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Fall history in older adults impacts acceleration profiles after a near collision with a moving pedestrian hazard

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Abstract

Background

Environmental hazards (e.g., pedestrian traffic) cause falls and testing environment impacts gait in older adults. However, most fall risk evaluations do not assess real-world moving hazard avoidance.

Aims

This study examined the effect of fall history in older adults on acceleration profiles before, during, and after a near collision with a moving hazard, in laboratory and real-world settings.

Methods

Older adults with (n = 14) and without a fall history (n = 15) performed a collision avoidance walking task with a sudden moving hazard in real-world and laboratory settings. Gait acceleration and video data of participants’ first-person views were recorded. Four mixed effects multilevel models analyzed the magnitude and variability of mean and peak anteroposterior and mediolateral acceleration while walking before, during, and after the moving hazard in both environments.

Results

In the real-world environment, older adults without a fall history increased their mean anteroposterior acceleration after the moving hazard (p = 0.046), but those with a fall history did not (p > 0.05). Older adults without a fall history exhibited more intersubject variability than those with a fall history in mean (p < 0.001) and peak anteroposterior (p = 0.015) acceleration across environments and epochs. Older adults without a fall history exhibited a slower peak mediolateral reaction during the moving hazard (p = 0.014) than those with a fall history.

Conclusions

These results suggest that compared to older adults with a fall history, older adults without a fall history are more adaptable and able to respond last-minute to unexpected hazards. Older adults with a fall history exhibited more homogenous responses.

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Data availability

The data sets generated or analyzed during the current study are not publicly available, because they contain information that could compromise the privacy of the research participants but are available from the corresponding author upon request.

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Acknowledgements

The authors would like to thank Alyssa Kappert for her assistance in the acquisition and post-processing of the data.

Funding

This research was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001111 to Lisa A. Zukowski: https://ncats.nih.gov/. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, High Point University, High Point, NC, USA

    Lisa A. Zukowski

  2. School of Kinesiology, Auburn University, Auburn, AL, USA

    Sarah A. Brinkerhoff & Jaimie A. Roper

  3. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, North Cyprus Via Mersin 10, Famagusta, Turkey

    Gozde Iyigun

  4. Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carol A. Giuliani

  5. Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carol A. Giuliani

  6. Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA

    Prudence Plummer

Authors
  1. Lisa A. Zukowski
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Contributions

All authors contributed to the study conception and design. Funding was acquired by LAZ, CAG, and PP. Material preparation and data collection were performed by LAZ, GI, CG, and PP. Data analysis was performed by SAB and JAR. The first draft of the manuscript was written by LAZ and SAB, and all authors revised it critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lisa A. Zukowski.

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The authors of this paper report no conflicts of interest.

Research involving human participants

This study was approved by the University’s Institutional Review Board and performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from all participants before participating in any testing procedures.

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Zukowski, L.A., Brinkerhoff, S.A., Iyigun, G. et al. Fall history in older adults impacts acceleration profiles after a near collision with a moving pedestrian hazard. Aging Clin Exp Res 35, 621–631 (2023). https://doi.org/10.1007/s40520-023-02345-7

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