Document Detail

Influence of lower extremity strength of healthy older adults on the outcome of an induced trip.
MedLine Citation:
PMID:  12028206     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine whether decreased lower extremity strength contributes to trip-related falls in older adults. DESIGN: A cross-sectional sample of older adults were safety-harnessed and tripped while walking using a concealed, mechanical obstacle. Lower extremity strength was compared between trip outcome groups. SETTING: A biomechanics research laboratory. PARTICIPANTS: Seventy-nine healthy, community-dwelling adults aged 65 and older (50 women). MEASUREMENTS: Ankle, knee, and hip flexion and extension strength were measured isometrically and isokinetically. Measured strengths were subjected to a factor analysis. Strength factor scores were compared between those who recovered from the trip and those who fell by three previously identified mechanisms: during-step, after-step, and elevating-response falls. RESULTS: Seven common factors, one associated with each direction of exertion at each joint and one with the time rate of moment increase, explained 88% of the variance in measured strength. The during-step (n=5) fallers were significantly stronger in the ankle extension (plantarflexion), knee flexion, overall extension, and total strength factors than those who successfully recovered using a similar, lowering strategy (n=26). The elevating-response faller (n=1) was stronger in the plantarflexion and overall extension factors than most of those who recovered using a similar, elevating strategy (n=11). Two of three after-step fallers were among the weakest subjects tested. CONCLUSION: Weak older adults and the strongest older adults may be at greater risk of falling from a trip, although by different mechanisms. High strength may increase the likelihood of a during-step or elevating-response fall; decreased strength may increase the likelihood of an after-step fall.
Michael J Pavol; Tammy M Owings; Kevin T Foley; Mark D Grabiner
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  50     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-07-31     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  256-62     Citation Subset:  IM    
Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, Ohio, USA.
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MeSH Terms
Accidental Falls*
Ankle Joint*
Cross-Sectional Studies
Factor Analysis, Statistical
Hip Joint*
Isometric Contraction*
Knee Joint*
Statistics, Nonparametric
Grant Support

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