title: Comparison between investigations of induced stepping postural responses and voluntary steps to better detect community-dwelling elderly fallers.
abstract: In this paper, we review a physiological task that is predominant in preventing humans from falling, but that simultaneously also challenges balance: taking a step. In particular, two variants of this task are presented and compared: the voluntary step versus a step induced by an external and unpredictable perturbation. We show that, while these contribute different information, it is interesting to compare these. Indeed, they both are relevant in a global balance assessment and should be included within this, at the same level as tests usually dispensed in the clinical environment such as posturography. We choose to focus on the community-dwelling elderly population, to discuss means of early detection of risk of falls, in order to prescribe an appropriate prevention. An overview of posture-movement coordination and balance recovery strategies is also provided. Finally, a working hypothesis is suggested on how "compensatory protective" steps are controlled and how their evaluation could bring additional information to the global balance assessment of risk of fall.
authors.affiliation: Université de Lyon, 69622 Lyon, France; IFSTTAR, UMR_T9406, LBMC laboratoire de biomécanique et mécanique des chocs, LBMC case 24, 25, avenue François-Mitterrand, 69675 Bron cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Tisserand
authors.affiliation: Université de Lyon, 69622 Lyon, France; IFSTTAR, UMR_T9406, LBMC laboratoire de biomécanique et mécanique des chocs, LBMC case 24, 25, avenue François-Mitterrand, 69675 Bron cedex, France. Electronic address: thomas.robert@ifsttar.fr.
authors.forename: T
authors.initials: T
authors.lastname: Robert
authors.affiliation: Université de Lyon, 69622 Lyon, France; EA 647, CRIS centre de recherche et d'innovation sur le sport, université Claude-Bernard Lyon 1, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Chabaud
authors.affiliation: Centre régional de prévention, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Livet
authors.affiliation: Service de médecine gériatrique, centre hospitalier Lyon Sud, Pierre-Bénite, France.
authors.forename: M
authors.initials: M
authors.lastname: Bonnefoy
authors.affiliation: Université de Lyon, 69622 Lyon, France; IFSTTAR, UMR_T9406, LBMC laboratoire de biomécanique et mécanique des chocs, LBMC case 24, 25, avenue François-Mitterrand, 69675 Bron cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Chèze
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D057187:Independent Living; D004856:Postural Balance; D016138:Walking
keywords: Ajustements posturaux anticipés (APA); Ajustements posturaux compensateurs (APC); Anticipatory Postural adjustments (APA); Balance recovery; Chute; Community-dwelling elderly; Compensatory postural adjustments (CPA); Faire un pas; Fall; Personnes âgées autonomes; Rattrapage de l’équilibre; Stepping