Concern about falling is associated with segmental control when turning in older adults

Background: Healthy young adults typically exhibit a progressive 'top-down' reorientation of body segments (i.e., head, trunk, then pelvis) during turning. This behaviour is less evident in older adults at risk of falling, who often reduce angular displacement between body segments during turns. The potential functional and psychological contributors to this so-called 'en-bloc' turning strategy are not yet understood.

Research question: Are there associations between concern about falling and variables representing en-bloc turning (i.e., increased coupling between body segments)?

Methods: Twenty-one older adults were assessed while turning during an adaptive walking task. We collected data from markers forming the head, trunk, and pelvis segments, while gait velocity throughout the turn was calculated from a sternum marker. We correlated several variables with concern about falling alone, as well as while controlling for functional balance ability.

Results: Correlation analyses revealed that concern about falling was related to en-bloc turning strategies and slower gait velocity throughout the turn, when analysed independently of functional balance. When controlling for balance ability, en-bloc turning strategies between the head and trunk, as well as the head and pelvis, remained significantly associated with concern about falling.

Significance: Findings offer an insight into the potential role that psychological characteristics may have in determining older adults' turning behaviour and associated risk of falling.