Stephen D. Perry

Bio: Stephen D. Perry is an academic researcher from Wilfrid Laurier University. The author has contributed to research in topics: Gait (human) & Gait. The author has an hindex of 26, co-authored 90 publications receiving 2766 citations. Previous affiliations of Stephen D. Perry include Illinois State University & Toronto Rehabilitation Institute.

Effect of Facilitation of Sensation From Plantar Foot-Surface Boundaries on Postural Stabilization in Young and Older Adults

Abstract: Background. One of the more pervasive effects of aging is loss of cutaneous sensation, which appears to correlate with im­ paired postural control and increased risk of falling. This study examined the potential for compensating for the destabilizing effects of reduced cutaneous sensitivity by placing a raised edge underneath the perimeter of the plantar foot surface, so as to facilitate sensation from the stability boundaries of the base of support. Methods.The main experiment involved 14 healthy older adults (aged 65-73) selected because they were known, from a previous study, to have moderate plantar cutaneous insensitivity. We also report results of an initial experiment involving 7 healthy young adults (aged 23-31). In both experiments, we studied effects of the plantar facilitation on control of rapid step­ ping reactions evoked by unpredictable postural perturbation, applied via sudden platform movement in forward, backward, and lateral directions. We also studied effects on "feet-in-place" responses evoked by continuous pseudorandom platform mo­ tion in mediolateral and anteroposterior directions. Subjects were blindfolded in all tests. Results.Plantar facilitation reduced the incidence of "extra" limb movements, beyond the initial step, during forward-step reactions in the older adults. There also appeared to be an improved ability to control feet-in-place reactions: young subjects were better able to recover balance without stepping when falling backward (given instructions to "try not to step"), and both young and older subjects reduced the extent to which the center of foot pressure approached the posterior foot boundary during continuous anteroposterior platform motion. Conclusions. This study provides evidence that mechanical facilitation of sensation from the boundaries of the plantar surface of the foot can improve the efficacy of certain types of stabilizing reactions evoked by unpredictable postural perturbation. The re­ sults may bedirectly transferable to the design of special footwear insoles to reduce instability and risk of falling in older adults.

Interventions for preventing falls in older people living in the community

Abstract: As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in a fracture. This review looked at the healthcare literature to establish which fall prevention interventions are effective for older people living in the community, and included 159 randomised controlled trials with 79,193 participants. Group and home-based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures. Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow-up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined. Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti-slip shoe device worn in icy conditions can also reduce falls. Taking vitamin D supplements does not appear to reduce falls in most community-dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment. Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls. Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure. In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling. The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

No sense of place : the impact of electronic media on socialbehavior

Abstract: How have changes in media affected our everyday experience, behavior, and sense of identity? Such questions have generated endless arguments and speculations, but no thinker has addressed the issue with such force and originality as Joshua Meyrowitz in No Sense of Place. Advancing a daring and sophisticated theory, Meyrowitz shows how television and other electronic media have created new social situations that are no longer shaped by where we are or who is "with" us. While other media experts have limited the debate to message content, Meyrowitz focuses on the ways in which changes in media rearrange "who knows what about whom" and "who knows what compared to whom," making it impossible for us to behave with each other in traditional ways. No Sense of Place explains how the electronic landscape has encouraged the development of: -More adultlike children and more childlike adults; -More career-oriented women and more family-oriented men; and -Leaders who try to act more like the "person next door" and real neighbors who want to have a greater say in local, national, and international affairs. The dramatic changes fostered by electronic media, notes Meyrowitz, are neither entirely good nor entirely bad. In some ways, we are returning to older, pre-literate forms of social behavior, becoming "hunters and gatherers of an information age." In other ways, we are rushing forward into a new social world. New media have helped to liberate many people from restrictive, place-defined roles, but the resulting heightened expectations have also led to new social tensions and frustrations. Once taken-for-granted behaviors are now subject to constant debate and negotiation. The book richly explicates the quadruple pun in its title: Changes in media transform how we sense information and how we make sense of our physical and social places in the world.

Understanding Media Enjoyment: The Role of Transportation Into Narrative Worlds

Abstract: “Transportation into a narrative world” is an experience of cognitive, emotional, and imagery involvement in a narrative. Transportation theory (Green & Brock, 2000, 2002) provides a lens for understanding the concept of media enjoyment. The theory suggests that enjoyment can benefit from the experience of being immersed in a narrative world, as well as from the consequences of that immersion. Consequences implied by transportation theory include connections with characters and self-transformations.