Control of compensatory stepping reactions: Age-related impairment and the potential for remedial intervention

Stepping is a prevalent and functional reaction to loss of balance, yet this element of postural control has only recently begun to receive due attention. It is likely that the impaired ability to execute compensatory stepping reactions is an important contributor to the unsteadiness, loss of balance confidence, and risk of falling that is associated with aging and age-related pathology. Even healthy, active older adults appear to experience difficulty in controlling stepping reactions, as evidenced by a tendency to require multiple steps to recover equilibrium. There seems to be a particular problem in controlling lateral stability. When stepping in response to forward or backward loss of balance, older adults often experience difficulty in countering the tendency of the body to fall laterally during the step. When stepping in response to lateral loss of balance, they often have problems controlling movement of the swing foot so as to avoid collision with the stance limb. The problems in controlling late...