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| Apparatus. (A) The seven-step instrumented stair. Step size: rise (height) 175 mm, going 175, 225, 275, and 325 mm. Four force platforms were embedded in steps 2-5. Handrails were provided on each side. Representation of the vertical and horizontal clearance and overhang in ascent (B), and descent (C).
Source publication
Older people have an increased risk of falling during locomotion, with falls on stairs being particularly common and dangerous. Step going (i.e., the horizontal distance between two consecutive step edges) defines the base of support available for foot placement on stairs, as with smaller going, the user's ability to balance on the steps may become...
Contexts in source publication
Context 1
... this study, we investigated the effect of changing the going (Figure 1) on stair negotiation performance and safety, by measuring key parameters including body orientation, velocity, foot clearance and overhang. We asked: (i) Does going size affect stair negotiation in older, more than in younger participants? ...
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... young (thirteen men, eight women; mean ± standard error "SE" 29 ± 1 years; mass 77.2 ± 4.7 kg; height 1.75 ± 0.003 m) and 20 older participants (10 men, 10 women; 74 ± 1 years; 75.2 ± 4.3 kg; 1.66 ± 0.003 m) negotiated a stair ( Figure 1A) at their self-selected speed. All participants were healthy and were recruited from the local community. ...
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... Overhang. The antero-posterior foot portion landing outside the step (Figures 1B,C) as a percentage of the anteroposterior foot length on the step at steady-state (see above). The fore-foot was identified as the geometrical average of the markers placed on the second and fifth metatarsal head and the dorsal aspect of the second toe distal tip. ...
Context 4
... coefficient of variation in foot clearances is shown in Figure 5. No significant group differences for horizontal lead foot clearance could be found (Figures 5A,E, Group p = 0.219). However, the coefficient of variation was larger for the standing start condition (Start p = 0.008). ...
Context 5
... regression analyses (Figure 6) for the older participants, showed that vertical clearance in the standing start trials at a going of 175 mm was lower for participants who reported a higher number of hours of physical activity [ Figure 6C, F (1, 18) = 9.3613, p = 0.0067, R 2 = 0.3421, correlation coefficient b = −0.7399], whilst at a going of 325 mm, the clearance was higher for participants who had a higher score in balance EC vs. EO [ Figure 6D, F (1, 17) Figure 6I, F (1, 17) = 5.3088, p = 0.0341, R 2 = 0.8556, b = −0.4810]. Horizontal clearance in walking start trials was lower for participants reporting fewer hours of physical activity at a going of 325 mm [ Figure 6E, F (1, 17) = 5.5676, p = 0.0305, ...
Context 6
... regression analyses (Figure 6) for the older participants, showed that vertical clearance in the standing start trials at a going of 175 mm was lower for participants who reported a higher number of hours of physical activity [ Figure 6C, F (1, 18) = 9.3613, p = 0.0067, R 2 = 0.3421, correlation coefficient b = −0.7399], whilst at a going of 325 mm, the clearance was higher for participants who had a higher score in balance EC vs. EO [ Figure 6D, F (1, 17) Figure 6I, F (1, 17) = 5.3088, p = 0.0341, R 2 = 0.8556, b = −0.4810]. Horizontal clearance in walking start trials was lower for participants reporting fewer hours of physical activity at a going of 325 mm [ Figure 6E, F (1, 17) = 5.5676, p = 0.0305, ...
Context 7
... at a going of 325 mm, the clearance was higher for participants who had a higher score in balance EC vs. EO [ Figure 6D, F (1, 17) Figure 6I, F (1, 17) = 5.3088, p = 0.0341, R 2 = 0.8556, b = −0.4810]. Horizontal clearance in walking start trials was lower for participants reporting fewer hours of physical activity at a going of 325 mm [ Figure 6E, F (1, 17) = 5.5676, p = 0.0305, ...
Context 8
... regression analyses (Figure 10) showed that for the older participants, foot overhang in standing start trials was larger for participants who reported taking fewer medications at a going of 175 mm [ Figure 10A, F (1, 16) For the younger group, foot overhang in standing start trials at a going of 275 mm was larger for participants with a higher score in the single-leg balance test [ Figure 10B, F (1, 15) = 24.6760, p < 0.001, b = −0.8750, ...
Context 9
... regression analyses (Figure 10) showed that for the older participants, foot overhang in standing start trials was larger for participants who reported taking fewer medications at a going of 175 mm [ Figure 10A, F (1, 16) For the younger group, foot overhang in standing start trials at a going of 275 mm was larger for participants with a higher score in the single-leg balance test [ Figure 10B, F (1, 15) = 24.6760, p < 0.001, b = −0.8750, ...
Context 10
... regression analyses (Figure 10) showed that for the older participants, foot overhang in standing start trials was larger for participants who reported taking fewer medications at a going of 175 mm [ Figure 10A, F (1, 16) For the younger group, foot overhang in standing start trials at a going of 275 mm was larger for participants with a higher score in the single-leg balance test [ Figure 10B, F (1, 15) = 24.6760, p < 0.001, b = −0.8750, ...
Context 11
... (2,14) = 7.3830, p = 0.0065] for participants reporting higher hours of physical activity (Figure 10E, step-1 of the regression b = −11.0459, p = 0.0128, R 2 = 0.3305) or a higher score in the balance EC vs. EO test (Figure 10F, step-2 of the regression b = −26.8983, ...
Context 12
... (2,14) = 7.3830, p = 0.0065] for participants reporting higher hours of physical activity (Figure 10E, step-1 of the regression b = −11.0459, p = 0.0128, R 2 = 0.3305) or a higher score in the balance EC vs. EO test (Figure 10F, step-2 of the regression b = −26.8983, p = 0.0199, R 2 = 0.5461). ...
Context 13
... = 0.0199, R 2 = 0.5461). Foot overhang at a going of 325 mm in walking trials [F (2, 13) = 9.6329, p = 0.0027) was predicted by hours of physical activity with larger overhang for higher number of hours ( Figure 10G, step-1 ...
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... balance. The medio-lateral RMS of CoP was greater in the older group than the young group (older 0.079 ± 0.017 m, younger 0.020 ± 0.003 m, p < 0.001) (Figure 11A). ...
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... EC, the antero-posterior RMS of CoP was greater in the older group (older 0.005 ± 0.0005 m, younger 0.0041 ± 0.0002 m, p = 0.035). There was no difference between age groups with EO (older 0.004 ± 0.0003 m, younger 0.0041 ± 0.0003 m, p = 0.907) ( Figure 11B) and for the ratio of RMS CoP between EC and EO (older 1.26 ± 0.08, younger 1.10 ± 0.09, p = 0.398) (Figure 11C). ...
Context 16
... EC, the antero-posterior RMS of CoP was greater in the older group (older 0.005 ± 0.0005 m, younger 0.0041 ± 0.0002 m, p = 0.035). There was no difference between age groups with EO (older 0.004 ± 0.0003 m, younger 0.0041 ± 0.0003 m, p = 0.907) ( Figure 11B) and for the ratio of RMS CoP between EC and EO (older 1.26 ± 0.08, younger 1.10 ± 0.09, p = 0.398) (Figure 11C). ...
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Citations
... Indeed, falls are a major cause of morbidity in older people and the primary cause of accidental death. It is not surprising that a significant number of hazardous falls happen while navigating stairs [5], [6]. The successful detection of stair gait activity can greatly alleviate the challenges faced by older individuals when navigating stairs and can also help mitigate the issue of falls. ...
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... Few sensors are needed for the detection of gait events, the main sensor is the accelerometer. Among the most often utilized sensors to detect human movement activities are triaxial accelerometers (e.g., walking, running, lying, etc. [5], [12], [13]. Accelerometer-based wearables can capture most forms of human movement [14]. ...
The identification of gait activities such as stair ascending and descending poses a significant challenge due to the proximity of data provided by the sensory pathway. Accurate identification of gait activities is crucial in conveying essential gait information to users for the recognition of human movement activities. However, gait patterns can vary significantly between individuals, making it challenging to develop a generalized algorithm for identifying incline surface gait activity. Factors such as walking speed, stride length, and body mechanics can all influence gait patterns, making it difficult to establish a consistent framework. Despite various research on gait event detection for level ground walking, the identification of gait activities on an inclined surface such as stairs, especially using smartphones as sensors, is currently lacking. The goal of this study is to investigate and develop a reliable and accurate method for detecting gait activities on an inclined surface such as stairs using smartphones as the sensing device. Specifically, this study focuses on investigating optimal placement of smartphones to extract tri- axis accelerometer data from the inertial sensors during stair movement. The inertial sensor data was collected from the smartphone at two different positions and two different orientations. The data was trained against 6 machine learning algorithms namely Decision Tree, Logistic Regression, Naive Bayes, Random Forest, Neural Networks and KNN. It was observed that, by using Decision Tree and Random Forest algorithm 100% accuracy was achieved, when smartphone was placed at the thigh during stair movement. Successful identification of stair movement activity by using a smartphone can significantly contribute to future research and could also prove useful to the wider community such as amputees and those with pathological gait. In addition, since smartphones are available to a wide group of people, a low-cost solution for gait activity identification can be realized, without requiring the use of external sensors and circuitry.
... Staircases become more challenging when, for example, the rise is increased (which creates additional demands for joint moment generation during stair ascent) or the run of the steps is decreased (which reduces the available area to safely land the leading limb during descent) (Novak, Komisar, Maki, & Fernie, 2016;Stacoff, Diezi, Luder, Stussi, & Kramers-de Quervain, 2005). The few studies that linked staircases of more challenging dimensions to an increased risk of falls did not investigate the gaze behaviour (Di Giulio et al., 2020;Novak et al., 2016;Riener, Rabuffetti, & Frigo, 2002;Roys, 2001;Templer, 1992;Wright & Roys, 2005). Nevertheless, it was found that younger adults adopted a more conservative gaze strategy in more challenging conditions by looking closer to their travel path when walking in terrains of higher difficulty (implemented by rocky trails of increased complexity) (Matthis, Yates, & Hayhoe, 2018) and when negotiating stairs two at a time compared to one at a time (Den Otter et al., 2011). ...
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Purpose:
Voluntary gait adaptability is a complex construct that requires cognitive demands and dynamic balance control; it also has implications for the daily lives of older adults. This ability has been extensively studied, however, a comprehensive overview of appropriate tasks for measuring voluntary gait adaptability in older adults is lacking. Our scoping review aimed to identify existing voluntary gait adaptability tasks for older adults, summarize the specific methodological features requiring cognitive demands found in previous studies, and categorize these tasks according to experimental procedure and setup.
Methods:
A comprehensive literature search was performed using six databases (PubMed, SPORTDiscus, Web of Science, CINAHL, MEDLINE, and Embase). This included studies that investigated voluntary gait adaptability in older adults (≥ 65 years old) with and without neurological disorders, with a focus on experimental tasks requiring cognitive function (e.g., response to visual or auditive stimuli) while walking.
Results:
Sixteen studies were included; most involved visual stimuli, such as obstacles, stairs, or colored cues, and few required auditory stimuli. The studies were categorized according to the experimental procedure, for example, ascent/descent of obstacles (n = 3), inconsistent surfaces (n = 1), lateral gait adjustment (n = 4), obstacle avoidance (n = 6), and stepping tasks (n = 2), as well as experimental setup, including instrumented treadmills (n = 3), stairs (n = 3), and walkways (n = 10).
Conclusion:
The results show wide heterogeneity between studies regarding experimental procedures and setup. Our scoping review highlights the need for additional experimental studies and systematic reviews on voluntary gait adaptability in older adults.
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Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs.
Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D).
Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion ( p = 0.01) decreased, hip flexion ( p = 0.02) and trunk lateral tilt ( p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side ( p = 0.003) and pelvic rotation ( p = 0.03) increased, while hip abduction of the swing leg ( p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis.
Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.
Many ageing people are staying at home, whether they are self-isolating or social distancing, because of the current Covid-19 situation. Fall incidents at home among the ageing are significantly associated with a high level of mortality. Bathrooms are frequently reported as a major environmental hazard in connection with falls. This serious health risk raises the matter of interior architecture. In terms of preventing falls, more architectural research focuses on interior elements e.g., handrail design, and non-slip mat, whilst less attention is paid to the issue of how ageing causes falls. Therefore, this article sheds light on the normal ageing process through an executive function that helps in the fall prevention of ageing people via decision-making and problem-solving. Normal ageing gradually results in declining executive function, including cognitive and motor functions, which limits and reduces day to day activities. The cognitive function (as a system) involves processing speed, accuracy in response, and error response whereas the motor function (as a mechanism) defines both gross and fine motor functions. A combination of cognitive and motor functions reflects conditions that may lead to a fall. Regarding the executive function, interior architecture for preventing falls in normal ageing people is strongly encouraged e.g., clear layout, timesaving activity, simplicity of design, lighting uniformity, short walking distance, cased opening, lightweight fixtures, and fine texture flooring. This article reviews the literature to address the knowledge gaps between interior architecture and human-centred design through ageing ergonomics, and employs a behaviour-focused aspect to interpret results for interior architects. Electronic databases, including Scopus, PubMed, and Google Scholar, were searched to specify appropriate papers, which were restricted to those in the English language. To improve the quality of the elderly’s life, this article provides recommendations that could assist interior architects in this challenge.
Serious falls occur frequently on stairs with inconsistent dimensions. Inconsistent smaller goings are thought to reduce user's foot clearances and foot contact lengths since individuals do not detect and alter their behaviour prior to the inconsistency, increasing the risk of a trip, heel-catch or over-step and potential slip on the stairs. So far, these mechanisms for a stair fall remain theoretical only. The aim of this paper was to identify the underlying mechanisms by which steps with inconsistent going size increase the risk of falls. For this study twenty-seven younger adults (24 ± 3 y, 1.74 ± 0.09 m, 71.41 ± 11.04 kg) and thirty-three older adults (70 ± 4 y, 1.68 ± 0.08 m, 67.90 ± 14.10 kg) ascended and descended a seven-step instrumented staircase in two conditions: 1) consistent dimensions with 200 mm risers and 250 mm goings and 2) inconsistent going dimensions where the going of the third step was reduced by 10 mm, and consequently the going of the second step was larger by 10 mm. Five repeated trials on the inconsistent stairs were performed to assess if there was an adaptation effect after first exposure.
In descent in the first inconsistent trial, foot contact lengths were not significantly different between conditions for the younger and older adults on the inconsistently shorter step (∼1%, p = .121). Foot trajectories were pulled further back in the last 22% of swing before contact (p = .025), contradicting previous expectations. Younger adults then had reduced clearances over the next step (∼5 mm, p = .027), which was inconsistently longer, increasing the risk of a heel-catch, whereas foot clearances for older adults were not different. With repeated inconsistent trials the foot contact length of older adults reduced on the shorter step (p = .024).
In ascent, in the first inconsistent trial, interaction effects were detected between groups and conditions on three steps: the inconsistently longer step (p = .003), the shorter step (p = .004), the next step (p = .006), as well as on the walkway (p = .048). Older adults positioned themselves further away from the stairs on the walkway compared to younger adults and then had a reduced foot contact length on the inconsistently shorter step (∼2.8%, p = .026), increasing the chances of under-stepping and slipping off the shorter step. Whereas younger adults were positioned closer to the stairs on the walkway, had increased foot contact lengths on the inconsistently longer step and contact lengths that were not different on the inconsistently shorter step. With repeated inconsistent trials, foot contact lengths were reduced on the longer step (p = .006) and then on the shorter step (p = .018).
These findings contradict previous assumptions that individuals do not adapt to inconsistent goings on stairs. In descent on the first trial, both groups adjusted their stepping behaviour late in the swing prior to contact with the first inconsistent step. In ascent younger adults made changes to their position and stepping behaviour before stepping on the stairs. These behaviours to mitigate the risk of the inconsistent step, did not persist in the repeat trials. Future investigations should establish the magnitude at which inconsistencies are detectable and can be acted upon and should include a wider range of individuals. This type of research could help inform future initiatives to prevent serious stair falls.
Many ageing people are staying at home, whether they are self-isolating or social distancing, because of the current Covid-19 situation. Fall incidents at home among the ageing are significantly associated with a high level of mortality. Bathrooms are frequently reported as a major environmental hazard in connection with falls. This serious health risk raises the matter of interior architecture. In terms of preventing falls, more architectural research focuses on interior elements e.g., handrail design, and non-slip mat, whilst less attention is paid to the issue of how ageing causes falls. Therefore, this article sheds light on the normal ageing process through an executive function that helps in the fall prevention of ageing people via decision-making and problem-solving. Normal ageing gradually results in declining executive function, including cognitive and motor functions, which limits and reduces day to day activities. The cognitive function (as a system) involves processing speed, accuracy in response, and error response whereas the motor function (as a mechanism) defines both gross and fine motor functions. A combination of cognitive and motor functions reflects conditions that may lead to a fall. Regarding the executive function, interior architecture for preventing falls in normal ageing people is strongly encouraged e.g., clear layout, timesaving activity, simplicity of design, lighting uniformity, short walking distance, cased opening, lightweight fixtures, and fine texture flooring. This article reviews the literature to address the knowledge gaps between interior architecture and human-centred design through ageing ergonomics, and employs a behaviour-focused aspect to interpret results for interior architects. Electronic databases, including Scopus, PubMed, and Google Scholar, were searched to specify appropriate papers, which were restricted to those in the English language. To improve the quality of the elderly’s life, this article provides recommendations that could assist interior architects in this challenge.
