The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effect of Obstacle Height on Balance Control While Stepping Over an Obstacle From a Position of Quiet Stance in Older Adults

노인의 정적인 자세로부터 장애물 보행 시 장애물 높이의 변화가 평형감각에 미치는 효과

  • Kim, Hyeong-Dong (Department of Physical Therapy, College of Health Science, Catholic University of Daegu)
  • 김형동 (대구가톨릭대학교 물리치료학과)
  • Received : 2009.03.25
  • Accepted : 2009.08.29
  • Published : 2009.09.25
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Abstract

Purpose: The purpose of this study was to examine the effect of an obstacle height on the balance control of older adults while stepping over an obstacle from a position of quiet stance. Methods: Fifteen community-dwelling healthy older adults (mean age, $74.4\pm4.27$ yrs; age range, 67-82 yrs) volunteered to participate in this study. The subjects performed gait initiation (GI) and they stepped over obstacles of two different heights (10 cm and 18 cm) at a self-paced speed from a position of quiet stance. Their performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Results: The M-L displacement of the COP significantly increased for an 18 cm obstacle height condition as compared to the GI and a 10 cm obstacle height condition (p<0.01). Furthermore, the M-L displacement of the COP for a 10 cm high obstacle was significantly greater for that for the GI (p<0.01). However, the mean of the A-P displacement of the COP was similar between the stepping conditions for the A-P displacement of the COP (p>0.05). Conclusion: This study suggests that the M-L COP displacement could be a better parameter to identify the dynamic balance control in older adults when negotiating obstacles.

Keywords

References

  1. Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82(8):1050-6. https://doi.org/10.1053/apmr.2001.24893
  2. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health. 1992;82(7):1020-3. https://doi.org/10.2105/AJPH.82.7.1020
  3. Campbell AJ, Borrie MJ, Spears GF et al. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing. 1990;19(2):136-41. https://doi.org/10.1093/ageing/19.2.136
  4. Tinetti ME, Speechley M. Prevention of falls among the elderly. N Engl J Med. 1989;320(16):1055-9. https://doi.org/10.1056/NEJM198904203201606
  5. Patla AE, Rietdyk S. Visual control of limb trajectory over obstacles during locomotion: effect of obstacle height and width. Gait Posture. 1993;1(1):45-60. https://doi.org/10.1016/0966-6362(93)90042-Y
  6. Begg RK, Sparrow WA, Lythgo ND. Time-domain analysis of foot-ground reaction forces in negotiating obstacles. Gait Posture. 1998;7(2):99-109. https://doi.org/10.1016/S0966-6362(97)00039-8
  7. Chou LS, Draganich LF. Stepping over an obstacle increases the motions and moments of the joints of the trailing limb in young adults. J Biomech. 1997;30(4):331-7. https://doi.org/10.1016/S0021-9290(96)00161-3
  8. Whipple RH, Wolfson LI, Amerman PM. The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study. J Am Geriatr Soc. 1987;35(1):13-20.
  9. Chen HC, Ashton-Miller JA, Alexander NB et al. Stepping over obstacles: gait patterns of healthy young and old adults. J Gerontol. 1991;46(6):M196-203. https://doi.org/10.1093/geronj/46.6.M196
  10. Begg RK, Sparrow WA. Gait characteristics of young and older individuals negotiating a raised surface: implications for the prevention of falls. J Gerontol A Bio Sci Med Sci. 2000;5(3):M147-54.
  11. Doyle RJ, Hsiao-Wecksler ET, Ragan BG et al. Generalizability of center of pressure measures of quiet standing. Gait Posture. 2007;25(2):166-71. https://doi.org/10.1016/j.gaitpost.2006.03.004
  12. Chang H, Krebs DE. Dynamic balance control in elders: gait initiation assessment as a screening tool. Arch Phys Med Rehabil. 1999;80(5):490-4. https://doi.org/10.1016/S0003-9993(99)90187-9
  13. Martin M, Shinberg M, Kuchibhatla M et al. Gait initiation in community-dwelling adults with Parkinson disease: comparison with older and younger adults without the disease. Phys Ther. 2002;82(6):566-77.
  14. Polcyn AF, Lipsitz LA, Kerrigan DC et al. Age-related changes in the initiation of gait: degradation of central mechanisms for momentum generation. Arch Phys Med Rehabil. 1998;79(12):1582-9. https://doi.org/10.1016/S0003-9993(98)90425-7
  15. Cummings SR, Nevitt MC. A hypothesis: the causes of hip fractures. J Gerontol. 1989;44(4):107-11.
  16. Berg KO, Wood-Dauphinee SL, Williams JI et al. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can. 1989;41(6):304-11. https://doi.org/10.3138/ptc.41.6.304
  17. Berg KO, Maki BE, Williams JI et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-80.
  18. Schuling J, de Haan R, Limburg M et al. The Frenchay Activities Index. Assessment of functional status in stroke patients. Stroke. 1993;24(8):1173-7. https://doi.org/10.1161/01.STR.24.8.1173
  19. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83. https://doi.org/10.1097/00005650-199206000-00002
  20. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98. https://doi.org/10.1016/0022-3956(75)90026-6
  21. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922-35.
  22. Turnbull JC, Kersten P, Habib M et al. Validation of the Frenchay Activities Index in a general population aged 16 years and older. Arch Phys Med Rehabil. 2000;81(8):1034-8. https://doi.org/10.1053/apmr.2000.7162
  23. Yip JY, Wilber KH, Myrtle RC et al. Comparison of older adult subject and proxy responses on the SF-36 health-related quality of life instrument. Aging Ment Health. 2001;5(2):136 -42. https://doi.org/10.1080/13607860120038357
  24. Chou LS, Draganich LF. Increasing obstacle height and decreasing toe-obstacle distance affect the joint moments of the stance limb differently when stepping over an obstacle. Gait Posture. 1998;8(3):186-204. https://doi.org/10.1016/S0966-6362(98)00034-4
  25. Wang Y, Watanabe K. The relationship between obstacle height and center of pressure velocity during obstacle crossing. Gait Posture. 2008;27(1):172-5. https://doi.org/10.1016/j.gaitpost.2007.03.004
  26. Chou LS, Kaufman KR, Hahn ME et al. Medio-lateral motion of the center of mass during obstacle crossing distinguishes elderly individuals with imbalance. Gait Posture. 2003;18(3):125-33.
  27. Maki BE, Edmondstone MA, McIlroy WE. Age-related differences in laterally directed compensatory stepping behavior. J Gerontol A Biol Sci Med Sci. 2000:55(5):M270-7. https://doi.org/10.1093/gerona/55.5.M270
  28. Hahn ME, Chou LS. Age-related reduction in sagittal plane center of mass motion during obstacle crossing. J Biomech. 2004;37(6):837-44. https://doi.org/10.1016/j.jbiomech.2003.11.010