Aging effect on successful reactive-recovery from unexpected slips: a 3D lower extremity joint moment analysis

The objective of the proposed study was to perform three-dimensional (3D) inverse dynamics analysis to determine lower extremity (ankle, knee and hip) joint moments on previously collected slip perturbation experimental data. In addition, the aging effect on the joint moment generation in both normal walking and reactive-recovery conditions was examined.

Dataset collected during previous slip and fall experiments, which were conducted in a typical gait analysis setting, were analyzed in current study. All the participants were subjected to the screening criteria, which defined the successful reactive-recovery (i.e. non-fall trials) based on slip distance, sliding heel velocity, whole body COM velocity, and motion pictures. Nine young and nine old healthy participants, who were identified possessing representative trials, were involved as participants in current study.

A local coordinate system was constructed on each joint and each segment of the lower extremity based on available landmarks using the Gram-Schmidt orthogonalization algorithm. 3D inverse dynamics was implemented to obtained lower extremity joint moments. Magnitude and timing of obtained joint moment patterns during stance phase were subjected to one and two-way analysis of covariance (ANCOVA) with walking velocity as covariate. The aging effect and gait condition effect were evaluated.

Increases in peak joint moment, peak joint power, and joint moment generation ratio were detected in successful reactive-recovery. Distinct age-related joint moment generation strategy was observed through findings of peak joint moment ratio and joint moment generation rate. The elderly, who were able to reactive recover, were found to be as rapid as their younger counterparts in terms of initiating and developing reactive joint moment.

It was concluded that ankle joint was critical in balance recovery while hip joint assumed the major responsibility of balance maintenance of upper body during successful reactive-recovery. Increased demand on muscle strength during balance recovery lead to the distinct joint moment generation strategy adopted by the elderly, and confirmed the necessity of lower extremity strength training. In addition, implementation of 3D joint moment analysis was justified in current study and was suggested in future slip and fall researches.