Guidelines for clinical applications of spatio-temporal gait analysis in older adults
Kressig RW, Beauchet O;
Aging Clin Exp Res. 2006 Apr;18(2):174-6
Quantifying spatio-temporal gait parameters in stationary and ambulatory geriatric settings may aid the early identification of potential fallers, as well as the documentation of illness-specific gait disorders and intervention-related changes in rehabilitative medicine. Bringing gait analysis out of the laboratory and into a clinical setting is the goal of the European GAITRite network group, initiated in 2003 in Geneva . To enhance reproducibility of gait measures and for better comparability of outcomes in clinical environments, a consensus on data collection was formulated and presented at the 2nd European GAITRite Meeting in Marseilles . The guidelines presented here are intended to facilitate network collaborations and to provide guidance to clinicians who wish to implement spatio-temporal gait analysis in clinical settings.
Does Fear of Falling Influence Spatial and Temporal Gait Parameters in Elderly Persons Beyond Changes Associated With Normal Aging?
Melissa E. Chamberlin; Brandy D. Fulwider; Sheryl L. Sanders and John M. Medeiros
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 60:1163-1167 (2005)
Background: Limited research exists on fear of falling and its affect on gait parameters. Studies have shown a relationship between fear of falling and restriction of activities. The purpose of this study was to determine if a fear of falling in elderly persons was associated with changes in spatial and temporal gait parameters, independent of a history of falls. It was hypothesized that, in elderly persons, gait changes would be associated with a preexisting fear of falling.
Methods: Ninety-five community-dwelling adults, aged 60-97 years (mean age = 74, standard deviation = 8.5) participated in this study. Participant scores on the Modified Falls Efficacy Scale determined an individual's placement into the "fearful" or "fearless" category. Spatial and temporal gait parameters of speed, stride length, step width, and double limb support time were assessed using the GAITRite system, a computerized electronic walkway.
Results: The fearful group had a significantly slower gait speed (p <.05) and shorter stride length (p <.05) when compared to the fearless group. Stride width was significantly longer (p =.05) and double limb support time was significantly prolonged (p <.05) in the fearful participants when measured against the fearless participants.
Conclusions: The results of this study support the hypothesis that fear of falling does influence spatial and temporal gait parameter changes in elderly persons. Slower gait speed, shorter stride length, increased stride width, and prolonged double limb support time were found to be associated with a preexisting fear of falling.
Age-related differences in spatiotemporal markers of gait stability during dual task walking
John H. Hollman; Francine M. Kovash; Jared J. Kubik; Rachel A. Linbo
Gait & Posture, Volume 26, Issue 1, June 2007, Pages 113-119
Abstract: Increased stride-to-stride variability during walking characterizes gait instability and predicts falling in older adults. Walking while performing cognitive tasks (dual task walking) is also associated with increased risk of falling. The purpose of the study was to examine whether gait velocity and stride-to-stride variability in gait velocity differ in older adults compared with middle-aged and younger adults during normal and dual task walking conditions. Sixty older (n = 20, mean age = 81 years), middle-aged (n = 20, mean age = 48 years), and young adults (n = 20, mean age = 25 years) participated in the study. Gait parameters were quantified with GAITRite1 instrumentation. In the dual task condition, participants spelled five-letter words in reverse while walking across the walkway. Across groups, gait velocity was slower (p < 0.001) and stride-to-stride variability in gait velocity was greater ( p = 0.001) in dual task walking. Older subjects walked more slowly than did middle-aged and younger subjects and the difference in gait velocity was greatest in the dual task condition (p < 0.05). Variability in stride velocity was increased in older subjects compared with middle-aged and younger subjects (p < 0.05). Additionally, in older subjects, impaired walking performance was associated with impaired cognitive performance in dual task walking. The gait changes observed in dual task walking characterize decreased gait stability and indicate that cognitively demanding tasks during walking have a destabilizing effect on gait and may place older people at a greater risk of falling. |
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