Trips and slips increase fall risk for young and older adults. To examine recovery responses, studies utilized treadmill and/or over-ground methods to simulate real-world perturbations. However, differences in the recovery response between treadmill and over-ground perturbations remain unexamined. To assess the current literature on the reactive recovery responses between over-ground- and split-belt treadmill trips and slips as well as the effect of aging on these responses. PubMed, Medline, Web of Science, SCOPUS, and Cochrane databases were searched for publications examining trips and slips in healthy young, healthy older adults, and older adults who fall. Included articles were in English, full-text accessible, and biomechanically quantified the reactive recovery responses for slips and trips during either over-ground or split-belt treadmill protocols. The initial database search yielded 1075 articles and 31 articles were included after title, abstract, and full-text screening. For slips, 7 articles utilized lubricated surfaces while 5 articles used treadmills. Further, 3 studies examined differences between older and younger adults. For trips, 9 articles utilized obstacles and 7 used treadmills. Further, 4 articles examined differences between older and young adults and 1 article only examined older adults during over-ground trips. For both perturbations, treadmill and over-ground protocols demonstrated similar anteroposterior destabilization on the center of mass. In the mediolateral direction, over-ground slips consistently found a lateral destabilization while treadmill articles did not examine this direction. Foot placement recovery responses varied less for both perturbation directions on a treadmill compared to over-ground. Although treadmill and over-ground perturbations destabilize the center of mass similarly, the recovery response to these perturbations were different on treadmills. Specifically, recovery responses were more consistent for both slips and trips on treadmills. As older adults have difficulty in perturbation recovery scaling, treadmills may be limited in their ability to investigate the variety of aging impairments on perturbation recovery responses.

Lateral stepping is a motor task that is widely used in everyday life to modify the base of support, change direction, and avoid obstacles. Anticipatory Postural Adjustments (APAs) are often analyzed to describe postural preparation prior to forward stepping, however, little is known about lateral stepping. The aim of the study is to characterize APAs preceding lateral steps and to investigate how these are affected by footwear and lower limb preference. Twenty-two healthy young participants performed a lateral step using both their preferred and non-preferred leg in both barefoot and shod conditions. APA spatiotemporal parameters (size, duration, and speed) along both the anteroposterior and mediolateral axes were obtained through force plate data. APAs preceding lateral stepping showed typical patterns both along the anteroposterior and mediolateral axis. RM-ANOVA highlighted a significant effect of footwear only on medio-lateral APAs amplitude (p = 0.008) and velocity (p = 0.037). No differences were found for the limb preference. APAs in lateral stepping presented consistent features in the sagittal component, regardless of limb/shoe factors. Interestingly, the study observed that footwear induced an increase in the medio-lateral APAs size and velocity, highlighting the importance of including this factor when studying lateral stepping.

Anticipatory postural adjustments (APAs) are crucial for maintaining postural stability during voluntary movements such as gait initiation. While APAs have been extensively studied in forward stepping, little is known about their characteristics during turning initiation. This study aimed to identify the characteristics of (i) APAs and subsequent first steps during turning in older adults (OA) and (ii) compare them to people with Parkinson’s disease (pwP). Twenty-two pwP (tested on medication) and 17 OA performed self-paced 360˚ turns which were embedded in a complex walking task. APAs and first step characteristics were recorded using motion capture and force plate data. For pwP, APAs in turning (unloading phase) were found to be primarily mediolateral, and of significantly reduced amplitude (median = 2.5, 95% CI[0.0053; 0.0089]) in comparison to OA (median = 5.0, 95% CI[0.0073; 0.0181]). Unlike OA there was no significant association between APAs and step characteristics. These findings suggest that APAs during turning are significantly impaired in pwP, even when tested ON medication, and that this impairment may contribute to the turning difficulties often experienced by this population. Overall, these results have potential implications for clinical assessments and rehabilitation interventions, emphasising the need to tailor strategies to address turning challenges pwP face in their daily life.

Objective: To assess the efficacy of anticipatory postural adjustments training on the ability to successfully step from freezing of gait, and to evaluate the contribution of attentional processes to potential benefits using an additional attentional-control training intervention. Design: Crossover-design. Subjects/Patients: Nineteen people with Parkinson’s and freezing (females: 10; age:75.5 ± 7.5 years) tested while ON medication. Methods: Participants navigated a cluttered virtual domestic environment with freeze-provoking tasks. Assessments occurred in the laboratory at baseline, post-anticipatory postural adjustments training, and post-attentional-control training, with randomized training order. All training was video-based. Video annotation was used to identify freezing events. Participants’ immediately recollected thoughts they had during the tasks were analysed with content analysis. Perceived safety and effectiveness of the strategies were reported in follow-up calls held 4 weeks post-assessment. Results: Successful step initiations increased from 57% at baseline to 77% post-anticipatory postural adjustments training (p = 0.034). Participants rated the interventions as safe and effective, reporting increased balance confidence (70% to 90%), and reduced fear (p = 0.01), after the anticipatory postural training. Attentional-control training alone was perceived as less effective compared with more goal-directed anticipatory postural adjustments training. Conclusion: Video-based anticipatory postural adjustments training significantly improved step initiation from freezing when used during challenging tasks and in complex environments. Anticipatory postural adjustments training shows promise as an effective “rescue strategy” that could be learned remotely/at home.

Background: Analgesics are widely used in competitive sports, but their patterns of use and detection in anti-doping controls vary significantly across drug classes. This study examined a decade of Italian anti-doping reports with three aims: to describe trends involving non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and narcotics; to characterize the distribution of specific active ingredients; and to analyze the relative contribution of these classes to anti-doping violations, placing the findings within the regulatory framework. Methods: Data from national anti-doping reporting systems were analyzed from 2013 to the first half of 2023. Yearly data included tested athletes, athlete declarations of NSAID use, and laboratory analytical findings for prohibited substances (glucocorticoids and narcotics). NSAID prevalence was calculated relative to tested athletes, while glucocorticoid and narcotic findings were assessed as absolute counts and proportions of total violations. Temporal trends were assessed using the Cochran–Armitage test. Results: NSAIDs consistently ranked as the most frequently reported medication, with nearly half of the tested athletes reporting their use and no significant linear trend in overall prevalence. However, a significant shift was observed within the NSAID class, with a marked decrease in declarations of COX-2 selective agents over time. Glucocorticoids accounted for a significant portion of prohibited substances, with fluctuating proportions (showing no significant linear trend), betamethasone being the most common active ingredient. Narcotics appeared only sporadically, although the use of non-prohibited opioids such as tramadol and codeine—absent from official reports—remains relevant for understanding analgesic practices. Conclusions: Analgesic use in Italian elite sports shows distinct patterns driven by therapeutic needs and anti-doping regulations. NSAIDs remain the primary choice for routine pain management, though the type of NSAID reported has shifted significantly. Glucocorticoids represent a notable share of prohibited findings with a fluctuating, rather than steadily increasing, pattern. Narcotics appear only sporadically in violation data. Ongoing monitoring will be crucial to understanding how evolving clinical practices and recent regulatory changes influence future detection trends and athlete health.