Quality of Daily-Life Gait: Novel Outcome for Trials that Focus on Balance, Mobility, and Falls

Abstract

Technological advances in inertial sensors allow for monitoring of daily-life gait characteristics as a proxy for fall risk. The quality of daily-life gait could serve as a valuable outcome for intervention trials, but the uptake of these measures relies on their power to detect relevant changes in fall risk. We collected daily-life gait characteristics in 163 older people (aged 77.5 ± 7.5, 107) over two measurement weeks that were two weeks apart. We present variance estimates of daily-life gait characteristics that are sensitive to fall risk and estimate the number of participants required to obtain sufficient statistical power for repeated comparisons. The provided data allows for power analyses for studies using daily-life gait quality as outcome. Our results show that the number of participants required (i.e., 8 to 343 depending on the anticipated effect size and between-measurements correlation) is similar to that generally used in fall prevention trials. We propose that the quality of daily-life gait is a promising outcome for intervention studies that focus on improving balance and mobility and reducing falls.

Association between Daily-Life Gait Quality Characteristics and Physiological Fall Risk in Older People

“…Our aim was to examine the association between gait quality characteristics with the severity of physiological fall risk in community-dwelling older people. These gait quality characteristics were previously validated on falls but analyses were performed in the same cohort (FARAO cohort, 319 older people aged 65–99 years) [ 4 , 5 , 6 , 7 , 14 ]. In line with the previous validation on falls [ 5 ], our results indicated that logarithmic rate of divergence per stride in VT and AP were associated with physiological fall risk while sample entropy and a gait quality composite score were, against our expectations, not associated with physiological fall risk after adjusting for walking speed.…”

“…For every gait quality characteristic, we took the median of all epochs over one week as a representation of someone’s daily life gait quality [ 4 , 5 , 7 ]. In total, we extracted walking speed and six gait characteristics: sample entropy in ML and VT, logarithmic rate of divergence in VT, ML and AP and the gait quality composite [ 5 , 14 ]. Walking speed was determined from the product of stride frequency and stride length, estimated from leg length and vertical trunk displacements assuming compass gait [ 20 ].…”

“…Walking speed was determined from the product of stride frequency and stride length, estimated from leg length and vertical trunk displacements assuming compass gait [ 20 ]. The gait quality composite is a weighed sum of the root mean square of the acceleration in ML, the index of harmonicity in ML, the magnitude of the acceleration at the dominant period in the frequency domain in the AP direction and the autocorrelation of the acceleration at the dominant period in the frequency domain in VT [ 14 ]. The gait quality composite was coded such that a higher gait quality composite score corresponded to a better gait quality.…”

“…This physiological fall risk measure not only takes into account fall history but also includes several measures of someone’s actual physical abilities. Moreover, it is a less noisy outcome measure of fall risk than (accidental) fall incidence [ 13 , 14 ]. For gait quality characteristics to be a valid instrument to identify people who would benefit from fall prevention intervention, these characteristics need to not only be predictive of falls but also associate with physiological fall risk.…”

Towards Wearable-Inertial-Sensor-Based Gait Posture Evaluation for Subjects with Unbalanced Gaits

“…Clinical gait analysis is designed to reveal the key links and influencing factors of gait anomalies through biomechanics and kinematics, to help evaluate and treat through rehabilitation, and to help to assist clinical diagnosis, curative effect evaluation, and pathological research, etc. [5,6]. An effective gait analysis is usually performed in clinical or research settings and quantitatively measures the exact angles of the knees, ankles, and hips when walking or running.…”