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Author Melzer, I.; Krasovsky, T.; Oddsson, L.I.E.; Liebermann, D.G. url  doi
openurl 
  Title Age-related differences in lower-limb force-time relation during the push-off in rapid voluntary stepping Type Journal Article
  Year 2010 Publication (up) Clinical Biomechanics (Bristol, Avon) Abbreviated Journal Clin Biomech (Bristol, Avon)  
  Volume 25 Issue 10 Pages 989-994  
  Keywords Accidental Falls/prevention & control; Age Factors; Aged; Aged, 80 and over; Aging/physiology; *Biomechanics; Female; Gait/*physiology; Humans; Male; *Postural Balance; Walking/*physiology  
  Abstract BACKGROUND: This study investigated the force-time relationship during the push-off stage of a rapid voluntary step in young and older healthy adults, to study the assumption that when balance is lost a quick step may preserve stability. The ability to achieve peak propulsive force within a short time is critical for the performance of such a quick powerful step. We hypothesized that older adults would achieve peak force and power in significantly longer times compared to young people, particularly during the push-off preparatory phase. METHODS: Fifteen young and 15 older volunteers performed rapid forward steps while standing on a force platform. Absolute anteroposterior and body weight normalized vertical forces during the push-off in the preparation and swing phases were used to determine time to peak and peak force, and step power. Two-way analyses of variance ('Group' [young-older] by 'Phase' [preparation-swing]) were used to assess our hypothesis (P </= 0.05). FINDINGS: Older people exerted lower peak forces (anteroposterior and vertical) than young adults, but not necessarily lower peak power. More significantly, they showed a longer time to peak force, particularly in the vertical direction during the preparation phase. INTERPRETATIONS: Older adults generate propulsive forces slowly and reach lower magnitudes, mainly during step preparation. The time to achieve a peak force and power, rather than its actual magnitude, may account for failures in quickly performing a preventive action. Such delay may be associated with the inability to react and recruit muscles quickly. Thus, training elderly to step fast in response to relevant cues may be beneficial in the prevention of falls.  
  Address Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0268-0033 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:20724044 Approved no  
  Call Number Serial 51  
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Author Bezalel, G.; Nachoum Arad, G.; Plotnik, M.; Friedman, J. pdf  url
doi  openurl
  Title Voluntary step execution in patients with knee osteoarthritis: Symptomatic vs. non-symptomatic legs Type Journal Article
  Year 2021 Publication (up) Gait & Posture Abbreviated Journal Gait Posture  
  Volume 83 Issue Pages 60-66  
  Keywords Accidental falls; Gait; Knee; Osteoarthritis; Voluntary step  
  Abstract BACKGROUND: Individuals with osteoarthritis fall at a greater rate than the general population, likely as a result of weakness, pain, movement limitations, and a decline in balance. Due to the high prevalence of osteoarthritis in the population, understanding the mechanisms leading to greater fall risk is an important issue to better understand. RESEARCH QUESTION: What is the influence of unilateral knee osteoarthritis on the characteristics of performing a voluntary step (i.e., similar to that performed to avoid a fall after a perturbation), compared to healthy age-matched controls? METHODS: Case-control study performed in a Health maintenance organization physical therapy clinic. The research group consisted of a referred sample of 21 patients with unilateral knee osteoarthritis. The control group consisted of 22 age-matched healthy individuals. All participants were over 65 years of age. Participants were excluded if they had a surgical procedure to back or lower limb within one year before testing, oncological or neurological disease or a deficit in tactile sense. Movements were performed with and without dual tasking. MEASUREMENTS: Duration of the initiation phase (cue to step initiation), preparatory phase (step initiation to foot off) and swing phase (foot off to foot contact). RESULTS: In the preparatory phase and swing phase, the osteoarthritis group moved more slowly than the control group, and these differences were larger for forward compared to backward movements. Dual-tasking slowed responses in the pre-movement initiation stage across groups. SIGNIFICANCE: The differences in basic parameters, and the slower movements in the osteoarthritis group, are consistent with known features of osteoarthritis, being a disease commonly regarded as primarily “mechanical”, and are likely to increase fall risk. These response deficits suggest we should take advantage of advanced rehabilitation techniques, including cognitive loading, to help prevent falls in older adults with osteoarthritis.  
  Address Dept. Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. Electronic address: jason@tau.ac.il  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0966-6362 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:33080457 Approved no  
  Call Number Serial 107  
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Author Melzer, I.; Liebermann, D.G.; Krasovsky, T.; Oddsson, L.I.E. url  doi
openurl 
  Title Cognitive load affects lower limb force-time relations during voluntary rapid stepping in healthy old and young adults Type Journal Article
  Year 2010 Publication (up) The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences Abbreviated Journal J Gerontol A Biol Sci Med Sci  
  Volume 65 Issue 4 Pages 400-406  
  Keywords *Accidental Falls; Adult; Aged; Aged, 80 and over; Aging/*physiology; Attention/physiology; Cognition/*physiology; Gait/*physiology; Humans; Postural Balance/*physiology; Reaction Time  
  Abstract BACKGROUND: Quick step execution may prevent falls when balance is lost; adding a concurrent task delays this function. We investigate whether push-off force-time relations during the execution of rapid voluntary stepping is affected by a secondary task in older and young adults. METHODS: Nineteen healthy older adults and 12 young adults performed rapid voluntary stepping under single- and dual-task conditions. Peak power, peak force, and time to peak force during preparatory and swing phases of stepping were extracted from center of pressure and ground reaction force data. RESULTS: For dual-task condition compared with single-task condition, older adults show a longer time to reach peak force during the preparation and swing phases compared with young adults (approximately 25% vs approximately 10%, respectively). Peak power and peak force were not affected by a concurrent attention-demanding task. CONCLUSION: Older adults have difficulty allocating sufficient attention for fast muscle recruitment when concurrently challenged by an attention-demanding task.  
  Address Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1079-5006 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:19939911 Approved no  
  Call Number Serial 50  
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