A novel system for introducing precisely-controlled, unanticipated gait perturbations for the study of stumble recovery.
Shane T King, Maura E Eveld, Andrés Martínez and 2 others
PMID 31182126WHAT IT FOUND
Obstacle trips can be delivered on a lab treadmill without healthy subjects sensing them, and the system records how both legs recover from stumbles.
It is a research tool, not a treatment shown to prevent falls.
Key findings
01In 168 perception trials, none of the obstacle deployments were perceived by subjects.
02The perturbation trials produced 190 successful stumbles out of 196 attempts, with a mean absolute error of 6.2% of swing phase, 2.5% of stride cycle, and about 25 ms.
03The system produced elevating, lowering, and delayed lowering recovery responses in 7 subjects.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only 7 healthy subjects were tested, so the results do not show how people with gait problems would respond. The work was done on a treadmill with a heavy steel obstacle, not in everyday overground walking. The paper did not test whether the system prevents falls or improves patient outcomes. Kinetic analysis excluded trials when the subject crossed belts or the obstacle moved, and ipsilateral kinetic data correspond to only 70 of 190 trials. The system cannot react to sudden changes in gait after the obstacle is released, because release is one to two strides before perturbation.
Declared interests
Funding was from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. No other conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not read this as evidence that treadmill stumble training prevents falls. The study tested a laboratory perturbation system in healthy subjects, and the authors state that the efficacy of using it as a training device to reduce community falls is unknown.