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Did you know that the biomechanics of reactive stepping have been widely studied in both young and older adults? Before getting into some of the details of the research, it is important to clarify what a reactive step is. Simply, a reactive step can be thought of as a common response humans use after a large disturbance to their balance – such as a trip or slip – in an attempt to prevent a fall and restore upright posture.

In a laboratory setting there are numerous ways to evoke reactive stepping responses. Two common methods include moving floors/platforms which translate underneath a participant’s feet, or forward-lean paradigms where a participant leans forward against a cable attached to a harness, where the cable is then released at a random interval. In both cases, when a large enough perturbation is applied, participants must use at least a single step to recover their balance.

Accordingly, research has shown that there are differences between young and older adults in these steps. For example, researchers have observed that many (50%) older adult women were unable to recover their balance with a single-step after being released from the smallest of the imposed forward-lean perturbations, which may have been due to limitations in the maximum speeds at which the older women moved their swing foot [1]. Separate laboratory studies have also observed a similar finding, that multi-step reactions were more common in older compared to young adults [2-7]. Interestingly, researchers have also shown that the number of older adult multiple steppers that experienced a fall in a 12-month follow-up period was greater compared with single steppers [8]. Along with multiple stepping, changes in reactive stepping with age can include shorter and slower steps, and smaller stability margins.

If you would like to learn more about this topic, contact us today to speak with one of our LISKE Team Experts who have studied this topic extensively.

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[1] Wojcik LA, Thelen DG, Schultz AB, Ashton-Miller JA, Alexander NB. Age and gender differences in single-step recovery from a forward fall. J Gerontol A Biol Sci Med Sci. 1999 Jan;54(1):M44-50. doi: 10.1093/gerona/54.1.m44. PMID: 10026662.

[2] Thelen DG, Wojcik LA, Schultz AB, Ashton-Miller JA, Alexander NB. Age differences in using a rapid step to regain balance during a forward fall. J Gerontol A Biol Sci Med Sci. 1997 Jan;52(1):M8-13. doi: 10.1093/gerona/52a.1.m8. PMID: 9008663.

[3] Schulz BW, Ashton-Miller JA, Alexander NB. Compensatory stepping in response to waist pulls in balance-impaired and unimpaired women. Gait Posture. 2005 Nov;22(3):198-209. doi: 10.1016/j.gaitpost.2004.09.004. Epub 2004 Nov 5. PMID: 16214659.

[4] Luchies CW, Alexander NB, Schultz AB, Ashton-Miller J. Stepping responses of young and old adults to postural disturbances: kinematics. J Am Geriatr Soc. 1994 May;42(5):506-12. doi: 10.1111/j.1532-5415.1994.tb04972.x. PMID: 8176145.

[5] Mille ML, Johnson-Hilliard M, Martinez KM, Zhang Y, Edwards BJ, Rogers MW. One step, two steps, three steps more ... Directional vulnerability to falls in community-dwelling older people. J Gerontol A Biol Sci Med Sci. 2013 Dec;68(12):1540-8. doi: 10.1093/gerona/glt062. Epub 2013 May 17. PMID: 23685768; PMCID: PMC3814241.

[6] Dijkstra BW, Horak FB, Kamsma YP, Peterson DS. Older adults can improve compensatory stepping with repeated postural perturbations. Front Aging Neurosci. 2015 Oct 21;7:201. doi: 10.3389/fnagi.2015.00201. PMID: 26539111; PMCID: PMC4612504.

[7] McIlroy WE, Maki BE. Age-related changes in compensatory stepping in response to unpredictable perturbations. J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M289-96. doi: 10.1093/gerona/51a.6.m289. PMID: 8914501.

[8] Carty CP, Cronin NJ, Nicholson D, Lichtwark GA, Mills PM, Kerr G, Cresswell AG, Barrett RS. Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults. Age Ageing. 2015 Jan;44(1):109-15. doi: 10.1093/ageing/afu054. Epub 2014 Jun 10. PMID: 24918170.