Document Detail


Step length after discrete perturbation predicts accidental falls and fall-related injury in elderly people with a range of peripheral neuropathy.
MedLine Citation:
PMID:  24183899     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Distal symmetric polyneuropathy increases fall risk due to inability to cope with perturbations. We aimed to 1) identify the frontal plane lower limb sensorimotor functions which are necessary for robustness to a discrete, underfoot perturbation during gait; and 2) determine whether changes in the post-perturbed step parameters could distinguish between fallers and non fallers.
METHODS: Forty-two subjects (16 healthy old and 26 with diabetic PN) participated. Frontal plane lower limb sensorimotor functions were determined using established laboratory-based techniques. The subjects' most extreme alterations in step width or step length in response to a perturbation were measured. In addition, falls and fall-related injuries were prospectively recorded.
RESULTS: Ankle proprioceptive threshold (APrT; p=.025) and hip abduction rate of torque generation (RTG; p=.041) independently predicted extreme step length after medial perturbation, with precise APrT and greater hip RTG allowing maintenance of step length. Injured subjects demonstrated greater extreme step length changes after medial perturbation than non-injured subjects (percent change = 18.5 ± 9.2 vs. 11.3 ± 4.57; p = .01).
CONCLUSIONS: The ability to rapidly generate frontal plane hip strength and/or precisely perceive motion at the ankle is needed to maintain a normal step length after perturbation, a parameter which distinguishes between subjects sustaining a fall-related injury and those who did not.
Authors:
Lara Allet; Hogene Kim; James Ashton-Miller; Trina De Mott; James K Richardson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-31
Journal Detail:
Title:  Journal of diabetes and its complications     Volume:  -     ISSN:  1873-460X     ISO Abbreviation:  J. Diabetes Complicat.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-11-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204583     Medline TA:  J Diabetes Complications     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013.
Affiliation:
Department of Physiotherapy, University of Applied Sciences of Western Switzerland, Geneva, Switzerland; Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA; Health Care Directorate, University Hospitals and University of Geneva, Geneva, Switzerland. Electronic address: lara.allet@hesge.ch.
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