| Summary: | Fall related injuries are a major public health concern due to their high associated medical costs and negative impact on quality of life. Obese and older adults are reported to fall more frequently than their normal-weight and young counterparts. To help identify potential mechanisms of these falls the purpose of the research within this dissertation was to investigate the effects of obesity and age on the likelihood of tripping and subsequent balance recovery.
Four experimental studies were conducted. The purpose of the first study was to investigate the effects of obesity, age and gender on the likelihood of tripping during level walking. Likelihood of tripping was assessed with median minimum foot clearance (MFC) and MFC interquartile range (IQR). Obesity did not increase the likelihood of tripping suggesting the increased rate of falls among obese adults is not likely due to a greater likelihood of tripping over an unseen obstacle. Additional results suggested females and individuals of shorter stature have an increased likelihood of tripping compared to their male and taller counterparts.
The purpose of the second study was two-fold. First, the effects of load carriage and ramp walking on the likelihood of tripping were investigated, followed by investigating the effects of age and obesity on the likelihood of tripping during load carriage and ramp walking. Again, likelihood of tripping was assessed with median MFC and MFC IQR. Load carriage increased the likelihood of tripping during both level and ramp walking and obesity and age increased the likelihood of tripping during selected combinations of load carriage and/or ramp walking. These results suggest that the increased rate of falls during load carriage and the increased rate of falls among obese and older adult workers reported elsewhere may be due in part to an increased likelihood of tripping.
The third study proposed a new method for investigating the likelihood of tripping as a function of obstacle height. The proposed method aimed to clear up ambiguous results often encountered when using MFC central tendency and variability to quantify likelihood of tripping. The method used trip probability curves and a statistical bootstrapping technique to compare trip probability at specific obstacle heights between groups of interest. An additional benefit of this method was that it was able to identify effects of factors not identifiable by the commonly used ANOVA analysis using MFC central tendency and variability.
The purpose of the fourth study was to investigate the effects of obesity, age and gender on balance recovery following a lab induced trip perturbation. Measures of balance recovery included fall rate, stepping strategy and characteristics, and trunk kinematics. Obese, older, and female adults fell more frequently after tripping and this higher fall rate may help explain the higher fall rates among obese, older and female adults reported elsewhere. Failed recoveries were associated with higher peak trunk angles and angular velocities in addition to the use of a lowering strategy. Obese, older, and female adults had higher peak trunk angles and angular velocities and older adults and females used lowering strategies more often. These alterations in trunk kinematics and stepping strategy may have contributed to the higher fall rate among these individuals. === Ph. D.
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