Skip to main content

Effects of Compliant Flooring on Dynamic Balance and Gait Characteristics of Community-dwelling Older Persons



Compliant flooring while providing the impact force attenuation in the event of falls, its low stiffness characteristic might impair balance and gait which consequently resulted in an increase in the risk of falling.


To investigate the effects of compliant flooring on dynamic balance and gait performance of older adults under challenging conditions.

Design and Participants

A cross-sectional designed with repeated measured. Thirty five community-dwelling older adults (mean age 74.91 ± 6.51 yrs) participated in this study.


Modified Dynamic Gait Index (mDGI) and Timed Up and Go (TUG) were used to assess dynamic balance. Spatio-temporal gait parameters were measured under comfortable and maximal speed. All tests were administered on the vinyl and compliant flooring in random order.


The time taken to complete TUG and the mDGI scores were similar between the two flooring types (p ≥ 0.05). Overall, gait characteristics were comparable when walking on the compliant and vinyl flooring for both speeds except for swing time, step time, and cadence.


The present study demonstrated that compliant flooring did not significantly affect dynamic balance and had minimal effects on gait characteristics. The compliant flooring appears to be safe for installing in self-ambulating older adult’s home.

This is a preview of subscription content, access via your institution.


  1. Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing. 1990;19(2):136–41.

    Article  CAS  PubMed  Google Scholar 

  2. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51–61.

    Article  PubMed  Google Scholar 

  3. Lachance CC, Mackey DC. Feasibility of compliant flooring in long-term care: results from a stakeholder symposium. Can J Aging. 2018;37(1):84–94.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. International comparison of cost of falls in older adults living in the community: a systematic review. Osteoporos Int. 2010;21(8):1295–306.

    Article  CAS  PubMed  Google Scholar 

  5. Demura S, Shin S, Takahashi S, Yamaji S. Relationships between gait properties on soft surfaces, physical function, and fall risk for the elderly. Adv Aging Res. 2013;2:57–64.

    Article  Google Scholar 

  6. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012(9):Cd007146. doi:

  7. Bhan S, Levine IC, Laing AC. Energy absorption during impact on the proximal femur is affected by body mass index and flooring surface. J Biomech. 2014;47(10):2391–7.

    Article  PubMed  Google Scholar 

  8. Glinka MN, Karakolis T, Callaghan JP, Laing AC. Characterization of the protective capacity of flooring systems using force-deflection profiling. Med Eng Phys. 2013;35(1):108–15.

    Article  PubMed  Google Scholar 

  9. Laing AC, Robinovitch SN. Low stiffness floors can attenuate fall-related femoral impact forces by up to 50% without substantially impairing balance in older women. Accid Anal Prev. 2009;41(3):642–50.

    Article  PubMed  Google Scholar 

  10. Wright AD, Laing AC. The influence of headform orientation and flooring systems on impact dynamics during simulated fall-related head impacts. Med Eng Phys. 2012;34(8):1071–8.

    Article  PubMed  Google Scholar 

  11. Drahota AK, Ward D, Udell JE, Soilemezi D, Ogollah R, Higgins B, et al. Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people. Age Ageing. 2013;42(5):633–40.

    Article  PubMed  Google Scholar 

  12. Gustavsson J, Bonander C, Andersson R, Nilson F. Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results. Inj Prev. 2015;21(5):320–4.

    Article  PubMed  Google Scholar 

  13. Simpson AH, Lamb S, Roberts PJ, Gardner TN, Evans JG. Does the type of flooring affect the risk of hip fracture?. Age Ageing. 2004;33(3):242–6.

    Article  CAS  PubMed  Google Scholar 

  14. Warren CJ, Hanger HC. Fall and fracture rates following a change from carpet to vinyl floor coverings in a geriatric rehabilitation hospital. A longitudinal, observational study. Clin Rehabil. 2013;27(3):258–63.

    Article  PubMed  Google Scholar 

  15. Donald IP, Pitt K, Armstrong E, Shuttleworth H. Preventing falls on an elderly care rehabilitation ward. Clin Rehabil. 2000;14(2):178–85.

    Article  CAS  PubMed  Google Scholar 

  16. Lachance CC, Jurkowski MP, Dymarz AC, Robinovitch SN, Feldman F, Laing AC, et al. Compliant flooring to prevent fall-related injuries in older adults: a scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety. PLoS ONE. 2017;12(2):e0171652. doi:

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Herman T, Inbar-Borovsky N, Brozgol M, Giladi N, Hausdorff JM. The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. Gait Posture. 2009;29(2):237–41.

    Article  PubMed  Google Scholar 

  18. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896–903.

    CAS  PubMed  Google Scholar 

  19. Bilney B, Morris M, Webster K. Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture. 2003;17(1):68–74.

    Article  PubMed  Google Scholar 

  20. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37(2):75–82.

    Article  PubMed  Google Scholar 

  21. Huang SL, Hsieh CL, Wu RM, Tai CH, Lin CH, Lu WS. Minimal detectable change of the Timed “Up & Go” test and the dynamic gait index in people with Parkinson disease. Phys Ther. 2011;91(1):114–21.

    Article  PubMed  Google Scholar 

  22. Topper AK, Maki BE, Holliday PJ. Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall?. J Am Geriatr Soc. 1993;41(5):479–87.

    Article  CAS  PubMed  Google Scholar 

  23. Shumway-Cook A, Baldwin M, Polissar NL, Gruber W. Predicting the probability for falls in community-dwelling older adults. Phys Ther. 1997;77(8):812–9.

    Article  CAS  PubMed  Google Scholar 

  24. Romero S, Bishop MD, Velozo CA, Light K. Minimum detectable change of the Berg Balance Scale and Dynamic Gait Index in older persons at risk for falling. J Geriatr Phys Ther. 2011;34(3):131–7.

    Article  PubMed  Google Scholar 

  25. Senden R, Savelberg HH, Grimm B, Heyligers IC, Meijer K. Accelerometry-based gait analysis, an additional objective approach to screen subjects at risk for falling. Gait Posture. 2012;36(2):296–300.

    Article  CAS  PubMed  Google Scholar 

Download references


This work was funded in part by a grant from The Siam Cement Group. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Somporn Sungkarat.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sittichoke, C., Buasord, J., Boripuntakul, S. et al. Effects of Compliant Flooring on Dynamic Balance and Gait Characteristics of Community-dwelling Older Persons. J Nutr Health Aging 23, 665–668 (2019).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Key words

  • Compliant flooring
  • Dynamic balance
  • Gait characteristics
  • Community-dwelling older adults