Differences in Trailing Limb Response Between Falls and Recoveries Following a Laboratory-Induced Slip

Details

• Personal Author:
  Allin LJ ; Madigan ML ; Nussbaum MA ; Wu X
• Description:
  Walking is commonly promoted as a way to increase physical activity among older adults. However, walking includes an inherent risk of slips and falls. When a slip occurs upon heel strike, a trailing (non-slipping) limb response is often required to recover balance. A better understanding of the trailing limb response characteristics that are associated with falls and recoveries could lead to training interventions to improve these responses, and reduce the risk of falls from a slip. PURPOSE: To identify differences in trailing limb responses between falls and recoveries following laboratory-induced slips. METHODS: Seventy-two adults were exposed to an unexpected slip by walking over a slippery surface. Each slip outcome was characterized as a fall or recovery based upon the force applied to a safety harness. Thirty-two slips were excluded from analysis because the slip distance was <20 cm (eliciting minimal trailing limb response), or because the outcome could not be unambiguously characterized as a fall or recovery. RESULTS: Of the 40 slips investigated, subjects used one of two trailing limb responses: a forefoot/toe-down (FT) response, where the forefoot or toe of the trailing foot contacted the floor posterior to the slipping foot; or a flat-foot (FF) response, where the entire sole of the trailing foot contacted the floor closer to the slipping foot than during the FT response. The trailing limb response influenced the type of fall experienced. Of 21 subjects who attempted FT responses, 7 fell straight down, 2 fell laterally, and 12 recovered. These falls exhibited 48% longer anteroposterior (AP) flight distance of the trailing foot (p=0.018), and 15% longer AP distance between heels at touch down of the trailing foot compared to recoveries (p=0.037). Lateral falls did not appear to result from a deficient trailing limb response. Of 19 subjects who attempted FF responses, 4 fell backwards and 15 recovered. These falls did not differ from recoveries in any response parameters (p>0.05). CONCLUSIONS: The FT response resulted in no backward falls, and exhibited differences in potentially modifiable response parameters between falls and recoveries. As such, training a FT response among older adults may help reduce risk of hip fracture associated with backward falls. Description provided by NIOSH
• Subjects:
  • Accidental Falls
  • Accidents
  • Accidents, Occupational
  • Age Factors
  • Biomechanical Phenomena
  • Occupational Health
  • Risk Assessment
  • Risk Factors
  • Safety
• Keywords:
  • Biomechanics
  • Slips, trips, and falls
  • STF
  • Physiological response
  • Accident analysis
  • Risk factors
  • Age factors
  • Lower extremities
• ISSN:
  0195-9131
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; OSHA Region 6 ; Texas ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  48
• NIOSHTIC Number:
  nn:20053983
• Citation:
  Med Sci Sports Exerc 2016 May; 48(5S):828-829
• Email:
  lallin@tamu.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  Virginia Polytechnic Institute and State University
• Peer Reviewed:
  True
• Start Date:
  20110901
• Source Full Name:
  Medicine and Science in Sports and Exercise
• End Date:
  20150831
• Download URL:
  https://stacks.cdc.gov/view/cdc/216635/cdc_216635_DS1.pdf
• File Type:
  [PDF - 231.43 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:020af6ecc402514c3aef96f70d4dde9876a6847ceae68bc3e892bf596f416e7238dba1694029a598af06bb64fc7ca344c8bc65e23e2a417f33cded1e6e020e82