Korean Journal of Applied Biomechanics (한국운동역학회지)

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

DOI QR Code

A Comparative Study on Biomechanical Variables of Elderly Women and Elderly Women at Risk of Fall in Gait by Environmental Conditions

환경조건에 따른 보행 시 낙상 위험 여성 노인과 정상 여성 노인의 생체역학적 변인 비교 연구

  • Kim, Tae-Whan (Department of Sport Science, Korea Institute of Sport Science) ;
  • Kim, Dae-Hyun (Department of Physical Education, Korea University) ;
  • Min, Seok-Ki (Department of Sport Science, Korea Institute of Sport Science) ;
  • Cho, Eun-Hyung (Department of Sport Science, Korea Institute of Sport Science) ;
  • Lee, Jin-Seok (Department of Sport Science, Korea Institute of Sport Science)
  • Received : 2021.08.13
  • Accepted : 2021.09.30
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study is to investigate the effect of biomechanical variables on gait according to indoor and outdoor environmental conditions in elderly women at risk of falling. Method: 26 elderly women aged 70 years or older, and consisted of 13 elderly people with a walking speed of less 1.0 m/s and 13 people in the fall risk group as normal groups. Depending on the purpose of the study, physical examination and psychological questionnaire were prepared, and then walking was performed in an indoor/outdoor environment, and the gait pattern, muscle activity, and plantar pressure results were compared and analyzed in the elderly females through a 2 group × 2 environment 2-way repeted ANOVA analysis. Results: The gait variable showed an interaction effect the cadence. The muscle variables showed interaction effects in the rectus femoris and tibialis anterior muscles, and the interaction effects of the plantar pressure variables were confirmed in the forefoot and midfoot of the contact area, and the midfoot of the mean pressure. Conclusion: These results indicate that both groups are exposed to falls risk when gait in an outdoor environment, but the fall risk group has a higher risk of falls in both the gait pattern, muscle activity, and plantar pressure variables. The results of this study are considered to be helpful as basic data and development of exercise programs to prevent falls.

Keywords

Acknowledgement

본 논문은 스포츠정책과학원의 기본과제 연구 일부 내용을 바탕으로 수정·보완하여 작성되었음.

References

  1. Alexander, N. B. (1996). Gait disorders in older adults. Journal of the American Geriatrics Society, 44(4), 434-451. https://doi.org/10.1111/j.1532-5415.1996.tb06417.x
  2. Bernardi, M., Rosponi, A., Castellano, V., Rodio, A., Traballesi, M., Delussu, A. S. & Marchetti, M. (2004). Determinants of sit-to-stand capability in the motor impaired elderly. Journal of Electromyography and Kinesiology, 14(3), 401-410. https://doi.org/10.1016/j.jelekin.2003.09.001
  3. Bosch, K., Nagel, A., Weigend, L. & Rosenbaum, D. (2009). From "first" to "last" steps in life-pressure patterns of three generations. Clinical Biomechanics, 24(8), 676-681. https://doi.org/10.1016/j.clinbiomech.2009.06.001
  4. Bradley, S. M. (2011). Falls in older adults. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 78(4), 590-595. https://doi.org/10.1002/msj.20280
  5. Cebolla, E. C., Rodacki, A. L. & Bento, P. C. (2015). Balance, gait, functionality and strength: comparison between elderly fallers and non-fallers. Brazilian Journal of Physical Therapy, 19(2), 164-151.
  6. Chang, J. T., Morton, S. C, Rubenstein, L. Z., Mojica, W. A., Maglione, M., Suttorp, M. J. ... & Shekelle, P. G. (2004). Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Bmj, 328(7441), 680. https://doi.org/10.1136/bmj.328.7441.680
  7. Chen, H. C., Ashton-Miller, J. A., Alexander, N. B. & Schultz, A. B. (1991). Stepping over obstacles: gait patterns of healthy young and old adults. Jurnal of Gerontology, 46(6), M196-M203.
  8. Chung, C. S., Yoon, T. J., Yu, Y. J. & Choi, C. S. (2004). Analysis of kinematics and EMG on stepping over obstacles in elderly persons. Korea Jurnal of Physical Education, 43, 423-436.
  9. Cromwell, R. L., Newton, R. A. & Forrest, G. (2002). Influence of vision on head stabilization strategies in older adults during walking. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(7), M442-M448.
  10. Eun, S. D. & Lee, K. K. (2004). The effect of the speed conditions of the gait pattern in treadmill walking of eldery persons. Korea Jurnal of Physical Education, 43, 397-404.
  11. Han, E., Cho, H., Mun, S., Yun, S. B. & Park. S. Y. (2020). Improvement of pedestrian Speed Criteria for the Pedestrian Green Interval at Silver Zone. The Journal of The Korea Institute of Intelligent Transport Systems, 19(4), 45-54. https://doi.org/10.12815/kits.2020.19.4.45
  12. Han, J. T. (2008). Analysis of gait characteristics during stairs and ramp ascent in elderly people. Daegu University Graduated a Doctor's degree.
  13. Hanawa, H., Kubota, K., Kokubun, T., Marumo, T., Hoshi, F., Kobayashi, A. & Kanemure, N. (2017). Muscle synergies underlying sit-to-stand tasks in elderly people and their relationship with kinetic characteristics. Journal of Electromyography and Kinesiology, 37, 15-20. https://doi.org/10.1016/j.jelekin.2017.08.004
  14. Hong, W. S. & Kim, G. W. (2002). Gait analysis of the healthy elderly over 65 years of age. Journal of Korean Physical Therapy, 14(4), 45-54.
  15. Jeon, H. M. & Park, S. K. (2015). Effects of Changes in Illumination Level and Slope on Fall-Related Biomechanical Risk Factors While Walking for Elderly Women. Korean Journal of Sport Biomechanics, 25(4), 413-421. https://doi.org/10.5103/KJSB.2015.25.4.413
  16. Jeon, K. K., Park, K. D., Park, S. H., Kang, Y. S. & Kim, D. G. (2009). Differences in angle of the lower extremities and electromyography of elderly women experienced a fall. Korean Journal of Sport Biomechanics, 19(2), 245-255. https://doi.org/10.5103/KJSB.2009.19.2.245
  17. Jung, K. H. (2013). Survey Overview and Main Results of the Survey on the Sutvey of the Elderly. Hallym Aging Society Research, 1, 1-22.
  18. Kang, K. H., Jeong, H. C. & Jeon, M. Y. (1999). A survey study on fall-related fracture in hospitalized elderly patient. Journal of Keukdong College, 251-264.
  19. Kemoun, G., Thoumie, P., Boisson, D. & Guieu, J. D. (2002). Ankle dorsiflexion delay can predict falls in the elderly. Journal of Rehabilitation Medicine, 34(6), 278-283. https://doi.org/10.1080/165019702760390374
  20. Kim, D. G. & Kang, H. J. (2017). An analysis on the Comparison of the Center of Pressure, Gait Angle, and Gait Time Between Female College Students and Elderly Women. The Official Journal of the Korean Academy of Kinesiology, 19(2), 61-67. https://doi.org/10.15758/jkak.2017.19.2.61
  21. Kim, J. M. & Lee, M. S. (2007). Risk factors for falls in the elderly population in Korea: An analysis of the third Korea national health and nutrition examination survey data. Korean Journal of Health Education and Promotion, 24(4), 23-39.
  22. Krasovsky, T., Lamontagne, A., Feldman, A. G. & Levin, M. F. (2014). Effects of walking speed on gait stability and interlimb coorsination in younger and older adults. Gait & Posture, 39(1), 378-385. https://doi.org/10.1016/j.gaitpost.2013.08.011
  23. Kwon, M. S., Kwon, Y. R., Park, Y. S. & Kim, J. W. (2018). Comparison of gait patterns in elderly fallrs and non-fallers. Technology and Health Care, 26(S1), 427-436. https://doi.org/10.3233/THC-174736
  24. Lee, J. Y. & Kim, T. H. (2018). Effects of Changes in the Indoor and Outdoor Environmental on the Walking Speed and Lower Extremity Musde Activities in People Age Forty and Older than Seventy Tears. Korean Society of Physical Medicine, 13(4), 139-148. https://doi.org/10.13066/kspm.2018.13.4.139
  25. Lexell, J., Taylor, C. C. & Sjostrom, M. (1988). What is the cause of the ageing atrophy?: Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15-to 83-year-old men. Journal of the Neurological Sciences, 84(2-3), 275-294. https://doi.org/10.1016/0022-510X(88)90132-3
  26. Maki, B. E. (1997). Gait changes in older adults: predictors of falls or indicators of fear?. Journal of the American Geriatirics Society, 45(3), 313-320. https://doi.org/10.1111/j.1532-5415.1997.tb00946.x
  27. Mecagni, C., Smith, J. P., Roberts, K. E. & O'Sullivan, S. B. (2000). Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study. Physical Therapy, 80(10), 1004-1011. https://doi.org/10.1093/ptj/80.10.1004
  28. Melzer, I., Kurz, I. & Oddsson, L. I. (2010). Aretrospective analysis of balance control parameters in elderly fallers and non-fallers. Clinical Biomechanics, 25(10), 984-988. https://doi.org/10.1016/j.clinbiomech.2010.07.007
  29. Menz, H. B., Lord, S. R. & Fizpatrick, R. C. (2007). A structural equation model relating impaired sensorimotor function, fear of falling and gait patterns in older people. Gait & Posture, 25(2), 243-249. https://doi.org/10.1016/j.gaitpost.2006.04.005
  30. Mills, P. M. & Barrett, R. S. (2001). Swing phase mechanics of healthy young and elderly men. Human Movement Science, 20(4-5), 427-446. https://doi.org/10.1016/S0167-9457(01)00061-6
  31. Mun, Y. H. (2005). The prevalence and associated factors of the inhome falls of the elderly. Journal of Korean Public Health Nursing, 19(2), 249-260.
  32. Nitz, J. C. & Choy, N. L. (2004). The efficacy of a specific balancestrategy training programme for preventing falls among older people: a pilot randomised controlled trial. Age and Ageing, 33(1), 52-58. https://doi.org/10.1093/ageing/afh029
  33. Olney, S. J. & Rocjards. C. (1996). Hemiparetic gait following stroke. Part 1: Characteristics. Gait & Posture, 4(2), 136-148. https://doi.org/10.1016/0966-6362(96)01063-6
  34. Pavol, M. J., Owings, T. M., Foley, K. T. & Grabiner, M. D. (2001). Mechanisms leading to a fall from an induced trip in healthy older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(7), M428-M437.
  35. Perry, J. & Davids, J. R. (1992). Gait analysis: normal and pathological function. Journal of Pediatiric Orthopaedics, 12(6), 815. https://doi.org/10.1097/01241398-199211000-00023
  36. Prange, G. B., Kallenberg, L. A. C., Jannink, M. J. A., Stienen, A. H. A, van der Kooij, H., Jzerman, M. J. & Hermens, H. J. (2009). Influence of gravity compensation on musde activity during reach and retrieval in healthy elderly. Journal of Electromyography and Kinesiology, 19(2), e40-e49.
  37. Prince, F., Corriveau, H., Hebert, R. & Winter, D. A. (1997). Gait in the elderly. Gait & Posture, 5(2), 128-135. https://doi.org/10.1016/S0966-6362(97)01118-1
  38. Rose, D. J. (2010). Fallproof!: a comprehensive balance and mobility training program. Hunman Kinetics.
  39. Ryu, J. S. (2019). Effects of Muscle Activation Pattern and Stability of the Lower Extremity;s Joint on Falls in the Elderly Walking-Half a Year Prospective Study. Korean Journal of Sport Biomechanics, 29(2), 79-88. https://doi.org/10.5103/KJSB.2019.29.2.79
  40. Samah, Z. A., Nordin, N. A. M., Shahar, S. & Singh, D. K. A. (2016). Can gait speed test be used as a falls risk screening tool in community dwelling older adults? A review. Polish Annals of Medicine, 23(1), 61-67. https://doi.org/10.1016/j.poamed.2015.04.007
  41. Schlicht, J., Camaione, D. N. & Owen, S. V. (2001). Effect of intense strength training on standing balance, walking speed, and sit-tostand performance in older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(5), M281-M286.
  42. Schmitz, A., Silder, A, Heiderscheit, B., Mahoney, J. & Thelen, D. G. (2009). Differences in lower-wxtremity muscular activation during walking between healthy older and young adults. Journal of Electromy-ography and Kinesiology, 19(6), 1085-1091. https://doi.org/10.1016/j.jelekin.2008.10.008
  43. Statistical Office. (2017). 2017 Senior Statistics.
  44. Statistical Office. (2020). 2020 Senior Statistics.
  45. Sung, S. C., Kang, C. G. & Lee, M. G. (2007). Effects of falling experience on physical fitness, isokinetic leg strength and balance in the elderly women. The Korean Journal of Physical Education, 46(3), 503-515.
  46. Unsworth, J. & Mode, A. (2003). Preventing falls in older people: risk factors and primary prevention through physical activity. British Journal of Community Nursing, 8(5), 214-220. https://doi.org/10.12968/bjcn.2003.8.5.11200
  47. Wright, R. L, Peters, D. M., Robinson, P. D., Watt, T. N. & Hollands, M. A. (2015). Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip. Gait & Posture, 41(1), 164-16. https://doi.org/10.1016/j.gaitpost.2014.09.025