Gait Parameters of Older Adults according to Their Fall History and Functional Capacity While Walking at Different Speeds

Gerontology ◽  
2021 ◽  
pp. 1-12
Author(s):  
Letícia Pophal da Silva ◽  
Natália Boneti Moreira ◽  
Paulo Barbosa de Freitas ◽  
Gleber Pereira ◽  
André Luiz Felix Rodacki
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Walking Speed ◽  
Principal Component ◽  
Step Length ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Gait Parameters ◽  
Spatiotemporal Parameters ◽  
Walking Speeds

Introduction: It is believed that functional capacity and fall history are factors capable of influencing the gait parameters of older adults. Thus, the objective of this study was to verify whether gait parameters of community-dwelling older adults differ according to their functional capacity and fall history when walking at self-selected walking speed (SSWS) and fast walking speed (FWS) using principal component analysis (PCA). Methods: Two hundred ninety-five participants (82.3% women and 17.7% men) were allocated in four groups according to their fall history and functional capacity: non-fallers with higher functional capacity (NFHFC, n = 94; 69.3 ± 5.5 years), non-fallers with lower functional capacity (NFLFC, n = 114; 72.0 ± 8.1 years), fallers with higher functional capacity (FHFC, n = 29; 70.0 ± 6.0 years), and fallers with lower functional capacity (FLFC, n = 58; 72.5 ± 8.2 years). Fall history, anthropometric data, functional capacity by short physical performance battery and mobility by Timed Up and Go (TUG), and spatiotemporal gait parameters were evaluated. Results: Data analysis indicated that FLFC presented the lowest scores, especially in the Five Times Sit-to-Stand Test and TUG. The PCA showed that the first principal component (PC1) explained the most substantial amount of the data variability in both walking speeds (SSWS and FWS), predominantly including temporal parameters. PC2 composed by spatial outcomes (stride and step length and walking speed) showed the highest effect size. PC1 and PC2 were able to differentiate functional status, regardless of fall history. Conclusions: Functional capacity showed great importance when analyzing gait parameters at different walking speeds (SSWS and FWS), regardless of fall history. Older adults with high functional capacity demonstrate better performance during gait. Besides, spatiotemporal parameters are the main factors explaining gait variability, both in SSWS and FWS.

The Effects of a Divided-Attention Timed Stepping Accuracy Task on Balance, Strength, Endurance, and Functional Performance in Healthy Older Adults: A Pilot Study

2019 ◽  
Vol 27 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Susan J. Leach ◽  
Joyce R. Maring ◽  
Ellen Costello
Keyword(s):  
Older Adults ◽  
Divided Attention ◽  
Functional Performance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Primary Outcome Measure ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Healthy Older Adults ◽  
Stepping Accuracy

The aim of this study was to investigate whether a 6-week Divided-Attention Stepping Accuracy Task (DATSAT) intervention improved the primary outcome measure, maximal step length; other balance measures (Berg Balance scale and Timed Up and Go test); leg strength; endurance (6-min walk test); and functional tasks in 15 community-dwelling healthy older adults (age: 71.5 years, female: 46.7%) compared with 15 community-dwelling healthy older adults in a Bike and Strength (B&S) program (age: 73.8 years, female: 33.3%). Participants trained 3× per week, 30–60 min per session. Stepping-group differences were significant for all measures. B&S group improved in maximal step length (anterior and lateral), strength, and one functional task. Stepping group outperformed B&S group in Timed Up and Go and maximal step length posterior. B&S group outperformed stepping group in two strength measures. Exertion scores were lower for the stepping group. Overall, Divided-Attention Timed Stepping Accuracy Task training resulted in more within-group improvements and two between-group measures with less perceived effort and shorter intervention times.

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

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.

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

2020 ◽  
Vol 13 (1) ◽  
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-s 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-s 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.

scholarly journals Is faster always better? The walking speed-dependency of gait variability in bilateral vestibulopathy

2018 ◽  
Author(s):  
Christopher McCrum ◽  
Florence Lucieer ◽  
Raymond van de Berg ◽  
Paul Willems ◽  
Angélica Pérez Fornos ◽  
...  
Keyword(s):  
Older Adults ◽  
Walking Speed ◽  
Clinical Care ◽  
Vestibular Function ◽  
Step Length ◽  
Gait Variability ◽  
Vestibular Evoked Myogenic Potentials ◽  
Step Width ◽  
Bilateral Vestibulopathy ◽  
Walking Speeds

AbstractStudy of balance and gait deficits associated with vestibulopathy is important for improving clinical care and is critical to our understanding of the vestibular contributions to gait and balance control. Previous studies report a speed-dependency of the vestibular contributions to gait, so we examined the walking speed effects on gait variability in healthy young and older adults and in adults with bilateral vestibulopathy (BVP). Forty-four people with BVP, 12 healthy young adults and 12 healthy older adults completed walking trials at 0.4m/s to 1.6m/s in 0.2m/s intervals on a dual belt, instrumented treadmill. Using a motion capture system and kinematic data, the means and coefficients of variation for step length, time, width and double support time were calculated. The BVP group also completed a video head impulse test and examinations of ocular and cervical vestibular evoked myogenic potentials and dynamic visual acuity. Walking speed significantly affected all assessed gait parameters. Step length variability at slower speeds and step width variability at faster speeds were the most distinguishing parameters between the healthy participants and people with BVP, and within people with BVP with different locomotor capacities. We observed for step width variability, specifically, an apparent persistent importance of vestibular function at increasing speeds. Gait variability was not associated with the clinical vestibular tests. Our results indicate that gait variability at multiple walking speeds has potential as an assessment tool for vestibular interventions.New & Noteworthy:Walking speed significantly but differentially affects gait variability in healthy adults and in adults with bilateral vestibulopathy. Gait variability at different speeds distinguishes between participants with and without bilateral vestibulopathy, but also between more and less able walkers with bilateral vestibulopathy. Specifically, for step width variability, an apparent persistent importance of vestibular function at increasing walking speeds was observed. Gait variability was generally not correlated with clinical tests of vestibular function.

scholarly journals Validity Analysis of WalkerViewTM Instrumented Treadmill for Measuring Spatiotemporal and Kinematic Gait Parameters

Sensors ◽  
2021 ◽  
Vol 21 (14) ◽  
pp. 4795
Author(s):  
Marco Bravi ◽  
Carlo Massaroni ◽  
Fabio Santacaterina ◽  
Joshua Di Tocco ◽  
Emiliano Schena ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Excellent Agreement ◽  
Intraclass Correlation ◽  
Step Length ◽  
Mean Value ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Gait Parameters ◽  
Spatiotemporal Parameters ◽  
Walking Speeds

The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerViewTM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.

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

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 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). On the basis of 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.

scholarly journals Comparison of Lateral Perturbation-Induced Step Training and Hip Muscle Strengthening Exercise on Balance and Falls in Community-Dwelling Older Adults: A Blinded Randomized Controlled Trial

2021 ◽  
Author(s):  
Mark W Rogers ◽  
Robert A Creath ◽  
Vicki Gray ◽  
Janice Abarro ◽  
Sandy McCombe Waller ◽  
...  
Keyword(s):  
Older Adults ◽  
Controlled Trial ◽  
Step Length ◽  
Community Dwelling ◽  
Controlled Study ◽  
Balance Performance ◽  
Muscle Strengthening ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Community Dwelling Older Adults

Abstract Background This factorial, assessor-blinded, randomized, and controlled study compared the effects of perturbation-induced step training (lateral waist-pulls), hip muscle strengthening, and their combination, on balance performance, muscle strength, and prospective falls among older adults. Methods Community-dwelling older adults were randomized to 4 training groups. Induced step training (IST, n = 25) involved 43 progressive perturbations. Hip abduction strengthening (HST, n = 25) utilized progressive resistance exercises. Combined training (CMB, n = 25) included IST and HST, and the control performed seated flexibility/relaxation exercises (SFR, n = 27). The training involved 36 sessions for a period of 12 weeks. The primary outcomes were the number of recovery steps and first step length, and maximum hip abduction torque. Fall frequency during 12 months after training was determined. Results Overall, the number of recovery steps was reduced by 31% and depended upon the first step type. IST and CMB increased the rate of more stable single lateral steps pre- and post-training than HST and SFR who used more multiple crossover and sequential steps. The improved rate of lateral steps for CMB exceeded the control (CMB/SFR rate ratio 2.68). First step length was unchanged, and HST alone increased hip torque by 25%. Relative to SFR, the fall rate ratios (falls/person/year) [95% confidence interval] were CMB 0.26 [0.07–0.90], IST 0.44 [0.18–1.08], and HST 0.30 (0.10–0.91). Conclusions Balance performance through stepping was best improved by combining perturbation and strength training and not strengthening alone. The interventions reduced future falls by 56%–74% over the control. Lateral balance perturbation training may enhance traditional programs for fall prevention.

scholarly journals Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Performance ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
P Values ◽  
Student’S T ◽  
The Impact ◽  
Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

scholarly journals A Comparison of Treadmill and Overground Walking Effects on Step Cycle Asymmetry in Young and Older Individuals

2013 ◽  
Vol 29 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Hanatsu Nagano ◽  
Rezaul K. Begg ◽  
William A. Sparrow ◽  
Simon Taylor
Keyword(s):  
Older Adults ◽  
Walking Speed ◽  
Step Length ◽  
Treadmill Walking ◽  
Older Individuals ◽  
Aging Effects ◽  
Overground Walking ◽  
Time Data ◽  
Step Cycle ◽  
Step Velocity

Although lower limb strength becomes asymmetrical with age, past studies of aging effects on gait biomechanics have usually analyzed only one limb. This experiment measured how aging and treadmill surface influenced both dominant and nondominant step parameters in older (mean 74.0 y) and young participants (mean 21.9 y). Step-cycle parameters were obtained from 3-dimensional position/time data during preferred-speed walking for 40 trials along a 10 m walkway and for 10 minutes of treadmill walking. Walking speed (young 1.23 m/s, older 1.24 m/s) and step velocity for the two age groups were similar in overground walking but older adults showed significantly slower walking speed (young 1.26 m/s, older 1.05 m/s) and step velocity on the treadmill due to reduced step length and prolonged step time. Older adults had shorter step length than young adults and both groups reduced step length on the treadmill. Step velocity and length of older adults’ dominant limb was asymmetrically larger. Older adults increased the proportion of double support in step time when treadmill walking. This adaptation combined with reduced step velocity and length may preserve balance. The results suggest that bilateral analyses should be employed to accurately describe asymmetric features of gait especially for older adults.

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