A comparison of sensor-based lower extremity reaction times, walking speeds, functional performance, and activity fear in older adults with a history of falls: a cross-sectional study

Çekok, Fatma Kübra; Anaforoğlu, Bahar · 2026 · Crossref

DOI: 10.1186/s12877-026-07313-0

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Summary

This cross-sectional study investigates the differences in sensor-based lower extremity reaction times, walking speeds, functional performance, and activity fear between older adults with and without a history of falls. Motivated by the high prevalence of falls among older adults and the recognized link between delayed motor responses and fall risk, the research aims to validate the use of wireless lighting systems (BlazePod™) as objective tools for assessing cognitive-motor interference. The authors hypothesized that individuals with a history of falls would exhibit slower reaction times, reduced physical performance, and higher fear of movement compared to non-fallers. The study recruited 62 older adults (aged 65+) from nursing homes in Mersin, Türkiye, divided into two groups: 30 participants with a history of at least two unexpected falls in the previous year and 32 controls with no fall history. Participants were excluded if they had cognitive impairment, neurological disorders, or conditions affecting lower extremity function. Lower extremity reaction times were measured using Simple Reaction Time (SRT) and Choice Reaction Time (CRT) tasks via three BlazePod™ pods, requiring participants to strike illuminated targets with their right leg. Functional mobility and balance were assessed using the Timed Up & Go (TUG), 10-Meter Walk (10MW), Five Times Sit-to-Stand (FTSS), and Berg Balance Scale (BBS). Fear of falling was evaluated using the Falls Efficacy Scale-International (FES-I). Statistical analyses included Mann–Whitney U tests for group differences and Spearman’s correlation for relationships between variables. Results indicated significant differences between the two groups across all measured parameters ($p < 0.001$). Older adults with a history of falls demonstrated substantially slower reaction times, with median SRT values of 1856 ms compared to 1102 ms in controls, and CRT values of 2160 ms versus 1174 ms. This group also exhibited poorer functional performance, including slower TUG times (15.2 s vs. 9.5 s), lower walking speeds, longer FTSS completion times, and lower BBS scores. Additionally, fallers reported significantly higher activity fear (median FES score of 44 vs. 18). Strong correlations were observed between reaction times and physical performance metrics, such as TUG and 10MW, as well as between reaction times and fear of falling. The study concludes that older adults with a history of falls exhibit slower lower-extremity reaction times, reduced physical performance, and greater fear of activity compared to non-fallers. These findings highlight the utility of sensor-based reaction time assessments as a complementary tool for identifying fall risk, offering more objective measurements than traditional clinical tests alone. The authors suggest that future interventions should target improving reaction times and balance confidence to reduce fall risk. While the cross-sectional design limits causal inference, the robust group differences support the integration of technology-assisted sensorimotor evaluations into comprehensive geriatric assessments.

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• age related perceptual decline