Limits of recovery against slip-induced falls while walking

Slip-induced falls in gait often have devastating consequences. The purposes of this study were 1) to select the determinants that can best discriminate the outcomes (recoveries or falls) of an unannounced slip induced in gait (and to find their corresponding threshold, i.e., the limits of recovery, which can clearly separate these two outcomes), and 2) to verify these results in a subset of repeated-slip trials. Based on the data collected from 69 young subjects during a slip induced in gait, nine different ways of combining the center of mass (COM) stability, the hip height, and its vertical velocity were investigated with the aid of logistic regression. The results revealed that the COM stability (s) and limb support (represented by the quotient of hip vertical velocity to hip height, S-hip) recorded at the instant immediately prior to the recovery step touchdown were sufficiently sensitive to account for all (100%) variance in falls, and specific enough to account for nearly all (98.3%) variability in recoveries. This boundary (S-hip = 0.22s-0.25), which quantifies the risk of falls in the stability-limb support quotient (s-S-hip) domain, was fully verified using second-slip and third-slip trials (n=76) with classification of falls at 100% and recoveries at 98.6%. The severity of an actual fall is likely to be greater further below the boundary, while the likelihood of a fall diminishes above it. Finally, the slope of the boundary also indicates the tradeoff between the stability and limb support, whereby high stability can compensate for the insufficiency in limb support, or vice versa. (C) 2011 Elsevier Ltd. All rights reserved.