{"doi":"10.1101/2024.01.04.574192","title":"How Older Adults Maintain Lateral Balance While Walking on Narrowing Paths","abstract":"ABSTRACT Background Older adults have difficulty maintaining side-to-side balance while navigating daily environments. Losing balance in such circumstances can lead to falls. We need to better understand how older adults adapt lateral balance to navigate environment-imposed task constraints. Research Question How do older adults adjust mediolateral balance while walking along continually-narrowing paths, and what are the stability implications of these adjustments? Methods Eighteen older (71.6±6.0 years) and twenty younger (21.7±2.6 years) healthy adults traversed 25m-long paths that gradually narrowed from 45cm to 5cm. Participants switched onto an adjacent path when they chose. We quantified participants’ lateral center-of-mass dynamics and lateral Margins of Stability ( MoS L ) as paths narrowed. We quantified lateral Probability of Instability ( PoI L ) as the cumulative probability that participants would take a laterally unstable ( MoS L <0) step as they walked. We also extracted these outcomes where participants switched paths. Results As paths narrowed, all participants exhibited progressively smaller average MoS L and increasingly larger PoI L . However, their MoS L variability was largest at both the narrowest and widest path sections. Older adults exhibited consistently both larger average and more variable MoS L across path widths. Taken into account together, these resulted in either comparable or somewhat larger PoI L as paths narrowed. Older adults left the narrowing paths sooner, on average, than younger. As they did so, older adults exhibited significantly larger average and more variable MoS L , but somewhat smaller PoI L than younger. Significance Our results directly challenge the predominant interpretation that larger average MoS L as indicating “greater stability”, which we argue is inconsistent with the principles underlying its derivation. In contrast, analyzing step-to-step gait dynamics, together with estimating PoI L allows one to properly quantify instability risk. Furthermore, the adaptive strategies uncovered using these methods suggest potential targets for future interventions to reduce falls in older adults.","journal":"bioRxiv (Cold Spring Harbor Laboratory)","year":2024,"id":493028,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9532,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":334659,"name":"Joseph P. Cusumano","orcid":"0000-0001-5451-6721","position":1,"is_corresponding":false},{"id":334660,"name":"Jonathan B. Dingwell","orcid":"0000-0001-6990-4153","position":2,"is_corresponding":false},{"id":334658,"name":"Meghan E. Kazanski","orcid":"0000-0002-0675-9160","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:09:00.148120Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}