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RISK OF FALLING IN ELDERLY PEOPLE: BIOMECHANICAL ASSESSMENT AND CLINICAL CORRELATIONS OF “ONE STEP NEGOTIATION”



Abstract

Aims: The aim of this study was to detect alterations in the motor pattern of elderly subjects while climbing a single step (“one step negotiation”) that may be correlated to motor disability and possibly the risk of falling.

Methods: We tested a sample of 41 elderly subjects with a mean age of 72.4 years (DS 4.87; range 65–86). The control group consisted of 18 young subjects with a mean age of 26.5 years (DS 2.12; range 24–33). In the population of both elderly and young subjects a functional test of the motor task of climbing a single step was carried out by a multifactorial analytical approach through the acquisition of kinematic, dynamic, and electromyographic variables. The elderly population was characterized clinically and functionally by assessing questionnaires including information about rate of coexisting diseases, disability, depression, motor and muscular function.

Results: Despite the high level of motor ability measured clinically, biomechanical analysis enabled us to demonstrate precise changes in step-climbing strategy in the elderly: a slowing down of the task and an increase in the double stance phase, increased anterior flexion of the trunk, increased flexion of the hip and reduced dorsal flexion of the ankle, as well as marked anomalies in muscle activation compared to controls.

Conclusions: The experimental set up and methodology used allowed us to make kinesiological aspects of “one step negotiation” task objective in the elderly. The results of this study provide useful indication for setting up an improvement program of motor ability in the elderly and prevent falls.

The abstracts were prepared by Ms Grazia Gliozzi. Correspondence should be addressed to her at the Italian Orthopaedic Research Society, Laboratory for Pathophysiology, Instituti Ortopedici Rizzoli, University of Bologna, Bologna, Italy.