Falling down stairs is one of the leading causes of accidental death in older adults. When and where someone looks, their level of confidence and visual cues in the environment around them all play a part in navigating stairs safely. Professor Mark Hollands and Dr Neil Thomas, from Liverpool John Moores University, used state-of-the-art sensor and motion capture technology to investigate how we might be able to make staircases safer for older people.
Gaze patterns change when we get older, making us less likely to look at the right place at the right time. This might explain why older people are more likely to put their feet in the wrong places, increasing the risk of a fallProfessor Mark Hollands, Principal Investigator
When people use stairs they tend to look a couple of steps ahead as they descend. When and where you look is important for safety and our gaze adapts depending on how difficult the path is.
Gaze patterns change when we get older, which makes us less likely to look at the right place at the right time. This might explain why older people are more likely to put their feet in the wrong places, increasing the risk of a fall.
Changes in when and where older people look as they are using stairs can be associated with the surrounding decor and anxiety or fear of falling.
We wanted to better understand how the visual characteristics of stairs affect older adults’ abilities to walk up and down them safely. In particular, we wanted to investigate how lighting and carpet patterns affect when and where people look, and their confidence in being able to walk on stairs.
Recreating the staircase experience in the lab
In our biomechanics lab at Liverpool John Moores University, we used a state-of-the-art experimental staircase.
Cutting-edge eye tracking technology allowed us to measure when and where participants looked. Using the same motion capture technology found in films to create CGI characters, we captured the 3D movements of participants. Sensors embedded into the staircase meant we could measure the pressure and force load of each participant’s steps and how they used the handrails. Putting all this together, we built a holistic view of where people are looking when walking on stairs, how they’re moving, and we performed a very detailed biomechanical analysis of their performance.
Participants were also given questionnaires to measure how their confidence, as well as their gaze and stepping accuracy, was affected by changing the lighting and step décor.
Putting all this together, we built a holistic view of where people are looking when walking on stairs, how they’re moving, and we performed a very detailed biomechanical analysis of their performanceDr Neil Thomas, Post-doctoral Researcher
Adjusting staircase lighting and decor could improve safety
We found that busy carpet patterns and low lighting, which replicates many older people’s homes, often when using suboptimal light bulbs, were detrimental to stepping safety, thus increasing the risk of tripping. Participants also tended to look fewer steps ahead in these conditions, which is a behaviour usually associated with more challenging walking environments.
Busy carpet patterns and low lighting can make it more difficult to see important features of the steps using peripheral vision. We believe that this was the main cause of risky stepping behavior, and why participants looked fewer steps ahead to see where they could put their feet.
Conversely, plain décor helped participants to step more safely, with increased clearance space over each step as they descended, along with improved balance and more confidence. What’s more, adding a highlighted step edge to plain décor made it even more likely that older people would put their feet in the best places to navigate the stairs safely.
The DMT has helped us progress our ideas by putting us in touch with local housing associations who are interested in collaborating with usProfessor Mark Hollands, Principal Investigator
This is a promising proof of concept study, but only shows how older adults navigate stairs in a laboratory environment. Next, we’re planning to test whether our decor recommendations result in a reduced risk of falling in real home and care home settings. The DMT has helped us progress our ideas by putting us in touch with local housing associations who are interested in collaborating with us. Our ideal end goal is to update building standard guidance on how to illuminate and decorate stairs, to make them safer for older adults.
You can see more examples of participants using the laboratory staircase here.
Professor Mark Hollands and Dr Neil Thomas were subsequently awarded DMT funding to use body worn sensors to inform home modifications with the aim of reducing falls risk in older adults. You can read more about this research, and all of the grants funded under that call, in the news item on our website.