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The effects of voluntary step-training on slip recovery



Graduation date: 2010Falls caused by slips are a major health risk to older adults and place a large financial strain on the health care system. Previous research has found that individuals can learn to recover their balance after being exposed to a series of simulated slips. However, training large numbers of older adults through repeated slip exposure is logistically improbable. An easier and less expensive method of training people not to fall is needed. The purpose of this study was to determine whether training the voluntary stepping response would improve the recovery response to an unexpected slip to a similar extent as seen with repeated slip training.\ud A sliding platform was used to cause 34 healthy young adults to lose their balance while rising from a simulated lifting task. Seventeen subjects in the slip-training group were exposed to slipping perturbations in varying, unpredictable directions for 26 trials. Seventeen subjects in the step-training group performed a corresponding sequence of cued voluntary stepping for 25 trials, followed by a single unexpected slip. Subjects were removed from data analysis if they fell or took a fundamentally different recovery step. Nineteen variables quantifying the proactive\ud and reactive qualities of the recovery response were derived from motion capture data and compared between the first and last slips of the slip-training and the slip following the step-training, all of which were forward-directed.\ud Both step- and slip-training resulted in a longer recovery step. The slip-training improved the response time and center of mass position at step lift-off when compared with the step-training. Slip-training also increased the distance between the stepping foot and center of mass and decreased the hip downward velocity at step touchdown, improving both stability and weight support. The slip-training appeared to prepare the reflexive initiation of the recovery step as well as the conscious control of step length, whereas the step-training only affected the step length.\ud Both training protocols showed that learning does occur from reflexively or voluntarily practicing recovery steps. People often fall from a balance loss because they do not take a sufficiently long recovery step. In these instances, step-training may improve the likelihood of balance recovery. This finding can be used to develop new training protocols for populations at risk for falls

Topics: balance, learning, slips
Year: 2009
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Provided by: ScholarsArchive@OSU
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