Optimal and Acceptable Handrail Design

Problem

Falls remain a leading cause of injury, disability, and death. Well-designed handrails are the most effective safety and accessibility features that we can add to stairs, ramps and other walkways to prevent falls, promote balance, and encourage safe walking. However, the consequences to safety when handrails are too high or too low, or do not have a shape that is easy or comfortable to grasp, are not well-understood. As a result, the current handrail provisions within the building code allow a wide range of handrail heights and cross-sectional designs that may not be appropriate for effective balance recovery in our population, particularly for older adults who are at greater risk of injury should a fall occur.

Goal

We are using biomechanical and motor control approaches to understand what comprises ‘optimal’ and ‘acceptable’ handrail heights and cross-sectional designs to promote balance recovery and prevent falls. This will allow us to provide evidence-based recommendations for handrail design that can inform building codes, accessibility standards, and guidelines for consumers who are installing handrails in their homes.

Approach

All of our testing is done in Toronto Rehab’s Challenging Environment Assessment Laboratory (see figure below), which allows us to study balance loss and recovery in realistic yet safe conditions. Younger and older adults walk back and forth along a level or sloped walkway or a flight of stairs while we vary handrail height and cross-sectional design. We then disrupt their balance by shaking the lab. Using motion capture systems, we can understand how quickly and accurately they reach to grasp the rail. Similarly, load cells on the handrail posts allow us to quantify the forces that are exerted on the rail during balance recovery. Collectively, this will help us to understand how the design of a handrail influences a person’s ability to recover from balance loss, and lead to evidence-based recommendations to guide safer handrail design standards.

Here’s our testing environment from the outside (left) and inside (right). We can install different walking surfaces for level-ground or ramp walking (top right) or stair walking (bottom right).

Here’s what our data collection looks like:

Here’s what our 3-D motion capture system records during data collection:

Here, Vicki and Philippa discuss the best handrail designs to prevent falls on stairs and around the home, based on the strongest biomechanical evidence evidence to date:

More recently, we have started to investigate the true loads that people apply to handrails in response to balance loss. We use an ultra-stiff apparatus to minimize the signal confounding due to the movement of StairLab itself. Vicki demonstrates the protocol below in slow motion. The fun begins around 4 seconds in.

Team

Vicki, Alison, Philippa, Tilak and Geoff.