Stride dynamics, gait variability and prospective falls risk in active community dwelling older women

Paterson, Kade L.; Hill, Keith; Lythgo, Noel

doi:10.1016/j.gaitpost.2010.11.014

Cited by 78 publications

(59 citation statements)

References 29 publications

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“…had the highest reported ES among all the linear measures, indicating that fallers had a highly inconsistent variability in the stride time series compared with non-fallers [5]. However, no collective trends were apparent among nonlinear measures investigated in an FNF setting [92]. The nonlinear measures of variability b 42 , W y and PPISD_2, as well as stability measures of both peak and average values of FM (figure 3), were best able to differentiate between fallers and non-fallers.…”

Section: Assessment Of Fallers Versus Non-fallersmentioning

confidence: 81%

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

341

281

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Falls not only present a considerable health threat, but the resulting treatment and loss of working days also place a heavy economic burden on society. Gait instability is a major fall risk factor, particularly in geriatric patients, and walking is one of the most frequent dynamic activities of daily living. To allow preventive strategies to become effective, it is therefore imperative to identify individuals with an unstable gait. Assessment of dynamic stability and gait variability via biomechanical measures of foot kinematics provides a viable option for quantitative evaluation of gait stability, but the ability of these methods to predict falls has generally not been assessed. Although various methods for assessing gait stability exist, their sensitivity and applicability in a clinical setting, as well as their cost-effectiveness, need verification. The objective of this systematic review was therefore to evaluate the sensitivity of biomechanical measures that quantify gait stability among elderly individuals and to evaluate the cost of measurement instrumentation required for application in a clinical setting. To assess gait stability, a comparative effect size (Cohen's d ) analysis of variability and dynamic stability of foot trajectories during level walking was performed on 29 of an initial yield of 9889 articles from four electronic databases. The results of this survey demonstrate that linear variability of temporal measures of swing and stance was most capable of distinguishing between fallers and non-fallers, whereas step width and stride velocity prove more capable of discriminating between old versus young (OY) adults. In addition, while orbital stability measures (Floquet multipliers) applied to gait have been shown to distinguish between both elderly fallers and non-fallers as well as between young and old adults, local stability measures (ls) have been able to distinguish between young and old adults. Both linear and nonlinear measures of foot time series during gait seem to hold predictive ability in distinguishing healthy from fall-prone elderly adults. In conclusion, biomechanical measurements offer promise for identifying individuals at risk of falling and can be obtained with relatively low-cost tools. Incorporation of the most promising measures in combined retrospective and prospective studies for understanding fall risk and designing preventive strategies is warranted.

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Section: Assessment Of Fallers Versus Non-fallersmentioning

confidence: 81%

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

341

281

View full text Add to dashboard Cite

show abstract

“…Both the functional capacity and gait variability of older adults have been assessed using continuous walking protocols [6,12,16]. However, results need to be interpreted with caution, considering the walking path configuration and trial duration employed.…”

Section: Introductionmentioning

confidence: 99%

Manipulating walking path configuration influences gait variability and six-minute walk test outcomes in older and younger adults

et al. 2016

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The current study determined whether manipulations to walking path configuration influenced six-minute walk test (6MWT) outcomes and assessed how gait variability changes over the duration of the 6MWT in different walking path configurations. Healthy older (ODR) and younger (YNG) (n=24) adults completed familiarisation trials and five randomly ordered experimental trials of the 6MWT with walking configurations of; 5M, 10M and 15M straight lines, a 6m by 3m rectangle (RECT), and a figure of eight (FIG8). Six-minute walk distance (6MWD) and walking speed (m.s -1 ) were recorded for all trials and the stride count recorded for experimental trials. Reflective markers were attached to the sacrum and feet with kinematic data recorded at 100Hz by a nine-camera motion capture system for 5M, 15M and FIG8 trials, in order to calculate variability in stride and step length, stride width, stride and step time and double limb support time. Walking speeds and 6MWD were greatest in the 15M and FIG8 experimental trials in both groups (p<0.01).Step length and stride width variability were consistent over the 6MWT duration but greater in the 5M trial vs. the 15M and FIG8 trials (p<0.05). Stride and step time and double limb support time variability all reduced between 10 and 30 strides (p<0.01). Stride and step time variability were greater in the 5M vs. 15M and FIG8 trials (p<0.01). Increasing uninterrupted gait and walking path length results in improved 6MWT outcomes and decreased gait variability in older and younger adults.

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“…Quantitative measures of the temporal structure of human gait variability - such as statistical persistence and the amount of information present within the motor time series - provides us with a window into the organization of the neuromuscular system21. Increasingly, abnormal gait patterns can be characterized by the altered temporal structure of gait variability, and have been associated with a variety of disorders ranging from joint and skeletal problems22 (lowest-level gait disturbances) to Huntington's disease23, Parkinson's disease24, higher level gait disorders25 and falls26272829.…”

mentioning

confidence: 99%

The influence of auditory-motor coupling on fractal dynamics in human gait

Hunt

McGrath

Stergiou

2014

Sci Rep

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Humans exhibit an innate ability to synchronize their movements to music. The field of gait rehabilitation has sought to capitalize on this phenomenon by invoking patients to walk in time to rhythmic auditory cues with a view to improving pathological gait. However, the temporal structure of the auditory cue, and hence the temporal structure of the target behavior has not been sufficiently explored. This study reveals the plasticity of auditory-motor coupling in human walking in relation to ‘complex' auditory cues. The authors demonstrate that auditory-motor coupling can be driven by different coloured auditory noise signals (e.g. white, brown), shifting the fractal temporal structure of gait dynamics towards the statistical properties of the signals used. This adaptive capability observed in whole-body movement, could potentially be harnessed for targeted neuromuscular rehabilitation in patient groups, depending on the specific treatment goal.

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Stride dynamics, gait variability and prospective falls risk in active community dwelling older women

Cited by 78 publications

References 29 publications

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Manipulating walking path configuration influences gait variability and six-minute walk test outcomes in older and younger adults

The influence of auditory-motor coupling on fractal dynamics in human gait

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