| Description |
Each year, millions of elderly people, age 65 and older, fall. Research estimates as many as one in three elderly falls each year. One out of five falls causes serious injury. Annual cost for falls is $31 billion. Falls are the leading cause of injury-related deaths for older adults. About 15% of elderly have recurrent falls each year. Research has shown that recurrent falls are above 50% among persons with Parkinson's disease (PD). Many of these falls have been attributed to flooring surfaces. There is little research on transitions between different surfaces, and the research that has been done has not included persons with PD. A better understanding of transitions between surfaces is needed to further inform at risk populations, builders, the scientific community, and therapists in order to better address fall prevention rehabilitation. Common indoor and outdoor surfaces were selected for this study. Carpet, laminate, and tile were used for the indoor surfaces. Cobble, concrete, and artificial turf were used for outdoor surfaces. A 9.75 m gait track was designed to give participants the best chance to consecutively strike six force plates that were embedded in the track. There were ten PD and five healthy age matched control (HC) participants in the study. Spatiotemporal/kinematic and fall risk parameters were evaluated. Transitions are important. Many of the differences in gait observed were on the transitions. PD overcompensated on nearly all surfaces and transitions, especially with minimum toe clearance (MTC). MTC in this study seemed to be the most indicative of a iv fall. PD participants adopted a proximal strategy using their hip and knee. HC participants have a more balanced strategy where they use their hip, knee, and ankle. Outdoor surfaces and transitions posed a greater risk than indoor surfaces. The transitions that had the most differences were similar between the PD and HC groups. Hip range of motion (HipROM) was defined as the difference between the maximum and minimum hip angles in the sagittal plane during a full gait cycle. The knee range of motion (KneROM) was defined as the difference between the maximum and minimum knee angles in the sagittal plane during a full gait cycle. Compliant surfaces, such as carpet and turf used in this study have interesting effects on gait. The increase in HipROM and KneROM indicate that participants should have an increase in MTC, but there is actually a decrease because the participants have to overcome the compliance of those surfaces. This study adds important information to the base of knowledge on falls. This knowledge can inform home builders, at risk populations (and family members/caretakers), physical therapists, and doctors to help prevent falls. |
