Influence of gait speed on stability: recovery from anterior slips and compensatory stepping

Falls precipitated by slipping are a major health concern, with the majority of all slip-related falls occurring during gait. Recent evidence shows that a faster and/or more anteriorly positioned center of mass (COM) is more stable against backward balance loss, and that compensatory stepping is the key to recovering stability upon balance loss. The purposes of this paper were to determine whether walking speed affected gait stability for backward balance loss at slip onset and touchdown of compensatory stepping, and whether compensatory stepping response resembled the regular gait pattern. Forty-seven young subjects were slipped unexpectedly either at a self-selected fast, natural or slow speed. Speed-related differences in stability at slip onset and touchdown of the subsequent compensatory step were analyzed using the COM position-velocity state. The results indicate that gait speed highly correlated with stability against backward balance loss at slip onset. The low COM velocity of the slow group was not sufficiently compensated for by a more anteriorly positioned COM associated with a shorter step length at slip onset. At touchdown of the compensatory step, the speed-related differences in stability diminished, due to the continued advantage of anterior COM positioning from a short compensatory step retained by the slow group, coupled with an increase in COM velocity. Compensatory step length and relative COM position altered as a function of gait speed, indicating the motor program for gait regulation may play a role in modulating the compensatory step.