Skip to main content
SpringerLink
Log in

Two-dimensional dynamic walking stability of elderly females with a history of falls

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

Injuries related with falls are a major health risk for the elderly. Accurate evaluation of the dynamic walking stability of elderly people is the key to fall prevention. A two-dimensional (2-D) model is proposed in this study given that the custom method is mainly focused on the dynamic walking stability along the antero-posterior axis. An inverted pendulum model was utilised to calculate the region of stability at toe-off, and stability conditions were evaluated first along the antero-posterior and medio-lateral axes. The analysis was then extended to the 2-D plane. In the 2-D case, the region of stability was determined based on the use of the information of the envelope of the foot. Twenty-four female participants, categorised as healthy young, healthy elderly, and elderly with a history of falls, were examined. Significant differences among the three groups were demonstrated with the 2-D analysis method, but not in the antero-posterior or medio-lateral analyses. The centre-of-masses of elderly fallers were significantly closer to the foot-supporting boundary compared with that of healthy young and elderly adults at toe-off. A 2-D analysis method using the envelope-of-foot could evaluate the dynamic stability of elderly females based on a more accurate scale.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. World Health Organization (2008) WHO global report on falls prevention in older age. World Health Organization, Geneva, Switzerland

    Google Scholar 

  2. Chompoopan W, Chompoopan W, Eungpinichpong W, Eungpinichpong W (2019) Effects of low intensity exercises on body balance and muscle strength of community elderly people. GEOMATE 17(61):86–90. https://doi.org/10.21660/2019.61.4786

    Article  Google Scholar 

  3. Blake AJ, Morgan K, Bendall MJ, Dallosso H, Ebrahim SB, Arie TH, Fentem PH, Bassey EJ (1988) Falls by elderly people at home: prevalence and associated factors. Age Ageing 17:365–372. https://doi.org/10.1093/ageing/17.6.365

    Article  CAS  PubMed  Google Scholar 

  4. Dunlop DD, Manheim LM, Sohn MW, Liu X, Chang RW (2002) Incidence of functional limitation in older adults: the impact of gender, race, and chronic conditions. Arch Phys Med Rehabil 83:964–971. https://doi.org/10.1053/apmr.2002.32817

    Article  PubMed  Google Scholar 

  5. Meyer G, Ayalon M (2006) Biomechanical aspects of dynamic stability. Eur Rev Aging Phys Act 3:29–33. https://doi.org/10.1007/s11556-006-0006-6

    Article  Google Scholar 

  6. Winter DA (1995) ABC of balance during standing and walking. Waterloo Biomechanics, Waterloo, CA

    Google Scholar 

  7. Tesio L, Rota V (2019) The motion of body center of mass during walking: a review oriented to clinical applications. Front Neurol 10:999. https://doi.org/10.3389/fneur.2019.00999

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mehdizadeh S, Van Ooteghem K, Gulka H, Nabavi H, Faieghi M, Taati B, Iaboni A (2021) A systematic review of center of pressure measures to quantify gait changes in older adults. Exp Gerontol 143:111170. https://doi.org/10.1016/j.exger.2020.111170

    Article  PubMed  Google Scholar 

  9. Hamza MF, Ghazilla RAR, Muhammad BB, Yap HJ (2020) Balance and stability issues in lower extremity exoskeletons: a systematic review. Biocybern Biomed Eng 40:1666–1679. https://doi.org/10.1016/j.bbe.2020.09.004

    Article  Google Scholar 

  10. Duclos C, Desjardins P, Nadeau S, Delisle A, Gravel D, Brouwer B, Corriveau H (2009) Destabilizing and stabilizing forces to assess equilibrium during everyday activities. J Biomech 42:379–382. https://doi.org/10.1016/j.jbiomech.2008.11.007

    Article  CAS  PubMed  Google Scholar 

  11. Howcroft J, Lemaire ED, Kofman J, McIlroy WE (2018) Dual-task elderly gait of prospective fallers and non-fallers: a wearable-sensor based analysis. Sensors (Basel) 18:1275. https://doi.org/10.3390/s18041275

    Article  Google Scholar 

  12. Joshi D, Nakamura BH, Hahn ME (2016) A novel approach for toe off estimation during locomotion and transitions on ramps and level ground. IEEE J Biomed Health Inform 20:153–157. https://doi.org/10.1109/JBHI.2014.2377749

    Article  PubMed  Google Scholar 

  13. Xiang Y, Arora JS, Abdel-Malek K (2010) Physics-based modeling and simulation of human walking: a review of optimization-based and other approaches. Struct Multidisc Optim 42:1–23. https://doi.org/10.1007/s00158-010-0496-8

    Article  Google Scholar 

  14. Usherwood JR, Channon AJ, Myatt JP, Rankin JW, Hubel TY (2012) The human foot and heel–sole–toe walking strategy: a mechanism enabling an inverted pendular gait with low isometric muscle force? J R Soc Interface 9:2396–2402. https://doi.org/10.1098/rsif.2012.0179

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Pai YC, Wening JD, Runtz EF, Iqbal K, Pavol MJ (2003) Role of feedforward control of movement stability in reducing slip-related balance loss and falls among older adults. J Neurophysiol 90:755–762. https://doi.org/10.1152/jn.01118.2002

    Article  PubMed  Google Scholar 

  16. Pai YC, Bhatt TS (2007) Repeated-slip training: an emerging paradigm for prevention of slip-related falls among older adults. Phys Ther 87:1478–1491. https://doi.org/10.2522/ptj.20060326

    Article  PubMed  Google Scholar 

  17. Pai Y-C, Rogers MW, Patton J, Cain TD, Hanke TA (1998) Static versus dynamic predictions of protective stepping following waist–pull perturbations in young and older adults. J Biomech 31:1111–1118. https://doi.org/10.1016/S0021-9290(98)00124-9

    Article  CAS  PubMed  Google Scholar 

  18. Winter DA (2009) Biomechanics and motor control of human movement, 4th edn. Wiley, Hoboken, NJ

    Book  Google Scholar 

  19. McIlroy WE, Maki BE (1996) Age-related changes in compensatory stepping in response to unpredictable perturbations. J Gerontol A Biol Sci Med Sci 51:M289–M296. https://doi.org/10.1093/gerona/51A.6.M289

    Article  CAS  PubMed  Google Scholar 

  20. Hasson CJ, Van Emmerik REA, Caldwell GE (2008) Predicting dynamic postural instability using center of mass time-to-contact information. J Biomech 41:2121–2129. https://doi.org/10.1016/j.jbiomech.2008.04.031

    Article  PubMed  PubMed Central  Google Scholar 

  21. Carty CP, Mills P, Barrett R (2011) Recovery from forward loss of balance in young and older adults using the stepping strategy. Gait Posture 33:261–267. https://doi.org/10.1016/j.gaitpost.2010.11.017

    Article  PubMed  Google Scholar 

  22. De Jong LAF, van Dijsseldonk RB, Keijsers NLW, Groen BE (2020) Test–retest reliability of stability outcome measures during treadmill walking in patients with balance problems and healthy controls. Gait Posture 76:92–97. https://doi.org/10.1016/j.gaitpost.2019.10.033

    Article  PubMed  Google Scholar 

  23. Fujimoto M, Chou LS (2016) Sagittal plane momentum control during walking in elderly fallers. Gait Posture 45:121–126. https://doi.org/10.1016/j.gaitpost.2016.01.009

    Article  PubMed  Google Scholar 

  24. Caderby T, Begue J, Peyrot N, Dalleau G (2019) Effect of speed on mediolateral dynamic stability during stepping in older adults. Comput Methods Biomech Biomed Eng 22:S474–S475. https://doi.org/10.1080/10255842.2020.1714986

    Article  Google Scholar 

  25. Rosenblatt NJ, Grabiner MD (2010) Measures of frontal plane stability during treadmill and overground walking. Gait Posture 31:380–384. https://doi.org/10.1016/j.gaitpost.2010.01.002

    Article  PubMed  Google Scholar 

  26. Nakano W, Fukaya T, Kanai Y, Akizuki K, Ohashi Y (2015) Effects of temporal constraints on medio-lateral stability when negotiating obstacles. Gait Posture 42:158–164. https://doi.org/10.1016/j.gaitpost.2015.05.004

    Article  PubMed  Google Scholar 

  27. Hof AL (2008) The ‘extrapolated center of mass’ concept suggests a simple control of balance in walking. Hum Mov Sci 27:112–125. https://doi.org/10.1016/j.humov.2007.08.003

    Article  PubMed  Google Scholar 

  28. Coleman TD, Lawrence HJ, Childers WL (2016) Standardizing methodology for research with uneven terrains focused on dynamic balance during gait. J Appl Biomech 32:599–602. https://doi.org/10.1123/jab.2016-0014

    Article  PubMed  Google Scholar 

  29. Bauby CE, Kuo AD (2000) Active control of lateral balance in human walking. J Biomech 33:1433–1440. https://doi.org/10.1016/s0021-9290(00)00101-9

    Article  CAS  PubMed  Google Scholar 

  30. Gao X, Wang L, Shen F, Ma Y, Fan Y, Niu H (2019) Dynamic walking stability of elderly people with various BMIs. Gait Posture 68:168–173. https://doi.org/10.1016/j.gaitpost.2018.11.027

    Article  PubMed  Google Scholar 

  31. O’Connor CM, Thorpe SK, O’Malley MJ, Vaughan CL (2007) Automatic detection of gait events using kinematic data. Gait Posture 25:469–474. https://doi.org/10.1016/j.gaitpost.2006.05.016

    Article  PubMed  Google Scholar 

  32. Woltring HJ (1986) A Fortran package for generalized, cross-validatory spline smoothing and differentiation. Adv Eng Softw 8:104–113. https://doi.org/10.1016/0141-1195(86)90098-7

    Article  Google Scholar 

  33. Giakas G, Baltzopoulos V (1997) A comparison of automatic filtering techniques applied to biomechanical walking data. J Biomech 30:847–850. https://doi.org/10.1016/S0021-9290(97)00042-0

    Article  CAS  PubMed  Google Scholar 

  34. Sjölander P, Michaelson P, Jaric S, Djupsjöbacka M (2008) Sensorimotor disturbances in chronic neck pain—range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther 13:122–131. https://doi.org/10.1016/j.math.2006.10.002

    Article  PubMed  Google Scholar 

  35. Ghoussayni S, Stevens C, Durham S, Ewins D (2004) Assessment and validation of a simple automated method for the detection of gait events and intervals. Gait Posture 20:266–272. https://doi.org/10.1016/j.gaitpost.2003.10.001

    Article  PubMed  Google Scholar 

  36. Tang Y, Li Z, Tian H, Ding J, Lin B (2019) Detecting toe-off events utilizing a vision-based method. Entropy (Basel) 21:329. https://doi.org/10.3390/e21040329

    Article  Google Scholar 

  37. Hof AL, Gazendam MGJ, Sinke WE (2005) The condition for dynamic stability. J Biomech 38:1–8. https://doi.org/10.1016/j.jbiomech.2004.03.025

    Article  CAS  PubMed  Google Scholar 

  38. Hahn ME, Chou LS (2004) Age-related reduction in sagittal plane center of mass motion during obstacle crossing. J Biomech 37:837–844. https://doi.org/10.1016/j.jbiomech.2003.11.010

    Article  PubMed  Google Scholar 

  39. Lee H-J, Chou L-S (2006) Detection of gait instability using the center of mass and center of pressure inclination angles. Arch Phys Med Rehabil 87:569–575. https://doi.org/10.1016/j.apmr.2005.11.033

    Article  PubMed  Google Scholar 

  40. Lugade V, Lin V, Chou LS (2011) Center of mass and base of support interaction during gait. Gait Posture 33:406–411. https://doi.org/10.1016/j.gaitpost.2010.12.013

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Natural Science Foundation of China (No. 11772037), Key R&D projects in Shanxi Province (No. 201903D321167), the National Key R&D Programme of China (No. 2018YFC2001400), and Beijing Academy of Science and Technology Budding Project (No. BGS201913).

Author information

Authors and Affiliations

  1. Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Haidian District, No. 37, Xueyuan Road, Beijing, 100191, China

    Xing GAO, Fei SHEN, Li WANG, Yingnan MA, Haijun NIU & Yubo FAN

  2. Beijing Research Center of Urban System Engineering, Beijing, 100035, China

    Xing GAO, Li WANG & Yingnan MA

Authors
  1. Xing GAO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fei SHEN
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li WANG
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yingnan MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haijun NIU
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yubo FAN
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haijun NIU.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Xing GAO and Fei SHEN are authors contributed to the work equally and should be regarded as co-first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

GAO, X., SHEN, F., WANG, L. et al. Two-dimensional dynamic walking stability of elderly females with a history of falls. Med Biol Eng Comput 59, 1575–1583 (2021). https://doi.org/10.1007/s11517-021-02410-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-021-02410-1

Keywords

Search

Navigation