ORIGINAL PAPER
The influence of the design of the assessment method on the attributes of reactive backwards stepping in young adults
1
Sri Ramachandra Institute of Higher Education and Research (deemed to be university), Chennai, India
Submission date: 2023-09-27
Acceptance date: 2024-05-06
Publication date: 2025-06-18
Corresponding author
Sivakumar Ramachandran
Sri Ramachandra Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), No1, Sri Ramachandra Nagar, Porur, Chennai 600116, India
Sri Ramachandra Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), No1, Sri Ramachandra Nagar, Porur, Chennai 600116, India
Physiother Quart. 2025;33(2):25-29
KEYWORDS
TOPICS
ABSTRACT
Objective:
Reactive backwards stepping occurs to prevent a backwards fall when a person’s centre of mass is shifted posteriorly by an unexpected external force. Methods such as the Balance Evaluation Systems Test (BESTest) and platform translations are used to assess the ability to perform backwards stepping. However, the response may vary based on the perturbations administered during testing, which could reflect the individual’s optimal response capability. This study aims to analyse the characteristics of backwards reactive stepping in both the BESTest and moving platform methods.
Methods:
In this observational study, 60 healthy young adults were tested for backwards stepping using the BESTest and a moving platform. Three trials were video-recorded and analysed. The first step length, first step time, balance recovery length and balance recovery time were measured and compared between the BESTest and moving platform methods. Mann–Whitney U was used to test the differences at a significance level of p < 0.05.
Results:
The results showed that the values for first step length, balance recovery length and balance recovery time were smaller for the moving platform perturbation compared to the BESTest (p < 0.05). Conversely, no difference was observed in first step time between the two methods.
Conclusions:
The design of the evaluation method influenced the characteristics of stepping. The moving platform elicited a more proficient backwards stepping reaction compared to the BESTest.
Reactive backwards stepping occurs to prevent a backwards fall when a person’s centre of mass is shifted posteriorly by an unexpected external force. Methods such as the Balance Evaluation Systems Test (BESTest) and platform translations are used to assess the ability to perform backwards stepping. However, the response may vary based on the perturbations administered during testing, which could reflect the individual’s optimal response capability. This study aims to analyse the characteristics of backwards reactive stepping in both the BESTest and moving platform methods.
Methods:
In this observational study, 60 healthy young adults were tested for backwards stepping using the BESTest and a moving platform. Three trials were video-recorded and analysed. The first step length, first step time, balance recovery length and balance recovery time were measured and compared between the BESTest and moving platform methods. Mann–Whitney U was used to test the differences at a significance level of p < 0.05.
Results:
The results showed that the values for first step length, balance recovery length and balance recovery time were smaller for the moving platform perturbation compared to the BESTest (p < 0.05). Conversely, no difference was observed in first step time between the two methods.
Conclusions:
The design of the evaluation method influenced the characteristics of stepping. The moving platform elicited a more proficient backwards stepping reaction compared to the BESTest.
REFERENCES (18)
1.
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?. Age Ageing. 2006;35(Suppl 2):ii7-ii11; doi: 10.1093/ageing/afl077.
2.
Mille ML, Rogers MW, Martinez K, Hedman LD, Johnson ME, Lord SR, Fitzpatrick RC. Thresholds for inducing protective stepping responses to external perturbations of human standing. J Neurophysiol. 2003;90(2):666–74; doi: 10.1152/jn.00974.2002.
3.
Kadono N, Pavol MJ. Effects of aging-related losses in strength on the ability to recover from a backward balance loss. J Biomech. 2013;46(1):13–8; doi: 10.1016/j.jbiomech.2012.08.046.
4.
Lee PY, Gadareh K, Bronstein AM. Forward-backward postural protective stepping responses in young and elderly adults. Hum Mov Sci. 2014;34(1):137–46; doi: 10.1016/j.humov.2013.12.010.
5.
Luchies CW, Alexander NB, Schultz AB, Ashton-Miller J. Stepping responses of young and old adults to postural disturbances: kinematics. J Am Geriatr Soc. 1994;42(5):506–12; doi: 10.1111/j.1532-5415.1994.tb04972.x.
6.
Brauer SG, Woollacott M, Shumway-Cook A. The influence of a concurrent cognitive task on the compensatory stepping response to a perturbation in balance-impaired and healthy elders. Gait Posture. 2002;15(1):83–93; doi: 10.1016/s0966-6362(01)00163-1.
7.
Halická Z, Lobotková J, Bzduskova D, Hlavacka F. Age-related changes in postural responses to backward platform translation. Physiol Res. 2012;61(3):331–5.
8.
Hsiao-Wecksler ET, Robinovitch SN. The effect of step length on young and elderly women’s ability to recover balance. Clin Biomech. 2007;22(5):574–80; doi: 10.1016/j.clinbiomech.2007.01.013.
9.
Horak FB, Wrisley DM, Frank J. The Balance Evaluation Systems Test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89(5):484–98; doi: 10.2522/ptj.20080071.
10.
Verniba D, Gage WH. A comparison of balance-correcting responses induced with platform-translation and shoulder-pull perturbation methods. J Biomech. 2020;112:110017; doi: 10.1016/j.jbiomech.2020.110017.
11.
Mansfield A, Maki BE. Are age-related impairments in change-in-support balance reactions dependent on the method of balance perturbation?. J Biomech. 2009;42(8):1023–31; doi: 10.1016/j.jbiomech.2009.02.007.
12.
Batcir S, Shani G, Shapiro A, Melzer I. Characteristics of step responses following varying magnitudes of unexpected lateral perturbations during standing among older people – a cross-sectional laboratory-based study. BMC Geriatr. 2022;22:400; doi: 10.1186/s12877-022-03080-w.
13.
Wu M, Ji L, Jin D, Pai Y. Minimal step length necessary for recovery of forward balance loss with a single step. J Biomech. 2007;40(7):1559–66; doi: 10.1016/j.jbiomech.2006.07.019.
14.
Batcir S, Shani G, Shapiro A, Alexander N, Melzer I. The kinematics and strategies of recovery steps during lateral losses of balance in standing at different perturbation magnitudes in older adults with varying history of falls. BMC Geriatr. 2020;20(1):249; doi: 10.1186/s12877-020-01650-4.
15.
Fujimoto M, Bair W-N, Rogers MW. Single and multiple step balance recovery responses can be different at first step lift-off following lateral waist-pull perturbations in older adults. J Biomech. 2017;55:41–7; doi: 10.1016/j.jbiomech.2017.02.014.
16.
DePasquale L, Toscano L. The Spring Scale Test: a reliable and valid tool for explaining fall history. J Geriatr Phys Ther. 2009;32(4):159–67.
17.
Promsri A, Haid T, Werner I, Federolf P. Leg dominance effects on postural control when performing challenging balance exercises. Brain Sci. 2020;10(3):128; doi: 10.3390/brainsci10030128.
18.
Bhise S, Patil N. Dominant and non-dominant leg activities in young adults. Int J Ther Rehabil Res. 2016;5(4):257.
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