Gait & posture · 2026
Stepping over obstacles: Lead foot clearance decreased with low-contrast obstacles in older adults with and without central vision loss.
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Napier-Dovorany Kierstyn, Rietdyk Shirley, Gruber Allison H, Hassan Shirin E
Аннотация
BACKGROUND: Adults with central vision loss (CVL) have a higher rate of tripping possibly due to impaired contrast sensitivity. This study determined how adults with CVL adjust their gait to step over an obstacle whose visibility varied by height and contrast.
METHODS: Twenty-nine older adults, 15 controls with normal vision (78.1 ± 5.7 years) and 14 with CVL (79.4 ± 6.0 years) walked along a 6-meter, black carpeted walkway and stepped over a single obstacle that varied in height (1 cm and 19 cm) and contrast (21% and 83% Michelson contrast). Ten trials for each condition were completed. Lower limb kinematics were recorded with motion capture cameras. Linear mixed-effect models assessed the impact of vision group, obstacle height, and obstacle contrast on foot positions relative to the obstacle, obstacle crossing speed, and head angle. Independent t-tests and Wilcoxon Rank-Sum tests compared vision variables between groups.
RESULTS: Adults with CVL had significantly worse visual acuity and contrast sensitivity than controls. All participants had lower foot clearance for low- versus high-contrast obstacles. When comparing tall versus short obstacles, adults with CVL had a greater change in gait speed, lead and trail foot clearance, and head angle than controls (p < 0.047).
SUMMARY: Adults in both vision groups adopted riskier foot clearance when stepping over low-contrast obstacles as compared to high-contrast. Conversely, the CVL group showed greater caution for tall obstacles, and compensated for their riskier behavior with short obstacles by lowering their head angle. Optimizing obstacle appearance may reduce risk of falls.
METHODS: Twenty-nine older adults, 15 controls with normal vision (78.1 ± 5.7 years) and 14 with CVL (79.4 ± 6.0 years) walked along a 6-meter, black carpeted walkway and stepped over a single obstacle that varied in height (1 cm and 19 cm) and contrast (21% and 83% Michelson contrast). Ten trials for each condition were completed. Lower limb kinematics were recorded with motion capture cameras. Linear mixed-effect models assessed the impact of vision group, obstacle height, and obstacle contrast on foot positions relative to the obstacle, obstacle crossing speed, and head angle. Independent t-tests and Wilcoxon Rank-Sum tests compared vision variables between groups.
RESULTS: Adults with CVL had significantly worse visual acuity and contrast sensitivity than controls. All participants had lower foot clearance for low- versus high-contrast obstacles. When comparing tall versus short obstacles, adults with CVL had a greater change in gait speed, lead and trail foot clearance, and head angle than controls (p < 0.047).
SUMMARY: Adults in both vision groups adopted riskier foot clearance when stepping over low-contrast obstacles as compared to high-contrast. Conversely, the CVL group showed greater caution for tall obstacles, and compensated for their riskier behavior with short obstacles by lowering their head angle. Optimizing obstacle appearance may reduce risk of falls.