Analysis of kinematics and EMG on stepping over obstacles in elderly persons

장애물 보행에 의한 노인 낙상의 운동학 및 근전도 분석

Chung, Chul-Soo;Yoon, Te-Jin;Yu, Yeon-Joo;Choi, Chi-Sun
정철수;윤태진;유연주;최치선

  • Published : 20040000

Abstract

The purpose of this study was to investigate characteristics of the kinematics and muscle activities while elderly persons who had experienced falling stepped over obstacles. Six elderly non-fallers and six elderly fallers stepped over obstacles of 0, 2.5, 5.1, 15.2 cm height. The results showed that the duration stepped over the obstacles was longer in female fallers than female non-fallers. The crossing speed in stepping over obstacles was slower in female fallers than female non-fallers. Both male and female showed the longest duration and the slowest speed while stepping over the height of 15.2cm. The distance between the rear edge of the obstacle and the heel after stepping over the obstacle was shorter in female fallers than in female non-fallers. The minimum foot clearance significantly increased in the increases of the height of the obstacles. However, the significant difference between fallers and non-fallers did not showed in the minimum foot clearance. Although no stride length, left stride length, and right stride length differences were found in four obstacles and falling experience, fallers exhibited more conservative strategy when crossing obstacles. Ankle angles in non-fallers showed a certain pattern with increases of the height of the obstacles, but fallers showed unstable dorsiflexion and plantarflexion. The knee and hip angles showed a certain pattern without any difference in the height of the obstacles whereas the knee and hip angles showed differences in fallers and non-fallers. The mean EMG did not show any significant difference in the heights of obstacles and falling experience. We concluded that elderly persons who experienced falling stepped over the obstacles with conservative strategy. To prevent and reduce the frequency of falls, elderly persons maintained and improved their mobility.

Keywords

References

  1. 김현숙, 권오윤, 이현주 (2002). 넘어진 노인과 넘어지지 않는 노인의 균형과 보행비교. 한국전문물리치료학회지, 9(1), 1-13
  2. 통계청 (1998). 장래인구추계
  3. Austin, G.P., Garrett G.E., & Bohannon R.W. (1999). Kinematic analysis of obstacle clearance during locomotion. Gait and Posture, 10, 109-120 https://doi.org/10.1016/S0966-6362(99)00022-3
  4. Blake A.J., Morgan M.J., Dallosso H., Ebrahim S.B.J., Arie T.H.D., Fentem P.H., & Bassey E.J. (1988). Falls by elderly people at home: prevalence and associated factors. Age and Ageing, 17, 365-372 https://doi.org/10.1093/ageing/17.6.365
  5. Campbell A.J., Borrie M.J., Spears G.F., Jackson S.L., Brown J.S., & Fitzgerald J.L. (1990). Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age and Ageing, 19, 136-141 https://doi.org/10.1093/ageing/19.2.136
  6. Chen H., Ashton-Miller J.A., Alexander N.B., & Schultz A.B. (1991). Stepping over obstacles: gait patterns of healthy young and old adults. Journal of Gerontology, 46(6), M196-203 https://doi.org/10.1093/geronj/46.6.M196
  7. Jones CJ, Robichaux J, & William P. (1992). The effects of a 16-week exercise program on the dynamic balance of older adults. Journal of Clinical and Experimental Gerontology, 14, 165-182
  8. King MB, Tinetti ME. (1995). Falls in community dwelling older persons. Journal of the American Geriatrics Society. 43, 1146
  9. Lee D.W. & Kerrigan D.C. (1999). Identification of kinetic differences between fallers and nonfallers in the elderly. American Journal of Physical Medidine & Rehabilitation, 78(3), 242-246 https://doi.org/10.1097/00002060-199905000-00011
  10. McFadyen B.J. & Prince F. (2002). Avoidance and accommodation of surface height changes by healthy, community-dwelling, young, and elderly men. Journal of Gerontology. Series A, Biological Sciences Medical Sciences, 57(4), B166-174
  11. Nevitt M.C., Cummings S.R., & Hudes E.S. (1991). Risk factors for injuries falls: a prospective study. Journal of Gerontolgy. Series A, Biological Sciences Medical Sciences, 46, M164-170
  12. Nevitt MC. (1997). Falls in the elderly: Risk factors and prevention, In: Masden JC et. al eds. Gait disorders of aging: Falls and therapeutic strategies. New York, Lippinctt - Raven
  13. Pijnappels M., Bobbert M.F., & Van Dieen J.H. (2001). Changes in walking pattern caused by the possibility of a tripping reaction. Gait and Posture, 14, 11-18 https://doi.org/10.1016/S0966-6362(01)00110-2
  14. Sparrow WA, Shinkfield AJ, Chow S, & Begg RK. (1996). Characteristics of gait in stepping over obstacles. Human Movement Science, 15:605-622 https://doi.org/10.1016/0167-9457(96)00022-X
  15. Watanabe K. & Miyakawa T. (1991). Motion analysis of walking during step over the different heights of obstacle: in cases of aged persons and students. In: Proceeding of the ⅩⅢth International Congress of Biomechanics, University of Western Australia, Perth, 467-469