Research + Evidence

Falls on stairs are common among older adults, and forward falls during descent are associated with high injury risk. Being elderly myself and having a number of stairs in my home I have given this issue some thought. Current fall-prevention guidance appropriately emphasizes handrail use, lighting, stair design, and strength and balance training. However, comparatively little attention has been given to task-modification strategies that alter how stair descent is performed.

I wonder whether an oblique stair-descent orientation—approximately 60 degrees relative to the direction of the stairs, rather than fully forward or fully sideways—may reduce fall risk during descent in some older adults.

This orientation would combine several independently supported safety mechanisms:

1.     It naturally enforces slower, deliberate descent, discouraging step skipping and rapid cadence.

2.     It shortens the effective step length, potentially reducing overstepping and foot overhang.

3.     It reduces forward momentum, which is strongly associated with injurious stair falls.

4.     It preserves visual preview of upcoming steps.

5.     Importantly, the position still permits continuous handrail use with one hand, maintaining a key evidence-supported safety behavior.

This configuration appears biomechanically plausible and readily testable. While I can make no claims regarding efficacy or suitability for people, I wonder if anyone has explored this or related strategies in practice or research?

Glenn Kimata, M.D. (retired)