Validity of the Gait Variability Index in older adults: Effect of aging and mobility impairments

Abstract

Gait variability, defined as the fluctuation in spatiotemporal characteristics between steps, is suggested to be a sensitive indicator of mobility deficits with aging and pathological processes. A challenge in quantifying gait variability is the decision of which spatiotemporal parameters to assess because gait parameters may exhibit different amounts of variability and may differentially relate to mobility performance. The Gait Variability Index (GVI), a composite measure of variability across several gait parameters, was previously developed to overcome this challenge. The present study seeks to validate the use of GVI in the older adult population. A retrospective analysis of gait and clinical data was conducted using data pooled from five prior studies. The final data set included 105 younger adults (YA, age < 65) and 81 older adults (OA, age ≥ 65). The GVI of OA (91.92 ± 8.75) was significantly lower compared to the GVI of YA (100.79 ± 7.99). Within OA, the GVI was significantly lower (p < 0.0001) in individuals with mobility deficits (84.35 ± 9.03) compared to those with high mobility function (96.35 ± 8.86). Furthermore, GVI was associated with mobility function, including walking speed and performance on the Berg Balance Scale. Our findings imply that the GVI is a valid assessment for gauging spatiotemporal gait variability in older adults, is sensitive to differentiate between high-functioning older adults and those with mild to moderate mobility deficits and is associated with some clinical measures of functional mobility and balance.

The brain map of gait variability in aging, cognitive impairment and dementia—A systematic review

“…In general, there is a limited theoretical framework to guide selection of gait variability measures (Lord et al 2011). While temporal and spatial gait variability might be assessed separately in order to detect underlying mechanisms, some recent studies have used dimension-reduction techniques to generate a global measure (Balasubramanian et al 2015, Gouelle et al 2015), or to reduce the number of measures (Verghese et al 2007, Lord et al 2013). The global measure has been reported to have high inter-session reliability and is thought to be more sensitive than individual measures (Gouelle et al 2013).…”

Enhanced Gait Variability Index in Older Asian Adults and Increased Physiological Fall Risk: Results from the Yishun Study

“…Balasubramanian et al (2015) [24] reported that the GVI decreased with advancing age but showed no relationship in those who were younger than 50. This was not surprising since variability in most of the gait spatiotemporal parameters increases with age [21], especially among older adults [22][23][24][25] . Furthermore, the slower the self-selected gait speed of the older adults, the greater was their EGVI.…”

“…Balasubramanian et al (2015) [24] validated the use of the GVI to discriminate high-functioning older adults from those with mild to moderate mobility de cits. Schmitt et al (2020) [14], validated the use of the composite EGVI versus individual spatiotemporal parameters among the PD population to assess for fall frequency.…”

Kinect-based gait analysis for automatic frailty syndrome assessment

“…the time in which both feet are in contact with the ground), variability of stride velocity, mean duration and variability of a single walking sequence, and so on; postural balance features, related to the skeleton posture during motion. For evaluating the frailty it is important to consider both of these parameters [5,13,25].…”

“…The clinical application of gait analysis allows the clinician to evaluate physical impairments that could be related to different diseases and disorders [9]. There are several examples of healthcare applications for assessing the postural balance [10], rehabilitation [11], monitoring of elderly people for falls detection [12] , evaluating the health index and the frailty syndrome in older adult [5,13,14,15], and so on.…”