Obesity in older adults is a growing public health problem. Excess weight causes biomechanical burden to lower extremity joints and contribute to joint pathology. The aim of this study was to identify specific characteristics of gait associated with body mass index (BMI). Preferred and maximum speed walking and related gait characteristics were examined in 164 (50-84 years) participants from Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted. Participants were divided into three groups based on their BMI: normal weight (19 ≤ BMI < 25 kg/ m 2 ), overweight (25 ≤ BMI < 30 kg/m 2 ) and obese (BMI 30 ≤ BMI < 40 kg/m 2 ). Total ankle generative mechanical work expenditure (MWE) in the anterior-posterior (AP) plane was progressively and significantly lower with increasing BMI for both preferred (p = 0.026) and maximum speed walking (p < 0.001). In the medial-lateral (ML) plane, total knee generative MWE was higher in obese participants in the preferred speed task (p = 0.002), and total hip absorptive MWE was higher in obese in both preferred speed (p < 0.001) and maximum speed (p = 0.002) walking task compared to the normal weight participants. Older adults with obesity show spatiotemporal gait patterns which may help to reduce contact impacts. In addition, in obese persons mechanical energy usages tend to be lower in the AP plane and higher in the ML plane. Since forward progression forces are mainly implicated in normal walking, this pattern found in obese participants is suggestive of lower energetic efficiency.

The effects of normal aging and orthopedic conditions on gait patterns during customary walking have been extensively investigated. Empirical evidence supports the notion that sex differences exist in the gait patterns of young adults but it is unclear as to whether sex differences exist in older adults. The aim of this study was to investigate sex-specific differences in gait among older adults. Study participants were 336 adults (50 – 96 years; 162 women) enrolled in the Baltimore Longitudinal Study of Aging (BLSA) who completed walking tasks at self-selected speed without assistance. After adjusting for significant covariates, women walked with higher cadence (p = 0.01) and shorter stride length (p = 0.006) compared to men, while gait speed was not significantly related to sex. Women also had less hip range of motion (ROM; p = 0.004) and greater ankle ROM (p < 0.001) in the sagittal-plane, and greater hip ROM (p = 0.004) in the frontal-plane. Hip absorptive mechanical work expenditure (MWE) of the women was greater in the sagittal-plane (p < 0.001) and lower in the frontal-plane (p < 0.001), compared to men. In summary, women’s gait is characterized by greater ankle ROM than men while men tend to have greater hip ROM than women. Characterizing unique gait patterns of women and men with aging may be beneficial for detecting the early stages of gait abnormalities that may lead to pathology.

No abstract

Diabetes may impact gait mechanics before onset of frank neuropathies and other associated threats to mobility. This study aims to characterize gait pattern alterations of type 2 diabetic adults without peripheral neuropathy during walking at maximum speed (fast-walking) as well as at self-selected speed (usual-walking). One-hundred and eighty-six participants aged 60 to 87 from the Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted and without peripheral neuropathy were classified as non-diabetic (N = 160) or having type 2 diabetes (N=26). Gait parameters from the fast-walking and usual-walking tests were compared between participants with and without type 2 diabetes. Participants with diabetes had a shorter stride length for fast-walking (p = 0.033) and a longer percentage of the gait cycle with the knee in 1st flexion for both fast- and usual-walking (p = 0.033, and 0.040, respectively) than non-diabetic participants. Participants with diabetes exhibited a smaller hip range of motion in the sagittal plane during usual-walking compared to non-diabetics (p = 0.049). During fast-walking, participants with diabetes used lower ankle generative mechanical work expenditure (MWE) and higher knee absorptive MWE compared to non-diabetic persons (p = 0.021, and 0.018, respectively). These findings suggest that individuals with type 2 diabetes without overt peripheral neuropathy exhibit altered and less efficient gait patterns than non-diabetic persons. These alterations are more apparent during walking at a maximum speed indicating that maximum gait testing may be useful for identifying early threats to mobility limitations in older adults with type 2 diabetes.

No abstract

The aim of this cross sectional study was to delineate age-associated kinematic and kinetic gait patterns of normal walking, and to test the hypothesis that older adults exhibit gait patterns that reduce generative mechanical work expenditures (MWEs). We studied 52 adult Baltimore Longitudinal Study of Aging participants (means age 72 ± 9, from 60 to 92 years) who could walk 4-meters unaided. 3-dimensional kinematic and kinetic parameters assessed during rotation-defined gait periods were used to estimate MWEs for the rotation of lower extremities about the medial-lateral (ML) and anterior-posterior (AP) axes of proximal joints, which represent MWEs in the AP and ML sides, respectively. Relationships between gait parameters and age were examined using regression analysis with adjustments for walking speed, sex, height, and weight. Older age was associated with slower self-selected walking speed (p < 0.001), shorter stride length (p < 0.001), and greater propensity of landing flat-footed (p = 0.003). With older age, hip generative MWE for thigh rotation was lower about the AP axis (hip abduction and adduction) during stance (p = 0.010) and higher about the ML axis (hip extension and flexion) during late stance (p < 0.001). Knee absorptive MWE for shank rotation about the AP axis (knee abduction and adduction) during early stance was also lower with older age (p < 0.003). These age-related gait patterns may represent a compensatory effort to maintain balance and may also reflect mobility limitations.

Ankle proprioceptive information is integrated by the central nervous system to generate and modulate muscle contractions for maintaining standing balance. This study evaluated the association of ankle joint proprioception with objective and self-report measures of balance, mobility, and physical function across the adult life span. Seven hundred and ninety participants (age range 24-97 years, 362 women) who completed ankle proprioception assessment between 2010 and 2014 were included in the present study from the population-based cohort of the Baltimore Longitudinal Study of Aging (BLSA), USA. Outcome measures included ankle joint proprioception measured as threshold for perception of passive movement (TPPM); single leg stance time; perceived difficulty for standing balance; usual, fastest, and narrow-path gait speed; walking index; short physical performance battery score; and self-reported activity restriction due to fear of falling. Descriptive variables included age, sex, body mass index, education, strength, and cognition. Analyses of covariance (ANCOVA) in general linear model (GLM) or multinomial logistic regression analyses were performed, as appropriate, to test the hypothesis that balance, mobility, and physical function were significantly different according to TPPM quintiles even after adjusting for relevant covariates. Those with TPPM >2.2°consistently demonstrated poor balance, mobility, and physical function. However, with increase in challenge (single leg stance, fastest walking speed, and SPPB), TPPM >1.4°was associated with significantly worse performance. In conclusion, ankle proprioceptive acuity has an overall graded relationship with objective and self-report measures of balance, mobility, and physical function. However, the cutoff proprioceptive acuity associated with substantial decline or inability to perform could depend on the challenge induced.

The aim of the present study was to examine differences in gait characteristics across the adult lifespan and to test the hypothesis that such differences are attributable at least in part to the decline in muscle strength. The data presented here are from 190 participants of the Baltimore Longitudinal Study of Aging (BLSA) aged from 32 to 93 years. Based on two age thresholds that best capture the effect of age on walking speed, participants were divided into three age groups: middle-age (32–57 years; N=27), old-age (58–78 years; N=125), and oldest-age (79–93 years; N=38). Participants were asked to walk at their preferred and maximum speeds while recorded with 3D gait analysis system. In addition, maximum isokinetic knee extensor strength was assessed. While walking at preferred speed, range of motion (ROM) and mechanical work expenditure (MWE) of the ankle were lower within middle-age (p < 0.001, p = 0.047, respectively), while hip ROM and MWE were lower (p = 0.006) and higher (p < 0.001), respectively within oldest-age with older age. Deterioration in ankle function during customary walking initiates already at middle-age. Differences in the maximum walking speed and ankle ROM between middle-age and old-age were explained by knee strength.