Measures of Gait Complexity during the Timed Up-and-Go Test in Older Adults with Vertebral Compression Fracture

Purpose

Objective motor and gait assessment is crucial for assessing fall risk and predicting intervention efficacy. This study compares the postural control and gait complexity in adults with and without vertebral compression fracture (VCF) during the timed up-and-go (TUG) test.

Methods

The groups of eligible older adults were divided into VCF (n = 21) and Control (without VCF; n = 43). The Biodex Balance System was used for postural stability and motor control tests. A TUG test was conducted, during which an inertial motion system was used to record joint kinematics and center of mass (CoM) trajectories. The gait complexity was assessed using multiscale entropy (MSE) analysis of pelvic acceleration.

Results

The VCF group had poor postural stability and longer times in the motor control test than the control group. During the sit-to-stand phase of the TUG test, the VCF group exhibited more significant mediolateral CoM displacement and less anteroposterior displacement than the control group. The VCF group had more significant vertical CoM displacement, lower acceleration, and lower ranges of motion in the cervical, thoracic, lumbar, and hip joints and longer stance phases than the control group while performing the TUG test. Furthermore, the VCF group had a higher complexity index of gait, indicating lower adaptability than the control group during walking.

Conclusion

Patients with VCF exhibited lower postural stability, potentially increasing their risk of falls. The patients adopted various less stable body configurations during the TUG test. Gait quality characteristics measured through MSE analysis may help evaluate the walking adaptability of individuals at risk of falls.