Inter and Intra-rater differences in the extent of lean release and its influence on forward-stepping characteristics.

Falls can occur as a result of a loss of balance while standing, but fortunately, they can be prevented through the use of appropriate compensatory postural reactions. Reactive postural control is a term that describes an individual’s capacity to maintain their center of mass (COM) within their base of support (BOS) when faced with an external destabilizing perturbation. These postural reactions occur quickly and rely on the integration of signals from the sensory systems. Reactive postural responses are broadly categorized into hip, ankle, and stepping strategies. The ankle strategy is the first to act when the perturbation is minor. The hip strategy is a response that is triggered when the base of support is limited and there is a large perturbation.This response occurs when the external force exceeds the human body’s ability to maintain its initial base of support. Stepping is the common strategy seen in the individual while performing posturalcontrol assessment in stance  In this the maximum leaning angle leads to forward stepping causing a single step or rapid step to regain balance during forward fall. The postural control assessment should be done in a complex and dynamic context by applying a sudden external perturbation and simulate the loss of balance in individuals, to mimic a real-life fall situation. Various assessment strategies for reactive postural control are been used in clinical setting like Balance evaluation system test, waist pulls and surface translation, but the destabilizing forces or perturbations are different in all the methods mentioned above. Compensatory stepping correction – forward is a component of reactive postural response in the balance evaluation systems test (BESTest), which evaluates the balance recovery of a person by taking a forward stepping when there is a sudden release from forward lean by release from- lean method. Despite having various ways of reactive stepping evaluation, few studies measured the stepping threshold in populations such as diabetes and elderly people. Research has shown that the leaning angle influences the stepping pattern and research is required to understand the spatiotemporal parameters and inter and intra-rater variability of stepping reactions in young adults