Role of heel lifting in standing balance recovery: A simulation study

Although lifting the heels has frequently been observed during balance recovery, the function of this movement has generally been overlooked. The present study aimed to investigate the functional role of heel lifting during regaining balance from a perturbed state. Computer simulation was employed to objectively examine the effect of allowing/constraining heel lifting on balance performance. The human model consisted of 3 rigid body segments connected by frictionless joints. Movements were driven by joint torques depending on current joint angle, angular velocity, and activation level. Starting from forward-inclined and static straight-body postures, the optimization goal was to recover balance effectively (so that ground projection of the mass center returned to the inside of the base of support) and efficiently by adjusting ankle and hip joint activation levels. Allowing/constraining heel lifting resulted in virtually identical movements when balance was mildly perturbed at the smallest lean angle (8°). At larger lean angles (8.5° and 9°), heel lifting assisted balance recovery more evidently with larger joint movements. Partial and altered timings of ankle/hip torque activation due to constraining heel lifting reduced linear and angular momentum generation for avoiding forward falling, and resulted in hindered balancing performance.