Date of Award
2018
Document Type
Dissertation
Degree Name
Ph.D. in Health and Kinesiology
Department
Health, Exercise Science, and Recreation Management
First Advisor
Dwight E. Waddell
Second Advisor
John C. Garner
Third Advisor
John P. Bentley
Relational Format
dissertation/thesis
Abstract
Background: Slips and falls account for large rates of injury and mortality in multiple populations. During an unexpected slip, sensory mechanisms are responsible for signaling the slip to the central nervous system, and a series of corrective responses is generated to arrest the slip and prevent a fall. While previous research has examined the corrective responses elicited, the answer of how these systems break down during a fall remains elusive. Purpose: To examine differences in postural control (slip detection), lower extremity corrective responses (slip recovery), and cortical control of the slip recovery response between individuals who fall and those who recover. Methods: One hundred participants were recruited for this study (50 males & 50 females). Participant’s gait kinematics and kinetics were collected during normal gait (NG) and an unexpected slip (US). The slip was classified as a fall or recovery, and by slip severity. Once classified, postural control, reaction times, corrective moments, and cortical contribution were examined between groups using ANOVAs and independent t-tests. Additionally, prediction equations for slip outcome, and slip severity were created using a binary logistic regression model. Slip Detection Results: Postural sway when the proprioceptive (OR = 0.02, CI: 0.01-1.34) and vestibular (OR = 0.60, CI: 0.26-1.39) systems are stressed were negatively associated with odds of falling. While postural sway when the visual system was stressed (OR = 3.18, CI: 0.887-11.445) was positively associated with odds of falling. Slip Recovery Results: Increased time to peak hip extension (OR = 1.006, CI: 1.00-1.01) and ankle dorsiflexion (OR = 1.005, CI: 1.00-1.01) moments increased the odds of falling. While the average ankle moment was negatively associated with falling (OR = 0.001, CI: 0.001-0.005). Cortical Contribution Results: Spectral power in the Piper frequency band was increased in US trials compared to NG. Further, fallers exhibited an increase in cortical activity compared to those who recovered. Conclusions: Rapid lower extremity corrective responses appear critical in arresting the slip and preventing a fall, and the temporal nature of this response may depend on slip detection and subsequent response selection. Moreover, our results suggest that more severe slips may require increased activation of higher centers of the motor cortex.
Recommended Citation
Wilson, Samuel J., "The Slippery Slope Between Falling And Recovering: An Examination Of Sensory And Somatic Factors Influencing Recovery After A Slip" (2018). Electronic Theses and Dissertations. 610.
https://egrove.olemiss.edu/etd/610