Probability of lateral instability while walking on winding paths

People with balance impairments often struggle performing turns or lateral maneuvers, which can increase risk of falls and injuries. Here we asked how people's mediolateral balance is impacted when walking on non-straight winding paths. Twenty-four healthy adults (12F / 12M; 25.8±3.5 yrs) participated. Each walked on each of six paths projected onto a treadmill, comprised of three pseudo-random path oscillation frequency combinations (straight, slowly-winding, quickly-winding), each presented at either wide or narrow width. We quantified stepping errors as the percent of steps taken off each path. We quantified minimum mediolateral Margin of Stability (MoS_L) at each step and calculated means (μ) and standard deviations (σ) for each trial. We calculated lateral Probability of Instability (PoI_L) as participants' statistical risk of taking unstable (MoS_L < 0) steps. On narrower paths, participants made more stepping errors and walked with smaller μ(MoS_L) for all path frequencies (p < 0.001), and exhibited increased PoI_L on the straight and slowly-winding paths (p < 0.001). On winding paths, participants made progressively more stepping errors and walked with smaller μ(MoS_L) as oscillation frequency increased on narrow paths (all p < 0.001) and on the wide quickly-winding paths (all p < 0.001). They also consistently walked with larger σ(MoS_L), and increased PoI_Lon higher sinuosity paths of both widths (all p < 0.001). Though many took numerous unstable steps, no participant fell. Our results demonstrate healthy adults' ability both to trade off increased risk of lateral instability for greater maneuverability, and to employ highly-versatile stepping strategies to maintain balance while walking.