DECREASED DIVERGENCE OF THE TRUNK MOVEMENT TRAJECTORIES DURING
TREADMILL WALKING IS NOT RELATED TO TRUNK FLEXION OF YOUNG SUBJECTS
FOLLOWING TREADMILL-DELIVERED DISTURBANCES MIMICING A TRIP
Simisola O. Oludare1, Nicholas Stergiou2, Mark D. Grabiner1
1. University of Illinois at Chicago, Chicago, Illinois, USA
2. University of Nebraska at Omaha, Omaha, Nebraska, USA
email: soluda2@uic.edu
INTRODUCTION
Trips are a major cause of falls by older adults
during walking [1]. Trunk kinematics at recovery
step completion following a laboratory-induced trip
and following a treadmill-delivered disturbance that
mimics a trip discriminates those who fall from
those who do not fall following the disturbances [2].
Given their ability to discriminate falls from
recoveries in this manner and the demonstrable
responsiveness to specific, targeted training, trunk
kinematics following a trip appear to qualify as a
biomarker for trip-related falls.
Measures of divergence of the trunk movement
trajectories during walking have been suggested as
estimators of all-cause fall risk of older adults
[3,4,5]. These measures, have been associated with
retrospectively determined all-cause falls by older
adults [6,7] and prospectively determined time to
first all-cause fall by older adults [8].
In this study we determined if the movement
trajectory of the trunk, measured as the largest
Lyapunov exponent (LyE) during unperturbed
treadmill walking, could estimate trunk kinematics
following increasingly challenging treadmill-
delivered disturbances that mimic a trip which
discriminate between fallers and non-fallers [2].
LyE reflects the continuous response of a system to
disturbances. We expected the largest LyE exponent
in the sagittal plane during unperturbed treadmill
walking to be positively and significantly correlated
to trunk flexion following increasingly challenging
treadmill-delivered disturbances that mimic a trip.
METHODS
Following informed consent, eight healthy young
adults (6 females, 23.1±2.5 years old, 165.4±10.7
42nd Annual Meeting of the American Society of Biomechanics, Rochester, MN, USA, August 8th – 11th, 2018
cm, and 60.9±14.1 kg) walked on a microprocessor
controlled treadmill for 10 minutes at 2.5 mph
before being subjected to eight randomized
disturbances from a static upright posture. The
disturbance magnitudes reflected treadmill belt
motion, under constant acceleration of 14 ms-2 to
peak velocities of 0.84 m/s, 1.12 m/s, 1.4 m/s, 1.68
m/s, 1.96 m/s, 2.24 m/s, 2.52 m/s and 2.8 m/s.
An eight camera motion capture system operating at
120 Hz tracked the motions of reflective markers
placed beneath the left scapula, over the shoe at the
heel and 2nd metatarsal phalangeal joints (MTPJ),
the acromion processes, the anterior superior iliac
spines and on the sacrum at S2.
The time series of the sagittal plane movement
trajectory of the trunk, represented by the scapula
marker, was used to calculate the largest LyE via
the Wolf et al’s algorithm and the methods of time
delay to reconstruct the state space. Briefly, the
state space was constructed by determining the
appropriate time delay and embedding dimension
via the average mutual information method and the
far nearest neighbors methods, respectively [9,10].
Following the state space reconstruction, Wolf et
al’s algorithm was implemented to compute the
divergence of the sagittal plane trajectories in state
space. The maximum divergence was determined to
be the largest LyE [10] based on 150 consecutive
steps.
The recovery response to each perturbation was
characterized as the trunk angle at the instant of
recovery step completion. Recovery step
completion was determined from the markers on the
shoe. The trunk angle was calculated using the
segment defined from the midpoint of the line
between the markers placed over the acromion
processes and the midpoint of the line between the
markers placed over the anterior superior iliac
spines. For each subject, the computed trunk angles
were fit using a second-order polynomial
(MATLAB, R2012a) after which each trunk angle
at a given disturbance was represented as the point
estimate using the subject-specific regression.
Correlations and regression analysis (SPSS, V24)
were used to describe the relationships between the
largest LyE and disturbance-specific point estimates
of the trunk angle at recovery step completion
RESULTS AND DISCUSSION
The linearly increasing peak disturbance velocities,
intended to increase the difficulty of the recovery,
resulted in a quadratic increase (R2= 0.77, p<0.001)
of the trunk angle at recovery step completion
(Figure 1).
For the eight participants, the largest LyE of the
scapula marker during unperturbed treadmill
walking was 0.90±0.57 (range: 0.22-1.86).
Figure 1: Trunk flexion angle at the instant of
recovery step completion following a treadmill-
delivered disturbances that mimicked a trip. The
disturbance magnitude was manipulated using by
increasing the peak velocity of treadmill belt
motion. Individual subject data (open circles) and
the line of best fit are shown.
Contrary to our expectations, the largest sagittal
plane LyE of the scapular marker during
42nd Annual Meeting of the American Society of Biomechanics, Rochester, MN, USA, August 8th – 11th, 2018
unperturbed treadmill walking was not significantly
correlated to trunk flexion following the
increasingly challenging treadmill-delivered
disturbances. The correlations, the values of which
ranged from 0.19 to 0.36 (all p>0.38), accounted for
a maximum of 13 percent of the shared variance.
The result merits consideration in the context of its
representing only a small sample of healthy young
subjects who participated in a novel protocol. In
light of these limitations, it seems premature to
conclude that divergence of sagittal plane trunk
movement trajectories during unperturbed treadmill
walking is, or is not, a risk factor for trip-related
falls by older adults.
CONCLUSIONS
The growth of the population of older adults ensures
that the magnitude of the multifaceted problem of
falls by older adults will grow proportionately. In
our view, replication of the experiment with young
subjects and repeating the experiment using older
adults merit consideration.
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