The influence of fear of falling on the control of upright stance across the lifespan

M Hill, L. Brayne, E. Hosseini, M. Duncan, T. Muehlbauer, S.R. Lord, T.J. Ellmers

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Background Standing at height, and subsequent changes in emotional state (e.g., fear of falling), lead to robust alterations in balance in adults. However, little is known about how height-induced postural threat affects balance performance in children. Children may lack the cognitive capability necessary to inhibit the processing of threatand fear-related stimuli, and as a result, may show more marked (and perhaps detrimental) changes in postural control compared to adults. This work explored the emotional and balance responses to standing at height in children and compared responses to young and older adults. Methods Children (age: 9.7 ± 0.8 years, n=38), young adults (age: 21.8 ± 4.0 years, n=45) and older adults (age: 73.3 ± 5.0 years, n=15) stood in bipedal stance in two conditions: on the floor and 80cm above ground. Centre of pressure (COP) amplitude (RMS), frequency (MPF) and complexity (sample entropy) were calculated to infer postural performance and strategy. Emotional responses were quantified by assessing balance confidence, fear of falling and perceived instability. Results Young and older adults demonstrated a postural adaptation characterised by increased frequency and decreased amplitude of the COP, in conjunction with increased COP complexity (sample entropy). In contrast, children demonstrated opposite patterns of changes: they exhibited an increase in COP amplitude and decrease in both frequency and complexity when standing in a hazardous situation. Significance Children and adults adopted different postural control strategies when standing at height. Whilst young and older adults exhibited a (potentially protective) “stiffening” response to a height-induced threat, children demonstrated a (potentially maladaptive) ineffective postural adaptation strategy. These observations expand upon existing postural threat related research in adults, providing important new insight into understanding how children respond to standing in a hazardous situation.
Original languageEnglish
Pages (from-to)226-232
Number of pages24
JournalGait & Posture
Volume109
Early online date29 Jan 2024
DOIs
Publication statusPublished - Mar 2024

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Keywords

  • Postural control
  • children
  • age
  • fear
  • concern
  • threat
  • anxiety
  • balance
  • height

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