Differences in Falls and Recovery from a Slip Based on an Individual’s Lower Extremity Corrective Response

Samuel J. Wilson, Paul T. Donahue, Charles C. Williams, Christopher M. Hill, Jeffrey D. Simpson, Dwight E. Waddell, Jeremy P. Loenneke, Harish Chander, Chip Wade, John C. Garner

Abstract


Background: Slips and falls account for high rates of injury and mortality in multiple populations. The corrective responses during the slip perturbation have been well documented. However, when a fall results from a slip, it is unclear which of these responses were inadequate. Objective: The purpose of this study was to examine differences in lower extremity corrective responses of the slip recovery response between individuals who fall and those who recover. Methodology: Sixty-four participants completed this study (32 males & 32 females). Participant’s gait kinematics and kinetics were collected during normal gait (NG) and an unexpected slip (US). A prediction equation for slip outcome and slip severity were created using a binary logistic regression model. Results: Our findings show an increased time to peak hip extension (OR = 1.006, CI: 1.000-1.011) and ankle dorsiflexion (OR = 1.005, CI: 1.001-1.009) moments increased the odds of falling, while the average ankle moment was negatively associated with falling (OR = 0.001, CI: 0.001-0.005). Conclusions: Rapid lower extremity corrective responses appear critical in arresting the slip and preventing a fall. While there are various strategies for slip recovery, our findings suggest that the primary recovery mechanism at the slipping hip may play a vital role in preventing the fall.

Keywords


Accidental Falls, Gait, Logistic Models, Lower Extremity

Full Text:

PDF

References


Adams PE, Martinez ME, Vickerie JL, Kirzinger WK. Summary health statistics for the U.S. population: National Health Interview Survey, 2010. Vital Health Stat 10. 2011 Dec;(251):1-117. PubMed PMID: 22624451.

Burns, E. R., Stevens, J. A., & Lee, R. (2016). The direct costs of fatal and non-fatal falls among older adults—United States. Journal of safety research, 58, 99-103.

Bursac, Z., Gauss, C. H., Williams, D. K., & Hosmer, D. W. (2008). Purposeful selection of variables in logistic regression. Source code for biology and medicine, 3(1), 17.

Cham, R., & Redfern, M. S. (2001). Lower extremity corrective reactions to slip events. Journal of biomechanics, 34(11), 1439-1445.

Chambers, A. J., & Cham, R. (2007). Slip-related muscle activation patterns in the stance leg during walking. Gait & posture, 25(4), 565-572.

Chander, H., Garner, J. C., & Wade, C. (2015a). Ground Reaction Forces in Alternative Footwear during Slip Events. International Journal of Kinesiology & Sports Science, 3(2), 1.

Chander, H., Garner, J. C., & Wade, C. (2015b). Heel contact dynamics in alternative footwear during slip events. International Journal of Industrial Ergonomics, 48, 158-166.

Chander, H., Garner, J. C., & Wade, C. (2016). Slip outcomes in firefighters: A comparison of rubber and leather boots. Occupational Ergonomics, 13(2), 67-77.

Chander, H., Wade, C., Garner, J. C., & Knight, A. C. (2016). Slip initiation in alternative and slip-resistant footwear. International journal of occupational safety and ergonomics, 1-12.

Chang, W.-R., Leclercq, S., Lockhart, T. E., & Haslam, R. (2016). State of science: occupational slips, trips and falls on the same level. Ergonomics, 59(7), 861-883.

Kosma, M., Hondzinski, J. M., & Buchanan, D. R. (2017). Exercise, health, and falls risks among older African American women. International Journal of Kinesiology and Sports Science, 5(3), 16-27.

Lee, A., Bhatt, T., Liu, X., Wang, Y., & Pai, Y.-C. (2018). Can higher training practice dosage with treadmill slip-perturbation necessarily reduce risk of falls following overground slip? Gait & posture, 61, 387-392.

Lockhart, T. E., Smith, J. L., & Woldstad, J. C. (2005). Effects of aging on the biomechanics of slips and falls. Human factors, 47(4), 708-729.

Merrill, Z., Chambers, A. J., & Cham, R. (2017). Arm reactions in response to an unexpected slip—impact of aging. Journal of biomechanics.

O’Connell, C., Chambers, A., Mahboobin, A., & Cham, R. (2016). Effects of slip severity on muscle activation of the trailing leg during an unexpected slip. Journal of electromyography and kinesiology, 28, 61-66.

Parijat, P., & Lockhart, T. E. (2012). Effects of moveable platform training in preventing slip-induced falls in older adults. Annals of biomedical engineering, 40(5), 1111-1121.

Redfern, M. S., Cham, R., Gielo-Perczak, K., Grönqvist, R., Hirvonen, M., Lanshammar, H., . . . Powers, C. (2001). Biomechanics of slips. Ergonomics, 44(13), 1138-1166.

Sadeghi, H., Hakim, M. N., Hamid, T. A., Amri, S. B., Razeghi, M., Farazdaghi, M., & Shakoor, E. (2017). The effect of exergaming on knee proprioception in older men: A randomized controlled trial. Archives of gerontology and geriatrics, 69, 144-150.

Sawers, A., Pai, Y.-C. C., Bhatt, T., & Ting, L. H. (2017). Neuromuscular responses differ between slip-induced falls and recoveries in older adults. Journal of neurophysiology, 117(2), 509-522.

Strandberg, L., & Lanshammar, H. (1981). The dynamics of slipping accidents. Journal of Occupational Accidents, 3(3), 153-162.

Yang, F., & Pai, Y.-C. (2011). Automatic recognition of falls in gait-slip training: Harness load cell based criteria. Journal of biomechanics, 44(12), 2243-2249.




DOI: https://doi.org/10.7575/aiac.ijkss.v.7n.3p.34

Refbacks

  • There are currently no refbacks.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

International Journal of Kinesiology and Sports Science

You may require to add the 'aiac.org.au' domain to your e-mail 'safe list’ If you do not receive e-mail in your 'inbox'. Otherwise, you may check your 'Spam mail' or 'junk mail' folders.