Task-Specific Perturbation Training Improves the Recovery Stepping Responses by Women With Knee Osteoarthritis Following Laboratory-Induced Trips.

Trip-specific training improves the kinematics of trip-specific compensatory stepping response (CSR) in the laboratory and reduces prospectively measured trip-related fall-rate of middle age and older women. We examined whether one session of trip-specific perturbation training could improve recovery step kinematics in women with knee osteoarthritis (OA), a condition known to increase fall risk. Seventeen women with self-reported symptomatic knee OA (age 61.

Trip-specific training enhances recovery after large postural disturbances for which there is NO expectation.

Purpose: Informed consent usually provides foreknowledge of experimental methods that can potentially increase expectation of stimuli and, therefore, influence the response. We determined the effects of increased expectation and trip-specific training on the recovery response following a treadmill-delivered, trip-specific disturbance. To deliver unexpected disturbances, subjects were deceived during the informed consent process.

Knee osteoarthritis negatively affects the recovery step following large forward-directed postural perturbations.

The reasons for higher fall risk of people with osteoarthritis (OA) compared to people without OA are not known. It is possible that following a loss of balance OA may negatively affect the recovery stepping response. Stepping responses have not been reported for people with knee OA.

Expectation of an upcoming large postural perturbation influences the recovery stepping response and outcome.

Tripping during locomotion, the leading cause of falls in older adults, generally occurs without prior warning and often while performing a secondary task. Prior warning can alter the state of physiological preparedness and beneficially influence the response to the perturbation. Previous studies have examined how altering the initial "preparedness" for an upcoming perturbation can affect kinematic responses following small disturbances that did not require a stepping response to restore dynamic stability.