Postural control and preferred walking speed of active and sedentary elderly adults: Relationship with plantar and dorsi flexor strength

Introduction: The association between high blood pressure (BP) and risk of death varies by age and appears to be attenuated in some elderly adults. Walking speed is an excellent measure of functional status and may identify which elders may be most at risk for the adverse consequences of hypertension. Hypothesis: We hypothesized that elevated BP would be associated with greater risk of mortality in faster walkers, but not in slower walkers. Methods: The study population included 2,340 persons ≥ 65 years, with measured BP, in the National Health and Nutrition Examination Survey (NHANES) waves 1999-2000 and 2001-2002. Mortality data was linked to death certificate data in the National Death Index. Walking speed was measured over a 20-foot walk; 243 (8%) did not complete the walk for various safety and logistical reasons. Participants with walking speed above the mean (2.7 ft/sec) were classified as faster walkers. Potential confouders included age, sex, race, survey year, lifestyle and physiologic factors, chronic health conditions, and antihypertensive use. Results: There were 589 deaths recorded through December 31 st , 2006. Among faster walkers, those with elevated systolic BP (≥140 mmHg) had a higher mortality rate compared to those with systolic BP <140 mmHg (236 vs. 161 per 100,000 person-years). Among slower walkers, mortality rates did not appear to differ by the presence of elevated systolic BP (586 vs. 563 per 100,000 person-years). This pattern remained after multivariable adjustment; there was an association between elevated systolic BP and mortality in faster, but not slower walkers (Table). Elevated diastolic BP was not independently associated with an increased risk of mortality. Conclusions: If confirmed in other studies, walking speed could be a simple measure to identify elderly adults who are most at risk for poor outcomes related to high blood pressure. Table Association of elevated blood pressure and mortality, stratified by walking speed Hazard Ratio (HR) of Death Faster Walking Speed >2.7 ft/sec (n = 1,279) Slower Walking Speed ≤ 2.7 ft/sec (n = 818) p-value for interaction HR (95% CI) p-value HR (95% CI) p-value Elevated Systolic BP (≥140 mmHg) 1.44 (1.04, 1.99) 0.03 1.08 (0.82, 1.42) 0.56 0.11 Elevated Diastolic BP (≥90 mmHg) 1.09 (0.52, 2.27) 0.82 0.65 (0.30, 1.45) 0.28 0.28 Funding (This research has received full or partial funding support from the American Heart Association, Western States Affiliate (California, Nevada&Utah))

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In response to the article published by Dewolf et al, entitled: “Effect of walking speed on the intersegmental coordination of lower-limb segments in elderly adults”, Gait & Posture (2019)

Gait & Posture ◽

10.1016/j.gaitpost.2019.08.015 ◽

2019 ◽

Author(s):

Mathieu Gueugnon ◽

Paul Ornetti ◽

Davy Laroche

Keyword(s):

Lower Limb ◽

Walking Speed ◽

Elderly Adults ◽

Intersegmental Coordination ◽

Gait Posture

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Effect of walking speed on inter-joint coordination differs between young and elderly adults

Journal of Biomechanics ◽

10.1016/j.jbiomech.2011.10.028 ◽

2012 ◽

Vol 45 (2) ◽

pp. 275-280 ◽

Cited By ~ 47

Author(s):

Shiu-Ling Chiu ◽

Li-Shan Chou

Keyword(s):

Walking Speed ◽

Elderly Adults ◽

Joint Coordination

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Postural Control in Young and Elderly Adults When Stance Is Perturbed: Kinematics

Journal of Gerontology ◽

10.1093/geronj/47.3.m79 ◽

1992 ◽

Vol 47 (3) ◽

pp. M79-M87 ◽

Cited By ~ 65

Author(s):

N. B. Alexander ◽

N. Shepard ◽

M. J. Gu ◽

A. Schultz

Keyword(s):

Postural Control ◽

Elderly Adults

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Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

10.21203/rs.3.rs-29886/v2 ◽

2020 ◽

Author(s):

Yuki Kusagawa ◽

Toshiyuki Kurihara ◽

Aiko Imai ◽

Sumiaki Maeo ◽

Takashi Sugiyama ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Older Women ◽

Walking Speed ◽

Community Dwelling ◽

Timed Up And Go ◽

Chair Stand ◽

Foot Posture ◽

Toe Flexor Strength ◽

Flexor Strength

Abstract Background: Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods: Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-second chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results: TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = -0.32, p = 0.07) and supinated (r = -0.56, p = 0.08) groups, and positively correlate with 30-second chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions: The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

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