171
Journal of Aging and Physical Activity, 2008, 16, 171-187
© 2008 Human Kinetics, Inc.
Michel-Pellegrino, Hewson, and Duchêne are with the Charles Delaunay Institute, Troyes University of
Technology, BP 2060 Troyes, France. Hogrel is with the Myology Institute, Pitié-Salpêtrière Hospital
Group, 75651 Paris, Cedex 13, France.
Biomechanical Analysis of Older
Adults Stepping Up: A Method
of Evaluating Balance
Valérie Michel-Pellegrino, David Hewson, Jean-Yves Hogrel,
and Jacques Duchêne
The aim of this study was to analyze differences in biomechanical parameters
between elderly and control participants when stepping up, to evaluate control
of balance. Eleven control and 14 elderly participants performed a step from an
initial static posture onto a 7-cm-high force plate. For the spontaneous-velocity
condition, elderly participants performed a slower progression velocity than
control participants. Elderly participants spent proportionally more time in stance
phase, with a corresponding decrease in swing phase, than the control partici-
pants, irrespective of movement velocity. In contrast, at spontaneous velocity the
parameters related to ground-reaction force (GRF) showed that anteroposterior
and mediolateral forces at toe-off of the support limb and the slope of vertical
force during weight transfer were significantly smaller for the elderly than for
control participants. These GRF parameters depended on the stepping-up velocity.
The elderly develop a spatiotemporal strategy and reduced movement velocity to
control support balance.
Keywords: postural balance, elderly, ground-reaction forces, force plate
Falls in the elderly are one of the most important public health problems for
health care services in the 21st century. As part of a fall-prevention strategy, it
would be of interest to evaluate balance regularly to detect risk of falls. Clinical
tests such as the timed get-up-and-go (Mathias, Nayak, & Isaacs, 1986), the Berg
Balance Scale (Shumway-Cook, Baldwin, Polissar, & Gruber, 1997), and the Tinetti
Balance Scale (Tinetti, Speechley, & Ginter, 1988) are used regularly to evaluate
movement and thus dynamic balance.
All of these tests are descriptive, however, and thus cannot explain the motor
process related to any underlying degradation of balance and the concomitant
increase in fall risk. Although the incidence of falls is well known to increase
with age, the motor mechanisms related to this phenomenon remain poorly
understood. Therefore, it is necessary to develop a biomechanical analysis to