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Walking is an important component of daily life requiring sensorimotor integration to be successful. Adding haptic input via light touch or anchors has been shown to improve standing balance; however, the effect of adding haptic input on walking is not clear. This scoping review systematically summarizes the current evidence regarding the addition of haptic input on walking in adults. Following an established protocol, relevant studies were identified using indexed data bases (Medline, EMBASE, PsychINFO, Google Scholar) and hand searches of published review articles on related topics. 644 references were identified and screened by a minimum of two independent researchers before data was extracted from 17 studies. A modified TREND tool was used to assess quality of the references which showed that the majority of studies were of moderate or high quality. Results show that adding haptic input changes walking behaviour. In particular, there is an immediate reduction in variability of gait step parameters and whole body stability, as well as a decrease in lower limb muscle activity. The effect of added haptic input on reflex modulation may depend on the limb of interest (i.e., upper or lower limb). Many studies did not clearly describe the amount and/or direction of haptic input applied. This information is needed to replicate and/or advance their results. More investigations into the use and design of the haptic tools, the attentional demands of adding haptic input, and clarity on short-term effects are needed. In addition, more is research needed to determine whether adding haptic input has significant, lasting benefits that may translate to fall prevention efforts.

Background The Balance Evaluation Systems Test (BESTest) and its two abbreviated versions (mini-BESTest and briefBESTest) are functional balance tools that have yet to be validated in middle aged and elderly people living in the community. Objective Determine the construct validity of the three BESTest versions by comparing them with commonly-used measures of balance, balance confidence and physical activity, and examining their ability to discriminate between groups with respect to falls and fall risk. Methods This was a secondary analysis of data from 79 adults (mean age 68.7 ± 10.57 years). Pearson correlation coefficients were used to examine the relationships between each BESTest measure and the Activities-Specific Balance Confidence (ABC) scale, the Physical Activity Scale for the Elderly (PASE), the Timed Up and Go (TUG) and the Single Leg Stance (SLS) test. Independent t-tests were used to examine differences in balance between fallers (≥1 fall in previous year) and non-fallers and individuals classified at low versus high fall risk using the Elderly Falls Screening Test (EFST). Results The BESTest measures showed moderate associations with the ABC scale and TUG (r = 0.62–0.67 and −0.60 to −0.68 respectively), fair associations (r = 0.33–0.40) with the PASE and moderate to high associations (r = 0.67–0.77) with the SLS. Fallers showed a trend (p = 0.054) for lower scores on the original BESTest, and people at high risk for falls had significantly lower scores on all BESTest versions. Conclusions These findings support the construct validity of the BESTest, mini-BESTest and briefBESTest in adults over 50 years old.

Reactive postural control, the ability to recover from an external perturbation to stability, ultimately determines whether an individual will fall following a loss of balance and should be routinely incorporated in balance assessment. The purpose of this study was to identify (1) methods used to assess reactive postural control in clinical practice and (2) factors associated with regular assessment of reactive postural control. A cross-sectional survey was conducted. Three hundred and fifty-seven physiotherapists in Ontario, Canada who treated adults with balance impairments answered questions about the components of balance they assess and how they assess reactive control in their practice. Of the 273 respondents who assessed reactive postural control at least some of the time, 15.4% used a standardized measure, 79.1% used a non-standardized approach, and 5.5% used both. Forty-five methods of assessing reactive control were reported. The most common methods used were non-standardized perturbations (43.5%; 104/239 respondents) and movement observation (18.8%; 45/239). The remaining 43 methods were each used by less than 8% of respondents. Practice area had the strongest association with regular assessment of reactive postural control (>60% of the time), and respondents working with neurological disorders were more likely to regularly evaluate reactive control than those working with people with orthopedic conditions. Despite the availability of valid standardized measures to evaluate reactive postural control, respondents relied primarily on non-standardized approaches and observational assessment. Future work should examine the factors influencing choice of reactive control assessment tools and awareness of standardized measures for reactive postural control.

Neuromuscular dyscontrol during gait following stroke may be further compromised by increased susceptibility to fatigue. Our purpose was to examine how extended effortful activity affected spatio-temporal gait parameters after stroke. The influence of sub-maximal exercise was assessed among 26 stroke survivors who performed the Six-Minute Walk Test with distance recorded every 2 min. Walking distance decreased 5.8 (S.D. 6.9) m in the second 2-min interval and another 2.3 (S.D. 9.9) m in the final 2 min (p = 0.0005). Secondly, we evaluated spatio-temporal gait parameters prior to and immediately following a standardized maximal exercise test on a cycle ergometer in 36 stroke survivors. In contrast to the expected reduction in walking speed, maximal exercise led to a 5.5 (S.D. 11.5) cm/s increase in preferred gait speed (p = 0.007) and a 4.5 (S.D. 7.7) steps/min increase in cadence (p = 0.0004), but did not affect gait symmetry. Subsequent division of participants by preferred pedaling cadence revealed that individuals with lower preferred cadence had the greatest increase in preferred speed, cadence and paretic leg step length (p < 0.01). These unexpected results suggest that potential fatigue-induced effects on gait may have been masked by immediate positive influences of movement rate on walking speed. Such activity-specific effects may have clinical applications for stroke patients and other populations with gait deviations.