Measuring foot placement and clearance during stair descent

Falls during stair descent are a serious problem and can lead to accidental death. Inappropriate foot placement on, and clearance over, steps have been identified as causes for falls on stairs. This study investigated a new method for measuring placement and clearance during stair descent in 10 healthy young subjects. The effect of foot length was accounted for during the measurement of foot placement by calculating the percentage length of the foot overhanging the step. Foot clearance was measured as the resultant of the minimum vertical and horizontal distances from the heel of the foot to the edge of the step. Clearance was divided into landing and passing clearance depending on the planned placement of the foot in relation to the step edge being cleared. Each subject performed seven trials of stairs descent. Mean (SD) and CV (SD) were 16% (6), 0.28 (0.15) for placement; 45.88 (10.05), 0.21 (0.07) for landing clearance; 107.25 (5.59), 0.25 (0.08) for passing clearance. There was no statistically significant effect of trial on placement and clearance (p > 0.05). There was a significant effect of step number on landing and passing clearance (p = 0.01, p < 0.001 respectively). Landing and passing clearances were greater for the third step compared to the second step. Passing clearance was also significantly greater than landing clearance (p < 0.001). The repeatable methods and findings from this study might be useful in providing a technical background and normal values for the design of future gait studies on stairs