Korean Journal of Applied Biomechanics (한국운동역학회지)

Korean Society of Applied Biomechanics (한국운동역학회)
권호 표지
DOI QR코드

DOI QR Code

Lower Extremities' Joint Stability during the Elderly Woman's Walking

  • Ryu, Ji-Seon (Motion Innovation Center, Korea National Sport University)
  • Received : 2017.01.23
  • Accepted : 2017.03.02
  • Published : 2017.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study was to investigate the periodicity of the lower extremity joint flexion/extension angle to compare the local stability between young and elderly women during walking on a treadmill. Method: Eighteen young women (mean $age=21.2{\pm}1.6y$; mean $mass=57.1{\pm}6.1kg$; mean $height=1.61{\pm}0.04m$) and 18 elderly women (mean $age=66.4{\pm}1.2y$; mean $mass=55.4{\pm}8.3kg$; mean $height=1.56{\pm}0.04m$) participated in this study. Approximate entropy (ApEn) was used to determine the periodicity in the lower limb joint angles. Results: The ApEn values of the two groups were statistically greater in the surrogate data test than in the original time series data (p<.05). The periodicity of the hip and ankle flexion/extension angles decreased in the elderly women group compared with the young women group (p<.05). The periodicity of the lower extremity joint flexion/extension angle showed that the ankle joint increased dominatingly in both groups (p<.05); the hip joint decreased compared with the knee joint in the young women group; and the knee joint decreased compared with the hip joint in the elderly women group (p<.05). Conclusion: These results suggest that the lower extremity joint flexion/extension angles of the young and elderly women during walking contained random noises as well as biological signals. In addition, the differences in the periodicity in the lower extremity joint between the young and elderly women may provide some insight in predicting potential falls and be used as a characteristic indicator for determining local stability in elderly women during walking.

Keywords

References

  1. American geriatrics S, British Geriatrics S. (2001). American academy of orthopaedic surgeons panel on falls guideline for the prevention of falls in older person. Journal of American Geriatrics Society, 49, 664-672. https://doi.org/10.1046/j.1532-5415.2001.49115.x
  2. Bartlett, R., Wheat, J. & Robins, M. (2007). Is movement variability important for sports biomechanics? Sports Biomechanics, 6, 224-243. https://doi.org/10.1080/14763140701322994
  3. Benjuy, N., Melze, I. & Kaplanski, J. (2004). Aging-induced shifts from a reliance on sensory input to muscle co-contraction during balanced standing. Journals of Gerontology Series A., Biological Sciences and Medical Sciences, 59(2), 166-171. https://doi.org/10.1093/gerona/59.2.M166
  4. Bergland, A., Jarnlo, G. B. & Laake, K. (2003). Predictor of falls in the elderly by location. Aging Clinical and Experimental Research, 15, 43-50. https://doi.org/10.1007/BF03324479
  5. Berry, S. D. & Miller, R. R. (2008). Falls: Epidemiology, pathophysiology, and relationship to fracture. Current Osteoporosis Reports, 6(4), 149-154. https://doi.org/10.1007/s11914-008-0026-4
  6. Buchner, D. M., Cress, M. E., de Lateur, B. J., Esselman, P. C., Margherita, A. J., Price, R. & Wagner, E. H. (1997). The effects of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. Journal of Gerontology, 52(4), 218-224.
  7. Campbell, A. J. & Robertson, M. (1999). Falls prevention over 2 years: A randomized controlled trial in woman 80 yrs and older. Age & Ageing, 28, 513-518. https://doi.org/10.1093/ageing/28.6.513
  8. Carter, N. D., Khan, K. M., Petit, M. A., Heinonen, A., Waterman, C., Donaldson, M. G., Janssen, P. A., Mallinson, A., Riddell, L., Kruse, K., Prior, J. C. & McKay, H. A. (2001). Results of a 10week community based strength and balance training program to reduce fall risk factors: a randomized controlled trial in 65-75 year old women with osteoporosis. British Journal of Sports Medicine, 35, 1-3. https://doi.org/10.1136/bjsm.35.1.1
  9. Casteel, C., Peek-Asa, C., Lacsamana, C., Vazquez, L. & Kraus, J. F. (2004). Evaluation of a falls prevention program for independent elderly. American Journal of Health Behavior, 28(1), 51-60.
  10. Collins, J. J. & De Luca, C. J. (1993). Open-loop and closed-loop control of posture -a random walk analysis of center of pressure trajectories. Experimental Brain Research, 95, 308-318. https://doi.org/10.1007/BF00229788
  11. Collins, J. J. & De Luca, C. J. (1995). The effects of visual input on openloop and closed-loop postural control mechanisms. Experimental Brain Research, 103(1), 151-163. https://doi.org/10.1007/BF00241972
  12. Curry, L. C. & Hogstel, M. O. (2002). Nursing assessment and intervention: Preventing fall-related injuries in long-term care facilities. Annals of Long-term Care, 10, 29-35.
  13. Dingwell, J. B., Cusumano, J. P., Sternad, D. & Cavanagh, P. R. (2000). Slower speeds in patients with diabetic neuropath lead to improved local dynamics stability of continuous overground walking. Journal of Biomechanics, 3, 1269-1277.
  14. Ferine, G. R., Gryfe, C. I., Holiday, P. J. & Liewellyn, A. (1982). The relationship of postural sway in standing to the incidence of falls in geriatric subjects. Age and Aging, 11(1), 11-16. https://doi.org/10.1093/ageing/11.1.11
  15. Hahn, M. E. & Chou, L. S. (2003). Can motion of individual body segments identify dynamic instability in the elderly? Clinical Biomechanics, 18, 737-744. https://doi.org/10.1016/S0268-0033(03)00139-6
  16. Hamill, J. & Ryu, J. (2003). Experiment in sport biomechanics. Daehanmedia, 111-121.
  17. Hausdorff, J. M., Forman, D. E., Ladin, Z., Goldberger, A. L., Gigney, D. R. & Wei, J. Y. (1994). Increased walking variability in elderly persons with coggestive heart failure. Journal of American Geriatrics Society, 42, 1056-1061. https://doi.org/10.1111/j.1532-5415.1994.tb06209.x
  18. Hausdorff, J., Mitchell, S., Firtion, R., Peng, C., Cudkowicz, M. & Wei, J. (1997). Altered fractal dynamics of gait: reduced stride-interval correlations with aging and huntington's disease. Journal of Applied Physiology, 82, 262-269. https://doi.org/10.1152/jappl.1997.82.1.262
  19. Hausdorff, J. M., Mitchell, S. L., Goldberger, A. L. & Wei, J. Y. (1997). Increased gait unsteadiness in community-dwelling elderly fallers. Archives Physical Medicine Rehabilitation, 78, 278-283. https://doi.org/10.1016/S0003-9993(97)90034-4
  20. Hausdorff, J., Rios, D. & Edelberg, H. (2001). Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives Physical Medicine Rehabilitation, 82, 1050-1056. https://doi.org/10.1053/apmr.2001.24893
  21. Health (2017). Chosun daily newspaper health section D1, Jan 11.
  22. Holt, K. G., Jeng, S. F., Ratcliffe, R. & Hamill, J. (1995). Energetic cost and stability during human walking at the preferred stride frequency. Journal of Motor Behavior, 27(2), 164-178. https://doi.org/10.1080/00222895.1995.9941708
  23. Newsmp(2017). http://www.newsmp.com/news/articleview.html?idxno=164205
  24. Hughes, V. A., Frontera, W. R., Wood, M., Evans, W. J., Dakkak, G. E., Roubenoff, R. & Fiatarone Singh, M. A. (2001). Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity and health. Journals of Gerontology Series A., Biological Sciences and Medical Sciences, 56, B209-B217. https://doi.org/10.1093/gerona/56.5.B209
  25. Jeon, M. Y., Jeong, H. C. & Choe, M. A. (2001). A study on the elderly patients hospitalized by the fracture from the fall. Korean Academy of Nursing, 31(3), 443-453. https://doi.org/10.4040/jkan.2001.31.3.443
  26. Johnell, O. & Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis International, 17, 1726-1733. https://doi.org/10.1007/s00198-006-0172-4
  27. Judge, J. O., Linsay, C., Underwood, M. & Winseminus, D. (1993). Balance improvements in older woman: Effects of exercise training. Physical Therapy, 73(4), 254-265. https://doi.org/10.1093/ptj/73.4.254
  28. Kauffman, T. L. (1999). Geriatric rehabilitation Manual. Philadelphia, Churchill Livingstone.
  29. Kesher, E. A. Allum, A. H. & Honegger, F. (1993). Predictors of Less Stable Postural Responses to Support Surface Rotations in Healthy Human Elderly. Journal of Vestibular Research, 3, pp.419-429.
  30. Kim, C. K. (2003). An analysis of fall incidence rate and the related factors of fall in hospitalized patients, Seoul National University, Graduate School, Nursing, Thesis.
  31. Laughton, C. A., Slavin, M., Katdare, K., Nolan, L., Bean, J. F., Kerrigan, D. C., Phillips, E., Lipsitz, L. A. & Collins, J. J. (2003). Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait & Posture, 18(2), 101-108. https://doi.org/10.1016/S0966-6362(02)00200-X
  32. Lord, S. R., Caplan, G. A. & Ward, J. A. (1993). Balance, reaction time, and muscle strength in exercising and non-exercising older woman: A pilot study. Archives of Physical Medicine and Rehabilitations, 74(8), 837-839. https://doi.org/10.1016/0003-9993(93)90010-8
  33. Maki, B. E. (1997). Gait changes in older adults: predictors of falls or indicators of fear? Journal of the American Geriatric Society, 45, 313-320. https://doi.org/10.1111/j.1532-5415.1997.tb00946.x
  34. Melzer, I. & Oddsson, L. I. (2004). The effect of a cognitive task on voluntary step execution in healthy elderly and young individuals. Journal of the American Geriatric Society, 52(8), 1255-1262. https://doi.org/10.1111/j.1532-5415.2004.52353.x
  35. Maki, B. E., Holliday, P. J. & Topper, A. K. (1998). A prospective study of postural balance and risk of falling in an ambulatory and independent dlderly population. Journal of Gerontology, 49, 72-84.
  36. Mariano, C. (2008). A 16-week tai chi program prevented falls in healthy older adults. Evidence Based Nursing, 11(2), 60. https://doi.org/10.1136/ebn.11.2.60
  37. Melzer, I., Kurz, I. & Oddsson, L. I. E. (2010) A retrospective analysis of balance control parameters in elderly fallers and non-fallers. Clinical Biomechanics, 25, 984-988. https://doi.org/10.1016/j.clinbiomech.2010.07.007
  38. Moore, J. B., Korff, T. & Kinzey, S. J. (2005). Acute effects of a single bout of resistance exercise on postural control in elderly persons. Perceptual and Motor Skills, 100, 725-733. https://doi.org/10.2466/pms.100.3.725-733
  39. Nakamura, T., Meguro, K. & Sasaki, H. (1996). Relationship between falls and stride length variability in senile dementia of the Alzheimer type. Journal of Gerontology, 42, 108-113. https://doi.org/10.1159/000213780
  40. Newell, K. M., Deutsch, K. M., Sosnoff, J. J. & Mayer-Kresss, G. (2006). Variability in motor output as noise : A default and erroneous proposition?, Movement system variability (pp.3-23). Champaign, IL: Human Kinetics.
  41. O'Brien, K. Culbam, E. & Pickles, B. (1997). Balance and Skeletal Alignment in a Group of Elderly Female Fallers and Non-fallers. Journal of Gerontology, 52, pp.221-226.
  42. Owings, T. M., Pavol, M. J., Foley, K. T. & Grabiner, M. D. (2000). Measures of postural stability are not predictors of recovery from large postual disturbances in healthy older adults. Journal of the American Geriatric Society, 48, 42-50. https://doi.org/10.1111/j.1532-5415.2000.tb03027.x
  43. Papadakis, N. C., Christstakis, D. G., Tzagarakis, G. N., Chlouverakis, G. I., Kampanis, N. A. & Stergiopoulos, K. N. (2009). Gait variability measuremrnts in lumbar spinal stenosis patients. Physiological Measurement, 1171.
  44. Park, J. S., Choi, E. Y. & Hwang, T. Y. (2002). The effects of strengthening leg muscular strength on the elderly's walking and balance ability. Journal of Korean Society of Physical Therapy, 14(2), 71-79.
  45. Persch, L. N., Ugrinowitsch, C., Pereira, G. & Rodacki, A. L. F. (2009). Strength training improves fall-related gait kinematics in the elderly: A randomized controlled trial. Clinical Biomechanics, 24, 819-825. https://doi.org/10.1016/j.clinbiomech.2009.07.012
  46. Piirtola, M. & Era, P. (2006). Force platform measurements as predictors of falls among older people. A Review. Gerontology, 52(1), 1-16. https://doi.org/10.1159/000089820
  47. Preatoni, E., Ferrario, M., Dona, G., Hamill, J. & Rodano, R. (2010). Motor variability in sports: A non-linear analysis of race walking. Journal of Sports Science, 28(12), 1327-1336. https://doi.org/10.1080/02640414.2010.507250
  48. Preatoni, E., Hamill, J., Harrison, A. J., Hayes, K., Emmerik, V. R., Wilson, C. & Rodano, R. (2014). Movement variability and skills monitoring in sports. Sports Biomechanics, 12(2), 69-92. https://doi.org/10.1080/14763141.2012.738700
  49. Riley, M. A. & Turvey, M. T. (2002). Variability of determinism in motor behavior. Journal of Motor Behavior, 34, 99-125. https://doi.org/10.1080/00222890209601934
  50. Rose, J. & Gable, J. G. (2006). Human walking. Williams & Wilkins, Baltimore.
  51. Ryu, J. S. (2008). Dynamic stability analysis of patients with degenerative osteoarthritis during walking. Korean Journal of Sport Biomechanics, 18(1), 12-30.
  52. Ryu, J. S. (2016). Effects of Prolonged Running-Induced Fatigue on Periodicity of Shank-Foot Segment Coupling and Free Torque. Korean Journal of Sport Biomechanics, 26(3), 257-264. https://doi.org/10.5103/KJSB.2016.26.3.257
  53. Rubenstein, L., Josephson, K. & Trueblood, P. (2000). Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. Journal of Gerontology: Medical Science, 55(6), M317-M321. https://doi.org/10.1093/gerona/55.6.M317
  54. Schonfelder, D. P. (2000). A fall prevention program for elderly individual: exercise in long term case setting. Journal of Gerontological Nursing, 126(3), 43-51.
  55. Schoenfelder, D. P. & Rubenstein, L. M. (2004). An exercise program to improve fall-related outcomes in elderly nursing home residents. Applied Nursing Research, 17(1), 21-31. https://doi.org/10.1016/j.apnr.2003.10.008
  56. Shimada, H., Obuchi, S., Kamide, N., Shiba, Y., Okamoto, M. & Kakurai, S. (2003). Relationship with dynamic balance function during standing and walking. American Journal of Physical and Medicine Rehabilitation, 83(7), 511-516.
  57. Song, K. A., Mun, J. S., Kang, S. S. & Choi, J. H. (2001). The Survey of Activities and Fear of Falling in the Community Dwelling Elderly. Journal of Korean Public Health Nursing, 15(2), 324-333.
  58. Statics Korea, Korean statical information service; http://www.kosis.kr, 2014, 2016.
  59. Stel, V. S., Smit, J. H., Pluijm, S. M. & Lips, P. (2003). Balance and mobility performance as treatable risk factors for recurrent falling in older persons. Journal of Clinical Epidemiology, 56, 659-668. https://doi.org/10.1016/S0895-4356(03)00082-9
  60. Stergiou, N. (2004). Innovative analyses of human movement-analytical tools for human movement. Human Kinetics.
  61. Theiler, J., Eubank, S., Longtin, A., Galdrikian, B. & Farmer, D. (1992). Testing for nonlinearity in time series: the method of surrogate data. Physica D58, 77-94.
  62. Tinetti, M. E., Speechley, M. & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701-1707. https://doi.org/10.1056/NEJM198812293192604
  63. Verghese, J., Holtzer, R., Lipton, R. B. & Wang, C. (2009). Quantitative gait markers and incident fall risk in older adults. Journals of Gerontology Series A., Biological Sciences and Medical Sciences, 64A, 896-901. https://doi.org/10.1093/gerona/glp033
  64. Winter, D. A. (1983). Biomechanical motor patterns in normal walking. Journal of Motor Behavior, 15(4), 302-330. https://doi.org/10.1080/00222895.1983.10735302
  65. Wolfson, L., Judge, J. & Whipple, R. (1995). Strengthening is a Major Factor in Balance, Gait and the Occurrence of Falls. Journal of Gerontology, 50, pp.64-67.
  66. Yi, J. H. & Ryu, J. S. (2011). Biomechanical alternation of the elderly depending on the type of gait termination. Korean Journal of Sport Biomechanics, 21(2), 189-196. https://doi.org/10.5103/KJSB.2011.21.2.189