Article

Deaths and injuries resulting from falls are a significant problem for older
adults. Over half of falls during walking result from a trip, and these are
likely to begin when the foot contacts the ground at the point of minimum toe
clearance (MTC) during the swing phase where the foot most closely approaches the
ground. MTC is commonly investigated using a limited number of points and on a
treadmill, which cannot account for flooring irregularities, speed changes, and
direction changes of overground gait. This paper presents a new method of
calculating 3D overground MTC that accounts for flooring variations and utilizes
hundreds of points on each shoe. These methods are applied to 10 unimpaired
adults during habitual gait: (1) without a concurrent task, (2) while carrying a
9-kg laundry basket, (3) while carrying a tray with a full glass of water on it,
and (4) while answering standardized conversational questions. Results indicated
that steps were slower and shorter during concurrent tasks while MTC changes were
dependent on task type (higher for basket, lower for questions, and unchanged for
water). Task-related MTC changes were independent of spatiotemporal gait changes.
Thus, MTC during overground gait, particularly while concurrent tasks are being
performed, may be an independent fall risk factor that merits further
investigation in subjects at-risk of falls. The relationships between MTC, gait
parameters, and older age or fall risk should be explored further in at-risk
subjects and circumstances to elucidate potential tripping mechanisms.
CI - Published by Elsevier B.V.

Langue : ANGLAIS