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Graham, D.F.; Modenese, L.; Trewartha, G.; Carty, C.P.; Constantinou, M.; Lloyd, D.G.; Barrett, R.S. (2016)
Publisher: Elsevier
Languages: English
Types: Article
Subjects: Falls, Static Optimisation, Hip fracture, Joint contact load, Musculoskeletal model

Classified by OpenAIRE into

mesheuropmc: musculoskeletal diseases

Hip joint contact loads during activities of daily living are not generally considered high enough to cause acute bone or joint injury. However there is some evidence that hip joint loads may be higher in stumble recovery from loss of balance. A common laboratory method used to evaluate balance recovery performance involves suddenly releasing participants from various static forward lean magnitudes (perturbation intensities). Prior studies have shown that when released from the same perturbation intensity, some older adults are able to recover with a single step, whereas others require multiple steps. The main purpose of this study was to use a musculoskeletal model to determine the effect of three balance perturbation intensities and the use of single versus multiple recovery steps on hip joint contact loads during recovery from forward loss of balance in community dwelling older adults (n=76). We also evaluated the association of peak hip contact loads with perturbation intensity, step length and trunk flexion angle at foot contact at each participant's maximum recoverable lean angle (MRLA). Peak hip joint contact loads were computed using muscle force estimates obtained using Static Optimisation and increased as lean magnitude was increased and were on average 32% higher for Single Steppers compared to Multiple Steppers. At the MRLA, peak hip contact loads ranged from 4.3 to 12.7 body weights and multiple linear stepwise regression further revealed that initial lean angle, step length and trunk angle at foot contact together explained 27% of the total variance in hip joint contact load. Overall findings indicated that older adults experience peak hip joint contact loads during maximal balance recovery by stepping that in some cases exceeded loads reported to cause mechanical failure of cadaver femurs. While step length and trunk flexion angle are strong predictors of step recovery performance they are at best moderate predictors of peak hip joint loading.

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    • Barrett, R. S., Cronin, N. J., Lichtwark, G. A., Mills, P. M., & Carty, C. P. (2012). Adaptive recovery responses to repeated forward loss of balance in older adults. Journal of Biomechanics, 45(1), 183-187.
    • Bergmann, G., Deuretzbacher, G., Heller, M., Graichen, F., Rohlmann, A., Strauss, J., & Duda, G. N. (2001). Hip contact forces and gait patterns from routine activities. Journal of Biomechanics, 34(7), 859-871.
    • Bergmann, G., Graichen, F., & Rohlmann, A. (1993). Hip joint loading during walking and running, measured in two patients. Journal of Biomechanics, 26(8), 969-990.
    • Bergmann, G., Graichen, F., & Rohlmann, A. (2004). Hip joint contact forces during stumbling. Langenbeck's Archives of Surgery, 389(1), 53-59.
    • Carty, C. P., Barrett, R. S., Cronin, N. J., Lichtwark, G. A., & Mills, P. M. (2012a). Lower limb muscle weakness predicts use of a multiple- versus single-step strategy to recover from forward loss of balance in older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 67(11), 1246-1252.
    • Carty, C. P., Cronin, N. J., Lichtwark, G. A., Mills, P. M., & Barrett, R. S. (2012b). Lower limb muscle moments and power during recovery from forward loss of balance in male and female single and multiple steppers. Clinical Biomechanics, 27(10), 1031-1037.
    • Carty, C. P., Cronin, N. J., Nicholson, D. E., Lichtwark, G. A., Mills, P. M., Kerr, G. K., Cresswell, A., & Barrett, R. S. (2015). Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults. Age and Ageing, 44(1), 109-115.
    • Carty, C. P., Mills, P., & Barrett, R. (2011). Recovery from forward loss of balance in young and older adults using the stepping strategy. Gait and Posture, 33(2), 261-267.
    • Cronin, N. J., Barrett, R. S., Lichtwark, G. A., Mills, P. M., & Carty, C. P. (2013). Muscle activation strategies used by single and multiple steppers in response to forward loss of balance. Journal of Electromyography and Kinesiology, 23, 1139-1144.
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