Age-related changes in spatial and temporal gait variables

Grabiner, Penny C.; Biswas, Supreeti; Grabiner, Mark D.

doi:10.1053/apmr.2001.18219

Cited by 179 publications

(157 citation statements)

References 15 publications

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“…This finding supports the idea that changes in fractal scaling are largely a reflection of central nervous system impairment, and not simply a reflection of a slower walking speed. Moreover, as mentioned, there are many studies that have demonstrated that measures of variability and dynamics are more sensitive to underlying, sometimes subtle changes, better discriminators of 'healthy' and 'sick' populations, and more successful at predicting events such as falls (Frenkel-Toledo et al, 2005a;Grabiner, Biswas, & Grabiner, 2001;Hausdorff, Edelberg et al, 1997;Hausdorff, Rios et al, 2001;Maki, 1997;Nakamura et al, 1996;Sheridan et al, 2003). While there is a relationship between measures of variability and average values, the one does not always fully represent the other.…”

Section: Gait Speed and Gait Dynamicsmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

707

594

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Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

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Section: Gait Speed and Gait Dynamicsmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

707

594

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“…Age differences between OY cohorts were classified into four categories: mean age difference less than 40 years [66]; between 40 and less than 45 years [8,35] between 45 and 50 [34,59,64,65,67,68,[76][77][78][79][80][81]; and greater than 50 [6,63,82 -84].…”

Section: Statistical Heterogeneitymentioning

confidence: 99%

“…After screening, 29 articles were considered eligible for inclusion in this review (figure 1). Twenty-one studies considered research questions focussed on OY [6,8,34,35,52,59,[63][64][65][66][67][68][76][77][78][80][81][82][83][84][85], whereas only 10 studies were designed to assess FNF [5,8,35,53,60,62,[72][73][74][75]. Granata & Lockhart [35] and Khandoker et al [8] presented a combination of both cohort comparisons within the same study.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…of step width [64,77,80,81,85], s.d. of stride time [64,77] and CV of stride velocity [63,82,84] had large mean Cohen's d (.1) values (figure 4), suggesting sufficient sensitivity of these conventional parameters to age-related differences. In addition, although reported only once, CV of MinFC showed the highest ES (ES ¼ 2.98) [34].…”

Section: Old Versus Young Comparisonsmentioning

confidence: 99%

“…[8,34,35,64,65,73,[76][77][78]80,81,85] and were assigned to the high-cost category (table 2). Seventeen measures were determined using a foot/floor mat [52,59,60,63,75,82,84] (medium cost), while 20 measures used foot switches or a portable insole plantar pressure measurement system [5,6,53,68,74] (medium cost).…”

Section: Costs/devicesmentioning

confidence: 99%

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

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

324

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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Striatal Dopamine Denervation Impairs Gait Automaticity in Drug‐Naïve Parkinson's Disease Patients

et al. 2020

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BackgroundGait automaticity, which is impaired in patients with Parkinson's disease (PD), can be quantified by gait variability analysis. Among the 3 regions of the striatum (sensorimotor, executive, and limbic), the sensorimotor region may play a crucial role in motor automaticity in healthy individuals. However, neural correlates of impaired gait automaticity are poorly investigated in PD.ObjectiveWe aimed to examine the relationship between gait automaticity and striatal dopaminergic depletion in drug‐naïve PD patients.MethodsA total of 21 drug‐naïve PD patients and 12 healthy controls were enrolled. Gait parameters were measured via wearable inertial sensors under fast‐paced gait or cognitive dual‐task conditions, and their respective coefficient of variation (CV) and dual‐task cost were calculated. The extent of striatal dopaminergic depletion was evaluated by dopamine transporter (DAT) imaging with single‐photon emission computed tomography using N‐ω‐fluoropropyl‐2β‐carbomethoxy‐3β‐(4‐[123I]iodophenyl)nortropane. Correlation between DAT uptake and gait variables was analyzed using the region‐of‐interest analysis for the 3 right or left striatal regions and voxel‐based analysis.ResultsPD had higher mean bilateral CV and dual‐task cost of stride length than healthy controls. The mean bilateral CV of stride length was negatively correlated with DAT uptake in the bilateral executive regions of the striatum. Voxel‐based analysis revealed a negative correlation between the mean bilateral CV of stride length and DAT uptake in the anteromedial striatum.ConclusionsDopaminergic denervation in the anteromedial striatum, a part of the executive region, is associated with impaired gait automaticity in drug‐naïve PD patients. This region may compensate for the posterior sensorimotor striatum, maintaining gait automaticity. © 2020 International Parkinson and Movement Disorder Society

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Age-related changes in spatial and temporal gait variables

Cited by 179 publications

References 15 publications

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

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

Striatal Dopamine Denervation Impairs Gait Automaticity in Drug‐Naïve Parkinson's Disease Patients

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