Human Physiology Theses and Dissertations

Permanent URI for this collection

https://hdl.handle.net/1794/3528

Browse

Browsing Human Physiology Theses and Dissertations by Subject "Balance"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Clinical and Laboratory Balance Assessment in the Elderly
    (University of Oregon, 2013-07-11) Chen, Tzurei; Chou, Li-Shan
    Falls can have severe consequences for elderly adults. In 2000, nearly 10,300 people aged 65 years or older died as a result of falls, and 2.6 million individuals were treated for non-fatal fall-related injuries. In order to reduce fall incidences, it is important to identify possible causes of falls, such as muscle weakness and imbalance. In this study, we examined balance control in the elderly during task transitions while performing the Timed Up and Go test (TUG). The TUG is a commonly used clinical balance test that includes transition phases between three daily activity tasks: sit-to-stand, walking and turning. Our findings suggested that elderly adults, especially fallers, have reduced balance control ability while making transitions during TUG. During sit-to-walk (STW), when compared to young adults, elderly adults demonstrated a smaller forward center of mass (COM) velocity, a smaller anterior-posterior (A-P) COM-Ankle angle, and a larger upward kinetic energy ratio at seat-off. Additionally, the medial-lateral COM control in elderly fallers was also perturbed due to their significant reduction in forward COM velocity. The reduced initial hip extensor moment and increased ankle plantarflexor moment in elderly fallers was associated with their reduced generation of horizontal momentum during STW. Smaller A-P COM-Ankle angles and taking more steps when making a turn demonstrated a reduction in balance control ability in elderly adults. Our analyses suggest that balance control is an important factor contributing to longer STW and turning durations of TUG. Furthermore, lower extremity muscle strength at hip and knee joints demonstrated a stronger association with STW than turning duration. To enhance the early detection of fall risk, we also assessed the ability of balance tests to predict future risk of falling in elderly adults. Our results indicated that biomechanical balance parameters measured during TUG were associated with future fall status. Among all biomechanical parameters investigated, frontal plane balance control parameters appear to be the most significant predictors for future falls. This dissertation includes unpublished co-authored material.
  • Thumbnail Image
    ItemOpen Access
    Dynamic Limits of Balance Control during Daily Functional Activities Associated with Falling
    (University of Oregon, 2012) Fujimoto, Masahiro; Fujimoto, Masahiro; Chou, Li-Shan
    Falls are one of the most serious problems among the elderly, resulting in fatal physical injuries. Early identification of people at a high risk of falling is needed to facilitate rehabilitation to reduce future fall risk. The overall goal of this dissertation was to develop biomechanical models that identify dynamic limits of balance control in daily functional activities associated with falling, including sit-to-stand (STS) movement, standing (stance perturbation), and walking. Poor performance of STS movement has been identified as one of the risk factors of falls among elderly individuals. We proposed a novel method to identify dynamic limits of balance control during STS movement using whole body center of mass (COM) acceleration and assessed its feasibility to differentiate individuals with difficulty in STS movement from healthy individuals. The results demonstrated that our model with COM acceleration could better differentiate individuals with difficulty in STS movement from healthy individuals than the traditional model with COM velocity. Poor postural control ability is also a risk factor of falls. Postural recovery responses to backward support surface translations during quiet standing were examined for healthy young and elderly adults. The results demonstrated that functional base of support (FBOS) and ankle dorsiflexor strength could be sensitive measures to detect elderly individuals with declined balance control. Our biomechanical model, which determines a set of balance stability boundaries, showed a better predictive capability than the statistical model for identifying unstable balance recovery trials, while the statistical model better predicted stable recovery trials. Lastly, walking requires a fine momentum control where COM acceleration could play an important role. Differences in control of dynamic stability during walking were examined with our proposed boundaries of dynamic stability. Elderly fallers adapted a more conservative gait strategy than healthy individuals, demonstrating significantly slower forward COM velocity and acceleration with their COM significantly closer to the base of support at toe-off, which could be indicative of a poor momentum control ability. Overall, this study demonstrated that COM acceleration would provide further information on momentum control, which could better reveal underlying mechanisms causing imbalance and provide an insightful evaluation of balance dysfunction. This dissertation includes unpublished co-authored material.