The development of a sensor that can measure balance during quiet standing and predict stepping response in the event of perturbation has many clinically relevant applica- tions, including closed-loop control of a neuroprothesis for standing. This study investigated the feasibility of an algorithm that can predict in real-time when an able-bodied individual who is quietly standing will have to make a step to compensate for an external perturbation. Anterior and posterior perturbations were performed on 16 able-bodied subjects using a pul- ley system with a dropped weight. A linear relationship was found between the peak center of pressure (COP) velocity and the peak COP displacement caused by the perturbation. This result suggests that one can predict when a person will have to make a step based on COP velocity measurements alone. Another important feature of this finding is that the peak COP velocity occurs considerably before the peak COP displacement. As a result, one can predict if a subject will have to make a step in response to a perturbation sufficiently ahead of the time when the subject is actually forced to make the step. The proposed instability detection algorithm will be implemented in a sensor system using insole sheets in shoes with minitur- ized pressure sensors by which the COPv can be continuously measured. The sensor system will be integrated in a closed-loop feedback system with a neuroprosthesis for standing in the near future
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