It is generally believed that, merely by walking slower, one can be safer and more stable. Contrary to this general concept, our recent computer model simulations showed that, at the onset of a slip, a slower velocity of the body center of mass (COM) may actually decrease stability and thereby lead to a backward loss of balance. A faster moving and/or a more forwardly positioned COM at slip onset can quickly carry the person forward to catch up with his/her slipping foot, thus avoiding a backward fall. Paradoxically, these findings suggest that age-related slowness in gait, rather than being safer, may actually predispose older adults to falling, accounting, at least in part, for a higher fall incidence rate among older adults. One possible mitigating factor, however, is that older adults can potentially compensate for the instability due to slowness by shortening their step length, thereby shifting the COM forward with respect to the base of support. The extent to which older individuals compensate for slowness-related gait instability is largely unknown. Successful recovery may, to some extent, rely on reactive stepping, although our preliminary findings indicate that such stepping fails more frequently in older than in young adults. Nevertheless, our preliminary findings also indicate that, after repeated exposure to induced slips, young and older adults avoided falling by improving their stability at slip onset through a forwardly shifted COM and an increased velocity. Thus, successful proactive behavior (e.g., changes in COM position and velocity to improve stability) can reduce or even eliminate the need for a reactive stepping response. In the following 3 stated aims, we are pioneering a line of research to investigate these issues, while exploring the mechanisms for effective intervention to reduce incidence of slip-related falls.
Aim 1 : We will test the theorized relationship between gait stability and the risk of slip-related falls.
Aim 2 : We will determine whether an age-related increase in slip-related fall incidence is attributable to a decrease in gait stability and/or to differences in the reactive response to a novel, unexpected slip.
Aim 3 : We will determine whether older adults decrease their fall incidence after repeated exposure to slips by improving gait stability and/or by enhancing their reactive responses.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG016727-07
Application #
7086127
Study Section
Geriatrics and Rehabilitation Medicine (GRM)
Program Officer
Badinelli, Joanna
Project Start
1999-09-01
Project End
2008-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
7
Fiscal Year
2006
Total Cost
$375,170
Indirect Cost
Name
University of Illinois at Chicago
Department
Other Health Professions
Type
Schools of Allied Health Profes
DUNS #
098987217
City
Chicago
State
IL
Country
United States
Zip Code
60612
Yang, Feng; Pai, Yi-Chung (2014) Can stability really predict an impending slip-related fall among older adults? J Biomech 47:3876-81
Zhang, Mei-Zhen; Yang, Feng; Wang, Edward et al. (2014) Association between anthropometric factors and falls in community-dwelling older adults during a simulated slip while walking. J Am Geriatr Soc 62:1808-10
Pai, Yi-Chung; Yang, Feng; Bhatt, Tanvi et al. (2014) Learning from laboratory-induced falling: long-term motor retention among older adults. Age (Dordr) 36:9640
Yang, Feng; Pai, Yi-Chung (2014) Can sacral marker approximate center of mass during gait and slip-fall recovery among community-dwelling older adults? J Biomech 47:3807-12
Wang, Ting-Yun; Bhatt, Tanvi; Yang, Feng et al. (2012) Adaptive control reduces trip-induced forward gait instability among young adults. J Biomech 45:1169-75
Yang, Feng; Espy, Debbie; Bhatt, Tanvi et al. (2012) Two types of slip-induced falls among community dwelling older adults. J Biomech 45:1259-64
Bhatt, Tanvi; Yang, Feng; Pai, Yi-Chung (2012) Learning to resist gait-slip falls: long-term retention in community-dwelling older adults. Arch Phys Med Rehabil 93:557-64
Yang, Feng; Pai, Yi-Chung (2011) Automatic recognition of falls in gait-slip training: Harness load cell based criteria. J Biomech 44:2243-9
Yang, Feng; Bhatt, Tanvi; Pai, Yi-Chung (2011) Limits of recovery against slip-induced falls while walking. J Biomech 44:2607-13
Bhatt, Tanvi; Yang, Feng; Pai, Yi-Chung (2011) Learning from falling: retention of fall-resisting behavior derived from one episode of laboratory-induced slip training. J Am Geriatr Soc 59:2392-3

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