Role of stability and limb support in recovery against a fall following a novel slip induced in different daily activities

The purpose of this study was to determine whether stability and limb support play a similar role in governing slip outcome in gait-slip as in sit-to-stand-slip, and whether such prediction could also be derived based on measures of these variables during regular, unperturbed movements. Fifty-three and forty-one young subjects all took one recovery step following an unannounced, novel, forward slip induced in gait and in sit-to-stand, respectively. Logistic regression was used to predict recovery outcome based on preslip and reactive measures of stability and limb support across tasks. Following slip onset, all subjects in both tasks experienced rapid decay in stability and limb support (indicated by a hip descent), leading to some actual falls that could not have been predicted from regular, preslip walking. Immediately before recovery step touchdown, stability and limb support could together best predict 88.9% and 100% falls, respectively, for gait-slip and sit-to-stand-slip. Because of differences in the execution of the recovery step, stability became a better predictor of fallers in sit-to-stand-slip than in gait-slip after recovery limb touchdown. Recovery steps were highly effective in restoring stability, regardless of outcome and task. The predictive strength of stability diminished in gait-slip or reduced in sit-to-stand-slip after recovery touchdown, while limb support remained able to differentiate fallers from those who recovered in both tasks. When slip-induced instability was combined with inadequate limb support, falls were nearly inevitable in both tasks.