Name: GABRIELA VIGORITO MAGALHAES
Publication date: 19/07/2024
Examining board:
Name |
Role |
|---|---|
| ELIANE CELINA GUADAGNIN | Examinador Externo |
| LUCAS SIMIELI | Examinador Externo |
| NATALIA MADALENA RINALDI | Presidente |
Summary: Going up and down stairs are relevant motor tasks that challenge the locomotor system of the older adults. Associatedly, the deficit in postural control after aging can influence the performance of older adults when subjected to complex tasks. However, the relationship between postural control performance and the locomotor pattern of older adults when negotiating stairs has not yet been fully elucidated. The objective of this study is to investigate the relationship between postural control performance and locomotor pattern during climbing and descending stairs in older adults and young adults. 15 young adults (29.86±6.57 years) and 16 older adults (65.25±3.94 years) capable of performing the experimental tasks participating in this study. To assess postural control, participants performed three conditions, namely: 1) bipedal base; 2) semi tandem base and 3) single-leg base. To evaluate the locomotor task, participants were asked to walk and climb the stairs one subway away at a self-selected velocity. After resting for a minute, they were asked to descend at a self-selected velocity and walk to the end of the walkway. To evaluate postural control, a force platform (Biomec 400, EMGSystem do Brasil, SP, LTDA) was used with an acquisition frequency of 100 Hz. For kinematic analysis of the stair activity, two digital cameras were used (GoPro brand, Hero 7 Black) with recordings at 60 Hz. The variables found related to postural control were: total speed, average oscillation amplitude for the anteroposterior and mediolateral sides and oscillation frequency variables with bands of 50% and 80% of power spectra for both locations. The kinematic gait variables were: velocity, length, width and duration of the step before and the step taken on the first step for the ascent and the step taken on the last step of the stairs and one step after for the descent. The variables related to the stairs were: vertical and horizontal foot-obstacle distance and were verified for all steps of the stairs during the ascent and descent. Multivariance tests were performed to analyze locomotor performance during stair negotiation and postural control among older adults and young adults. To investigate the relationship between fear of falling and locomotor performance on stairs, Pearson's demonstration test was performed and to verify the relationship between postural control performance and locomotor pattern on stairs, Pearson's demonstration test was performed and, for the furthermore, related to vertical-foot step distance values, linear regression analyzes were performed to investigate the association of postural control performance and locomotor adjustments in negotiating stairs. The older adults presented a moderate level of physical activity and were similar to young adults, as well as similar in relation to muscle power and risk of falls. Older adults showed greater oscillation of the center of pressure for temporal variables and was related to the level of complexity of the task. However, there was no difference in the performance of the frequency variables, but it was related to the level of complexity. Older adults, compared to young adults, did not present different locomotor strategies when negotiating the stairs. For both groups, the steps approaching (N-1) and exceeding the first step (N) showed better locomotor behavior with greater velocity and length and shorter duration, when compared to the other steps taken during climbing the stairs. As for descending, locomotor performance was better as the task was performed, with greater velocity and length and shorter duration of steps as the participants descended. Negative correlations were found between the fear of falling and the behavior of the spatio-temporal gait variables, except the duration of the steps, and variables related to the stairs, which indicates that the greater the fear of falling, the lower the locomotor performance during negotiation of stairs. Finally, this study found that the task of climbing stairs imposes greater demands on the locomotor pattern of both groups, which favors a greater risk of falls in this activity. Thus, older adults with a moderate level of physical activity present postural and locomotor behavior similar to young people. These results found specify the mechanisms and moments of risk related to the stairs, as well as the importance of the level of physical activity and the fear of falling and, mainly, postural control in the parameters and locomotor adjustments of climbing and descending the stairs. With this, it is possible to identify risk factors when negotiating stairs, especially in the older adults population, as well as outline training and fall prevention behaviors. Furthermore, these results provide information for the rehabilitation of older adults with a history of falls on stairs and older adults who are at risk.
Keywords: postural control; stair negotiation; aging.
