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The Influence of Dual-Task Conditions on Postural Control and Instrumented Timed Up and Go Performance in Fallers and Non-Fallers

Sample, Renee Lynn
http://orcid.org/0000-0002-2319-6320
http://rave.ohiolink.edu/etdc/view?acc_num=dayton1469031688

Abstract Details

2016, Doctor of Philosophy (Ph.D.), University of Dayton, Mechanical Engineering.
One in three older adults fall each year; many falls resulting in moderate to severe injuries. Falls are a multi-faceted problem, with risk factors that include balance and gait impairments. Balance and movement assessments are often used to identify individuals at risk of falls by identifying a change in the center of pressure excursions or movements. This study examined two fall risk assessments, posturography analyzed through traditional time-domain measures and newer non-linear measures and the instrumented Timed Up and Go (iTUG), under standard and dual-task conditions, to determine better ways to distinguish individuals with subtle deficits contributing to fall risk. One hundred fifty older adult fallers and non-fallers performed quiet-standing posturography and iTUG methodologies. Test conditions included standard testing conditions, cognitive dual-task, manual dual-task, and cognitive+manual dual task. Five traditional postural sway parameters, four non-linear postural sway parameters were calculated, and eight iTUG parameters were calculated. One-way multivariate analysis of variance (p<0.05) was used to compare fallers versus non-fallers and to compare each type of dual task. Effect sizes were calculated using the Cohen’s d method. Stepwise logistic regression was performed to identify the postural sway and iTUG parameters that best differentiated fallers from non-fallers for the traditional Timed Up and Go Test, iTUG test, posturography test and a combined model including the iTUG and posturography tests. Results demonstrated that not just one dual-task prevailed over the overs, rather when analyzing posturography data through traditional measures the manual dual-task provided greater differentiation between fall risk groups, when analyzing posturography data through non-linear measures the cognitive dual-task provided greater differentiation between fall risk groups, and when utilizing the iTUG test the cognitive+manual dual-task affected the iTUG parameters the most, with fall risk differentiation seen in the sit-to-stand measures. A stepwise logistic regression model was created, with all of the posturography, traditional and nonlinear, parameters and all iTUG output parameters input into the model. The resulting fall risk model has a max re-scaled R2 value of 0.3244, sensitivity of 54.3% and specificity of 82.7%. The parameters included in the model are height, sit-to-stand duration, stand-to-sit duration, turn peak velocity, and A/P sway range. Dual-tasks and non-linear analysis measures were valuable additions to posturography and iTUG fall risk assessments. Future work is necessary to extend exploration of dual-tasks and how they affect fallers and non-fallers differently.
Kimberly Bigelow (Advisor)
Wiebke Diestelkamp (Committee Member)
Kurt Jackson (Committee Member)
Allison Kinney (Committee Member)
153 p.
Biomechanics; Mechanical Engineering
Posturography; Instrumented Timed Up and Go, iTUG; Older Adults; Dual-task

Recommended Citations

Citations

  • Sample, R. L. (2016). The Influence of Dual-Task Conditions on Postural Control and Instrumented Timed Up and Go Performance in Fallers and Non-Fallers [Doctoral dissertation, University of Dayton]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1469031688

    APA Style (7th edition)

  • Sample, Renee. The Influence of Dual-Task Conditions on Postural Control and Instrumented Timed Up and Go Performance in Fallers and Non-Fallers. 2016. University of Dayton, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=dayton1469031688.

    MLA Style (8th edition)

  • Sample, Renee. "The Influence of Dual-Task Conditions on Postural Control and Instrumented Timed Up and Go Performance in Fallers and Non-Fallers." Doctoral dissertation, University of Dayton, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1469031688

    Chicago Manual of Style (17th edition)

dayton1469031688
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© 2016, all rights reserved.
This open access ETD is published by University of Dayton and OhioLINK.