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Our previous blog has explored the landing phase of balance recovery during a reactive step (such as after a trip). The purpose of this blog is to briefly discuss some of the reported changes in this phase of balance recovery as we age.

Overall, research on the landing phase of forward stepping suggests that in older adults, initial voluntary and forward reactive steps may not be as stabilizing as in young adults [1-3]. This may possibly contribute to the use of multiple steps by older adults during many different activities.

Specifically, older adults exhibit an increased overshoot (and increased variability) of the center of mass after the point of foot contact [1-3]. This is thought to possibly be a function of poor dynamic stability control [2]. Interestingly, it has been observed that in older adults, decreased strength may be linked with an increased likelihood of sustaining an after-step fall (i.e., a fall occurring at least 470 ms after recovery step contact) [4].

Why is studying balance control after the foot contacts the ground important? There are many reasons, but it is known that sufficient control of the center of mass (COM) when both of our feet are on the ground is very important, illustrated by the fact that improper weight shifting is a predominant cause of falls in frail older adults [5].

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[1] Singer, J. C., Prentice, S. D., & McIlroy, W. E. (2012). Dynamic stability control during volitional stepping: a focus on the restabilisation phase at movement termination. Gait and Posture, 35(1), 106-110.

[2] Singer, J. C., Prentice, S. D., & McIlroy, W. E. (2013). Age-related changes in mediolateral dynamic stability control during volitional stepping. Gait and Posture, 38(4), 679-683.

[3] Singer, J. C., Prentice, S. D., & McIlroy, W. E. (2016). Age-related challenges in reactive control of mediolateral stability during compensatory stepping: a focus on the dynamics of restabilisation. Journal of Biomechanics, 49(5), 749-755.

[4] Pavol, M. J., Owings, T. M., Foley, K. T., & Grabiner, M. D. (2002). Influence of lower extremity strength of healthy older adults on the outcome of an induced trip. Journal of the American Geriatrics Society, 50(2), 256-262.

[5] Robinovitch, S. N., Feldman, F., Yang, Y., Schonnop, R., Leung, P. M., Sarraf, T., . . . Loughin, M. (2013). Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet, 381(9860), 47-54.