The Relation of Kinematic Synergy to Stabilize the Center of Mass During Walking With Future Falls: A 1-Year Longitudinal Study

Author(s):  
Momoko Yamagata ◽  
Hiroshige Tateuchi ◽  
Itsuroh Shimizu ◽  
Junya Saeki ◽  
Noriaki Ichihashi

Abstract Background: An incorrect transfer of center of mass (CoM) to outside the base of support is a frequent cause of falls, and segmental coordination to control CoM is crucial during walking. Uncontrolled manifold (UCM) analysis is a method of examining the relation between variances in segmental coordination and the CoM stability. However, no study has investigated through a prospective cohort study how variance in segmental configurations to stabilize CoM relates to future falls. This study explored whether variances to stabilize the CoM were related to future falls.Methods: At the baseline visit, 30 community-dwelling older adults walked 20 times on a 6-m walkway. Using kinematic data during walking, UCM analysis was performed to investigate how segmental configuration contributes to the CoM stability in the frontal plane. One year after the baseline visit, we evaluated whether the subjects experienced falls; 12 had experienced falls and 16 had not. Comparisons of variances between older adults with and without falls were conducted by covariate analysis.Results: No significant differences in variances were found in the mediolateral direction, whereas in the vertical direction, older adults with fall experiences had a greater variance, reflecting unstable CoM, than those with no fall experiences.Conclusions: We verified that the high variance in segmental configurations that destabilize CoM in the vertical direction was related to future falls. The variables of UCM analysis can be useful to evaluate fall risks.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Momoko Yamagata ◽  
Hiroshige Tateuchi ◽  
Itsuroh Shimizu ◽  
Junya Saeki ◽  
Noriaki Ichihashi

Abstract Background Incorrect body weight shifting is a frequent cause of falls, and the control of the whole-body center of mass (CoM) by segmental coordination is essential during walking. Uncontrolled manifold (UCM) analysis is a method of examining the relation between variance in segmental coordination and CoM stability. However, no prospective cohort study has thoroughly investigated how variance in segmental configurations to stabilize the CoM relates to future falls. This study explored whether variance to stabilize the CoM was related to future falls. Methods At the baseline visit, 30 community-dwelling older adults walked 20 times on a 6-m walkway. Using kinematic data collected during walking by a three-dimensional motion capture system, UCM analysis was performed to investigate how segmental configuration contributes to CoM stability in the frontal plane. One year after the baseline visit, we evaluated whether the subjects experienced falls. Twelve subjects had experienced falls, and 16 had not. Comparisons of variance between older adults with and without falls were conducted by covariate analysis. Results No significant differences in variance were found in the mediolateral direction, whereas in the vertical direction, older adults with fall experiences had a greater variance, reflecting an unstable CoM, than those with no fall experiences. Conclusions We verified that the high variance in segmental configurations that destabilize the CoM in the vertical direction was related to future falls. The variables of UCM analysis can be useful for evaluating fall risk.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 841-841
Author(s):  
Jessica Cheng

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p<.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.


Author(s):  
Lingxiao He ◽  
Philipe de Souto Barreto ◽  
Juan Luis Sánchez Sánchez ◽  
Yves Rolland ◽  
Sophie Guyonnet ◽  
...  

Abstract Background Growth differentiation factor 15 (GDF15) has been associated with several age-related disorders, but its associations with functional abilities in community-dwelling older adults are not well studied. Methods The study was a secondary analysis on 1096 community-dwelling older adults (aged 69 to 94 years) recruited from the Multidomain Alzheimer’s Preventive Trial. Plasma GDF15 was measured one year after participants’ enrolment. Annual data of physical performance (grip strength and short physical performance battery [SPPB]) and global cognitive functions (mini-mental state examination [MMSE] and a composite cognitive score) were measured for four years. Adjusted mixed-effects linear models were performed for cross-sectional and longitudinal association analyses. Results A higher GDF15 was cross-sectionally associated with a weaker grip strength (β = -1.1E-03, 95%CI [-2.0E-03, -1.5E-04]), a lower SPPB score (β = -3.1E-04, 95%CI [-5.4E-04, -9.0E-05]) and worse cognitive functions (β = -2.4E-04, 95%CI [-3.3E-04, -1.6E-04] for composite cognitive score; β = -4.0E-04, 95%CI [-6.4E-04, -1.6E-04] for MMSE). Participants with higher GDF15 demonstrated greater longitudinal declines in SPPB (β = -1.0E-04, 95%CI [-1.7E-04, -2.0E-05]) and composite cognitive score (β = -2.0E-05, 95%CI [-4.0E-05, -3.6E-06]). The optimal initial GDF15 cutoff values for identifying participants with minimal clinically significant decline after one year were 2189 pg/mL for SPPB (AUC: 0.580) and 2330 pg/mL for composite cognitive score (AUC: 0.587). Conclusions Plasma GDF15 is cross-sectionally and longitudinally associated with lower-limb physical performance and global cognitive function in older adults. Circulating GDF15 alone has limited capacity of discriminating older adults who will develop clinically significant functional declines.


2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.


2018 ◽  
Vol 108 (2) ◽  
pp. 126-139 ◽  
Author(s):  
Amy Muchna ◽  
Bijan Najafi ◽  
Christopher S. Wendel ◽  
Michael Schwenk ◽  
David G. Armstrong ◽  
...  

Background:Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.Methods:Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.Results:Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.Conclusions:Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.


2020 ◽  
Vol 91 ◽  
pp. 104161 ◽  
Author(s):  
Jaqueline Mello Porto ◽  
Natália Camargo Rodrigues Iosimuta ◽  
Renato Campos Freire Júnior ◽  
Roberta de Matos Brunelli Braghin ◽  
Érika Leitner ◽  
...  

Sensors ◽  
2019 ◽  
Vol 20 (1) ◽  
pp. 63 ◽  
Author(s):  
Ilaria Mileti ◽  
Juri Taborri ◽  
Stefano Rossi ◽  
Zaccaria Del Prete ◽  
Marco Paoloni ◽  
...  

Maintaining balance stability while turning in a quasi-static stance and/or in dynamic motion requires proper recovery mechanisms to manage sudden center-of-mass displacement. Furthermore, falls during turning are among the main concerns of community-dwelling elderly population. This study investigates the effect of aging on reactive postural responses to continuous yaw perturbations on a cohort of 10 young adults (mean age 28 ± 3 years old) and 10 older adults (mean age 61 ± 4 years old). Subjects underwent external continuous yaw perturbations provided by the RotoBit1D platform. Different conditions of visual feedback (eyes opened and eyes closed) and perturbation intensity, i.e., sinusoidal rotations on the horizontal plane at different frequencies (0.2 Hz and 0.3 Hz), were applied. Kinematics of axial body segments was gathered using three inertial measurement units. In order to measure reactive postural responses, we measured body-absolute and joint absolute rotations, center-of-mass displacement, body sway, and inter-joint coordination. Older adults showed significant reduction in horizontal rotations of body segments and joints, as well as in center-of-mass displacement. Furthermore, older adults manifested a greater variability in reactive postural responses than younger adults. The abnormal reactive postural responses observed in older adults might contribute to the well-known age-related difficulty in dealing with balance control during turning.


Author(s):  
P. Srisuwan ◽  
D. Nakawiro ◽  
S. Chansirikarnjana ◽  
O. Kuha ◽  
S. Kengpanich ◽  
...  

BACKGROUND: Cognitive interventions have the potential to enhance cognition among healthy older adults. However, little is known of the factors associated with the joining and participating of older people in group-based multicomponent cognitive training (CT). OBJECTIVES: To explore factors that contribute to joining and regularly practicing CT over 1 year among healthy older adults. DESIGN: A qualitative study. SETTING: Geriatric clinic in Bangkok, Thailand. PARTICIPANTS: 40 nondemented community-dwelling older adults INTERVENTION: The CT of executive functions, attention, memory and visuospatial functions (TEAM-V) program was conducted over 5 sessions, with a 2-week interval between each session. MEASUREMENTS: An inductive qualitative approach, based on semi-structure interviews with 40 healthy older adults, was employed. The interviews explored factors of joining CT at baseline, factors of regularly participating in class at 6 months and at home at 1 year. Data were coded and analyzed using and the thematic analysis approach. RESULTS: After analyzing factors concerning joining CT, 3 core themes emerged: (1) individual characteristics with 3 subthemes of “health status”, “time arrangement”, and “financial status”; (2) individual perceptions with 2 subthemes of “perceived susceptibility to dementia” and “perceived severity of dementia” and (3) encouragement from families and friends. After analyzing factors of practicing CT in class, 3 core themes emerged: (1) program with 3 subthemes of “session”, “group facilitators” and “notification before class”; (2) accessibility with 2 subthemes of “distance” and “transportation” and (3) encouragement from families and friends. After analyzing factors of practicing CT at home, 2 core themes emerged: (1) contents of the training program and (2) encouragement from families and friends. CONCLUSIONS: Increased awareness of holistic factors including older adults’ characteristic and perceptions, support from families and friends and accessibility should be emphasized in planning CT. Designing the content of CT that could be applied or adapted in daily living and effective program components such as a notification system could increase practicing.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S220-S220
Author(s):  
Nikki Hill ◽  
Jacqueline Mogle ◽  
Sakshi Bhargava ◽  
Tyler Bell ◽  
Rachel Wion

Abstract Personality traits, particularly neuroticism, have been associated with self-reported memory problems, but little is known regarding differences across racial groups. Community-dwelling older adults (n=425; M(SD) = 76.7(4.7) years; 62.6% female; 72.0% White) without cognitive impairment completed up to 11 annual comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study. Multilevel modeling tested: 1) the association of neuroticism, conscientiousness, extraversion, openness, and agreeableness with three types of self-reported memory problems (frequency, one-year decline, and ten-year decline), and 2) whether these associations differed by race, specifically Black and White. Neuroticism predicted self-reported frequency of memory problems and perceived one-year decline when considered alone; however, this did not remain significant after including all personality traits. Conscientiousness influenced perceived ten-year memory decline in Black older adults but not White. Our findings suggest that the influence of personality on self-reported memory problems may not be consistent across racial groups.


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