Abstract

The aim of this study was to validate the effectiveness of the newly developed intelligent foot orthosis (IFO) at preventing lateral falls. The IFO is a wearable fall prevention system based on using a small magnetorheological brake to control the height of the lateral sole. Experiments were performed to compare the walking motions on a lateral slope under four conditions: without IFO, with IFO current-OFF, with IFO current-ON, and with IFO control-ON. The mediolateral center of gravity and center of pressure horizontal distance (ML COG–COP HD) were measured in three-dimensional motion analysis to represent the change in posture on the frontal plane. To observe the corresponding muscular activity, surface electromyography (EMG) was performed to obtain the mean and peak root-mean-square (RMS) for the tibia anterior (TA) and peroneus longus (PL) in the first half of the stance phase when the IFO applied control. In the results, ML COG-COP HD increased significantly under the “with IFO control-ON” compared to the “without IFO” and “with IFO current-ON” conditions. The mean RMS of the TA was significantly decreased under the “with IFO current-ON” and “with IFO control-ON” conditions compared to the “without IFO” condition. These results demonstrate that the posture moved away from the lateral fall direction primarily due to IFO assistance rather than muscular activity, which would be a consequence of human postural control. Thus, the IFO does appear to help prevent lateral falls.

References

1.
Suzuki
,
T.
,
2018
, “
Accident Prevention for the Elderly
,” Japan.
J. Safety Promo.
,
11
(
2
), pp.
13
–1
9
.
2.
Bergen
,
G.
,
Stevens
,
M. R.
, and
Burns
,
E. R.
,
2016
, “
Falls and Fall Injuries Among Adults Aged ≥65 Years - United States, 2014
,”
MMWR Morb. Mortal Wkly. Rep.
,
65
(
37
), pp.
993
998
.10.15585/mmwr.mm6537a2
3.
Forster
,
A.
, and
Young
,
J.
,
1995
, “
Incidence and Consequences of Falls Due to Stroke: A Systematic Inquiry
,”
BMJ
,
311
(
6997
), pp.
83
86
.10.1136/bmj.311.6997.83
4.
Parkkari
,
J.
,
Kannus
,
P.
,
Palvanen
,
M.
,
Natri
,
A.
,
Vainio
,
J.
,
Aho
,
H.
,
Vuori
,
I.
, and
Järvinen
,
M.
,
1999
, “
Majority of Hip Fractures Occur as a Result of a Fall and Impact on the Greater Trochanter of the Femur: A Prospective Controlled Hip Fracture Study With 206 Consecutive Patients
,”
Calcif. Tissue Int.
,
65
(
3
), pp.
183
187
.10.1007/s002239900679
5.
Hayes
,
W. C.
,
Myers
,
E. R.
,
Morris
,
J. N.
,
Gerhart
,
T. N.
,
Yett
,
H. S.
, and
Lipsitz
,
L. A.
,
1993
, “
Impact Near the Hip Dominates Fracture Risk in Elderly Nursing Home Residents Who Fall
,”
Calcif. Tissue Int.
,
52
(
3
), pp.
192
198
.10.1007/BF00298717
6.
Moon
,
Y.
, and
Sosnoff
,
J. J.
,
2017
, “
Safe Landing Strategies During a Fall: Systematic Review and Meta-Analysis
,”
Arch. Phys. Med. Rehabil.
,
98
(
4
), pp.
783
794
.10.1016/j.apmr.2016.08.460
7.
Dionyssiotis
,
Y.
,
2012
, “
Analyzing the Problem of Falls Among Older People
,”
Int. J. General Med.
,
5
, pp. 805–813.10.2147/IJGM.S32651
8.
Pyykkö
,
I.
,
Jäntti
,
P.
, and
Aalto
,
H.
,
1990
, “
Postural Control in Elderly Subjects
,”
Age Ageing
,
19
(
3
), pp.
215
221
.10.1093/ageing/19.3.215
9.
Schrager
,
M. A.
,
Kelly
,
V. E.
,
Price
,
R.
,
Ferrucci
,
L.
, and
Shumway-Cook
,
A.
,
2008
, “
The Effects of Age on Medio-Lateral Stability During Normal and Narrow Base Walking
,”
Gait Posture
,
28
(
3
), pp.
466
471
.10.1016/j.gaitpost.2008.02.009
10.
van Dijk
,
M. M.
,
Sandstad
,
S.
,
Ghosh
,
N.
,
Dejaeger
,
E.
,
Beyens
,
H.
, and
Verheyden
,
G.
,
2015
, “
Diagonal and Lateral Limits of Stability Post Stroke Show a Significant Relation With Gait, Balance and the Risk of Falling
,”
Physiotherapy
,
101
(S1), pp.
e1572
e1573
.10.1016/j.physio.2015.03.1575
11.
Amano
,
S.
,
Skinner
,
J. W.
,
Lee
,
H. K.
,
Stegemöller
,
E. L.
,
Hack
,
N.
,
Akbar
,
U.
,
Vaillancourt
,
D.
,
McFarland
,
N. R.
, and
Hass
,
C. J.
,
2015
, “
Discriminating Features of Gait Performance in Progressive Supranuclear Palsy
,”
Parkinsonism Relat. Disord.
,
21
(
8
), pp.
888
893
.10.1016/j.parkreldis.2015.05.017
12.
Ahn
,
J.
,
Sakurai
,
S.
, and
Kim
,
H.
,
2007
, “
Comparison of Muscular Activity of the Lower Limb While Running on Inclined Surfaces
,”
Japanese J. Phys. Fitness Sports Med.
,
56
(
1
), pp.
167
178
.10.7600/jspfsm.56.167
13.
Morimura
,
K.
,
Yamamoto
,
R.
, and
Shiraishi
,
T.
,
2020
, “
A Study of a Fall Prevention System for Patients With Walking Disabilities
,”
The Proceedings of the Dynamics & Design Conference
, Osaka, Japan (Online), p.
423
.
14.
Delafontaine
,
A.
,
Gagey
,
O.
,
Colnaghi
,
S.
,
Do
,
M. C.
, and
Honeine
,
J. L.
,
2017
, “
Rigid Ankle Foot Orthosis Deteriorates Mediolateral Balance Control and Vertical Braking During Gait Initiation
,”
Front. Hum. Neurosci.
,
11
, p.
214
.10.3389/fnhum.2017.00214
15.
Ohata Koji
,
IN.
, and
Takemura
,
T.
,
2004
, “
The Effect of Lateral Wedged Insoles for Gait on Electromyographic Analysis
,”
J. Jpn. Phys. Ther. Assoc.
,
31
(
3
), pp.
175
181
.10.15063/rigaku.KJ00001021068
16.
Khamis
,
S.
, and
Yizhar
,
Z.
,
2007
, “
Effect of Feet Hyperpronation on Pelvic Alignment in a Standing Position
,”
Gait Posture
,
25
(
1
), pp.
127
134
.10.1016/j.gaitpost.2006.02.005
17.
Kohei
,
M.
,
Rieko
,
Y.
, and
Toshihiko
,
S.
,
2021
, “
Orthosis With a Controllable Plantar Height for Fall Prevention Using a Compact Magnetorheological Fluid Brake
,”
J. Intell. Mater. Sys. Struct.
,
33
(
7
), pp.
928
941
. 10.1177/1045389X211038710
18.
Morimura
,
K.
,
Yamamoto
,
R.
, and
Shiraishi
,
T.
,
2020
, “
Control of Plantar Height by an MR Fluid Brake for Fall Prevention of Patients With Walking Disabilities
,”
Proc. Int. Conf. Motion Vib. Control
,
2020
(
15
), p.
10067
.10.1299/jsmeintmovic.2020.15.10067
19.
Choi
,
A.
,
Jung
,
H.
, and
Mun
,
J. H.
,
2019
, “
Single Inertial Sensor-Based Neural Networks to Estimate COM-COP Inclination Angle During Walking
,”
Sensors
,
19
(
13
), p.
2974
.10.3390/s19132974
20.
Rogers
,
M. W.
,
Hedman
,
L. D.
,
Johnson
,
M. E.
,
Cain
,
T. D.
, and
Hanke
,
T. A.
,
2001
, “
Lateral Stability During Forward-Induced Stepping for Dynamic Balance Recovery in Young and Older Adults
,”
J. Gerontol. A Biol. Sci. Med. Sci.
,
56
(
9
), pp.
M589
M594
.10.1093/gerona/56.9.M589
21.
Mousavi
,
S. H.
,
van Kouwenhove
,
L.
,
Rajabi
,
R.
,
Zwerver
,
J.
, and
Hijmans
,
J. M.
,
2021
, “
The Effect of Changing Mediolateral Center of Pressure on Rearfoot Eversion During Treadmill Running
,”
Gait Posture
,
83
, pp.
201
209
.10.1016/j.gaitpost.2020.10.032
22.
Lee
,
Y. J.
,
Liang
,
J. N.
,
Chen
,
B.
, and
Aruin
,
A. S.
,
2019
, “
Characteristics of Medial-Lateral Postural Control While Exposed to the External Perturbation in Step Initiation
,”
Sci. Rep.
,
9
(
1
), p.
16817
.10.1038/s41598-019-53379-9
23.
Lee
,
H. J.
, and
Chou
,
L. S.
,
2006
, “
Detection of Gait Instability Using the Center of Mass and Center of Pressure Inclination Angles
,”
Arch. Phys. Med. Rehabil.
,
87
(
4
), pp.
569
575
.10.1016/j.apmr.2005.11.033
24.
Chen
,
C.-J.
, and
Chou
,
L.-S.
,
2007
, “
Center of Mass and Ankle Inclination Angles: An Alternative Detection of Gait Instability
,”
J. Biomech.
,
40
, p.
S286
.10.1016/S0021-9290(07)70282-8
25.
Lee
,
P.-A.
,
Wu
,
K.-H.
,
Lu
,
H.-Y.
,
Su
,
K.-W.
,
Wang
,
T.-M.
,
Liu
,
H.-C.
, and
Lu
,
T.-W.
,
2021
, “
Compromised Balance Control in Older People With Bilateral Medial Knee Osteoarthritis During Level Walking
,”
Sci. Rep.
,
11
(
1
), p.
3742
.10.1038/s41598-021-83233-w
26.
Fujimoto
,
M.
,
Bair
,
W. N.
, and
Rogers
,
M. W.
,
2015
, “
Center of Pressure Control for Balance Maintenance During Lateral Waist-Pull Perturbations in Older Adults
,”
J. Biomech.
,
48
(
6
), pp.
963
968
.10.1016/j.jbiomech.2015.02.012
27.
Itami
,
S.
,
2022
, “A Study of an Orthosis with Controllable Plantar Height by a Compact MR Brake for Fall Prevention of People with Walking Disabilities,” Thesis,
Yokohama National University
,
Kanagawa, JP
.
28.
Murray
,
M. P.
,
Kory
,
R. C.
, and
Clarkson
,
B. H.
,
1969
, “
Walking Patterns in Healthy Old Men
,”
J. Gerontol.
,
24
(
2
), pp.
169
178
.10.1093/geronj/24.2.169
29.
Ikai
,
T.
,
Kamikubo
,
T.
,
Takehara
,
I.
,
Nishi
,
M.
, and
Miyano
,
S.
,
2003
, “
Dynamic Postural Control in Patients With Hemiparesis
,”
Am. J. Phys. Med. Rehabil.
,
82
(
6
), pp.
463
469
.10.1097/01.PHM.0000069192.32183.A7
30.
Matjačić
,
Z.
,
Zadravec
,
M.
, and
Olenšek
,
A.
,
2020
, “
Biomechanics of in-Stance Balancing Responses Following Outward-Directed Perturbation to the Pelvis During Very Slow Treadmill Walking Show Complex and Well-Orchestrated Reaction of Central Nervous System
,”
Front. Bioeng. Biotechnol.
,
8
, pp. 1–14, Article No. 884.10.3389/fbioe.2020.00884
31.
Blenkinsop
,
G. M.
,
Pain
,
M. T. G.
, and
Hiley
,
M. J.
,
2017
, “
Balance Control Strategies During Perturbed and Unperturbed Balance in Standing and Handstand
,”
R. Soc. Open Sci.
,
4
(
7
), p.
161018
.10.1098/rsos.161018
32.
Hashimoto
,
M.
, and
Nakae
,
N.
,
2001
, “
Motor Skill and Physical Therapy. Motor Control of Body From the Viewpoint of Foot
,”
Rigakuryoho Kagaku
,
16
(
3
), pp.
123
128
.10.1589/rika.16.123
33.
Yagi
,
M.
,
Suzuki
,
K.
,
Anan
,
M.
, and
Shinkoda
,
K.
,
2012
, “
Influences of Functional Ankle Instability on Postural Control During Transitioning to One-Leg Standing
,”
Rigakuryoho Kagaku
,
27
(
4
), pp.
373
377
.10.1589/rika.27.373
34.
Pheasant
,
S. T.
,
1981
, “
A Review of: “Human Walking”. V. T. Inman, H.J. Ralston, and F. Todd, Eds., (Baltimore, London: Williams & Wilkins, 1981.) [pp. 154.]
,”
Ergonomics
,
24
(
12
), pp.
969
976
.10.1080/00140138108924919
35.
Brockett
,
C. L.
, and
Chapman
,
G. J.
,
2016
, “
Biomechanics of the Ankle
,”
Orthopaedics Trauma
,
30
(
3
), pp.
232
238
.10.1016/j.mporth.2016.04.015
36.
Michael
,
J. M.
,
Golshani
,
A.
,
Gargac
,
S.
, and
Goswami
,
T.
,
2008
, “
Biomechanics of the Ankle Joint and Clinical Outcomes of Total Ankle Replacement
,”
J. Mech. Behav. Biomed. Mater.
,
1
(
4
), pp.
276
294
.10.1016/j.jmbbm.2008.01.005
37.
Mansfield
,
P. J.
, and
Neumann
,
D. A.
,
2019
, “
Chapter 11 - Structure and Function of the Ankle and Foot
,”
Essentials of Kinesiology for the Physical Therapist Assistant
,
P. J.
Mansfield
, and
D. A.
Neumann
, eds., 3rd ed.,
Mosby
,
St. Louis (MO)
, pp.
311
350
.
38.
Neumann
,
D. A.
,
2010
,
Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation
,
Elsevier
,
Missouri
.
39.
Shiraishi
,
T.
, and
Morishita
,
S.
,
2004
, “
Measurements of Typical Characteristics of MR Fluids and Their Application to Design of MR Devices Considering Working Modes
,”
Trans. Jpn. Soc. Mech. Eng. Ser. C
,
70
(
696
), pp.
2308
2314
.10.1299/kikaic.70.2308
40.
Shiraishi
,
T.
,
Sakuma
,
T.
, and
Morishita
,
S.
,
2008
, “
Design and Performance Verification of Variable Dampers Using MR Fluid
,”
ASME
Paper No. IMECE2003-41346.10.1115/IMECE2003-41346
41.
Sarkar
,
C.
, and
Hirani
,
H.
,
2015
, “
Effect of Particle Size on Shear Stress of Magnetorheological Fluids
,”
Smart Sci.
,
3
(
2
), pp.
65
73
.10.1080/23080477.2015.11665638
42.
Yamamoto
,
R.
,
Morimura
,
K.
, and
Shiraishi
,
T.
,
2021
, “
A Feasibility Study of an Intelligent Fall Prevention System: A Sideways Fall Dynamic Model and the Effect of Lateral Insole
,”
Proc. World Physiotherapy Congress
, PO-00361.
43.
Gait Solution, 2022, Pacific Supply Co., Ltd, accessed Feb. 19, 2022, https://www.p-supply.co.jp/data/files/00001157-1.pdf
44.
Winter
,
D. A.
,
2009
,
Biomechanics and Motor Control of Human Movement
,
Wiley
, Hoboken, NJ, pp.
83
91
.
45.
Nakamura
,
R.
,
Saito
,
H.
, and
H
,
N.
,
2007
,
Fundamental Kinesiology
,
Ishiyaku Publishers Inc
., Bunkyo-ku, Japan, pp.
348
358
.
46.
Kondoh
,
S.
,
Araki
,
S.
, and
Kaji
,
K.
,
1995
, “
Relationship Among Walking Speed, Stride Length, and Cadence in Hemiplegic Patients
,”
Rigakuryoho Kagaku
,
10
(
1
), pp.
11
14
.10.1589/rika.10.11
47.
Sekiya
,
N.
,
1996
, “
The Invariant Relationship Between Step Length and Step Rate During Free Walking
,”
J. Hum. Move. Stud.
,
30
, pp.
241
257
.https://jglobal.jst.go.jp/en/detail?JGLOBAL_ID=201302198340256130
48.
Iritani
,
M.
,
2011
,
Iritani Shiki Sokuteiban Kisohen
,
Publisher of Motion and Medical
, Yokohama, Kanagawa, Japan.
49.
Collins
,
N.
,
Crossley
,
K.
,
Beller
,
E.
,
Darnell
,
R.
,
McPoil
,
T.
, and
Vicenzino
,
B.
,
2008
, “
Foot Orthoses and Physiotherapy in the Treatment of Patellofemoral Pain Syndrome: Randomised Clinical Trial
,”
BMJ
, p.
337
.10.1136/bmj.a1735
50.
Eng
,
J. J.
, and
Pierrynowski
,
M. R.
,
1993
, “
Evaluation of Soft Foot Orthotics in the Treatment of Patellofemoral Pain Syndrome
,”
Phys. Ther.
,
73
(
2
), pp.
62
68
.10.1093/ptj/73.2.62
51.
Seniam, 2022, “The SENIAM project (Surface Electromyography for the Non-Invasive Assessment of Muscles), Sensor Placement,” Seniam, The Netherlands, accessed July 27, 2022, http://www.seniam.org/
52.
Kenny
,
R. P. W.
,
Eaves
,
D. L.
,
Martin
,
D.
,
Hatton
,
A. L.
, and
Dixon
,
J.
,
2019
, “
The Effects of Textured Insoles on Quiet Standing Balance in Four Stance Types With and Without Vision
,”
BMC Sports Sci., Med. Rehabil.
,
11
(
1
), p.
5
.10.1186/s13102-019-0117-9
53.
Perry
,
S. D.
,
Radtke
,
A.
,
McIlroy
,
W. E.
,
Fernie
,
G. R.
, and
Maki
,
B. E.
,
2008
, “
Efficacy and Effectiveness of a Balance-Enhancing Insole
,”
J. Gerontol. A Biol. Sci. Med. Sci.
,
63
(
6
), pp.
595
602
.10.1093/gerona/63.6.595
54.
Eils
,
E.
,
Streyl
,
M.
,
Linnenbecker
,
S.
,
Thorwesten
,
L.
,
Völker
,
K.
, and
Rosenbaum
,
D.
,
2004
, “
Characteristic Plantar Pressure Distribution Patterns During Soccer-Specific Movements
,”
Am. J. Sports Med.
,
32
(
1
), pp.
140
145
.10.1177/0363546503258932
55.
Okoba
,
R.
,
Hasegawa
,
M.
,
Yoshizuka
,
H.
,
Honda
,
Y.
,
Egoshi
,
S.
,
Mitsutake
,
T.
, and
Asami
,
T.
,
2018
, “
Effects of a Perceptual Stimulus Insole on Foot Dynamics During Gait
,”
Rigakuryoho Kagaku
,
33
(
2
), pp.
343
346
.10.1589/rika.33.343
56.
Bavdek
,
R.
,
Zdolšek
,
A.
,
Strojnik
,
V.
, and
Dolenec
,
A.
,
2018
, “
Peroneal Muscle Activity During Different Types of Walking
,”
J. Foot. Ankle Res.
,
11
(
1
), p.
50
.10.1186/s13047-018-0291-0
57.
Fujisawa
,
H.
,
2009
,
Observational Motion Analysis Practice Note
,
Ishiyaku Publishers Inc.
, Bunkyo-ku, Japan, pp.
978
974
.
58.
Suzuki
,
T.
,
2002
, “
Spasticity Control in Exercise Therapy
,”
J. Clin. Rehabil.
,
11
, pp.
907
912
.
59.
Fettrow
,
T.
,
DiBianca
,
S.
,
Vanderlinde dos Santos
,
F.
,
Reimann
,
H.
, and
Jeka
,
J.
,
2020
, “
Flexible Recruitment of Balance Mechanisms to Environmental Constraints During Walking
,”
Front. Virtual Reality
,
1
, Article No. 5.10.3389/frvir.2020.00005
60.
Goto
,
J.
,
2003
, “
The Control of Muscle Tone
,”
J. Kansai Phys. Ther.
,
3
, pp.
21
31
.
You do not currently have access to this content.