Increased Risk of Falling in Older Adults When Coordinating Obstacle Avoidance and Grasping.

Abstract

This study aimed to investigate the kinematic changes in obstacle avoidance and prehension tasks performed simultaneously by older adults with a history of falls at different levels of task difficulty. Twenty-six older adults were divided into faller and nonfaller groups. The experimental protocol was divided into two different tasks: walking with obstacle avoidance and walking with obstacle avoidance combined with a reach-to-grasp task. Two types of sensors (Kinect v2 and Leap Motion Controller, respectively) were used to analyze gait and grasp. Fallers presented kinematic changes associated with the grasping task during obstacle avoidance, such as a decrease in the velocity of the center of mass and the step length, an increase in the step width, a decrease in toe-obstacle horizontal distance, and an increase in vertical foot clearance distance, and an increase in movement time in the grasping task compared with nonfallers. To cope with the obstacle avoidance demands of both walking and grasping, fallers turned to a specific sequencing strategy. While slowing down, they attended first to the grasping task and then to crossing the obstacle on the floor.