title: Biomechanical influences on balance recovery by stepping.
abstract: Stepping represents a common means for balance recovery after a perturbation to upright posture. Yet little is known regarding the biomechanical factors which determine whether a step succeeds in preventing a fall. In the present study, we developed a simple pendulum-spring model of balance recovery by stepping, and used this to assess how step length and step contact time influence the effort (leg contact force) and feasibility of balance recovery by stepping. We then compared model predictions of step characteristics which minimize leg contact force to experimentally observed values over a range of perturbation strengths. At all perturbation levels, experimentally observed step execution times were higher than optimal, and step lengths were smaller than optimal. However, the predicted increase in leg contact force associated with these deviations was substantial only for large perturbations. Furthermore, increases in the strength of the perturbation caused subjects to take larger, quicker steps, which reduced their predicted leg contact force. We interpret these data to reflect young subjects' desire to minimize recovery effort, subject to neuromuscular constraints on step execution time and step length. Finally, our model predicts that successful balance recovery by stepping is governed by a coupling between step length, step execution time, and leg strength, so that the feasibility of balance recovery decreases unless declines in one capacity are offset by enhancements in the others. This suggests that one's risk for falls may be affected more by small but diffuse neuromuscular impairments than by larger impairment in a single motor capacity.
authors.affiliation: Department of Orthopaedic Surgery, San Francisco General Hospital and University of California, 94110, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Hsiao
authors.forename: S N
authors.initials: SN
authors.lastname: Robinovitch
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005544:Forecasting; D006801:Humans; D007866:Leg / Q000502:physiology*; D008297:Male; D008954:Models, Biological; D004856:Postural Balance / Q000502:physiology*