Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

Abstract

Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities.Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses.Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls declined with increasing age (mean values and CoV) and demonstrated sex differences (mean values).Conclusions: Based on an international multicenter collaboration, we propose consensus guidelines for gait assessment and spatiotemporal gait analysis based on the recorded footfalls, and reference values for healthy older adults.

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“…Ambulatory activity for these mostly octogenarians was high, with similar values for all participants apart from one highly active individual, who walked on average over 18,000 steps a day, and was active for 237 minutes of the day. Participants walked with an average gait speed of 1.01 ms -1 which is comparable to age-referenced data (Beauchet et al, 2017). TUG single task scores were comparable to those reported for non-fallers (Weiss et al, 2013), although balance confidence scores were considerably higher (80% compared with 53% confidence).…”

Age-related differences in gait adaptations during overground walking with and without visual perturbations using a virtual reality headset

“…However, even if we used 3 steps for acceleration/deceleration phases that were in average shorter than 2 m, we believe this was not a major methodological limitation of this study. Indeed, more recent guidelines for the assessment of gait in older adults from the Biomathics and Canadian Gait Consortiums Initiative reported that a steady-state gait can be achieved by instructing participants to start walking 1 m prior to the data recording zone and stopping at least 1 m beyond it 39 . Moreover, other studies have suggested that the transition of the body to steady gait pattern occurs rapidly over a period that can range from one 40 to three steps 41 and that measures of gait variability measured on a shorter walkway with shorter acceleration/deceleration phases (i.e., 4-m walkway plus 1-m for acceleration and deceleration phases) showed: (1) good test–retest reliability and concurrent validity, as indicated by associations with functional status and poorer health 42 ; (2) associations with history of falls in the past year 43 ; and (3) predictive ability for future mobility impairments and disability 44 .…”

Gait Characteristics Based on Shoe-Type Inertial Measurement Units in Healthy Young Adults during Treadmill Walking

“…In addition, cluster group 3 (lowest level) yielded similar GV and PCI ranges compared with the healthy elderly population evaluated in previous studies (our young adults vs. elderly adults in previous studies = stride length: 3.31% vs. 2.23%-2.42%, single support phase: 6.24% vs. 3.90%-6.00%, double support phase: 12.16% vs. 6.00%-6.80%, and PCI: 4.11% vs. 3.30% to 6.10%) [1,6,10,13,49]. Increased PCI values imply poorer bilateral coordination that may be related to worsened gait coordination capacity and worsened dynamic stability [10][11][12][13].…”