The body configuration at step contact critically determines the successfulness of balance recovery in response to large backward perturbations.

The mechanical efficiency of stepping to recover balance can be expressed by a biomechanical model that includes the trunk inclination angle and the angle of the leg at the instant of stepping-foot contact. The aim of the present study was to test the hypothesis that this model would accurately predict the successfulness of recovery attempts (recovery vs. falls) following large backward perturbations. Ten young participants were exposed to a series of 12 very large postural perturbations in the backward direction by means of a support-surface translation. At the instant of stepping-foot contact, we calculated the trunk inclination angle and the angle of the stepping leg with the vertical. Reaction time, step duration, step velocity and step length were also determined. A logistic regression analysis revealed that the model with leg and trunk inclination angles accurately predicted successful recovery, with a more forward tilted trunk and a further backward positioned leg increasing the probability of success. The set of spatiotemporal step variables was significantly less predictive. Over the course of the experiment, participants gradually became more successful in recovering balance, which coincided with an increase in leg but not in trunk angles. In conclusion, the body configuration at the instant of first stepping-foot contact accurately predicted successful balance recovery after a backward postural perturbation. Given the observation that participants improved their performance by increasing their leg angles, which suggests that it may be easier to improve this variable, compared to the trunk angle, by exercise interventions.

[1]  W. McIlroy,et al.  Training Rapid Stepping Responses in an Individual With Stroke , 2011, Physical Therapy.

[2]  Sarah E Lamb,et al.  Interventions for preventing falls in older people living in the community. , 2012, The Cochrane database of systematic reviews.

[3]  E. T. Hsiao,et al.  Common protective movements govern unexpected falls from standing height. , 1997, Journal of biomechanics.

[4]  Laura A. Wojcik,et al.  Age differences in using a rapid step to regain balance during a forward fall. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[5]  Cécile Smeesters,et al.  Instructions limiting the number of steps do not affect the kinetics of the threshold of balance recovery in younger adults. , 2007, Journal of biomechanics.

[6]  S. Cummings,et al.  TYPE OF FALL AND RISK OF HIP AND WRIST FRACTURES: THE STUDY OF OSTEOPOROTIC FRACTURES , 1993, Journal of the American Geriatrics Society.

[7]  Y. Pai,et al.  Deficient limb support is a major contributor to age differences in falling. , 2007, Journal of biomechanics.

[8]  E. T. Hsiao,et al.  Biomechanical influences on balance recovery by stepping. , 1999, Journal of biomechanics.

[9]  S. Robinovitch,et al.  The effect of step length on young and elderly women's ability to recover balance. , 2007, Clinical biomechanics.

[10]  T. M. Owings,et al.  Mechanisms of failed recovery following postural perturbations on a motorized treadmill mimic those associated with an actual forward trip. , 2001, Clinical biomechanics.

[11]  T. M. Owings,et al.  Mechanisms leading to a fall from an induced trip in healthy older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[12]  Michael L Madigan,et al.  Age and stepping limb performance differences during a single-step recovery from a forward fall. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[13]  A B Schultz,et al.  Age and gender differences in single-step recovery from a forward fall. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  A B Schultz,et al.  Muscle activities used by young and old adults when stepping to regain balance during a forward fall. , 2000, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[15]  Constantinos N Maganaris,et al.  Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly. , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[16]  M. Madigan,et al.  Age-related differences in peak joint torques during the support phase of single-step recovery from a forward fall. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  Y. Pai,et al.  Mechanisms of limb collapse following a slip among young and older adults. , 2006, Journal of biomechanics.

[18]  M. Bobbert,et al.  Push-off reactions in recovery after tripping discriminate young subjects, older non-fallers and older fallers. , 2005, Gait & posture.

[19]  E. T. Hsiao,et al.  Elderly subjects' ability to recover balance with a single backward step associates with body configuration at step contact. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.