Effects of perturbation magnitude on dynamic stability when walking in destabilizing environments.

External perturbations applied to the walking surface or visual field can challenge an individual's ability to maintain stability during walking. Accurately quantifying and predicting changes in stability during walking will further our understanding of how individuals respond to challenges encountered during daily life and guide the development of assessments and rehabilitation interventions for individuals at increased risk of falling. This study is the first to determine how orbital and local dynamic stability metrics, including maximum Floquet multipliers and local divergence exponents, change in response to continuous mediolateral visual and surface perturbations of different amplitudes. Eleven healthy individuals walked in a fully immersive virtual environment. Participants completed two 3-min walking trials each under the following nine conditions: no perturbations, surface perturbations at each of 3 amplitudes, and visual perturbations at each of 5 amplitudes. All perturbations were applied as continuous pseudo-random oscillations. During both surface and visual perturbations, individuals were significantly more orbitally and locally unstable compared to un-perturbed walking. As walking surface perturbation amplitudes increased, individuals were more orbitally (but not locally) unstable. As visual perturbation amplitudes increased, individuals were more locally (but not orbitally) unstable between lower and higher amplitudes. Overall, these dynamic stability metrics were much less sensitive to changes in perturbation amplitudes than to differences between un-perturbed and perturbed walking, or to differences between mechanical and visual perturbations. This suggests that the type of perturbation(s) applied has a far greater impact than the magnitude of those perturbations in determining the response that will be elicited.