Dynamic stability during increased walking speeds is related to balance confidence of older adults: a pilot study.
Jutaluk Kongsuk, David A Brown, Christopher P Hurt
PMID 31302337WHAT IT FOUND
Older adults with lower balance confidence stopped walking at slower speeds on a treadmill.
Their instability, measured by step-to-step variability, increased just before they chose to stop. This suggests confidence relates to actual control limits, not just fear.
Key findings
01Balance confidence scores correlated strongly with the fastest walking speed older adults were willing to attempt.
02Older adults who stopped early showed increased variability in their anterior-posterior stability in the step immediately before quitting.
03On average, older adults became mechanically unstable at a slower speed than younger adults.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Very small sample size (14 older adults). Convenience sampling limits generalizability. The use of a pelvic harness and robotic safety device may have altered natural gait mechanics. Cognitive function was not assessed, which can influence gait and confidence. The study cannot determine if low confidence caused the stopping behavior or if the inability to walk faster caused the low confidence. Balance confidence was measured by self-report, not during the task.
Declared interests
One author is a scientific consultant for HDT Global, the company that sells the KineAssist device used in the study, and is a co-inventor with potential royalty payments.
The easy way to misread this
Do not conclude that balance confidence is a direct proxy for mechanical stability limits. The study found no correlation between confidence and the 'zero crossing' speed. Confidence correlated with the *willingness* to attempt speed and with *variability* in stability, not the fixed mechanical threshold of instability.