Older Adult Hill Transition Strategies are Determined by Task Demands and Cautious Gait Patterns

Falls are the leading cause of injury for all age groups. However, adults over 65 are at a higher risk, with one-third falling each year. Transitioning between level and hill surfaces poses a greater fall risk than walking on either surface alone. Previous studies found that young adults adopted a cautious gait pattern to mitigate this risk. As older adults typically employ a cautious pattern during level walking, we investigated how they modify their gait pattern to safely transition between surfaces. Twenty adults over the age of 65 transitioned onto and off of a 15° ramp while we recorded kinematics and muscle activity. During the level-to-downhill and uphill-to-level transitions, participants took slower, shorter steps indicative of an exaggerated cautious gait pattern. The older adults also exhibited greater muscle activity during the transitions, which may be due to muscle weakness requiring compensatory strategies to meet the greater demands of the task. However, the slower, shorter steps when transitioning from uphill to level suggest that these compensations may not always be adequate. Thus, it is important to consider the relationship between physical abilities and task demands in evaluating walking terrains that may be excessively difficult or dangerous for older adults.