Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls – Results from the Baltimore Longitudinal Study of Aging

IF 2.2 3区医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2024-11-13 DOI:10.1016/j.gaitpost.2024.11.004

Seung-uk Ko , Gerald J. Jerome , Eleanor M. Simonsick , Luigi Ferrucci

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Abstract

Background

Falls in older adults increase the risk of mobility loss. Proper understanding of gait mechanisms related to falls may provide novel solutions for maintaining mobility in older adults.

Research question

Identify fall-related gait patterns through analyzing alterations in gait parameters to walk faster than usual pace in older adults.

Methods

A Total of 519 participants (mean age = 73.12 years; 51.05 % female), including non-fallers (n = 396) and fallers (n = 123), aged 60–96 years were assessed in the Baltimore Longitudinal Study of Aging. Participants completed gait assessments at both usual and fast paces. Range of motions (ROM) for the hip, knee, and ankle joint in the sagittal plane and hip abductor ROM during normal and fast pace gait were measured by 3D motion capture system (Vicon 612). For all gait variables, percentage-changes (PC; (((fast-walking_parameter – usual-walking_parameter) /usual-walking_parameter)*100)) was calculated. Associations of PC for gait speed and PC for other gait parameters were compared between fallers and non-fallers.

Results

Compared to non-fallers, fallers walked with shorter stride, elongated double support time and shorter knee ROM in the faster pace walk (p = 0.044, p = 0.019, and p = 0.036, respectively). PCs of all gait related variables were significantly associated with PC of gait speed in non-fallers (ps < 0.005), while in the fallers, only PC for stride length, cadence, and hip ROM were associated with PC for gait speed (ps < 0.001).

Significance

Among non-fallers related PC for gait speed was associated with PC across gait parameters suggesting the use of similar biomechanical approaches in usual and fast gait. Compared to non-fallers, fallers demonstrated different mechanisms of transition from usual to fast gait. Evaluating speed-up strategies could provide insight into subtle yet important gait modifications in apparently well-functioning older adults that would help identify individuals at high risk of falling.

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对跌倒和未跌倒的健康老年人正常步态加速机制的横断面分析--巴尔的摩老龄化纵向研究的结果。

背景：老年人跌倒会增加丧失行动能力的风险。正确理解与跌倒有关的步态机制可为老年人保持行动能力提供新的解决方案：研究问题：通过分析步态参数的变化来确定老年人跌倒相关的步态模式：巴尔的摩老龄化纵向研究》共评估了 519 名参与者（平均年龄为 73.12 岁；51.05% 为女性），包括未跌倒者（396 人）和跌倒者（123 人），年龄在 60-96 岁之间。参与者以平常步速和快速步速完成步态评估。通过三维运动捕捉系统（Vicon 612）测量了正常步速和快步时髋关节、膝关节和踝关节在矢状面上的运动范围（ROM）以及髋关节外展运动范围。所有步态变量的百分比变化（PC; (((fast-walking_parameter - usual-walking_parameter) /usual-walking_parameter)*100)) 均被计算出来。比较了跌倒者和非跌倒者步速的PC与其他步态参数的PC之间的关联：结果：与非跌倒者相比，跌倒者在快步走时步幅更短、双支撑时间更长、膝关节 ROM 更短（分别为 p = 0.044、p = 0.019 和 p = 0.036）。在非跌倒者中，所有步态相关变量的 PC 均与步速 PC 显著相关（PS < 0.005），而在跌倒者中，只有步长、步幅和髋关节 ROM 的 PC 与步速 PC 相关（PS < 0.001）：在非跌倒者中，步速的 PC 与步态参数的 PC 相关，这表明在普通步态和快速步态中使用了类似的生物力学方法。与非跌倒者相比，跌倒者从普通步态过渡到快速步态的机制不同。对加速策略进行评估可以帮助人们了解表面上功能良好的老年人微妙而重要的步态改变，有助于识别跌倒高危人群。

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.