I Maidan1, S Eyal2, I Kurz3, N Geffen4, E Gazit4, L Ravid4, N Giladi5, A Mirelman6, J M Hausdorff7. 1. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel. Electronic address: inbalm@tlvmc.gov.il. 2. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel. 3. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel; Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 4. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel. 5. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Sieratzki Chair in Neurology Tel Aviv University, Israel; Department of Neurology and Neurosurgery, Sackler School of Medicine, Tel Aviv University, Israel. 6. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Department of Neurology and Neurosurgery, Sackler School of Medicine, Tel Aviv University, Israel; Laboratory of Early Markers of Neurodegeneration; Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel. 7. Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Medical Center, Israel; Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States.
Abstract
INTRODUCTION: Tripping over an obstacle is one of the most common causes of falls among older adults. However, the effects of aging, obstacle height and anticipation time on negotiation strategies have not been systematically evaluated. METHODS: Twenty older adults (ages: 77.7±3.4years; 50% women) and twenty young adults (age: 29.3±3.8years; 50% women) walked through an obstacle course while negotiating anticipated and unanticipated obstacles at heights of 25mm and 75mm. Kinect cameras captured the: (1) distance of the subject's trailing foot before the obstacles, (2) distance of the leading foot after the obstacles, (3) clearance of the leading foot above the obstacles, and (4) clearance of the trailing foot above the obstacles. Linear-mix models assessed changes between groups and conditions. RESULTS: Older adults placed their leading foot closer to the obstacle after landing, compared to young adults (p<0.001). This pattern was enhanced in high obstacles (group*height interaction, p=0.033). Older adults had lower clearance over the obstacles, compared to young adults (p=0.007). This was more pronounced during unanticipated obstacles (group*ART interaction, p=0.003). The distance of the leading foot and clearance of the trailing foot after the obstacles were correlated with motor, cognitive, and functional abilities. CONCLUSIONS: These findings suggest that there are age-related changes in obstacle crossing strategies that are dependent on the specific characteristics of the obstacle. The results have important implications for clinical practice, suggesting that functional exercise should include obstacle negotiation training with variable practice of height and available response times. Further studies are needed to better understand the effects of motor and cognitive abilities.
INTRODUCTION: Tripping over an obstacle is one of the most common causes of falls among older adults. However, the effects of aging, obstacle height and anticipation time on negotiation strategies have not been systematically evaluated. METHODS: Twenty older adults (ages: 77.7±3.4years; 50% women) and twenty young adults (age: 29.3±3.8years; 50% women) walked through an obstacle course while negotiating anticipated and unanticipated obstacles at heights of 25mm and 75mm. Kinect cameras captured the: (1) distance of the subject's trailing foot before the obstacles, (2) distance of the leading foot after the obstacles, (3) clearance of the leading foot above the obstacles, and (4) clearance of the trailing foot above the obstacles. Linear-mix models assessed changes between groups and conditions. RESULTS: Older adults placed their leading foot closer to the obstacle after landing, compared to young adults (p<0.001). This pattern was enhanced in high obstacles (group*height interaction, p=0.033). Older adults had lower clearance over the obstacles, compared to young adults (p=0.007). This was more pronounced during unanticipated obstacles (group*ART interaction, p=0.003). The distance of the leading foot and clearance of the trailing foot after the obstacles were correlated with motor, cognitive, and functional abilities. CONCLUSIONS: These findings suggest that there are age-related changes in obstacle crossing strategies that are dependent on the specific characteristics of the obstacle. The results have important implications for clinical practice, suggesting that functional exercise should include obstacle negotiation training with variable practice of height and available response times. Further studies are needed to better understand the effects of motor and cognitive abilities.
Authors: Zhenlan Li; Tian Wang; Mengyue Shen; Tao Song; Jie He; Wei Guo; Zhen Wang; Jie Zhuang Journal: Int J Environ Res Public Health Date: 2022-06-30 Impact factor: 4.614