Repeated-slip training: an emerging paradigm for prevention of slip-related falls among older adults.
Falls frequently cause injury-related hospitalization or death among older adults. This article reviews a new conceptual framework on dynamic stability and weight support in reducing the risk for falls resulting from a forward slip, based on the principles of motor control and learning, in the context of adaptation and longer-term retention induced by repeated-slip training. Although an unexpected slip is severely destabilizing, a recovery step often is adequate for regaining stability, regardless of age. Consequently, poor weight support (quantified by reduction in hip height), rather than instability, is the major determinant of slip-related fall risk. Promisingly, a single session of repeated-slip training can enhance neuromechanical control of dynamic stability and weight support to prevent falls, which can be retained for several months or longer. These principles provide the theoretical basis for establishing task-specific adaptive training that facilitates the development of protective strategies to reduce falls among older adults.
Pai
Yi-Chung
YC
Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor St, Room 426 (M/C 898), Chicago, IL 60612, USA. cpai@uic.edu
Bhatt
Tanvi S
TS
D000058:Accidental Falls / Q000517:prevention & control*; D000222:Adaptation, Physiological; D001835:Body Weight / Q000502:physiology; D005684:Gait / Q000502:physiology; D006801:Humans; D026741:Physical Therapy Modalities; D011434:Proprioception / Q000502:physiology*; D012153:Retention, Psychology
J Neurophysiol. 2005 Jul;94(1):673-87
15788517
Phys Ther. 1993 Jun;73(6):346-51; discussion 351-4
8497509
J Gerontol. 1990 Mar;45(2):M49-54
2313043
Gait Posture. 2004 Feb;19(1):16-23
14741300
J Biomech. 2006;39(12):2194-204
16125182
N Engl J Med. 1988 Dec 29;319(26):1701-7
3205267
Phys Ther. 1997 May;77(5):488-507
9149760
Gait Posture. 2004 Oct;20(2):154-62
15336285
Exp Brain Res. 1995;103(3):476-8
7789454
Exp Brain Res. 1976 Aug 27;26(1):59-72
964327
Prosthet Orthot Int. 1986 Dec;10(3):139-41
3808919
J Neurophysiol. 1994 Feb;71(2):611-22
8176430
Clin Biomech (Bristol, Avon). 2001 Nov;16(9):813-9
11714559
Arch Intern Med. 1989 Jul;149(7):1628-33
2742437
J Gerontol A Biol Sci Med Sci. 1997 Mar;52(2):M80-7
9060974
J Physiol. 2002 Sep 1;543(Pt 2):709-17
12205202
Neurosci Lett. 1991 May 13;126(1):71-4
1866087
J Gerontol A Biol Sci Med Sci. 1998 Nov;53(6):M471-80
9823752
Clin Geriatr Med. 1985 Aug;1(3):501-12
3913506
Brain Res Cogn Brain Res. 2003 Apr;16(2):192-8
12668227
Gait Posture. 2002 Feb;15(1):75-82
11809583
J Gerontol. 1985 May;40(3):287-95
3989241
J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M492-5
12145361
Exp Brain Res. 2001 May;138(2):210-8
11417462
J Gerontol. 1991 May;46(3):M69-76
2030269
J Biomech. 1999 Aug;32(8):779-86
10433419
J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M289-96
8914501
Brain Res. 1975 Feb 21;85(1):103-7
1109686
Res Q Exerc Sport. 1989 Dec;60(4):342-7
2489861
Gait Posture. 2000 Oct;12(2):87-93
10998604
Age Ageing. 1997 Jul;26(4):261-8
9271288
Phys Ther. 2001 Jan;81(1):9-746
11175682
J Gerontol A Biol Sci Med Sci. 2004 May;59(5):494-502
15123760
Int J Aging Hum Dev. 1986;23(2):97-114
3557634
J Neurophysiol. 2000 Aug;84(2):1026-34
10938325
Brain Res Brain Res Rev. 2002 Oct;40(1-3):178-91
12589916
Clin Geriatr Med. 1985 Aug;1(3):679-94
3913516
J Neurophysiol. 1980 Oct;44(4):650-64
7431045
J Biomech. 2007;40(7):1559-66
17052723
Phys Ther. 1989 Nov;69(11):923-31
2813520
J Biomech. 2001 Nov;34(11):1439-45
11672718
Gait Posture. 2006 Oct;24(2):237-46
16221549
J Gerontol A Biol Sci Med Sci. 2001 Jul;56(7):M428-37
11445602
Exp Brain Res. 2003 Aug;151(3):301-8
12802549
J Neurophysiol. 2006 May;95(5):2913-22
16407423
J Biomech. 2000 Mar;33(3):387-92
10673124
Trends Neurosci. 2006 Jan;29(1):58-64
16290273
J Biomech. 1997 Apr;30(4):347-54
9075002
J Neurophysiol. 2003 Aug;90(2):755-62
12904492
Exp Brain Res. 2002 Aug;145(4):528-38
12172665
J Neurophysiol. 2002 Jul;88(1):339-53
12091559
J Exp Psychol Hum Percept Perform. 1994 Oct;20(5):987-99
7964533
J Gerontol. 1994 Mar;49(2):M72-84
8126355
Gait Posture. 2005 Feb;21(2):146-56
15639393
Nat Neurosci. 2000 Nov;3 Suppl:1212-7
11127840
Nature. 2003 Oct 9;425(6958):616-20
14534587
Arch Phys Med Rehabil. 1997 Jul;78(7):737-44
9228877
Annu Rev Neurosci. 1989;12:157-83
2648948
Exp Brain Res. 2006 Mar;170(1):61-73
16344930
Gait Posture. 2005 Jan;21(1):48-58
15536033
J Biomech. 2007;40(6):1318-25
16876174
Nat Rev Neurosci. 2004 Nov;5(11):853-62
15496863
Arch Phys Med Rehabil. 1989 Oct;70(10):751-4
2802954
J Biomech. 1984;17(1):53-60
6715389
Ann Intern Med. 1994 Sep 15;121(6):442-51
8053619
Science. 2001 Nov 2;294(5544):1030-8
11691980
Gerontol Clin (Basel). 1963;5:129-38
13977074
Br Med J. 1977 Jan 29;1(6056):261-4
837061
Exerc Sport Sci Rev. 2003 Jan;31(1):19-25
12562166
J Neurosci. 1994 May;14(5 Pt 2):3208-24
8182467
J Neurophysiol. 1986 Jun;55(6):1369-81
3734861
J Neurophysiol. 2005 Sep;94(3):1971-9
15928059
J Am Geriatr Soc. 1993 May;41(5):479-87
8486878
J Neurophysiol. 2002 Feb;87(2):1138-41
11826079
J Biomech. 2007;40(4):804-11
16723127
J Neurophysiol. 2001 Aug;86(2):971-85
11495965
Clin Geriatr Med. 2002 May;18(2):141-58
12180240
Gait Posture. 2002 Apr;15(2):159-71
11869910
Biol Cybern. 1987;57(3):169-85
3676355
Exp Brain Res. 1994;102(2):339-49
7705511
J Neurophysiol. 1989 Oct;62(4):841-53
2809706
J Am Geriatr Soc. 1996 Mar;44(3):300-4
8600201
Acta Otolaryngol. 1986 Jul-Aug;102(1-2):87-92
3488637
Behav Neurosci. 1985 Apr;99(2):233-56
3843710
J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M496-503
12145362
Science. 1997 Aug 8;277(5327):821-5
9242612