Research by Professor Mark Hollands and Dr Neil Thomas funded by the Vivensa Foundation examined how vision and environmental design affect stair safety in older adults.
Falls on stairs are a major risk, partly because ageing alters gaze patterns—older people are less likely to look in the right place at the right time, increasing the chance of misplacing their feet.
Using a laboratory staircase with eye tracking, motion capture, and force sensors, the researchers built a detailed picture of how people look, move, and step. They also measured participants’ confidence under different conditions.
The study found that poor lighting and busy carpet patterns—common in many homes—made stair navigation more difficult. These conditions reduced stepping accuracy, encouraged riskier behaviour, and led people to look fewer steps ahead.
In contrast, plain stair designs improved balance, foot placement, and confidence. Adding clearly highlighted step edges further increased safety.
This research programme investigates how turning movements are coordinated, how this changes with ageing and Parkinson’s disease (PD), and how impairments can be improved.
Early work showed that turning relies on coordinated sequencing of the eyes, head, trunk, and pelvis, typically led by the head–eye system. Constraining vision or head movement disrupts this process, highlighting the importance of sensorimotor integration. Turning strategies also adapt to task demands: faster or more constrained movements promote more rigid, “en bloc” patterns, demonstrating that such behaviour can be functional rather than purely pathological.
With ageing, coordination becomes less flexible, with increased coupling between body segments. In PD, these changes are more pronounced, leading to reduced segmental dissociation, impaired eye–head–body coordination, and greater rigidity. This suggests PD reflects an exaggerated loss of movement adaptability.
The programme also validated wearable IMUs for measuring turning coordination, enabling objective, clinically feasible assessment. Importantly, a randomized controlled trial showed that task-specific training can improve turning performance and reduce “en bloc” movement in PD.
Overall, the work demonstrates that turning impairments are mechanistically understood, measurable, and modifiable, with important implications for rehabilitation and fall prevention.
