An update from Dr Sara Harper – Public Overview – July 2024
Use of SMA Stairs: Fall 2024 – Spring 2025 – KIN451-452 Research in Exercise Science course
Comparative Analysis of Musculoskeletal Health and Fall Risk: A Multifaceted Approach Using DXA, Physical Performance Tests, and Lifestyle Assessment
This approach directly involves multiple students, conducting a capstone, high-quality research study design.
Falls and mobility decline are concerning issues for older adults. Lower limb differences in muscle function and aerobic capacity may influence these issues – even in healthy older adults. My central hypothesis is that older adults with lower limb asymmetries will have a greater fall risk and worse physical function compared to young, healthy adults.
Why: How does stairway ascent/descent ability relate to these common physical performance measurements in older adults, with a reference population of young adults? Stairway ascent/descent low step clearance increases fall risk.
How: Individuals 50+ years old compared to 18-30 years old will perform (1) whole-body DXA scan, allowing for evaluation of bone mineral content & bone mineral density differences in lower limbs, (2) short physical performance battery, (3) stairway ascent/descent foot clearance, (4) balance error scoring system test (BESS Test), (5) reaction assessment, (6) knee extensor strength, (5) fall risk questionnaire, and (6) a few questions about their stairway use.
Research questions:
- Are there significant differences in these measures (between limbs, between age groups)?
- How does stairway foot clearance correlate with bone mineral density, bone mineral content, balance error scoring system test, reaction, knee extensor strength, and fall risk?
Research Grants
- UAH New Faculty Research Program. Evaluating Foot Placement on Instrumented Stairway Steps (Funded).
This approach will be using (1) Vicon motion capture, (2) Pupil Labs Neon (https://pupil-labs.com/products/neon), and (3) instrumented/force plate steps in the first study, comparing control (sham), black contrast stripe, and reflective stripe on the leading edge of the treads and how it affects ascent and descent foot placement. Using the force plate steps in study one allows us to capture all forces, moments, and center of pressure data for proof-of-concept in young, healthy adults, providing the necessary preliminary data to propose a robust approach for an NIA R15 grant in October 2024.
- Human Factors and Ergonomics DE&I Seed Grant. Improving Stairway Designs for Individuals with Vision Impairment Seed Grant Targeting the Intersections of HFE and AntiBias. (In Review).
- National Council on Aging – National Falls Prevention Fellowship. (In Review).
Lab Status: Renovation of the Healthy Age-Related Physical Function Exercise/Ergonomics Research (HARPER) Laboratory (ongoing)
Current/In-process Research:
- Home Stairway Survey: Attitudes and intentions to use handrails on both sides of stairways and add tread-edge striping to home stairways.
- Roy, Chen, and I (all at UAH) are currently writing a manuscript entitled New Falls in Older Adults: Preventative Approaches to Proactively Address Fall-Risk, which will discuss (1) Age is a key determinant of falls, (2) Existing machine-learning-based approaches can separate different groups based on fall risk, (3) Existing machine-learning-based approaches show too many false reportings and misreporting while detecting clinically at risk, (4) Future approaches combining wearables equipped with sensing and lightweight predictive ML, (5) Change-point detection approaches can help identify signatures of falls and design online algorithms to preempt and mitigate falls.
- I also received internal research support (UAH) to investigate the use of augmented reality to inform individual high-contrast marking preferences for stairways. This funding will help make it possible to collect the preliminary data for the R15 grant submission (described below).
Related Research Grants/Projects: Two Summer Research and Creative Experience for Undergraduates (RCEU)s are related stairway safety, but will compare use of an instrumented (force plate) steps to public stairways and using stereo cameras, instrument / measure stairs ‘outside of the lab’.
- RCEU, Parker Nelson. Evaluation of stair contrast markings for older adults and individuals experiencing low vision. Role: PI, Summer 2024. Accepted on March 29, 2024.
- RCEU, Jamie Roberson. Toward improving stairway safety: Using depth cameras for foot clearance measurement. Role: Co-I, Summer 2024. Accepted on March 29, 2024.
AR studies: Our goals are to inform ideal contrast parameters for individuals when presented with a visual stimulus while stationary including samples in young, healthy adults, older adults, and adults with low vision.
A subset of the population would be asked to perform stairway trials, using an augmented reality headset to ‘impose’ contrast conditions visually on steps without changing their physical profile. Findings could be used to inform future contrast practices (e.g., not recommending wearing an AR headset on everyday stairs).
Pro: One neat aspect of using AR is that we can change different contrast parameters within seconds, and it does not require the alteration of the stairs directly. Cons: (1) some of the newer AR models are not necessarily set up well for eyeglass users (Magic Lead), (2) Different models may have limits in visual acuity application.
Other Future Directions – lighting control in and around stairways: Other aspects —the lab space will be outfitted with a DMX controller (theater-style lighting, with options for customizing the output). This will allow for very fine measurement and control of illuminance conditions. There is one window in the lab in case a study does call for complications of window lighting; otherwise, it will have a custom blackout covering to control the lighting in the environment.
Making everyday stairs, instrumented stairs: Using the framework from the RCEUs (listed below), a bigger-picture goal is to improve data collection outside of the lab setting, including using known quantities to assess/measure foot clearance with minimal stereo cameras, using wearable sensors to provide user movement feedback (i.e., IMUs).
