Effect of Forward Leaning Characteristics on Protective Step during Performing Voluntary-induced Stepping Response in Young and Older Adults

Arissara Sangkaew, Arisara Nooeieiad, Natthida Saipet, Premsikan Sathitporn, Ananya Nakaem, Rumpa Boonsinsukh, Chanatip Pureesathit, Natchamon Chawpeng, Natnicha Kerdpaibull, Pornprom Chayasit, Suppaka Chataluek, Supanuch Kerdsiri
Purpose:

This study aimed primarily to examine the effect of forward leaning distance during performing VSR on protective step length. The secondary objectives were to compare protective step length of healthy young and older adults in response to the same forward leaning distance; and to compare voluntary leaning characteristics between the two groups.

Methods:

A cross-sectional study was conducted in 30 healthy young adults (aged 19.53 ± 0.73 years) and ten healthy older adults (aged 68.9 ± 4.4 years). Healthy young adults were assigned to perform VSR with 2 different forward leaning conditions, leaning with short distance and leaning with long distance (Ds and Dl). The distance of both conditions was calculated based on the data of pelvis displacement during performing VSR from the previous study. Healthy older adults were asked to perform VSR with their preferred leaning distance that they could recover balance with a single step. Protective step length, leaning strategy, strategies of responses, and strategies of controlling body was collected by a video recorder. The Kinovea program was used to analyze and export the data. Statistical analysis was performed using paired sample t-test and Chi-square at p0.05.

Results:

The protective step length was significantly greater in condition Dl than Ds (p 0.001, 95% CI -0.04 to -0.01). The step length of young adults in condition Ds was comparable to the step length of older adults. However, older adults showed grasping strategy, other reactions, instability, trunk bending strategies in greater percentage than young adult participants (p 0.05). These additional strategies indicated less stability in older adults as compared to young participants. Young adults also had hip and neck flexion at foot touchdown in a greater percentage than older adults, suggesting that young adults had better postural control to break CoM movement than older adults.

Conclusion(s):

Forward leaning distance during VSR affected protective step length. In the condition that the forward leaning distance was equal, protective step length did not differ by aging. However, aging influenced the postural stability after performing VSR.

Implications:

As leaning distance influences stepping responses, the modification of leaning distance can change the difficulty of VSR task. The farther an individual leans forward, the more challenging it becomes for them to accomplish the VSR task. Moreover, the training of VSR in people with advancing age should focus on both step length and stability of step, which could be found by monitoring the stability at foot touchdown, ability to control body motion and other unnecessary reactions.

Funding acknowledgements:
There was no funding support for this work.
Keywords:
Postural control
Balance
Aging
Primary topic:
Disability and rehabilitation
Second topic:
Community based rehabilitation
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by institutional review board of Srinakharinwirot University.
Provide the ethics approval number:
PTPT2021-006
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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