University of Koblenz co-operatively researches how older people can avoid falls

Stumble-fall prevention and neuromuscular control of movement as well as the adaptability of muscles and tendons over the lifespan are the focus of research by the "Training and Movement Science" working group at the Department of Sports and Exercise Sciences at the University of Koblenz. Its head, Prof Dr Kiros Karamanidis, is also the manager of the Institute for Medical Technology and Information Processing Middle Rhine (MTI).

"Together with the Faculty of Mathematics, Computer Sciences and Technology at Koblenz University of Applied Sciences in Remagen, we simulate tripping on a treadmill in the biomechanics laboratory," says Karamanidis, explaining the procedure. The participants are held in a safety system in the recently opened biomechanics lab and walk on a treadmill. This treadmill produces several unpredictable tripping events. They are individually adjusted to the gait and age of the participant. Thanks to the support system, no participant can fall. Nevertheless, participants experience the feeling of a near-fall and may be briefly caught in the support system before it intervenes in time if necessary. The aim of this training is to improve reactive balance and to realistically simulate near-falls in a safe environment.

On average, some participants would fall during the first three near-falls if they were not secured. After that, this no longer happens, explains Karamanidis. "We were able to prove that such interventions reduce the risk of falling. The participants have learnt to master the situation and can transfer what they have learnt to everyday situations." Even after one and a half years, the risk of falls in 70-year-olds who have spent 20 minutes on the treadmill is reduced, according to the scientist.

The working group was able to prove that it is not primarily the reduction in muscle strength that causes susceptibility to stumbling in ageing people, but rather the degeneration of neuromuscular control of locomotion or ineffective communication and cooperation between the brain and muscles in the event of unexpected postural disturbances. "The improved gait stability clearly does not depend on muscle strength, as this does not change after 20 minutes on the treadmill," says Karamanidis. The brain, on the other hand, learns to optimise cooperation with the muscles again - and this effect lasts for a long time.

Everyone can work on their stumbling memory in everyday life so that it functions well for as long as possible - even if many people have forgotten how to deal with potential falls. Karamanidis' research group is developing a cuff with an integrated brake so that the general public can benefit from treadmill training or stumble training. It is attached to the knee or hip joint. Braking impulses ensure that the gait is disturbed during treadmill training. "Sensors in the cuff measure the knee angle and can set an individualised stumble," explains Karamanidis. In future, the cuff could be used in physiotherapy practices or clinics with existing secured treadmills.

Internationally competitive laboratory

In the new biomechanics laboratory, the scientists also integrate in vivo muscle-tendon measurement procedures and measuring instruments. Through his company PROTENDON, Karamanidis has various measuring instruments and software tools, such as mechatronic systems to disturb gait, EMG sensors, force sensors and ultrasound devices, which he will integrate into the biomechanics lab in Remagen. This means that the researchers will soon be able to work together with equipment from Koblenz University of Applied Sciences in an internationally competitive laboratory. PhD candidates, post-docs and Bachelor's and Master's students from the University and Koblenz University of Applied Sciences will also be able to work on projects together or individually and generate data there.

The new laboratory will also become an essential part of the MTI Mittelrhein, in which the participating research groups from the University of Koblenz, Koblenz University of Applied Sciences and the regional clinics in the field of "Health and Medial Science" can come together and contribute. The University of Koblenz and Koblenz University of Applied Sciences already have a long-standing collaboration through the MTI, which is to be further strengthened with the new laboratory.

There are also plans to carry out research projects in the field of clinical biomechanics in cooperation with clinics in the area. Karamanidis and his colleagues at the RheinAhr Campus Remagen, Faculty of Mathematics, Computer Sciences and Engineering have known each other for over 14 years (including Prof. Dr Ulrich Hartmann and Prof. Dr Lukas Scheef) and have already published several joint papers, for example in Nature portfolio journals. The researchers have been able to raise almost one million euros in third-party funds. They would like to build on and continue this.

The biomechanics laboratory at the RheinAhr Campus Remagen was realised with financial support from the Rhineland-Palatinate Ministry of Academic Affairs and Health as part of the HAW-direkt programme. It opens up new application possibilities in the fields of AI and the prevention and rehabilitation of musculoskeletal injuries and diseases in sport, professorship appointments and everyday life. It is important to Karamanidis that the research is mechanistically orientated and that injuries and diseases are treated in an evidence-based manner, with the aim of transferring basic research into application, for example through cooperation with clinics, sports associations and industry.