Effects of Foot Placement on Postural Sway in the Anteroposterior and Mediolateral Directions

The common practice of standardizing foot placement in postural research and in clinical practice may serve to increase postural sway. The focus of this study was to investigate foot placement strategies in the tandem (anteroposterior, AP) and side-to-side (mediolateral, ML) stance in healthy adults. Foot placement was either experimenter-controlled or selected by the participant. Greater sway was observed for the AP stance than the ML stance, where sway was minimal. When foot placement was self-selected, participants recruited additional degrees of freedom by rotating both feet outward to expand the base of support; they narrowed their stance width in the AP stance only. Self-selection served to decrease AP sway for the AP stance and increase ML sway for both the AP and ML stances. A dynamical measure, the largest Lyapunov exponent, supported the finding that self-selection of foot placement serves to stabilize posture. The implication is that improvements in postural control were due primarily to self-selection of foot placement and not to adjustments in stance width. Experimental and perhaps clinical procedures should be revised to allow participants to self-select foot placement during postural tasks.