title: Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults.
abstract: BACKGROUND
  a fall occurs when an individual experiences a loss of balance from which they are unable to recover. Assessment of balance recovery ability in older adults may therefore help to identify individuals at risk of falls. The purpose of this 12-month prospective study was to assess whether the ability to recover from a forward loss of balance with a single step across a range of lean magnitudes was predictive of falls.
  
  
  METHODS
  two hundred and one community-dwelling older adults, aged 65-90 years, underwent baseline testing of sensori-motor function and balance recovery ability followed by 12-month prospective falls evaluation. Balance recovery ability was defined by whether participants required either single or multiple steps to recover from forward loss of balance from three lean magnitudes, as well as the maximum lean magnitude participants could recover from with a single step.
  
  
  RESULTS
  forty-four (22%) participants experienced one or more falls during the follow-up period. Maximal recoverable lean magnitude and use of multiple steps to recover at the 15% body weight (BW) and 25%BW lean magnitudes significantly predicted a future fall (odds ratios 1.08-1.26). The Physiological Profile Assessment, an established tool that assesses variety of sensori-motor aspects of falls risk, was also predictive of falls (Odds ratios 1.22 and 1.27, respectively), whereas age, sex, postural sway and timed up and go were not predictive.
  
  
  CONCLUSIONS
  reactive stepping behaviour in response to forward loss of balance and physiological profile assessment are independent predictors of a future fall in community-dwelling older adults. Exercise interventions designed to improve reactive stepping behaviour may protect against future falls.
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute and School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Carty
authors.affiliation: Neuromuscular Research Centre, Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Cronin
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute and School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
authors.forename: Deanne
authors.initials: D
authors.lastname: Nicholson
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia.
authors.forename: Glen A
authors.initials: GA
authors.lastname: Lichtwark
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute and School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Mills
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Kerr
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Australia.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Cresswell
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute and School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
authors.forename: Rod S
authors.initials: RS
authors.lastname: Barrett
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000222:Adaptation, Physiological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D005684:Gait; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D004856:Postural Balance; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012678:Sensation Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D013997:Time Factors
keywords: ageing; balance recovery; falls prevention; forward loss of balance; older adults; reactive stepping