Age-related intrinsic limitations in preventing a trip and regaining balance after a trip

This paper reviews the literature to determine directions for prevention of falls among the elderly by establishing causal factors for falls resulting from a trip. The literature on risk factors for falls is briefly reviewed, but the main emphasis is on experimental studies to complement observational studies with more detailed insight into factors determining fall risk. Changes in gait pattern, reduced vision, and cognitive impairments appear to increase the probability of tripping in the elderly and can in part be targeted in interventions. Recovery of balance after a trip is limited in the elderly probably because forward placement of the recovery leg is slower, likely due to neural factors. Furthermore. balance recovery is impaired in the elderly because joints moments in the stance leg are generated more slowly and reach lower peak values, likely due to a combination of muscular and neural factors. These results suggest that coordination and strength training can contribute to fall prevention among the elderly. (c) 2005 Elsevier Ltd. All rights reserved.