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E-mail: soluda2@uic.edu
INTRODUCTION
Falls that occur in the community following a trip during locomotion are usually Trip-specific training improves compensatory stepping responses after
not accompanied by prior warning (1). laboratory-induced trips and reduces the rate of prospectively measured trip-
related falls in the community (5).
In expectation of an imminent disturbance, the neuromuscular state (2) and
behavioral response (3) of an individual is changed to meet the postural However, the beneficial effects of trip-specific training on recovery following an
demand. unexpected disturbance is not known.
Pater et. al. reported that expectation of a disturbance may reduce the Therefore, the aim of this study was to determine if trip-specific training by young
likelihood of a fall by 35 percent after a treadmill-induced trip-like disturbance adults improved compensatory stepping responses after delivery of a large
(4). unexpected postural disturbance.
In the study by Pater et. al. (4), the participants’ expectation of the postural HYPOTHESIS
disturbance was altered by not informing them during the experimental protocol We hypothesized that key kinematics of the recovery stepping response of
that a postural disturbance will be induced. trained subjects in response to a large unexpected postural disturbance
would be significantly better than those of untrained subjects.
The participants in the experimental group performed 13 trials. During the first
trial the participants were instructed to minimize their postural sway for a period
of 60 seconds. This was followed by 12 trials during which postural disturbance
was delivered.
Before trial 13, subjects were told that we were assessing the effect of training • Comparison I showed that trip- • Comparison I showed that trip-
on postural sway while they performed the verbal arithmetic test. Approximately specific training reduced the trunk specific training reduced the trunk
30 seconds into the trial an unexpected postural disturbance was delivered. flexion angle at recovery step angular velocity at recovery step
The thirteenth trial was categorized as the “trained and unexpected” response. completion by 60 percent (p < 0.01). completion was reduced by 98
POSTURAL DISTURBANCE AND RECOVERY RESPONSE • Comparison II showed that percent (p < 0.01).
expectation reduced the trunk • Comparison II showed that
A sawtooth disturbance was delivered via a microprocessor controlled flexion angle at recovery step expectation reduced the trunk
treadmill (ActiveStep, Lebannon, NH) while participants stood still and looked completion of by 40 percent angular velocity at recovery step
straight ahead (Figure 2). This disturbance produced a recovery stepping (p=0.06). completion by 56 percent (p=0.02).
response similar to that of an over-ground trip (6). Participants were informed
to take as many steps as needed to remain standing. DISCUSSION
Figure 2. The treadmill accelerated to a The results imply that the previously reported results on the efficacy of trip-
peak velocity of 0.89m/s in 150 ms and specific training (5) may reflect the acquisition of a motor skill, the triggering of
then decelerated to 0m/s in 1 s. which could be stimulus dependent, that is, trip-specific, and the execution of
which is, to some extent, independent of expectation.
The three dimensional motions of 22 passive reflective markers placed over If the results of this study prove to be repeatable in different populations, the
the body were captured by a motion capture system (Motion Analysis, Santa approach used in this study can be generalized to better assess the
Rosa, CA, USA) operating at 120 Hz. Kinematic variables were computed effectiveness of fall prevention interventions.
using custom software (MATLAB, Mathworks, Natick MA).
REFERENCES
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437 7. Crenshaw et al. J Biomech. 2012;45: 129–133
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4. Pater et al. Gait & Posture. 2015; 41(1): 335-337 2001;56(7):M428-M437