Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults

Journal article


Gerards, M.H.G., Meijer, K., Karamanidis, K., Grevendonk, L., Hoeks, J., Lenssen, A.F. and McCrum, C. (2021). Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults. Frontiers in Sports and Active Living. 3, p. 682861. https://doi.org/10.3389/fspor.2021.682861
AuthorsGerards, M.H.G., Meijer, K., Karamanidis, K., Grevendonk, L., Hoeks, J., Lenssen, A.F. and McCrum, C.
AbstractGiven that falls most commonly occur during walking due to unexpected balance perturbations like trips and slips, walking-based balance assessment including walking stability and adaptability to such perturbations could be beneficial for fall risk assessment in older adults. This cross-sectional study reanalyzed data from two larger studies conducted with the same walking protocol. Participants completed unperturbed walking trials at speeds of 0.4 m/s up to 1.8 m/s in 0.2 m/s steps. Ten unannounced treadmill belt acceleration perturbations were then applied while participants walked at equivalent stability, assessed using the margins of stability. Retrospective (12 months) falls incidence was collected to divide participants into people with and without a history of falls. Twenty older adults (mean age 70.2 ± 2.9 years) were included in this analysis; eight people with one or more recent falls and 12 people without, closely matched by sex, age and height. No significant differences were found in unperturbed walking parameters or their variability. Overall perturbation-recovery step behavior differed slightly (not statistically significant) between the groups after the first perturbation and differences became more pronounced and significant after repetition of perturbations. The No-Falls group significantly reduced the number of recovery steps needed across the trials, whereas the Falls group did not show these improvements. People with a previous fall tended to have slightly delayed and more variable recovery responses after perturbation compared to non-fallers. Non-fallers demonstrate more signs of adaptability to repeated perturbations. Adaptability may give a broader indication of the ability of the locomotor system to respond and improve responses to sudden walking perturbations than unperturbed walking variability or recovery to a single novel perturbation. Adaptability may thus be a more useful marker of falls history in older adults and should be considered in further research.
KeywordsSports and Active Living; accidental falls; risk assessment; perturbation; aging; adaptation; stability recovery; falls prevention
Year2021
JournalFrontiers in Sports and Active Living
Journal citation3, p. 682861
PublisherFrontiers Media SA
ISSN2624-9367
Digital Object Identifier (DOI)https://doi.org/10.3389/fspor.2021.682861
Publication dates
Online19 May 2021
Publication process dates
Accepted19 Apr 2021
Deposited07 Jun 2021
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Licensehttp://creativecommons.org/licenses/by/4.0/
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