Age and gender differences in single-step recovery from a forward fall

Abstract

Background. Previous work has found that healthy older men were significantly less able than young male adults to recover balance by taking a single rapid step upon sudden release from forward leans. In light of the higher rates of falls and fall-related injuries among older women compared to older men, we hypothesized that healthy older women would perform more poorly than either female young adults or older men in this test of abilities to recover balance rapidly. Methods. Ten young (mean age 25.0 years) and 10 older (73.7 years) healthy women were released from forward leans and instructed to regain standing balance by taking a single step forward. The lean angle was incrementally increased from its smallest value, approximately 14°, until the subject failed to regain balance as instructed. Lower extremity kinematics were measured, and findings were compared with those of the earlier study of healthy young and old men. Results. Five of the 10 older women could not recover balance with a single step after release from the smallest of the imposed forward leans. For the 5 older women who succeeded in recovering as instructed from at least one lean, the mean maximum lean angle was significantly smaller than that for young women (16.2°vs 30.7°, p < .001) or older men (16.2°vs 23.9°, p = .014). In contrast, there was no significant difference in mean maximum lean angle between female and male young adults. Conclusions. Healthy older women, compared to either young women or older men, were significantly less able to recover balance by taking a single rapid step during a forward fall. The decreased abilities of older women appeared to result from limitations in the maximum speeds at which they moved their swing foot during recovery.