Influence of age and falls incidence on tau guidance of centre of pressure movement during gait initiation

Background Prospective balance control can be assessed in terms of the characteristics of a tau-guidance function that summarizes the velocity profile of Centre of Pressure (CoP) movement during gait initiation. This allows the nature of CoP movement to be assessed on a continuum between controlled ‘soft’- and unstable ‘hard’ CoP-motion gap-closure. Previous research has shown less stable movement patterns with harder closures with increasing age, which makes movements more prone to overshooting and could possibly explain the increasing falls risk with age. Research questions The primary research question was ‘what is the relationship between falls incidence and tau-guidance in the mediolateral centre of pressure movements during gait initiation?’ The secondary research question was ‘what are the influences of age and task demands on the variability of tau-guidance characteristics?’. Methods Sixteen young adults and 76 older adults performed 33 gait initiations from a force platform, stepping onto stepping-targets imposing differing task demands. Older participants completed a one-year follow-up screening for falls. An analysis was performed investigating linear relationships between a tau-guidance function and the time-to-closure (tau) of the mediolateral centre of pressure motion-gap with coupling constant K (dependent variable). Results Gait-related falls during the 12-month follow-up period were associated with higher tau-K values. Furthermore, longer movement preparation time was associated with lower K values, particularly in fallers. Previously-reported age-related increases of the tau-coupling constant values which were found in studies of unconstrained gait initiation were not present in our results. Significance The presence of the targeting task provided a more prescriptive environment compared to unconstrained gait initiation and could explain the absence of age-related changes to the produced K values. Falls incidence was found to be associated with higher values of K, indicating less stable movement. Future studies should investigate the practical implications of these findings for falls prevention.