A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined...

Area of Science:

• Biomechanics
• Gerontology
• Rehabilitation Science

Background:

• Falls pose a significant risk to older adults, often resulting in hip fractures.
• Effective fall prevention requires training individuals to regain balance during a fall, particularly in the posterolateral direction.
• Perturbation-based balance training (PBT) is a recognized method for improving reactive stepping.

Purpose of the Study:

• To analyze the reactive step characteristics induced by a laterally inclined platform.
• To investigate the influence of platform inclination on reactive leg selection and step width.
• To assess the potential of the inclined platform as a tool for simulating posterolateral falls and its alignment with modified constraint-induced movement therapy (mCIMT).

Main Methods:

• A cross-sectional study involving 46 healthy participants.
• Participants performed a simulated backward fall using a "lean and release" maneuver on a laterally inclined platform at two angles.
• Kinovea software was utilized for analyzing reactive step width, with statistical analysis including ANOVA and Fisher's exact test.

Main Results:

• The inclined platform induced narrowed step widths, indicating a tendency towards posterolateral falls.
• A significant preference for the unloaded leg as the reactive leg was observed (p < 0.001).
• Higher platform angles significantly influenced reactive leg selection (p < 0.001).

Conclusions:

• The inclined platform effectively simulates posterolateral falls.
• The observed reactive stepping characteristics align with those seen in modified constraint-induced movement therapy (mCIMT).
• This device shows promise for developing and evaluating fall prevention strategies, particularly for fall-prone individuals.