whether age affects gait balance recovery adaptation, its retention over months, and the transfer of adaptation to an untrained reactive balance task. Healthy adults (26 young, 27 middle-aged, and 25 older; average ages 24, 52, and 72 yr, respectively) completed two tasks. The primary task involved treadmill walking: either unperturbed (control; n = 39) or subject to unexpected trip perturbations (training; n = 39). A single trip perturbation was repeated after a 14-wk retention period. The secondary transfer task, before and after treadmill walking, involved sudden loss of balance in a lean-and-release protocol. For both tasks, the anteroposterior margin of stability (MoS) was calculated at foot touchdown. For the first (i.e., novel) trip, older adults required one more recovery step (P = 0.03) to regain positive MoS compared with younger, but not middle-aged, adults. However, over several trip perturbations, all age groups increased their MoS for the first recovery step to a similar extent (up to 70%) and retained improvements over 14 wk, although a decay over time was found for older adults (P = 0.002; middle-aged showing a tendency for decay: P = 0.076). Thus, although adaptability in reactive gait stability control remains effective across the adult life span, retention of adaptations over time appears diminished with aging. Despite these robust adaptations, the perturbation training group did not show superior improvements in the transfer task compared with age-matched controls (no differences in MoS changes), suggesting that generalizability of acquired fall-resisting skills from gait-perturbation training may be limited.NEW & NOTEWORTHY The human neuromotor system preserves its adaptability across the adult life span. However, although adaptability in reactive gait stability control remains effective as age increases, retention of recovery response adaptations over time appears to be reduced with aging. Furthermore, acquired fall-resisting skills from single-session perturbation training seem task specific, which may limit the generalizability of such training to the variety of real-life falls.
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PMID:Retention and generalizability of balance recovery response adaptations from trip perturbations across the adult life span. 3150 70

Background: Near-falls such as a trip, slip, stumble, or misstep involve a loss of balance (LOB) that does not result in a fall, occur more frequently than actual falls, and are associated with an increased fall risk. To date, studies have largely involved detection of simulated laboratory LOBs using wearable devices in young adults. Data on the detection of and kinematics of naturally occurring LOBs in people at high risk of falling are lacking. This may provide a new way to identify older adults at high risk for falls. We aimed to explore key body kinematics underlying real-world trips in at-fall risk community dwelling older adults wearing inertial measurement units (IMU). Methods: Five community-dwelling older adults with a history of falls who reported trips during the study period participated. They wore a voice recorder and 4 IMUs mounted on feet, lower back and wrist for two consecutive weeks to provide a record of the context and timing of LOB events. Sensor data prior to time-stamped voice recording of a trip were processed in order to visually identify unusual foot trajectories and lower back and arm orientations. Then, data of feet, lower back and wrist position and orientation were combined to create a three-dimensional animation representing the estimated body motion during the noted time segments in order to corroborate the occurrence of a trip. Events reported as a trip by the participant and identified as a trip by a researcher, blinded to voice recordings description, were included in the final analysis. Results: A total of 18 trips obtained from five participants were analyzed. Twelve trips occurred at home, three outside and for three the location was not reported. Trips were identified in the sensor data by observing (1) additional peaks to the typical foot velocity signal during swing phase; (2) increased velocity of the contralateral foot and (3) sharp changes in lower back pitch angles. Conclusions: Our approach demonstrates the feasibility of identifying and studying the mechanisms and context underlying trip-related LOBs in at-fall risk older adults during real world activities.
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PMID:Detection of Real-World Trips in At-Fall Risk Community Dwelling Older Adults Using Wearable Sensors. 3298 85