Factors Affecting Minimum Foot Clearance in the Elderly Walking: A Multiple Regression Analysis
Author(s)
Keizo Sato
Affiliation(s)
Division of Biomedical Engineering for Health & Welfare, Tohoku University, Sendai, Japan.
Division of Biomedical Engineering for Health & Welfare, Tohoku University, Sendai, Japan.
ABSTRACT
Because falls among the elderly can cause serious injury leading to a bedridden state, methods to maintain motor function in the elderly and prevent falls are important. Among falls by the elderly are tripping falls, in which the forefoot gets caught on the floor to cause the fall. Minimum foot clearance (MFC), the smallest distance between the floor and the foot during the swing phase of gait, has been given attention as a cause of tripping falls, as elderly people at risk of falling have been reported to have low MFC. No research has been done, however, to examine what geriatric factors determine MFC. In this study, various measurements were taken on muscle strength, joint angles, and other characteristics as factors possibly influencing the height of MFC, a multiple regression analysis was performed with MFC as the dependent variable, and those factors with high degrees of influence were extracted. The results revealed that the height of MFC is highly influenced by strength of the hip flexors and angle of ankle dorsiflexion. The results of this study should be taken into consideration when having elderly people do fall prevention training.
Because falls among the elderly can cause serious injury leading to a bedridden state, methods to maintain motor function in the elderly and prevent falls are important. Among falls by the elderly are tripping falls, in which the forefoot gets caught on the floor to cause the fall. Minimum foot clearance (MFC), the smallest distance between the floor and the foot during the swing phase of gait, has been given attention as a cause of tripping falls, as elderly people at risk of falling have been reported to have low MFC. No research has been done, however, to examine what geriatric factors determine MFC. In this study, various measurements were taken on muscle strength, joint angles, and other characteristics as factors possibly influencing the height of MFC, a multiple regression analysis was performed with MFC as the dependent variable, and those factors with high degrees of influence were extracted. The results revealed that the height of MFC is highly influenced by strength of the hip flexors and angle of ankle dorsiflexion. The results of this study should be taken into consideration when having elderly people do fall prevention training.
Cite this paper
Sato, K. (2015) Factors Affecting Minimum Foot Clearance in the Elderly Walking: A Multiple Regression Analysis. Open Journal of Therapy and Rehabilitation, 3, 109-115. doi: 10.4236/ojtr.2015.34015.
Sato, K. (2015) Factors Affecting Minimum Foot Clearance in the Elderly Walking: A Multiple Regression Analysis. Open Journal of Therapy and Rehabilitation, 3, 109-115. doi: 10.4236/ojtr.2015.34015.
References
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http://www.mhlw.go.jp/english/wp/wp-hw6/index.html [2] Julia, L. (2006) Age in the Welfare State: The Origins of Social Spending on Pensioners, Workers, and Children. Cambridge University Press, Cambridge, 246. [3] Gillespie, L.D., et al. (2012) Interventions for Preventing Falls in Older People Living in the Community. In: Cochrane Database of Systematic Reviews, John Wiley & Sons Ltd., Chichester.
http://dx.doi.org/10.1002/14651858.CD007146.pub3 [4] Joseph, C.M., Lewis, S. and Leslie, W. (1997) Gait Disorders of Aging: Falls and Therapeutic Strategies. Lippincott Williams & Wilkins, Philadelphia. [5] Graafmans, W.C., et al. (1996) Falls in the Elderly: A Prospective Study of Risk Factors and Risk Profiles. American Journal of Epidemiology, 143, 1129-1136.
http://dx.doi.org/10.1093/oxfordjournals.aje.a008690 [6] Haga, H., et al. (1986) Falls in the Institutionalized Elderly in Japan. Archives of Gerontology and Geriatrics, 5, 1-9.
http://dx.doi.org/10.1016/0167-4943(86)90002-6 [7] Elble, R.J., et al. (1991) Stride-Dependent Changes in Gait of Older People. Journal of Neurology, 238, 1-5.
http://dx.doi.org/10.1007/BF00319700 [8] Maki, B.E. (1997) Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear. J Am GeriatrSoc, 45, 313-320.
http://dx.doi.org/10.1111/j.1532-5415.1997.tb00946.x [9] Elble, R., Hughes, L. and Higgins, C. (1992) The Syndrome of Senile Gait. Journal of Neurology, 239, 71-75.
http://dx.doi.org/10.1007/BF00862975 [10] Aoyagi, K., et al. (1998) Falls among Community-Dwelling Elderly in Japan. Journal of Bone and Mineral Research, 13, 1468-1474.
http://dx.doi.org/10.1359/jbmr.1998.13.9.1468 [11] Chiba, H., et al. (2005) Differential Gait Kinematics between Fallers and Non-Fallers in Community-Dwelling Elderly People. Geriatrics & Gerontology International, 5, 127-134.
http://dx.doi.org/10.1111/j.1447-0594.2005.00281.x [12] Norkin, C.C. and White, D.J. (2009) Measurement of Joint Motion: A Guide to Goniometry. F a Davis. [13] Hausdorff, J.M., et al. (1997) Increased Gait Unsteadiness in Community-Dwelling Elderly Fallers. Archives of Physical Medicine and Rehabilitation, 78, 278-283.
http://dx.doi.org/10.1016/S0003-9993(97)90034-4 [14] Andersson, E.A., Nilsson, J. and Thorstensson, A. (1997) Intramuscular EMG from the Hip Flexor Muscles during Human Locomotion. Acta Physiologica Scandinavica, 161, 361-370.
http://dx.doi.org/10.1046/j.1365-201X.1997.00225.x [15] Perry, J. and Burnfield, J.M. (2010) GAIT ANALYSIS. Normal and Pathological Function. SLACK Inc., Thorofare, 152-153. [16] Fox, M.D. and Delp, S.L. (2010) Contributions of Muscles and Passive Dynamics to Swing Initiation over a Range of Walking Speeds. Journal of Biomechanics, 43, 1450-1455.
http://dx.doi.org/10.1016/j.jbiomech.2010.02.009 [17] JudgeRoy, J.O., Davis, B. and Ounpuu, S. (1996) Step Length Reductions in Advanced Age: The Role of Ankle and Hip Kinetics. The Journals of Gerontology Series A, 51A, 303-312.
http://dx.doi.org/10.1093/gerona/51A.6.M303
[1] Ministry of Health, L.a.W., Annual Health, Labour and Welfare Report 2011-2012. Gyosei Corp.
http://www.mhlw.go.jp/english/wp/wp-hw6/index.html [2] Julia, L. (2006) Age in the Welfare State: The Origins of Social Spending on Pensioners, Workers, and Children. Cambridge University Press, Cambridge, 246. [3] Gillespie, L.D., et al. (2012) Interventions for Preventing Falls in Older People Living in the Community. In: Cochrane Database of Systematic Reviews, John Wiley & Sons Ltd., Chichester.
http://dx.doi.org/10.1002/14651858.CD007146.pub3 [4] Joseph, C.M., Lewis, S. and Leslie, W. (1997) Gait Disorders of Aging: Falls and Therapeutic Strategies. Lippincott Williams & Wilkins, Philadelphia. [5] Graafmans, W.C., et al. (1996) Falls in the Elderly: A Prospective Study of Risk Factors and Risk Profiles. American Journal of Epidemiology, 143, 1129-1136.
http://dx.doi.org/10.1093/oxfordjournals.aje.a008690 [6] Haga, H., et al. (1986) Falls in the Institutionalized Elderly in Japan. Archives of Gerontology and Geriatrics, 5, 1-9.
http://dx.doi.org/10.1016/0167-4943(86)90002-6 [7] Elble, R.J., et al. (1991) Stride-Dependent Changes in Gait of Older People. Journal of Neurology, 238, 1-5.
http://dx.doi.org/10.1007/BF00319700 [8] Maki, B.E. (1997) Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear. J Am GeriatrSoc, 45, 313-320.
http://dx.doi.org/10.1111/j.1532-5415.1997.tb00946.x [9] Elble, R., Hughes, L. and Higgins, C. (1992) The Syndrome of Senile Gait. Journal of Neurology, 239, 71-75.
http://dx.doi.org/10.1007/BF00862975 [10] Aoyagi, K., et al. (1998) Falls among Community-Dwelling Elderly in Japan. Journal of Bone and Mineral Research, 13, 1468-1474.
http://dx.doi.org/10.1359/jbmr.1998.13.9.1468 [11] Chiba, H., et al. (2005) Differential Gait Kinematics between Fallers and Non-Fallers in Community-Dwelling Elderly People. Geriatrics & Gerontology International, 5, 127-134.
http://dx.doi.org/10.1111/j.1447-0594.2005.00281.x [12] Norkin, C.C. and White, D.J. (2009) Measurement of Joint Motion: A Guide to Goniometry. F a Davis. [13] Hausdorff, J.M., et al. (1997) Increased Gait Unsteadiness in Community-Dwelling Elderly Fallers. Archives of Physical Medicine and Rehabilitation, 78, 278-283.
http://dx.doi.org/10.1016/S0003-9993(97)90034-4 [14] Andersson, E.A., Nilsson, J. and Thorstensson, A. (1997) Intramuscular EMG from the Hip Flexor Muscles during Human Locomotion. Acta Physiologica Scandinavica, 161, 361-370.
http://dx.doi.org/10.1046/j.1365-201X.1997.00225.x [15] Perry, J. and Burnfield, J.M. (2010) GAIT ANALYSIS. Normal and Pathological Function. SLACK Inc., Thorofare, 152-153. [16] Fox, M.D. and Delp, S.L. (2010) Contributions of Muscles and Passive Dynamics to Swing Initiation over a Range of Walking Speeds. Journal of Biomechanics, 43, 1450-1455.
http://dx.doi.org/10.1016/j.jbiomech.2010.02.009 [17] JudgeRoy, J.O., Davis, B. and Ounpuu, S. (1996) Step Length Reductions in Advanced Age: The Role of Ankle and Hip Kinetics. The Journals of Gerontology Series A, 51A, 303-312.
http://dx.doi.org/10.1093/gerona/51A.6.M303