Can initial and additional compensatory steps be predicted in young, older, and balance-impaired older females in response to anterior and posterior waist pulls while standing?

The initiation of a single compensatory step in response to balance perturbations has been predicted with accuracies of up to 71%. We sought to determine whether similar methods also could be used to predict the onset of additional compensatory steps in both healthy and balance-impaired older females. Anterior and posterior waist pulls of five different magnitudes were applied to 13 unimpaired young (mean age 23 years), 12 unimpaired older (mean age 71 years), and 15 balance-impaired older (mean age 76 years) women. Body segment kinematic data were recorded at 100 Hz. A step was predicted when the time for the center-of-mass to reach the vertical projection of the boundary of the base-of-support fell below a certain threshold. The results show that 83% of all steps and non-steps were correctly predicted at an optimal time-to-boundary threshold (τopt) of 0.78 s. Step prediction accuracy did not differ significantly by group: 86% of steps and non-steps by young, 84% by unimpaired old, and 82% by balance-impaired old women were correctly predicted at τopt of 0.58, 0.67, and 0.78 s, respectively. Anterior steps and non-steps were predicted more accurately than posterior ones (94% vs. 79% correct at τopt of 0.52 and 0.84 s, respectively) and initial steps were better predicted than additional ones (87% vs. 81% correct at τopt of 0.77 and 0.34 s, respectively). We conclude that this step prediction method reasonably predicts initial and additional steps in the anterior and posterior direction by all three subject cohorts.