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. 2025 May 20;25(1):360.
doi: 10.1186/s12877-025-06024-2.

Stepping through fear: analysing postural control in elderly women during transitional locomotor tasks

Justyna Michalska  1 , Anna Kamieniarz-Olczak  2 , Grzegorz Juras  2 , Kajetan J Słomka  2
Affiliations

Stepping through fear: analysing postural control in elderly women during transitional locomotor tasks

Justyna Michalska et al. BMC Geriatr. .

Abstract

Background: Fear of falling (FoF) is prevalent among older adults, particularly women, and is a known factor increasing fall risk during movement. FoF may naturally arise after the first fall incident as well as long before the first fall occurs. This study examined how FoF intensity affects static balance and transitional locomotor tasks in 81 healthy women aged 60 and older.

Methods: Participants were divided into LOW, MODERATE, and HIGH FoF groups based on their Falls Efficacy Scale-International (FES-I) scores. Static balance was measured by center of pressure velocity (vCOP), while transitional tasks were assessed through transit time (TT), double support period (DSP), and stability times (S1-the time needed to destabilize the body before taking a step and S2- the time required to stabilize the position after taking a step) under unimpeded transition on a flat surface, obstacle clearance, step-up, and step-down conditions.

Results: The findings showed no significant differences in static balance (vCOP) across FoF groups. However, the HIGH FoF group took longer to complete transitional tasks, with significantly increased TT, DSP, and S1 compared to the MODERATE group, particularly during obstacle clearance and step-up/down movements. This suggests that individuals with higher FoF take a more cautious approach, prioritizing stability over speed. No significant differences in S2 were found, indicating that FoF does not affect balance recovery after a step.

Conclusion: The study concludes that while FoF does not impair static balance, it significantly impacts movement initiation and execution in transitional tasks. Prolonged preparation time (S1) in the HIGH FoF group highlights the role of fear in delaying movement. These findings are important for designing interventions to reduce FoF and prevent falls in older adults.

Keywords: Aging; Fear of falling; Postural control; Postural threat; Step initiation.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The subjects provided a written informed consent for voluntary participation in the study. The research was approved by the University Bioethics Committee for Scientific Research at The Jerzy Kukuczka Academy of Physical Education (approval number: 1/2021). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Four conditions of the transitional locomotor tasks
Fig. 2
Fig. 2
Median values for the transit time, stability time 1, stability time 2, double-support period (minimum, maximum marked as error bars) in fourth trials (2nd phase) performed by LOW, MODERATE and HIGH concern participants. Horizontal bars indicate statistically significant differences between groups
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