A systematic review of gait perturbation paradigms for improving reactive stepping responses and falls risk among healthy older adults.

Journal article


McCrum, C, Gerards, MHG, Karamanidis, K, Zijlstra, W and Meijer, K (2017). A systematic review of gait perturbation paradigms for improving reactive stepping responses and falls risk among healthy older adults. European Review of Aging and Physical Activity. 14, p. 3. https://doi.org/10.1186/s11556-017-0173-7
AuthorsMcCrum, C, Gerards, MHG, Karamanidis, K, Zijlstra, W and Meijer, K
Abstract

BACKGROUND: Falls are a leading cause of injury among older adults and most often occur during walking. While strength and balance training moderately improve falls risk, training reactive recovery responses following sudden perturbations during walking may be more task-specific for falls prevention. The aim of this review was to determine the variety, characteristics and effectiveness of gait perturbation paradigms that have been used for improving reactive recovery responses during walking and reducing falls among healthy older adults. METHODS: A systematic search was conducted in PubMed, Web of Science, MEDLINE and CINAHL databases in December 2015, repeated in May 2016, using sets of terms relating to gait, perturbations, adaptation and training, and ageing. Inclusion criteria: studies were conducted with healthy participants of 60 years or older; repeated, unpredictable, mechanical perturbations were applied during walking; and reactive recovery responses to gait perturbations or the incidence of laboratory or daily life falls were recorded. Results were narratively synthesised. The risk of bias for each study (PEDro Scale) and the levels of evidence for each perturbation type were determined. RESULTS: In the nine studies that met the inclusion criteria, moveable floor platforms, ground surface compliance changes, or treadmill belt accelerations or decelerations were used to perturb the gait of older adults. Eight studies used a single session of perturbations, with two studies using multiple sessions. Eight of the studies reported improvement in the reactive recovery response to the perturbations. Four studies reported a reduction in the percentage of laboratory falls from the pre- to post-perturbation experience measurement and two studies reported a reduction in daily life falls. As well as the range of perturbation types, the magnitude and frequency of the perturbations varied between the studies. CONCLUSIONS: To date, a range of perturbation paradigms have been used successfully to perturb older adults' gait and stimulate reactive response adaptations. Variation also exists in the number and magnitudes of applied perturbations. Future research should examine the effects of perturbation type, magnitude and number on the extent and retention of the reactive recovery response adaptations, as well as on falls, over longer time periods among older adults.

KeywordsAdaptation; Aged; Ageing; Biomechanics; Falls; Locomotion; Motor learning; Postural balance; Rehabilitation; Systematic review; 1106 Human Movement And Sports Science; 1117 Public Health And Health Services; Gerontology
Year2017
JournalEuropean Review of Aging and Physical Activity
Journal citation14, p. 3
PublisherSpringer
ISSN1813-7253
Digital Object Identifier (DOI)https://doi.org/10.1186/s11556-017-0173-7
Publication dates
Print02 Mar 2017
Publication process dates
Deposited30 May 2017
Accepted27 Feb 2017
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Open
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McCrum, C, Epro, G, Meijer, K, Zijlstra, W, Brüggemann, G-P and Karamanidis, K (2016). Locomotor stability and adaptation during perturbed walking across the adult female lifespan. Journal of Biomechanics. 49 (7), pp. 1244-1247. https://doi.org/10.1016/j.jbiomech.2016.02.051
Use of a Lucas-Kanade-Based Template Tracking Algorithm to Examine In Vivo Tendon Excursion during Voluntary Contraction Using Ultrasonography.
Karamanidis, K, Travlou, A, Krauss, P and Jaekel, U (2016). Use of a Lucas-Kanade-Based Template Tracking Algorithm to Examine In Vivo Tendon Excursion during Voluntary Contraction Using Ultrasonography. Ultrasound in Medicine and Biology. 42 (7), pp. 1689-1700. https://doi.org/10.1016/j.ultrasmedbio.2016.02.019
Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy.
Eysel-Gosepath, K, McCrum, C, Epro, G, Brüggemann, G-P and Karamanidis, K (2016). Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy. Somatosensory and Motor Research. 33 (2), pp. 72-78. https://doi.org/10.1080/08990220.2016.1178635
Matching participants for triceps surae mechanical properties eliminates age-related differences in drop jump performance
Koenig, M, Hemmers, S, McCrum, C, Epro, G, Ackermans, TMA, Hartmann, U and Karamanidis, K (2016). Matching participants for triceps surae mechanical properties eliminates age-related differences in drop jump performance. 11th Joint Conference on Motor Control & Learning, Biomechanics & Training of the German Society of Sports Sciences. Darmstadt, Germany 28 - 30 Sep 2016
Aging and the effects of a half marathon on Achilles tendon force-elongation relationship.
Ackermans, TMA, Epro, G, McCrum, C, Oberländer, KD, Suhr, F, Drost, MR, Meijer, K and Karamanidis, K (2016). Aging and the effects of a half marathon on Achilles tendon force-elongation relationship. European Journal of Applied Physiology. 116 (11-12), pp. 2281-2292. https://doi.org/10.1007/s00421-016-3482-z
Age-related differences in drop jump performance are eliminated when triceps surae mechanical properties are matched
Koenig, M, Hemmers, S, McCrum, C, Epro, G, Ackermans, TMA, Hartmann, U and Karamanidis, K (2016). Age-related differences in drop jump performance are eliminated when triceps surae mechanical properties are matched. Dutch Society for Movement Sciences (VvBN) PhD Day 2016. Maastricht 09 - 09 Nov 2016
Effect of exercise-induced enhancement of the leg-extensor muscle-tendon unit capacities on ambulatory mechanics and knee osteoarthritis markers in the elderly.
Karamanidis, K, Oberländer, KD, Niehoff, A, Epro, G and Brüggemann, G-P (2014). Effect of exercise-induced enhancement of the leg-extensor muscle-tendon unit capacities on ambulatory mechanics and knee osteoarthritis markers in the elderly. PLoS ONE. 9 (6). https://doi.org/10.1371/journal.pone.0099330