Effects of age, physical and self-perceived balance abilities on lateral stepping adjustments during competing lateral balance tasks

Background: Daily walking paths exhibit varying environment features and require continuous adjustments to locomotor trajectories. Humans maintain lateral balance while navigating paths by modifying stepping in accordance with changing side-to-side path limitations (e.g. path width, lateral location). These processes are influenced by one's actual physical ability to maintain balance, as well as their self-perceived balance ability. Older adults experience decreases in each of these abilities, which may alter their capacity to execute appropriate lateral stepping adaptations. Research Question: How do age, physical and self-perceived balance abilities interact to influence lateral stepping adaptations of older adults walking in complex environments with dynamic lateral path features? Methods: Twenty young (age mean ± SD: 21.7 ± 2.6) and 18 older adults (age mean ± SD: 71.6 ± 6.0) walked on an instrumented treadmill in a virtual-reality system. Participants adjusted lateral stepping during two competing lateral balance sub-tasks that manipulated either path width or location. Participants began walking on a gradually-narrowing path (sub-task A), then decided when/ how to laterally maneuver to an adjacent path (sub-task B). Recorded path characteristics were used to quantify spatial thresholds for stepping error onset and sub-task exchange. Results: Older adults made sub-task A stepping errors on wider paths and exchanged sub-tasks earlier. These differences were not directly attributed to age. Statistical path analyses revealed that physical balance ability mediated age effects on stepping error onset, while self-perceived balance ability mediated age effects on sub-task exchange. Both age groups exchanged sub-tasks when stepping accuracy likelihoods were similar and high, ∼90 %. Significance: This work demonstrates important mechanisms for how age, via degradation of physical and self-perceived balance abilities, indirectly and differentially influences navigation of competing lateral balance tasks. Mediating physical and perceptual factors are potential targets for improving older adults’ navigation of complex environments.