Stepping through fear: analysing postural control in elderly women during transitional locomotor tasks

Fear of falling (FoF) is prevalent among older adults, particularly women, and is a known factor increasing fall risk during movement. FoF may naturally arise after the first fall incident as well as long before the first fall occurs. This study examined how FoF intensity affects static balance and transitional locomotor tasks in 81 healthy women aged 60 and older.

Participants were divided into LOW, MODERATE, and HIGH FoF groups based on their Falls Efficacy Scale-International (FES-I) scores. Static balance was measured by center of pressure velocity (vCOP), while transitional tasks were assessed through transit time (TT), double support period (DSP), and stability times (S1-the time needed to destabilize the body before taking a step and S2- the time required to stabilize the position after taking a step) under unimpeded transition on a flat surface, obstacle clearance, step-up, and step-down conditions.

The findings showed no significant differences in static balance (vCOP) across FoF groups. However, the HIGH FoF group took longer to complete transitional tasks, with significantly increased TT, DSP, and S1 compared to the MODERATE group, particularly during obstacle clearance and step-up/down movements. This suggests that individuals with higher FoF take a more cautious approach, prioritizing stability over speed. No significant differences in S2 were found, indicating that FoF does not affect balance recovery after a step.

The study concludes that while FoF does not impair static balance, it significantly impacts movement initiation and execution in transitional tasks. Prolonged preparation time (S1) in the HIGH FoF group highlights the role of fear in delaying movement. These findings are important for designing interventions to reduce FoF and prevent falls in older adults.