A new measure of trip risk integrating minimum foot clearance and dynamic stability across the swing phase of gait
Abstract Minimum toe clearance (MTC) is thought to quantify the risk of the toe contacting the ground during the swing phase of gait and initiating a trip, but there are methodological issues with this measure and the risk of trip-related falls has been shown to also be associated with gait speed an...
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| description | Abstract Minimum toe clearance (MTC) is thought to quantify the risk of the toe contacting the ground during the swing phase of gait and initiating a trip, but there are methodological issues with this measure and the risk of trip-related falls has been shown to also be associated with gait speed and dynamic stability. This paper proposes and evaluates a new measure, trip risk integral (TRI), that circumvents many issues with MTC as typically calculated at a single point by considering minimum foot clearance across the entire swing phase and taking into account dynamic stability to estimate risk of falling due to a trip rather than risk of the foot contacting the floor. Shoes and floor surfaces were digitized and MTC and TRI calculated for unimpaired younger ( N = 14, age = 26 ± 5), unimpaired older ( N = 14, age = 73 ± 7), and older adults who had recently fallen ( N = 11, age = 72 ± 5) walking on surfaces with no obstacles, visible obstacles, and hidden obstacles at slow, preferred, and fast gait speeds. MTC and TRI had significant ( F ≥ 5, p ≤ 0.005) but differing effects of gait speed and floor surface. As gait speed increased (which increases risk of trip-related falls) MTC indicated less and TRI greater risk, indicating that TRI better quantifies risk of falling due to a trip. While MTC and TRI did not differ by subject group, strong speed-related effects of TRI ( F ≥ 8, p ≤ 0.0007) resulted in improved TRI for fallers due to their slower self-selected preferred gait. This demonstrates that slower gait is both an important covariate and potential intervention for trip-related falls. |
| doi_str_mv | 10.1016/j.jbiomech.2017.02.024 |
| format | Article |
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This paper proposes and evaluates a new measure, trip risk integral (TRI), that circumvents many issues with MTC as typically calculated at a single point by considering minimum foot clearance across the entire swing phase and taking into account dynamic stability to estimate risk of falling due to a trip rather than risk of the foot contacting the floor. Shoes and floor surfaces were digitized and MTC and TRI calculated for unimpaired younger ( N = 14, age = 26 ± 5), unimpaired older ( N = 14, age = 73 ± 7), and older adults who had recently fallen ( N = 11, age = 72 ± 5) walking on surfaces with no obstacles, visible obstacles, and hidden obstacles at slow, preferred, and fast gait speeds. MTC and TRI had significant ( F ≥ 5, p ≤ 0.005) but differing effects of gait speed and floor surface. As gait speed increased (which increases risk of trip-related falls) MTC indicated less and TRI greater risk, indicating that TRI better quantifies risk of falling due to a trip. While MTC and TRI did not differ by subject group, strong speed-related effects of TRI ( F ≥ 8, p ≤ 0.0007) resulted in improved TRI for fallers due to their slower self-selected preferred gait. This demonstrates that slower gait is both an important covariate and potential intervention for trip-related falls.</description><identifier>ISSN: 0021-9290</identifier><identifier>EISSN: 1873-2380</identifier><identifier>DOI: 10.1016/j.jbiomech.2017.02.024</identifier><identifier>PMID: 28302314</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Accidental Falls - prevention & control ; Adaptation ; Adaptive control ; Adolescent ; Adult ; Adults ; Age ; Age factors ; Ankle ; Arches ; Biomechanical Phenomena ; Biomechanics ; Clinical trials ; Clusters ; Colleges & universities ; Data acquisition ; Digitization ; Dynamic stability ; Electric contacts ; Electrical stimuli ; Eye ; Fallers ; Falling ; Fatigue ; Fatigue tests ; Feet ; Female ; Flooring ; Floors and Floorcoverings ; Foot - physiology ; Gait ; Gait - physiology ; Health risks ; Humans ; Irregular floor ; Kinetics ; Knee ; Male ; Markers ; Mathematical analysis ; Mechanical Phenomena ; Minima ; Minimum toe clearance ; Motion perception ; Motor task performance ; Multiple sclerosis ; Obstacles ; Older adults ; Older people ; Physical Medicine and Rehabilitation ; Position (location) ; Posture ; Prostheses ; Protocol (computers) ; Risk ; Risk Assessment ; Shoes ; Stimulation ; Stroke ; Toe ; Trajectory control ; Tripping ; Walking ; Young Adult</subject><ispartof>Journal of biomechanics, 2017-04, Vol.55, p.107-112</ispartof><rights>2017</rights><rights>Published by Elsevier Ltd.</rights><rights>Copyright Elsevier Limited 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c668t-ba1af833154a54352623923c39cccda8cd63f8b68e4ee1d50835f35bdc4a53523</citedby><cites>FETCH-LOGICAL-c668t-ba1af833154a54352623923c39cccda8cd63f8b68e4ee1d50835f35bdc4a53523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1885095724?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,777,781,882,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28302314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schulz, Brian W</creatorcontrib><title>A new measure of trip risk integrating minimum foot clearance and dynamic stability across the swing phase of gait</title><title>Journal of biomechanics</title><addtitle>J Biomech</addtitle><description>Abstract Minimum toe clearance (MTC) is thought to quantify the risk of the toe contacting the ground during the swing phase of gait and initiating a trip, but there are methodological issues with this measure and the risk of trip-related falls has been shown to also be associated with gait speed and dynamic stability. This paper proposes and evaluates a new measure, trip risk integral (TRI), that circumvents many issues with MTC as typically calculated at a single point by considering minimum foot clearance across the entire swing phase and taking into account dynamic stability to estimate risk of falling due to a trip rather than risk of the foot contacting the floor. Shoes and floor surfaces were digitized and MTC and TRI calculated for unimpaired younger ( N = 14, age = 26 ± 5), unimpaired older ( N = 14, age = 73 ± 7), and older adults who had recently fallen ( N = 11, age = 72 ± 5) walking on surfaces with no obstacles, visible obstacles, and hidden obstacles at slow, preferred, and fast gait speeds. MTC and TRI had significant ( F ≥ 5, p ≤ 0.005) but differing effects of gait speed and floor surface. As gait speed increased (which increases risk of trip-related falls) MTC indicated less and TRI greater risk, indicating that TRI better quantifies risk of falling due to a trip. While MTC and TRI did not differ by subject group, strong speed-related effects of TRI ( F ≥ 8, p ≤ 0.0007) resulted in improved TRI for fallers due to their slower self-selected preferred gait. This demonstrates that slower gait is both an important covariate and potential intervention for trip-related falls.</description><subject>Accidental Falls - prevention & control</subject><subject>Adaptation</subject><subject>Adaptive control</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Age factors</subject><subject>Ankle</subject><subject>Arches</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Clinical trials</subject><subject>Clusters</subject><subject>Colleges & universities</subject><subject>Data acquisition</subject><subject>Digitization</subject><subject>Dynamic stability</subject><subject>Electric contacts</subject><subject>Electrical stimuli</subject><subject>Eye</subject><subject>Fallers</subject><subject>Falling</subject><subject>Fatigue</subject><subject>Fatigue tests</subject><subject>Feet</subject><subject>Female</subject><subject>Flooring</subject><subject>Floors and Floorcoverings</subject><subject>Foot - physiology</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Health risks</subject><subject>Humans</subject><subject>Irregular floor</subject><subject>Kinetics</subject><subject>Knee</subject><subject>Male</subject><subject>Markers</subject><subject>Mathematical analysis</subject><subject>Mechanical Phenomena</subject><subject>Minima</subject><subject>Minimum toe clearance</subject><subject>Motion perception</subject><subject>Motor task performance</subject><subject>Multiple sclerosis</subject><subject>Obstacles</subject><subject>Older adults</subject><subject>Older people</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Position (location)</subject><subject>Posture</subject><subject>Prostheses</subject><subject>Protocol (computers)</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>Shoes</subject><subject>Stimulation</subject><subject>Stroke</subject><subject>Toe</subject><subject>Trajectory control</subject><subject>Tripping</subject><subject>Walking</subject><subject>Young Adult</subject><issn>0021-9290</issn><issn>1873-2380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk1v1DAQhiMEokvhL1SWuHDJ4o84cS4VVcWXVIkDcLYmzmTX28RebKfV_nucblugFyRLPvh53_HMO0VxxuiaUVa_3613nfUTmu2aU9asKc-nelasmGpEyYWiz4sVpZyVLW_pSfEqxh2ltKma9mVxwpWgXLBqVYQL4vCWTAhxDkj8QFKwexJsvCbWJdwESNZtyGSdneaJDN4nYkaEAM4gAdeT_uBgsobEBJ0dbToQMMHHSNIWSbxd1PstxDvzDdj0ungxwBjxzf19Wvz89PHH5Zfy6tvnr5cXV6Wpa5XKDhgMSggmK5CVkLzmouXCiNYY04MyfS0G1dUKK0TWS6qEHITsepP5jIvT4vzou5-7CXuDLgUY9T7YCcJBe7D63xdnt3rjb7Ssmly1zQbv7g2C_zVjTHqy0eA4gkM_R51HrRTnslEZffsE3fk5uNxeppSkrWx4lan6SN3NJ-Dw-BlG9RKr3umHWPUSq6Y8n0V49ncrj7KHHDPw4QhgHuiNxaCjsZgT6m1Ak3Tv7f9rnD-xMGMO3cB4jQeMf_rRMQv092W5lt1ijaCMV1T8BgqHzaQ</recordid><startdate>20170411</startdate><enddate>20170411</enddate><creator>Schulz, Brian W</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TB</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170411</creationdate><title>A new measure of trip risk integrating minimum foot clearance and dynamic stability across the swing phase of gait</title><author>Schulz, Brian W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c668t-ba1af833154a54352623923c39cccda8cd63f8b68e4ee1d50835f35bdc4a53523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Accidental Falls - prevention & control</topic><topic>Adaptation</topic><topic>Adaptive control</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Age</topic><topic>Age factors</topic><topic>Ankle</topic><topic>Arches</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Clinical trials</topic><topic>Clusters</topic><topic>Colleges & universities</topic><topic>Data acquisition</topic><topic>Digitization</topic><topic>Dynamic stability</topic><topic>Electric contacts</topic><topic>Electrical stimuli</topic><topic>Eye</topic><topic>Fallers</topic><topic>Falling</topic><topic>Fatigue</topic><topic>Fatigue tests</topic><topic>Feet</topic><topic>Female</topic><topic>Flooring</topic><topic>Floors and Floorcoverings</topic><topic>Foot - physiology</topic><topic>Gait</topic><topic>Gait - physiology</topic><topic>Health risks</topic><topic>Humans</topic><topic>Irregular floor</topic><topic>Kinetics</topic><topic>Knee</topic><topic>Male</topic><topic>Markers</topic><topic>Mathematical analysis</topic><topic>Mechanical Phenomena</topic><topic>Minima</topic><topic>Minimum toe clearance</topic><topic>Motion perception</topic><topic>Motor task performance</topic><topic>Multiple sclerosis</topic><topic>Obstacles</topic><topic>Older adults</topic><topic>Older people</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Position (location)</topic><topic>Posture</topic><topic>Prostheses</topic><topic>Protocol (computers)</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>Shoes</topic><topic>Stimulation</topic><topic>Stroke</topic><topic>Toe</topic><topic>Trajectory control</topic><topic>Tripping</topic><topic>Walking</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schulz, Brian W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of biomechanics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schulz, Brian W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A new measure of trip risk integrating minimum foot clearance and dynamic stability across the swing phase of gait</atitle><jtitle>Journal of biomechanics</jtitle><addtitle>J Biomech</addtitle><date>2017-04-11</date><risdate>2017</risdate><volume>55</volume><spage>107</spage><epage>112</epage><pages>107-112</pages><issn>0021-9290</issn><eissn>1873-2380</eissn><abstract>Abstract Minimum toe clearance (MTC) is thought to quantify the risk of the toe contacting the ground during the swing phase of gait and initiating a trip, but there are methodological issues with this measure and the risk of trip-related falls has been shown to also be associated with gait speed and dynamic stability. This paper proposes and evaluates a new measure, trip risk integral (TRI), that circumvents many issues with MTC as typically calculated at a single point by considering minimum foot clearance across the entire swing phase and taking into account dynamic stability to estimate risk of falling due to a trip rather than risk of the foot contacting the floor. Shoes and floor surfaces were digitized and MTC and TRI calculated for unimpaired younger ( N = 14, age = 26 ± 5), unimpaired older ( N = 14, age = 73 ± 7), and older adults who had recently fallen ( N = 11, age = 72 ± 5) walking on surfaces with no obstacles, visible obstacles, and hidden obstacles at slow, preferred, and fast gait speeds. MTC and TRI had significant ( F ≥ 5, p ≤ 0.005) but differing effects of gait speed and floor surface. As gait speed increased (which increases risk of trip-related falls) MTC indicated less and TRI greater risk, indicating that TRI better quantifies risk of falling due to a trip. While MTC and TRI did not differ by subject group, strong speed-related effects of TRI ( F ≥ 8, p ≤ 0.0007) resulted in improved TRI for fallers due to their slower self-selected preferred gait. This demonstrates that slower gait is both an important covariate and potential intervention for trip-related falls.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>28302314</pmid><doi>10.1016/j.jbiomech.2017.02.024</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of biomechanics, 2017-04, Vol.55, p.107-112 |
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| subjects | Accidental Falls - prevention & control Adaptation Adaptive control Adolescent Adult Adults Age Age factors Ankle Arches Biomechanical Phenomena Biomechanics Clinical trials Clusters Colleges & universities Data acquisition Digitization Dynamic stability Electric contacts Electrical stimuli Eye Fallers Falling Fatigue Fatigue tests Feet Female Flooring Floors and Floorcoverings Foot - physiology Gait Gait - physiology Health risks Humans Irregular floor Kinetics Knee Male Markers Mathematical analysis Mechanical Phenomena Minima Minimum toe clearance Motion perception Motor task performance Multiple sclerosis Obstacles Older adults Older people Physical Medicine and Rehabilitation Position (location) Posture Prostheses Protocol (computers) Risk Risk Assessment Shoes Stimulation Stroke Toe Trajectory control Tripping Walking Young Adult |
| title | A new measure of trip risk integrating minimum foot clearance and dynamic stability across the swing phase of gait |
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