Assessing the stability of human locomotion: A review of current measures

Falling poses a major threat to the steadily growing population of the elderly in modern-day society. A major challenge in the prevention of falls is the identification of individuals who are at risk of falling owing to an unstable gait. At present, several methods are available for estimating gait stability, each with its own advantages and disadvantages. In this paper, we review the currently available measures: the maximum Lyapunov exponent (lS and lL), the maximum Floquet multiplier, variability measures, long-range correlations, extrapolated centre of mass, stabilizing and destabilizing forces, foot placement estimator, gait sensitivity norm and maximum allowable - perturbation. We explain what these measures represent and how they are calculated, andwe assess their validity, divided up into construct validity, predictive validity in simple models, convergent validity in experimental studies, and predictive validity in observational studies. We conclude that (i) the validity of variability measures and lS is best supported across all levels, (ii) the maximum Floquet multiplier and lL have good construct validity, but negative predictive validity in models, negative convergent validity and (for lL) negative predictive validity in observational studies, (iii) long-range correlations lack construct validity and predictive validity inmodels and have negative convergent validity, and (iv) measures derived from perturbation experiments have good construct validity, but data are lacking on convergent validity in experimental studies and predictive validity in observational studies. In closing, directions for future research on dynamic gait stability are discussed. © 2013 The Author(s) Published by the Royal Society. All rights reserved.