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The Role of Recovery Lower Limb Segments in Post-Slip Determination of Falls Due to Instability or Limb Collapse

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Abstract

Slip-related falls can be induced by instability or limb collapse, but the key factors that determine these two fall causations remain unknown. The purpose of this study was to investigate the factors that contribute towards instability-induced and limb-collapse-induced slip-related falls by investigating 114 novel slip trials. The segment angles and moments of the recovery limb after slip-onset from pre-left-touchdown (pre-LTD) to post-left-touchdown (post-LTD) were calculated, and logistic regression was used to detect which variable contributed most to instability-induced and limb-collapse-induced falls. The results showed that recovery from instability was determined by the angle of the thigh at LTD (87.7%), while recovery from limb collapse was determined by the angle of the shank at post-LTD (90.4%). Correspondingly, instability-induced falls were successfully predicted (81.5%) based on the initial thigh angle at pre-LTD and the following peak thigh moment, while limb-collapse-induced falls were successfully predicted (85.5%) based on the initial shank angle at LTD and the following peak shank moment. According to our findings, taking a shorter recovery step and/or increasing the counterclockwise moment of the thigh after pre-LTD would help individuals resist instability-induced falls, while taking a larger recovery step and/or increasing the clockwise moment of the shank post-LTD would help resist limb-collapse-induced falls. The findings of this study are crucial for future clinical applications, because individually tailored reactive balance training could be provided to reduce vulnerability to specific types of falls and improve recovery rates post-slip exposure.

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Acknowledgments

This work was supported by NIH R01-AG029616 and NIH R01-AG044364. We thank Ms. Alison Schenone for helpful edits.

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Authors and Affiliations

  1. Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, 60612, USA

    Shuaijie Wang, Tanvi Bhatt & Yi-Chung Pai

  2. Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, 07052, USA

    Xuan Liu

Authors
  1. Shuaijie Wang
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  2. Tanvi Bhatt
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  3. Xuan Liu
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  4. Yi-Chung Pai
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Correspondence to Yi-Chung Pai.

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Associate Editor Thurmon E. Lockhart oversaw the review of this article.

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Appendix

Appendix

See Table 4.

Table 4 The initial instant of significant difference (p < 0.05) in segment angle (or moment) detected between slip outcomes groups (F1 vs. R, F2 vs. R).
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Wang, S., Bhatt, T., Liu, X. et al. The Role of Recovery Lower Limb Segments in Post-Slip Determination of Falls Due to Instability or Limb Collapse. Ann Biomed Eng 48, 192–202 (2020). https://doi.org/10.1007/s10439-019-02327-9

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