Obesity as a Factor Contributing to Falls by Older Adults
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The growth of the worldwide population of older adults presents significant challenges, many inter-related, that range from the health of individuals to the health of national economies. In the US, more than one-third of older adults may be obese, a condition that may independently increase the risk for mobility impairment, fall-related injury and, possibly, costs of post-injury treatment and care. The effectiveness of conventional exercise-based fall prevention programs is significant but smaller than both the annual rate of falling of older adults and rate of growth of this population, who are at greatest risk for injurious falls. The anthropometric and functional consequences of obesity may impose limitations on the ability to perform compensatory stepping responses following large postural disturbances. The focus of this paper is the potential of task-specific training to improve compensatory stepping responses and reduce falls by obese people given the individual-specific anthropometric and functional consequences of obesity.
KeywordsBalance Gait Impairment Intervention Injury Mobility Stability Obesity Falls Older adults
Michael Madigan reports grants from CDC-NIOSH.
Compliance with Ethics Guidelines
Conflict of Interest
Michael Madigan and Noah J. Rosenblatt declare that they have no conflict of interest.
Mark D. Grabiner has a US patent "Fall prevention training system and method using a dynamic perturbation platform". M.D. Grabiner, R. Greenwald, Buck A, Paflika, R, US Patent number 7,980,856 B2, issue date, 19 July 2011, with royalties paid through the University of Illinois at Chicago (UIC) . He is also one of the inventors of the ActiveStep treadmill but does not have a FCOI to disclose; UIC owns the patent for the ActiveStep treadmill (Institutional COI).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Fryhofer, SA. Report of the Council of Science and Public Health, Report 3-A-13, Resolution115-A-12, Is Obesity a Disease. 2012, www.ama-assn.org/resources/doc/csaph/a13csaph3.pdf.
- 8.••Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012. doi: 10.1002/14651858.CD007146.pub3. This work highlights the effectiveness of conventional exercise-based programs to reduce fall risk and rate of falling by about 30 percent. However, it also indirectly highlights the effectiveness of exercise-based programs will not likely be able to keep up with the rate at which the population of older adults, those most likely to fall, is increasing. Google Scholar
- 15.Compston JE, Flahive J, Hooven FH, Anderson FA Jr, Adachi JD, Boonen S, et al. Obesity, health-care utilization, and health-related quality of life after fracture in postmenopausal women: Global Longitudinal Study of Osteoporosis in Women (GLOW). Calcif Tissue Int. 2014;94(2):223–31.Google Scholar
- 16.Fakhouri THI, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the united States, 2007-2010, NCHS Data Brief 106, September 2012, www.cdc.gov/nchs/data/databriefs/db106.htm.
- 25.•Rosenblatt NJ, Grabiner MD. Relationship between obesity and falls by middle-aged and older women. Arch Phys Med Rehabil. 2012;93:718–22. This work is significant because it highlighted not only that following a laboratory-induced trip obese middle age and older women fell more frequently than non-obese women but also identified a possible biomechanical mechanism of the fall. PubMedCrossRefGoogle Scholar
- 26.Allin LJ, Wu X, Nussbaum MA, Madigan ML. Obesity increases fall risk after slipping among young adults. 7th World Congress of Biomechanics, July 6-11, 2014, Boston, MA, In press.Google Scholar
- 27.Hita-Contreras F, Martínez-Amat A, Lomas-Vega R, Álvarez P, Mendoza N, Romero-franco N, et al. Relationship of body mass index and body fat distribution with postural balance and risk of falls in Spanish postmenopausal women. Menopause. 2012;20:202–8.Google Scholar
- 41.Maki BE, McIlroy WE. Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Aging. 2006;35(S2):ii12–8.Google Scholar
- 42.Matrangola SL. An experimental and simulation based approach toward understanding the effects of obesity on balance recovery from a postural perturbation. PhD Dissertation, Virginia Polytechnic Institute and State University, 2011.Google Scholar
- 43.Caudle SK, Matrangola SL, Madigan ML. Comparison of trunk kinematics between experimental tripping protocols. American Society of Biomechanics, 2011 http://www.asbweb.org/.
- 46.Rauch J, Veilleux L-N, Rauch F, Bock D, Welisch E, Filler G, et al. Muscle force and power in obese and overweight children. Musculoskelet Neuronal Interact. 2012;12:80–3.Google Scholar
- 47.Koushyar H, Nussbaum MA, Madigan ML. Effect of obesity on lower extremity strength of young and older females. 7th World Congress of Biomechanics, July 6-11, 2014 in Boston, MA, In press.Google Scholar
- 51.Tomioka M, Owings TM, Grabiner MD. Lower extremity strength and coordination are independent contributors to maximum vertical jump height. J Appl Biomech. 2001;17:181–7.Google Scholar
- 52.Henry FM. Specificity versus generality in learning motor skill. In: Brown RC, Kenyon GS, editors. Classical studies on physical activity. Englewood Cliffs: Prentice Hall; 1968. p. 331–40.Google Scholar
- 54.••Grabiner MD, Marone J, Gatts S, Bareither ML, Troy KL. Task-specific training reduces trip-related fall risk in women. Med Sci Sports Exerc. 2012;44:2410–4. Compared to control group women, middle age and older women who participated in a short-term trip-specific fall prevention intervention had fewer falls after a carefully controlled laboratory-induced trip (odds ratio = 0.13). PubMedCrossRefGoogle Scholar
- 55.••Rosenblatt NJ, Marone J, Grabiner MD. Preventing trip-related falls by community-dwelling adults: a prospective study. J Am Geriatr Soc. 2013;61:1629–31. Compared to control group women, middle age and older women who participated in a 2-week trip-specific fall prevention intervention had fewer trip-related falls reported prospectively during a 12 month post-training period (incidence rate ratio = 0.54). PubMedCrossRefGoogle Scholar