Characterizing the demands of backward balance loss and fall recovery during stair descent to prevent injury

Philippa Gosine; Vicki Komisar; Alison C Novak

doi:10.1016/j.apergo.2019.102900

Characterizing the demands of backward balance loss and fall recovery during stair descent to prevent injury

Appl Ergon. 2019 Nov:81:102900. doi: 10.1016/j.apergo.2019.102900. Epub 2019 Aug 2.

Authors

Philippa Gosine¹, Vicki Komisar², Alison C Novak³

Affiliations

¹ KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street - Room 407, Toronto, Ontario, M5S 3G9, Canada.
² KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada.
³ KITE, Toronto Rehabilitation Institute, University Health Network, 13-000, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W8, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue - Room 160, Toronto, Ontario, M5G 1V7, Canada. Electronic address: Alison.novak@uhn.ca.

PMID: 31422249
DOI: 10.1016/j.apergo.2019.102900

Abstract

Understanding the demands of balance recovery on stairs is important for developing strategies to prevent falls on stairs. This study characterized recovery strategies and whole-body movement following unexpected backward balance loss during stair descent in twelve young adults. Following balance loss, peak downward COM velocity was approximately double that experienced during non-perturbation stair descent. Participants used several balance recovery strategies: harness reliance (n = 1), no grasping reaction (n = 3), and grasping some environmental feature (n = 8). Of the five participants who used the handrail, four demonstrated grasping errors. Peak resultant handrail forces ranged from 24.2N to 238.3N. The results highlight the challenge of balance recovery during stair descent, showing that some people will use any available surface to arrest a fall. Our findings serve as a benchmark to understand the impact of stair-related interventions on fall recovery.

Keywords: Balance recovery; Kinematics; Stair ambulation.

MeSH terms

Accidental Falls / prevention & control*
Adult
Biomechanical Phenomena
Female
Hand Strength
Humans
Male
Postural Balance*
Stair Climbing / physiology*
Young Adult