A Comparison of Straight- and Curved-Path Walking Tests Among Mobility-Limited Older Adults

Odonkor, Charles A.; Thomas, Julia C.; Holt, Nicole; Latham, Nancy K.; VanSwearingen, Jessie M.; Brach, Jennifer S.; Leveille, Suzanne G.; Jette, Alan M.; Bean, Jonathan F.

doi:10.1093/gerona/glt060

Cited by 42 publications

(37 citation statements)

References 36 publications

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“…Ankle ROM with reduction in both plantar flexion and dorsiflexion was found to be relevant when performing the figure of 8 walking test (F8WT) [30]. TUGT and F8WT involve similar movements, whereby the participant is required to turn around a cone placed at a distance of approximately 5 ft.…”

Section: Discussionmentioning

confidence: 99%

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Jung

Yamasaki

2016

J Physiol Anthropol

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BackgroundReduced lower extremity range of motion (ROM) and muscle strength are related to functional disability in older adults who cannot perform one or more activities of daily living (ADL) independently. The purpose of this study was to determine which factors of seven lower extremity ROMs and two muscle strengths play dominant roles in the physical performance of community-dwelling older women.MethodsNinety-five community-dwelling older women (mean age ± SD, 70.7 ± 4.7 years; age range, 65–83 years) were enrolled in this study. Seven lower extremity ROMs (hip flexion, hip extension, knee flexion, internal and external hip rotation, ankle dorsiflexion, and ankle plantar flexion) and two muscle strengths (knee extension and flexion) were measured. Physical performance tests, including functional reach test (FRT), 5 m gait test, four square step test (FSST), timed up and go test (TUGT), and five times sit-to-stand test (FTSST) were performed.ResultsStepwise regression models for each of the physical performance tests revealed that hip extension ROM and knee flexion strength were important explanatory variables for FRT, FSST, and FTSST. Furthermore, ankle plantar flexion ROM and knee extension strength were significant explanatory variables for the 5 m gait test and TUGT. However, ankle dorsiflexion ROM was a significant explanatory variable for FRT alone. The amount of variance on stepwise multiple regression for the five physical performance tests ranged from 25 (FSST) to 47% (TUGT).ConclusionsHip extension, ankle dorsiflexion, and ankle plantar flexion ROMs, as well as knee extension and flexion strengths may play primary roles in the physical performance of community-dwelling older women. Further studies should assess whether specific intervention programs targeting older women may achieve improvements in lower extremity ROM and muscle strength, and thereby play an important role in the prevention of dependence on daily activities and loss of physical function, particularly focusing on hip extension, ankle dorsiflexion, and ankle plantar flexion ROMs as well as knee extension and flexion strength.

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Section: Discussionmentioning

confidence: 99%

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Jung

Yamasaki

2016

J Physiol Anthropol

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“…Moreover, age influences prioritization strategies (Lindenberger et al, 2000; Beurskens and Bock, 2012; Schaefer, 2014), as does cognitive flexibility (Ble et al, 2005; Coppin et al, 2006; Hobert et al, 2011). A study by Lowry found that cognitive flexibility was related to the number of steps performed in a single-task Figure-of-8 Walk Test (F8WT) (Lowry et al, 2012), whereas another study found no associations between cognitive flexibility and the F8WT (Odonkor et al, 2013). Some studies have found that cognitive flexibility is associated with gait speed in dual tasking among older people, especially for walking paths with increasing complexity that are more cognitively demanding (Ble et al, 2005; Coppin et al, 2006; Hirota et al, 2010; Hobert et al, 2011; Killane et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…We included a curved walking path, as curved walking comprises a large part of the daily route—in some situations even more than straight walking (Glaister et al, 2007). Curved walking poses a computational challenge (Courtine and Schieppati, 2004; Lowry et al, 2012; Odonkor et al, 2013) as it requires a constant asymmetry of trajectory while preserving postural balance, and thus, it involves predictive control of the planned trajectory (Berthoz and Viaud-Delmon, 1999; Courtine and Schieppati, 2003). Also, turning measures are related to fall risk in older adults (Dite and Temple, 2002; Welch et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Evidence for a Selectively Regulated Prioritization Shift Depending on Walking Situations in Older Adults

Salkovic

Hobert

Bellut

et al. 2017

Front. Aging Neurosci.

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Background: Older adults have increased risks of balance issues and falls when walking and performing turns in daily situations. Changes of prioritization during different walking situations associated with dual tasking may contribute to these deficits. The objective of this study was therefore to investigate whether older adults demonstrate changes of prioritization during different walking paths.Methods: In total, 1,054 subjects with an age range from 50 to 83 years were selected from the first follow-up visit of the TREND (Tuebinger evaluation of Risk factors for Early detection of Neurodegenerative Disorders) study. They were classified according to their performance on the Trail Making Test (TMT) into good and poor TMT performers (based on recent results showing that cognitive flexibility affects prioritization strategies during straight walking). Absolute dual-task performance and relative dual-task costs (DTC, relative performance under dual-task conditions compared with single-task conditions) were assessed in two paradigms: walking while subtracting serial 7 s and walking while checking boxes on a clipboard. Both tasks were performed on straight and curved paths.Results: Overall, the poor TMT performers group performed worse in all single and dual tasks. Interestingly, the relative change in performance measured by dual-task costs differed in the groups between the two walking paths. On straight paths, poor TMT performers had a similar DTC of walking to that of good performers (p = 0.10) but had a significantly lower DTC of subtracting (p = 0.02). On curved paths, poor performers had a similar DTC of subtracting (p = 0.10), but their DTC of walking was significantly higher (p < 0.0001).Conclusion: Given that walking on curved paths is considered more difficult than that on straight paths and that the serial subtracting dual task is more difficult than the box checking dual task, this study in older adults provides evidence for the existence of a (walking) situation-dependent change of prioritization. If confirmed in other studies, situation-dependent change of prioritization should be included as a potential factor contributing to gait and balance impairments, and increased fall risk in older adults.

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“…As demonstrated in prior studies, gait parameters are influenced by both central and peripheral neurologic factors. 32,33 Seminal work by Strotmeyer et al, shows that a decline in peripheral nerve function secondary to peripheral vascular disease is an important source of mobility decline. 34,35 Gait speed has also been proven to have good relationship with lower limb power and strength.…”

Section: Discussionmentioning

confidence: 99%

“…34,35 Gait speed has also been proven to have good relationship with lower limb power and strength. 32,36-38 In view of this, gait serves as a seemingly good proxy of health attributes that are important to recovery from physiologic perturbation due to surgery. Although a simple walking test, gait speed captures very essential cognitive, central and peripheral neurological components of an individual’s health, which belies its complexity.…”

Section: Discussionmentioning

confidence: 99%

New Utility for an Old Tool

Odonkor

Schonberger

Dai

et al. 2013

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective The primary aim of this study was to design prediction models based on a functional marker (preoperative gait-speed) to predict readiness for home discharge time of ≤ 90 minutes, and to identify those at risk for unplanned admissions, after elective ambulatory surgery. Design This prospective observational cohort study evaluated all patients scheduled for elective ambulatory surgery. Home discharge readiness and unplanned admissions were the primary outcomes. Independent variables included preoperative gait speed, heart rate, and total anesthesia time. The relationship between all predictors and each primary outcome was determined in separate multivariable logistic regression models. Results After adjustment for covariates, gait speed with adjusted odds ratio = 3.71 (95% CI: 1.21-11.26), p=0.02; was independently associated with early home discharge readiness ≤90 minutes. Importantly, gait speed dichotomized as greater or less than 1 m/s predicted unplanned admissions with odds ratio = 0.35 (95% CI: 0.16 to 0.76, p=0.008) for those with speeds ≥ 1 m/s in comparison to those with speed < 1 m/s. In a separate model, prior history of cardiac surgery with adjusted odds ratio =7.5 (95% CI: 2.34-24.41)(p=0.001) was independently associated with unplanned admissions after elective ambulatory surgery, when other covariates were held constant. Conclusions This study demonstrates use of novel prediction models based on gait speed testing to predict early home discharge and to identify those patients at risk for unplanned admissions, after elective ambulatory surgery.

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A Comparison of Straight- and Curved-Path Walking Tests Among Mobility-Limited Older Adults

Cited by 42 publications

References 36 publications

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women

Evidence for a Selectively Regulated Prioritization Shift Depending on Walking Situations in Older Adults

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