{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:13:15Z","timestamp":1790691195536,"version":"4.1.0"},"reference-count":58,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Fear of falling and environmental barriers in the home are two major factors that cause the incidence of falling. Poor visibility at night is one of the key environmental barriers that contribute to falls among older adult residents. Ensuring their visual perception of the surroundings, therefore, becomes vital to prevent falling injuries. However, there are limited works in the literature investigating the impact of the visibility of the target on older adults\u2019 walking destinations and how that impact differs across them with different levels of fear of falling. Objective: The purpose of the study was to examine the effects of target salience on older adults\u2019 walking performance and investigate whether older adults with varying levels of fear of falling behave differently. Methods: The salient target was constructed with LED strips around the destination of walking. Fifteen older adults (aged 75 years old and above), seven with low fear of falling and eight with high fear of falling, volunteered for the study. Participants walked from the designated origin (i.e., near their beds) to the destination (i.e., near the bathroom entrance), with the target turned on or off around the destination of the walking trials. Spatiotemporal gait variables and lower-body kinematics were recorded by inertial sensors and compared by using analysis of variance methods. Results: Data from inertial sensors showed that a more salient target at the destination increased older adults\u2019 gait speed and improved their walking stability. These changes were accompanied by less hip flexion at heel strikes and toe offs during walking. In addition, older adults with low fear of falling showed more substantial lower-body posture adjustments with the salient target presented in the environment. Conclusions: Older adults with a low fear of falling can potentially benefit from a more salient target at their walking destination, whereas those with a high fear of falling were advised to implement a more straightforward falling intervention in their living areas.<\/jats:p>","DOI":"10.3390\/s22239352","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T03:32:25Z","timestamp":1669865545000},"page":"9352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Salient Targets and Fear of Falling Changed the Gait Pattern and Joint Kinematic of Older Adults"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-3190","authenticated-orcid":false,"given":"Yue","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Lu","sequence":"additional","affiliation":[{"name":"Shimberg Center for Housing Studies, University of Florida, Gainesville, FL 32611, USA"},{"name":"Microelectronics Thrust, Function Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou 511453, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas S.","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Ahrentzen","sequence":"additional","affiliation":[{"name":"Shimberg Center for Housing Studies, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"ref_1","unstructured":"(2022, May 03). Centers for Disease Control and Prevention Web-Based Injury Statistics Query and Reporting System (WISQARS): Older Adult Fall Prevention, Available online: https:\/\/www.cdc.gov\/falls\/index.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1002\/jbmr.4048","article-title":"The Effect of Fall Biomechanics on Risk for Hip Fracture in Older Adults: A Cohort Study of Video-Captured Falls in Long-Term Care","volume":"35","author":"Yang","year":"2020","journal-title":"J. Bone Miner Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Laved\u00e1n, A., Viladrosa, M., J\u00fcrschik, P., Botigu\u00e9, T., Nu\u00edn, C., Masot, O., and Laved\u00e1n, R. (2018). Fear of Falling in Community-Dwelling Older Adults: A Cause of Falls, a Consequence, or Both?. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197792"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Roy, N., Dub\u00e9, R., Despr\u00e9s, C., Freitas, A., and L\u00e9gar\u00e9, F. (2018). Choosing between Staying at Home or Moving: A Systematic Review of Factors Influencing Housing Decisions among Frail Older Adults. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0189266"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1093\/geront\/gnab169","article-title":"Aging in Place During a Pandemic: Neighborhood Engagement and Environments Since the COVID-19 Pandemic Onset","volume":"62","author":"Finlay","year":"2022","journal-title":"Gerontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12984-018-0458-8","article-title":"Mobility Related Physical and Functional Losses Due to Aging and Disease\u2014A Motivation for Lower Limb Exoskeletons","volume":"16","author":"Grimmer","year":"2019","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1152\/physrev.00061.2017","article-title":"Sarcopenia: Aging-Related Loss of Muscle Mass and Function","volume":"99","author":"Larsson","year":"2019","journal-title":"Physiol. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1023\/B:JOHE.0000016717.22032.03","article-title":"Falls and Fall-Related Injuries Among the Elderly: A Survey of Residential-Care Facilities in a Swedish Municipality","volume":"29","author":"Sadigh","year":"2004","journal-title":"J. Commun. Health"},{"key":"ref_9","unstructured":"Zhang, Z., Kapoor, U., Narayanan, M., Lovell, N.H., and Redmond, S.J. (2011\u20133, January 30). Design of an Unobtrusive Wireless Sensor Network for Nighttime Falls Detection. Proceedings of the 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Boston, MA, USA."},{"key":"ref_10","first-page":"CD007146","article-title":"Interventions for Preventing Falls in Older People Living in the Community","volume":"2021","author":"Gillespie","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1080\/02763893.2019.1683672","article-title":"Falls in Older Adults: A Systematic Review of Literature on Interior-Scale Elements of the Built Environment","volume":"34","author":"Valipoor","year":"2020","journal-title":"J. Aging Environ."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/opo.12141","article-title":"Stepping Accuracy and Visuomotor Control among Older Adults: Effect of Target Contrast and Refractive Blur","volume":"34","author":"Black","year":"2014","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/injuryprev-2012-040707","article-title":"A Qualitative Study on the Perceptions of Preventing Falls as a Health Priority among Older People in Northern India","volume":"20","author":"Jagnoor","year":"2014","journal-title":"Inj. Prev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E6720","DOI":"10.1073\/pnas.1611699114","article-title":"The Critical Phase for Visual Control of Human Walking over Complex Terrain","volume":"114","author":"Matthis","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/j.1475-1313.2011.00837.x","article-title":"The Effect of the Visual Characteristics of Obstacles on Risk of Tripping and Gait Parameters during Locomotion: Obstacle Characteristics and Risk of Tripping","volume":"31","author":"Rietdyk","year":"2011","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.gaitpost.2014.10.005","article-title":"Proactive Gait Strategies to Mitigate Risk of Obstacle Contact Are More Prevalent with Advancing Age","volume":"41","author":"Muir","year":"2015","journal-title":"Gait Posture"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.gaitpost.2005.10.002","article-title":"Evidence for a Link between Changes to Gaze Behaviour and Risk of Falling in Older Adults during Adaptive Locomotion","volume":"24","author":"Chapman","year":"2006","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/13882350701673266","article-title":"The Impact of Mobility and Public Transport on the Independence of Visually Impaired People","volume":"9","author":"Montarzino","year":"2007","journal-title":"Vis. Impair. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/00222895.1988.10735430","article-title":"The Role of Visual Information in Control of a Constrained Locomotor Task","volume":"20","author":"Laurent","year":"1988","journal-title":"J. Mot. Behav."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/1477153507084198","article-title":"A Novel Night Lighting System for Postural Control and Stability in Seniors","volume":"40","author":"Figueiro","year":"2008","journal-title":"Light. Res. Technol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Figueiro, M.G., Plitnick, B., Rea, M.S., Gras, L.Z., and Rea, M.S. (2011). Lighting and Perceptual Cues: Effects on Gait Measures of Older Adults at High and Low Risk for Falls. BMC Geriatr, 11.","DOI":"10.1186\/1471-2318-11-49"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"111307","DOI":"10.1016\/j.exger.2021.111307","article-title":"Testing of path-based visual cues on patterned carpet to assist older adults\u2019 gait in a continuing care retirement community","volume":"149","author":"Lu","year":"2021","journal-title":"Exp. Gerontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.gaitpost.2021.04.030","article-title":"Impact of Destination-Based Visual Cues on Gait Characteristics among Adults over 75 Years Old: A Pilot Study","volume":"87","author":"Luo","year":"2021","journal-title":"Gait Posture"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1177\/1477153509336803","article-title":"Effects of Dynamic Lighting on the Visual Performance of Older Adults","volume":"41","author":"Laufer","year":"2009","journal-title":"Light. Res. Technol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Money, A.G., Atwal, A., Boyce, E., Gaber, S., Windeatt, S., and Alexandrou, K. (2019). Falls Sensei: A Serious 3D Exploration Game to Enable the Detection of Extrinsic Home Fall Hazards for Older Adults. BMC Med. Inf. Decis. Mak., 19.","DOI":"10.1186\/s12911-019-0808-x"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1177\/19375867221113067","article-title":"Exploring Older Adults\u2019 Nighttime Trips to the Bathroom Under Different Lighting Conditions: An Exploratory Field Study","volume":"15","author":"Lu","year":"2022","journal-title":"HERD"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ageing\/afi196","article-title":"Development and Initial Validation of the Falls Efficacy Scale-International (FES-I)","volume":"34","author":"Yardley","year":"2005","journal-title":"Age Ageing"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/ageing\/afp225","article-title":"The Falls Efficacy Scale International (FES-I). A Comprehensive Longitudinal Validation Study","volume":"39","author":"Delbaere","year":"2010","journal-title":"Age Ageing"},{"key":"ref_29","first-page":"1","article-title":"Xsens MVN: Consistent Tracking of Human Motion Using Inertial Sensing","volume":"1","author":"Schepers","year":"2018","journal-title":"Xsens. Technol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000212543","article-title":"The Post-Fall Syndrome","volume":"28","author":"Murphy","year":"1982","journal-title":"Gerontology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1177\/1071181320641418","article-title":"Influences of Smartphone Operation on Gait and Posture During Outdoor Walking Task","volume":"64","author":"Luo","year":"2020","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.gaitpost.2012.07.012","article-title":"Quantitative Estimation of Foot-Flat and Stance Phase of Gait Using Foot-Worn Inertial Sensors","volume":"37","author":"Mariani","year":"2013","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1177\/1541931213601745","article-title":"Effects of Movement Speed and Magnetic Disturbance on the Accuracy of Inertial Measurement Units","volume":"61","author":"Chen","year":"2017","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Winter, D.A. (2009). Biomechanics and Motor Control of Human Movement, John Wiley & Sons. [4th ed.].","DOI":"10.1002\/9780470549148"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/0021-9290(74)90056-6","article-title":"Measurement and Reduction of Noise in Kinematics of Locomotion","volume":"7","author":"Winter","year":"1974","journal-title":"J. Biomech."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.medengphy.2015.06.010","article-title":"Influence of Contextual Task Constraints on Preferred Stride Parameters and Their Variabilities during Human Walking","volume":"37","author":"Ojeda","year":"2015","journal-title":"Med. Eng. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jbiomech.2015.12.010","article-title":"Adaptability of Stride-to-Stride Control of Stepping Movements in Human Walking","volume":"49","author":"Cusumano","year":"2016","journal-title":"J. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.humov.2015.06.010","article-title":"Level Walking in Adults with and without Developmental Coordination Disorder: An Analysis of Movement Variability","volume":"43","author":"Du","year":"2015","journal-title":"Hum. Mov. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.gaitpost.2015.07.009","article-title":"Plantar-Flexion of the Ankle Joint Complex in Terminal Stance Is Initiated by Subtalar Plantar-Flexion: A Bi-Planar Fluoroscopy Study","volume":"42","author":"Koo","year":"2015","journal-title":"Gait Posture"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/jor.22775","article-title":"Effects of High Heel Wear and Increased Weight on the Knee during Walking: HIGH HEELS AND KNEE LOADING","volume":"33","author":"Titchenal","year":"2015","journal-title":"J. Orthop. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences, Routledge.","DOI":"10.4324\/9780203771587"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"M583","DOI":"10.1093\/gerona\/54.11.M583","article-title":"Gait Characteristics as Risk Factors for Falling From Trips Induced in Older Adults","volume":"54","author":"Pavol","year":"1999","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.gaitpost.2015.02.019","article-title":"Increased Double Support Variability in Elderly Female Fallers with Vestibular Asymmetry","volume":"41","author":"Larsson","year":"2015","journal-title":"Gait Posture"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.gaitpost.2013.11.013","article-title":"Sensory Loss and Walking Speed Related Factors for Gait Alterations in Patients with Peripheral Neuropathy","volume":"39","author":"Wuehr","year":"2014","journal-title":"Gait Posture"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1093\/ageing\/afp250","article-title":"Ageing and Gait Variability\u2014A Population-Based Study of Older People","volume":"39","author":"Callisaya","year":"2010","journal-title":"Age Ageing"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1093\/ageing\/afr055","article-title":"Gait, Gait Variability and the Risk of Multiple Incident Falls in Older People: A Population-Based Study","volume":"40","author":"Callisaya","year":"2011","journal-title":"Age Ageing"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1093\/gerona\/gls224","article-title":"Cognitive Function, Gait, and Gait Variability in Older People: A Population-Based Study","volume":"68","author":"Martin","year":"2013","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.gaitpost.2021.07.016","article-title":"The Association between Simple Reaction Time Variability and Gait Variability: The Tasmanian Study of Cognition and Gait","volume":"89","author":"Jayakody","year":"2021","journal-title":"Gait Posture"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2147\/NDT.S2070","article-title":"Gait Analysis in Demented Subjects: Interests and Perspectives","volume":"4","author":"Beauchet","year":"2008","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1177\/1071181321651082","article-title":"Effects of Light Conditions and Falls Concerns on Older Adults\u2019 Gait Characteristics: A Preliminary Study","volume":"65","author":"Luo","year":"2021","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_51","first-page":"1514","article-title":"Center of Mass Velocity Based Predictions in Balance Recovery Following Pelvis Perturbations during Human Walking","volume":"219","author":"Vlutters","year":"2016","journal-title":"J. Exp. Biol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3807","DOI":"10.1016\/j.jbiomech.2014.10.027","article-title":"Can Sacral Marker Approximate Center of Mass during Gait and Slip-Fall Recovery among Community-Dwelling Older Adults?","volume":"47","author":"Yang","year":"2014","journal-title":"J. Biomech."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0021-9290(85)90042-9","article-title":"Biped Gait Stabilization via Foot Placement","volume":"18","author":"Townsend","year":"1985","journal-title":"J. Biomech."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.gaitpost.2010.12.013","article-title":"Center of Mass and Base of Support Interaction during Gait","volume":"33","author":"Lugade","year":"2011","journal-title":"Gait Posture"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1093\/ageing\/afp066","article-title":"The Influence of Fear of Falling on Gait and Balance in Older People","volume":"38","author":"Reelick","year":"2009","journal-title":"Age Ageing"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1519\/00139143-200932030-00002","article-title":"Interpreting Fear of Falling in the Elderly: What Do We Need to Consider?","volume":"32","author":"Deshpande","year":"2009","journal-title":"J. Geriatr. Phys. Ther."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1080\/03610730303711","article-title":"Balance, Muscle Strength, and Fear of Falling in Older Adults","volume":"29","author":"Binda","year":"2003","journal-title":"Exp. Aging Res."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Bjerk, M., Brovold, T., Skelton, D.A., and Bergland, A. (2018). Associations between Health-Related Quality of Life, Physical Function and Fear of Falling in Older Fallers Receiving Home Care. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0945-6"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/23\/9352\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:08Z","timestamp":1760146268000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/23\/9352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":58,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["s22239352"],"URL":"https:\/\/doi.org\/10.3390\/s22239352","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,1]]}}}