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. 2023 Oct 27:2023:7385119.
doi: 10.1155/2023/7385119. eCollection 2023.

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

Jaison Jacob Mathunny  1 , Hari Krishnan Srinivasan  1 , Ashok Kumar  1 , Varshini Karthik  1
Affiliations

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

Jaison Jacob Mathunny et al. Appl Bionics Biomech. .

Abstract

Perturbation-based balance training (PBT) improves reactive stepping in older adults and people with neurological disorders. Slip-induced falls are a threat to older adults, leading to hip fractures. Fall-prone individuals must be trained to regain balance during a fall in the posterolateral direction. This study aims to analyze the characteristics of the reactive step induced by a laterally inclined platform. This cross-sectional study included 46 healthy participants who performed a "lean and release" backward fall using a platform with two inclined angles on each side. Kinovea software was used to analyze the step width. Reactive steps, characterized by crossover or medial foot placement, are preventive measures against posterolateral falls. The first objective was on the narrowed step width that was subjected to analysis using analysis of variance (ANOVA) and Tukey's post hoc assessment, indicating a tendency toward posterolateral falls. As part of our second objective, the inclined platform resulted in uneven loading between the legs, with a preference for the unloaded leg as the reactive leg (p < 0.001), as determined by Fisher's exact test and Cramer's V. These characteristics align closely with those observed in modified constraint-induced movement therapy (mCIMT). The angled platform had a significant effect on selecting the reactive leg, particularly at higher angles (p < 0.001). Thus, the study suggested that the device is capable of inducing posterolateral falls and exhibited mCIMT characteristics.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The whole setup of lean and release backward fall with a laterally inclined platform.
Figure 2
Figure 2
Laterally inclined platform setup.
Figure 3
Figure 3
Measurement of step width using Kinovea software. (a) The grid in Kinovea software is calibrated to ensure accurate measurements. (b) Step width (SW) measurement: Real Kinovea data are collected, as illustrated in the SW3 of diagram (c). The measured step width is 1.64 cm, which is calculated by subtracting the resultant 12.86 cm from the initial 14.5 cm since the right leg has crossed the midline. Reference distance test: A reference distance test is performed in the background, where a 16.89 cm Kinovea measured distance is validated between stickers placed within a grid section that measures physically 17 cm. (c) SW1 case: SW1 represents a case where the right leg did not cross the midline and is positioned 14.5 cm away from the midline. Therefore, SW1 is 29 cm. SW2 case: SW2 represents a case where the step width is on the midline, resulting in a step width (SW2) of 14.5 cm.
Figure 4
Figure 4
The box plot shows the exact width of where each step was placed. The rectangular box in the bottom left corner shows the mean distance from the center of the stance.
See this image and copyright information in PMC

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