{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:37Z","timestamp":1787022157395,"version":"build-2736575974"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treadmill belt perturbations have high clinical feasibility for use in perturbation-based training in older people, but their kinematic validity is unclear. This study examined the kinematic validity of treadmill belt accelerations as a surrogate for overground walkway trips during gait in older people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty-eight community-dwelling older people were exposed to two unilateral belt accelerations (8 m s\n                      <jats:sup>-2<\/jats:sup>\n                      ) whilst walking on a split-belt treadmill and two trips induced by a 14 cm trip-board whilst walking on a walkway with condition presentation randomised. Anteroposterior margin of stability (MoS), number of falls, and trunk and lower limb kinematics were quantified for the step prior and five recovery steps following the treadmill perturbations and the walkway trips which elicited elevating and lowering strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Rates of falls following the treadmill accelerations and walkway trips were 0% and 13.1%, respectively. MoS was similar during the first recovery step (\n                      <jats:italic>P<\/jats:italic>\n                      &gt;0.05) but less negative during subsequent recovery steps following treadmill belt accelerations than walkway trips (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01) regardless of recovery strategy. Excluding the first recovery step in the lowering strategy, recovery step lengths, toe clearance, maximum trunk, hip and knee angles (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05) were smaller during recovery on the treadmill compared to the walkway.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Destabilisation by treadmill belt accelerations quickly dissipated after only one recovery step but continued for multiple recovery steps following walkway trips. Smaller trunk displacement, step lengths, toe clearance and no falls on the treadmill indicate treadmill belt accelerations may not accurately simulate the biomechanical challenge of obstacle-induced trips in older people.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0312261","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T13:31:08Z","timestamp":1736429468000},"page":"e0312261","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Treadmill belt accelerations may not accurately replicate kinematic responses to tripping on an obstacle in older people"],"prefix":"10.1371","volume":"20","author":[{"given":"Dayeon C.","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daina L.","family":"Sturnieks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-8565","authenticated-orcid":true,"given":"Kirsty A.","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9272-7300","authenticated-orcid":true,"given":"Patrick Y. 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Begg","year":"2007","journal-title":"Gait & posture"},{"issue":"6","key":"pone.0312261.ref003","doi-asserted-by":"crossref","first-page":"M196","DOI":"10.1093\/geronj\/46.6.M196","article-title":"Stepping Over Obstacles: Gait Patterns of Healthy Young and Old Adults","volume":"46","author":"H.-C. Chen","year":"1991","journal-title":"J. Gerontol"},{"issue":"4","key":"pone.0312261.ref004","doi-asserted-by":"crossref","first-page":"B166","DOI":"10.1093\/gerona\/57.4.B166","article-title":"Avoidance and accommodation of surface height changes by healthy, community-dwelling, young, and elderly men,","volume":"57","author":"B.J. McFadyen","year":"2002","journal-title":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences"},{"issue":"7","key":"pone.0312261.ref005","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1093\/gerona\/glq015","article-title":"Impaired depth perception and restricted pitch head movement increase obstacle contacts when dual-tasking in older people,","volume":"65","author":"J.C. Menant","year":"2010","journal-title":"Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences"},{"issue":"7","key":"pone.0312261.ref006","doi-asserted-by":"crossref","first-page":"M428","DOI":"10.1093\/gerona\/56.7.M428","article-title":"Mechanisms leading to a fall from an induced trip in healthy older adults,","volume":"56","author":"M.J. Pavol","year":"2001","journal-title":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences"},{"issue":"2","key":"pone.0312261.ref007","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jelekin.2007.06.004","article-title":"Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly","volume":"18","author":"M. Pijnappels","year":"2008","journal-title":"Journal of Electromyography and Kinesiology"},{"issue":"2","key":"pone.0312261.ref008","first-page":"339","article-title":"Strategies for recovery from a trip in early and late swing during human walking","volume":"102","author":"J.J. Eng","year":"1994","journal-title":"Exp. Brain Res"},{"key":"pone.0312261.ref009","article-title":"Rapid inhibition accuracy and leg strength are required for community-dwelling older people to recover balance from induced-trips and slips: An experimental prospective study","author":"Y. Okubo","year":"2021","journal-title":"J. Geriatr. Phys. Ther"},{"issue":"2","key":"pone.0312261.ref010","doi-asserted-by":"crossref","first-page":"83","DOI":"10.11005\/jbm.2017.24.2.83","article-title":"Sarcopenia: neurological point of view","volume":"24","author":"Y.N. Kwon","year":"2017","journal-title":"Journal of Bone Metabolism"},{"issue":"7","key":"pone.0312261.ref011","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.ssci.2005.08.008","article-title":"Age-related intrinsic limitations in preventing a trip and regaining balance after a trip","volume":"43","author":"J.H. van Dieen","year":"2005","journal-title":"Safety Science"},{"issue":"2","key":"pone.0312261.ref012","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.gaitpost.2006.09.010","article-title":"Practicing recovery from a simulated trip improves recovery kinematics after an actual trip","volume":"26","author":"K.A. Bieryla","year":"2007","journal-title":"Gait & Posture"},{"key":"pone.0312261.ref013","article-title":"Task-specific training reduces trip-related fall risk in women","author":"M.D. Grabiner","year":"2012","journal-title":"Medicine and science in sports and exercise"},{"key":"pone.0312261.ref014","article-title":"Perturbation-based balance training using repeated trips on a walkway vs. belt accelerations on a treadmill: a cross-over randomised controlled trial in community-dwelling older adults","volume":"3","author":"P.Y. Song","year":"2021","journal-title":"Frontiers in Sports and Active Living"},{"issue":"3","key":"pone.0312261.ref015","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00221-004-2078-8","article-title":"The presence of an obstacle influences the stepping response during induced trips and surrogate tasks","volume":"161","author":"K.L. Troy","year":"2005","journal-title":"Exp. Brain Res"},{"issue":"1","key":"pone.0312261.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2318-13-49","article-title":"Pilot comparative effectiveness study of surface perturbation treadmill training to prevent falls in older adults","volume":"13","author":"J.D. Lurie","year":"2013","journal-title":"BMC Geriatr"},{"issue":"9","key":"pone.0312261.ref017","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1111\/jgs.12428","article-title":"Preventing trip\u2010related falls by community\u2010dwelling adults: A prospective study","volume":"61","author":"N.J. Rosenblatt","year":"2013","journal-title":"J. Am. Geriatr. Soc"},{"issue":"2","key":"pone.0312261.ref018","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jelekin.2007.06.007","article-title":"Biomechanical and age-related differences in balance recovery using the tether-release method","volume":"18","author":"E.T. Hsiao-Wecksler","year":"2008","journal-title":"J. Electromyogr. Kinesiol"},{"issue":"12","key":"pone.0312261.ref019","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/S0021-9290(98)00124-9","article-title":"Static versus dynamic predictions of protective stepping following waist\u2013pull perturbations in young and older adults","volume":"31","author":"Y.-C. Pai","year":"1998","journal-title":"J. Biomech"},{"issue":"9","key":"pone.0312261.ref020","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0268-0033(01)00077-8","article-title":"Mechanisms of failed recovery following postural perturbations on a motorized treadmill mimic those associated with an actual forward trip","volume":"16","author":"T.M. Owings","year":"2001","journal-title":"Clinical Biomechanics"},{"issue":"4","key":"pone.0312261.ref021","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/ageing\/26.4.261","article-title":"Circumstances and consequences of falls in independent community-dwelling older adults","volume":"26","author":"W.P. Berg","year":"1997","journal-title":"Age and Ageing"},{"issue":"2","key":"pone.0312261.ref022","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1109\/MEMB.2003.1195695","article-title":"Strategies for dynamic stability during adaptive human locomotion","volume":"22","author":"A.E. Patla","year":"2003","journal-title":"IEEE Engineering in Medicine and Biology Magazine"},{"issue":"9","key":"pone.0312261.ref023","first-page":"1489","article-title":"Effect of reactive balance training involving repeated slips and trips on balance recovery among older adults: a blinded randomized controlled trial, The Journals of Gerontology","volume":"74","author":"Y. Okubo","year":"2019","journal-title":"Series A"},{"issue":"12","key":"pone.0312261.ref024","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1111\/ggi.13082","article-title":"Perturbation\u2010based balance training for falls reduction among older adults: Current evidence and implications for clinical practice","volume":"17","author":"M.H. Gerards","year":"2017","journal-title":"Geriatrics & gerontology international"},{"issue":"1","key":"pone.0312261.ref025","first-page":"1","article-title":"A novel system for introducing precisely-controlled, unanticipated gait perturbations for the study of stumble recovery","volume":"16","author":"S.T. King","year":"2019","journal-title":"Journal of Neuroengineering and Rehabilitation"},{"issue":"1","key":"pone.0312261.ref026","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/0165-0270(95)00149-2","article-title":"Mechanically induced stumbling during human treadmill walking","volume":"67","author":"A. Schillings","year":"1996","journal-title":"J. Neurosci. Methods"},{"issue":"1","key":"pone.0312261.ref027","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0966-6362(02)00160-1","article-title":"Multiple-step strategies to recover from stumbling perturbations","volume":"18","author":"A.F. Cordero","year":"2003","journal-title":"Gait & posture"},{"issue":"6","key":"pone.0312261.ref028","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.humov.2013.07.008","article-title":"Dynamic stability control during perturbed walking can be assessed by a reduced kinematic model across the adult female lifespan","volume":"32","author":"F. S\u00fcptitz","year":"2013","journal-title":"Human Movement Science"},{"issue":"1","key":"pone.0312261.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s42003-018-0238-9","article-title":"Retention, savings and interlimb transfer of reactive gait adaptations in humans following unexpected perturbations","volume":"1","author":"C. McCrum","year":"2018","journal-title":"Communications Biology"},{"issue":"1","key":"pone.0312261.ref030","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jbiomech.2013.10.035","article-title":"Method for evoking a trip-like response using a treadmill-based perturbation during locomotion","volume":"47","author":"P.H. Sessoms","year":"2014","journal-title":"J. Biomech"},{"key":"pone.0312261.ref031","unstructured":"V.M. Systems, Plug-in Gait Reference Guide. https:\/\/usermanual.wiki\/Document\/Plugin20Gait20Reference20Guide.754359891\/view, 2018 (accessed)."},{"issue":"12","key":"pone.0312261.ref032","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1016\/j.jbiomech.2011.05.039","article-title":"Automatic recognition of falls in gait-slip training: harness load cell based criteria","volume":"44","author":"F. Yang","year":"2011","journal-title":"J. Biomech"},{"issue":"1","key":"pone.0312261.ref033","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbiomech.2004.03.025","article-title":"The condition for dynamic stability","volume":"38","author":"A. Hof","year":"2005","journal-title":"J. Biomech"},{"key":"pone.0312261.ref034","volume-title":"Holm\u2019s Sequential Bonferroni ProcedureEncyclopedia of Research Design","author":"H. Abdi","year":"2010"},{"key":"pone.0312261.ref035","first-page":"268","volume-title":"Reactive Response and Adaptive Modifications in Dynamic Stability to Changes in Lower Limb Dynamics in the Elderly while Walking","author":"K. Karamanidis","year":"2011"},{"issue":"1","key":"pone.0312261.ref036","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s11357-019-00130-x","article-title":"Older adults demonstrate interlimb transfer of reactive gait adaptations to repeated unpredictable gait perturbations","volume":"42","author":"C. McCrum","year":"2020","journal-title":"Geroscience"},{"issue":"2","key":"pone.0312261.ref037","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/02701367.1983.10605290","article-title":"Anatomical data for analyzing human motion","volume":"54","author":"S. Plagenhoef","year":"1983","journal-title":"Res. Q. Exerc. Sport"},{"issue":"3","key":"pone.0312261.ref038","doi-asserted-by":"crossref","first-page":"M97","DOI":"10.1093\/geronj\/48.3.M97","article-title":"Kinematics of recovery from a stumble","volume":"48","author":"M.D. Grabiner","year":"1993","journal-title":"J. Gerontol"},{"issue":"2","key":"pone.0312261.ref039","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0966-6362(99)00022-3","article-title":"Kinematic analysis of obstacle clearance during locomotion","volume":"10","author":"G.P. Austin","year":"1999","journal-title":"Gait & posture"},{"issue":"1","key":"pone.0312261.ref040","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/0966-6362(93)90042-Y","article-title":"Visual control of limb trajectory over obstacles during locomotion: effect of obstacle height and width","volume":"1","author":"A.E. Patla","year":"1993","journal-title":"Gait & posture"},{"issue":"2","key":"pone.0312261.ref041","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1123\/jab.29.2.188","article-title":"A comparison of treadmill and overground walking effects on step cycle asymmetry in young and older individuals","volume":"29","author":"H. Nagano","year":"2013","journal-title":"J. Appl. Biomech"},{"key":"pone.0312261.ref042","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jelekin.2016.09.004","article-title":"Dynamic gait stability of treadmill versus overground walking in young adults","volume":"31","author":"F. Yang","year":"2016","journal-title":"J. Electromyogr. Kinesiol"},{"issue":"2","key":"pone.0312261.ref043","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.gaitpost.2004.01.014","article-title":"Gait instability and fractal dynamics of older adults with a \"cautious\" gait: why do certain older adults walk fearfully?,","volume":"21","author":"T. 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