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Completed

NCT Number: NCT03758040

Mechanisms of Fall Resistance to Diverse Slipping Conditions

Falls are the leading source of injury for all ages, and for older adults are the primary cause of injury related death. Loss of foot to ground traction accounts for 25-40% of falls, typically referred to as a slip. Slips alter the relationship between center of mass and lower limb base of support resulting in altered whole-body angular momentum and inability to support body weight due to loss of stability. But not all slips lead to falls. Stability may be recovered through a combination of response movements, such as swinging the arms or rapid recovery steps. Stability must be recovered quickly otherwise insufficient bodyweight support rapidly leads to a damaging ground collision. A high percentage of falls result in fractures, contusions and sprains to both the trunk and limbs, while slips disproportionately cause lower back injuries. A primary goal of fall prevention training is to improve the ability to resist slips using perturbations that mimic the specific sensory and biomechanical context of natural slip events. However, generating lifelike slip perturbations that mimic the diversity of slipping conditions poses a significant hurdle to improving a more general slip resistance ability. Using movement analysis, the investigators will determine the relationships between diverse slip conditions, reactive responses to slips from those conditions, and slip vulnerability across the gait cycle to generate new data that may guide future interventions.

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Key information

Conditions

Age range

19 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Biomechanics Research Building

Omaha, Nebraska, 68182, United States

About this study

Recent evidence suggests most slip-related falls in daily life happen in diverse slipping conditions where the ground is not level, or the person is turning or changing direction. While slips that occur during straight walking on level ground and the responses to those slips are relatively well understood, very little is known about slips that occur while walking on slopes or curved paths and which reactive responses are effective to prevent falls in such conditions. This limits the ability of clinicians to incorporate a diverse range of slipping experiences into fall prevention interventions. Understanding how reactive responses and slip vulnerability depend on diverse slip conditions may guide future interventions that promote a more general fall resistance to the broader range of slips encountered in the real environment.

This project will determine the impact of turns and slopes on reactive movements and fall vulnerability by determining the effects of path curvature on reactive movements and slip vulnerability at different times in the gait cycle and determining the effects of ground slope on reactive movements and slip vulnerability at difference times in the gait cycle. It is hypothesized that diverse slipping conditions will change the reactive responses involving protective stepping and arm swing and that the distinct dynamics of turns and slopes produce maximum vulnerability to slips at different times in the gait cycle compared to slips during straight walking on level ground. To evaluate these aims, the investigators will administer slip perturbations on slopes that vary in both magnitude and direction, on curved paths that vary in curvature, and with slip onset that varies across early, middle, and late stance. Understanding the relationships between diverse slipping conditions, reactive responses, slip severity and fall vulnerability may guide future research and training interventions towards more comprehensive fall resistance ability.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 19-35

Exclusion criteria

  • Uncontrolled hypertension
  • Peripheral arterial disease
  • Knee osteoarthritis
  • Vertigo
  • Meniere's disease
  • Chronic dizziness
  • History of back or lower extremity injury
  • Surgery that affects mobility
  • Neurological disease that limits the ability to walk

Treatment and study plan

Slips on Turns

Other

A slip will be administered to participants at 3 different times in the gait cycle for each of 3 different patch curvatures and 2 different legs for a total of 18 slip episodes. Slips will be delivered while walking along a straight path (infinite radius), or curved paths with radii 2, or 1 meters.

Slips on Slopes

Other

Slips will be administered to participants at 3 different times in the gait cycle over sloped ground surface of no slope, ±5.0 and ±10.0 degrees slopes in the direction of walking, and 5.0 and 10.0 degrees perpendicular to the direction of walking. On slopes perpendicular to the direction of walking, slips will be administered to the uphill or downhill foot. A total of 27 slip episodes will be administered. Sloped walking surfaces will be generated with the Computer Assisted Rehabilitation Environment (CAREN) system treadmill.

Primary outcomes

  1. Fall Rates - Slips on Turns

    Time frame: Up to 4 hours

    Percentage of trials which result in a fall is recorded. Falls are classified when a load cell embedded in the harness system measures support forces exceeding 30% body weight.

  2. Fall Rates - Slips on Slopes

    Time frame: Up to 4 hours

    Percentage of trials which result in a fall is recorded. Falls are classified when a load cell embedded in the harness system measures support forces exceeding 30% body weight.

Secondary outcomes

  1. Slipping Foot Distance

    Time frame: Up to 4 hours

    The distance travelled by the slipping foot relative to the center of mass following the administered slip perturbation

  2. Slipping Foot Maximum Velocity

    Time frame: Up to 4 hours

    The maximum velocity of the slipping foot relative to the center of mass following the administered slip perturbation

  3. Trunk Maximum Angular Momentum

    Time frame: Up to 4 hours

    The maximum angular momentum of the trunk following the administered slip perturbation

  4. Reactive Stepping Response Placement

    Time frame: Up to 4 hours

    Position of the placement of the reactive stepping response relative to the center of mass following the administered slip perturbation

  5. Reactive Stepping Response Time

    Time frame: Up to 4 hours

    Duration of time between the onset of the administered slip perturbation and the placement of the reactive stepping response

  6. Reactive Arm Swing Momentum Change

    Time frame: Up to 4 hours

    The change in arm momentum between the onset of the administered slip perturbation and the end of the slip

Sponsors and collaborators

Lead sponsor

University of Nebraska

Other

Collaborators

  • National Institute on Aging (NIA)

Registry information

Important dates

Study start
2019
Primary completion
2021
Study completion
2021
First posted
Nov 29, 2018
Registry last updated
Jul 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.