Possible recovery or unavoidable fall? A model to predict the one step balance recovery threshold and its stepping characteristics

In order to prevent fall related injuries and their consequences, one needs to be able to predict the outcome of a given balance perturbation: a possible Balance Recovery (BR) or an unavoidable fall? Given that results from the existing experimental studies are difficult to compare and to generalize, we propose to address this question with a numerical tool. Built on existing concepts from the biomechanics and robotics literature, it includes the optimal use of BR reactions and particularly the possibility to perform a recovery step. It allows estimating 1) the possibility to recover a steady balance from a given initial state or perturbation using at most one recovery step; 2) the set of recovery steps leading to a BR. Using standard sets of parameters for young and elderly population, we assessed this model׳s predictions against experimental data from the literature in the anterior direction. Two classical representations of the human body (inverted pendulum (IP) vs. linear inverted pendulum (LIP)) were also compared. The results showed that the model correctly predicted the possibility to recover using a single protective step (1-Step BR threshold) and the characteristics (step length and time) of the protective step for both the young and the elderly. This tool has a real potential in the field of fall prevention to detect risky situation. It could also be used to get insights into the neuromuscular mechanisms involved in the BR process.