The effect of cane length and step height on muscle strength and body balance of elderly people in a stairway environment

BACKGROUND: It has been reported that 75% of stairway accidents occur while descending stairs. Using a cane can help to prevent older people and those with limited mobility from falling. However, studies have shown that two-thirds of older cane users use a cane that is longer than the recommended length, which may cause unnecessary muscular loads. This study aims to assess balance and muscular load in older people descending different height steps with different cane lengths. METHODS: Nine participants (5 males and 4 females) aged over 65 years participated in this study. Cane length and stair height were independent variables. Electromyography signals were recorded from the biceps brachii of the arm that usually held the cane and from both gastrocnemius muscles. In addition, the center of pressure (CoP) was assessed as an indicator of balance in older people descending a step. RESULTS: Descending from higher steps resulted in the use of greater arm and leg strength at the time of first foot contact. However, cane length did not affect any of the root mean square values. In addition, the CoP Stabilometric Parameters showed that mean distance, antero-posterior mean distance, total excursions, antero-posterior total excursions, mean velocity, and antero-posterior mean velocity were significantly affected by step height, but not by cane length. CONCLUSIONS: If cane length is within the currently suggested range, then it has little effect on the force load on the arm and legs when descending a step. Step height has a greater effect than cane length on the strategies used by older people to maintain stability.