A novel handrail cueing system to prevent falls in older adults

Abstract

Balance-recovery reactions that involve rapid reaching movements to grasp a handrail for support can play a critical role in preventing falls. To execute these reactions, the central nervous system (CNS) requires visuospatial information (VSI) about the handrail location. However, the urgent need to react rapidly may limit ability to acquire this information after loss of balance occurs. Instead, it appears that the CNS may continually monitor the environment and store salient VSI for use if and when a loss of balance occurs. Age-related deficits in visual attention may impair ability to use grasping reactions to recover balance by impeding the acquisition, processing and storage of required VSI. To counter this problem, we have developed a proximity-triggered handrail cueing system (patent pending) that provides a visual cue (flashing lights) and/or verbal cue (“attention, use the handrail”) so as to attract attention to the handrail. The cueing system comprises light-emitting diodes mounted inside a translucent black railing, speakers inserted into the handrail mounting fixtures, and a photocell that triggers the cueing as the person approaches. To test the system, grasping reactions were evoked as subjects walked along an extended (2x6 m) motion platform configured to simulate an office environment (including a stair, handrail and visual distracters). The platform was triggered to move suddenly and unexpectedly when the subject was adjacent to the handrail. Pilot results (21 subjects) showed that the rail was grasped more frequently when there was a verbal cue (67%) or a visual cue (40%), compared to conventional-handrail trials (10%).