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Concern about falling is associated with segmental control when turning in older adults
Adam J Cocks1, William R Young2, Toby J Ellmers3
1Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, UK; Centre for Cognitive Neuroscience, Brunel University London, Uxbridge, UK; College of Health and Life Sciences, Brunel University London, Uxbridge, UK.
Gait & Posture
|May 23, 2021
Summary
Older adults concerned about falling adopt an en-bloc turning strategy, moving their body as one unit. This turning behavior is linked to fear of falling, even when balance is good.
Area of Science:
- Gerontology
- Biomechanics
- Psychology of Aging
Background:
- Healthy young adults use a sequential 'top-down' body reorientation during turns (head, trunk, pelvis).
- Older adults at risk of falling often exhibit 'en-bloc' turning, characterized by reduced segment angular displacement.
- The functional and psychological factors influencing en-bloc turning in older adults are not well understood.
Purpose of the Study:
- To investigate the association between concern about falling and en-bloc turning strategies in older adults.
- To determine if this association persists when controlling for functional balance ability.
Main Methods:
- Twenty-one older adults performed an adaptive walking task involving turns.
- Kinematic data of head, trunk, and pelvis segments were collected using marker-based motion analysis.
- Gait velocity was calculated, and correlation analyses were performed between turning strategies and concern about falling, with and without controlling for balance.
Main Results:
- Concern about falling was significantly associated with en-bloc turning strategies and slower gait velocity when analyzed independently of balance.
- Even after controlling for functional balance ability, en-bloc turning (head-trunk and head-pelvis coupling) remained significantly linked to concern about falling.
Conclusions:
- Psychological factors, specifically concern about falling, play a role in shaping turning biomechanics in older adults.
- En-bloc turning may be a compensatory strategy influenced by fear of falling, impacting fall risk in older populations.

