Balance Performance and Step Width in Noninstitutionalized, Elderly, Female Fallers and Nonfallers

Abstract

The purposes of this study were to compare age, static balance performance, and step-width variables between elderly noninstitutionalized women with and without a history of falls and to determine the relationship between balance performance and step width. Each subject performed a maximum of three timed trials on the sharpened Romberg and one-legged stance tests with eyes open and with eyes closed. The first and best trial measurements were used for analysis. Each subject walked on paper walkways making ink prints for step-width measurements. The mean and the variability of each subject's step-width measurements were used for analysis. Data from 110 women, aged 60 to 89 years, were analyzed. The fallers (n = 26) had significantly lower values than the nonfallers (n = 84) on the best trial of the sharpened Romberg test in the eyes-open condition (t = 1.98, df = 108, p less than .05). No significant differences between fallers and nonfallers were revealed in age, the mean and variability of step width, the first trials of the balance tests, and the best trials on the other balance tests. For the total group, the mean measurements on the first trials were significantly lower than those on the best trials for each balance test. Small, but statistically significant (p less than .05), negative relationships existed between balance performance and the mean and variability of step width. The results of this study indicate that the methods of measuring balance and step width are clinically applicable, and the data of patients from a similar population sample may be compared with the data established in this study.

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

“…Studies with faller category 2 and faller category 1 reported variability of step width with similar ES values [5,8,53,60,72,73]; however, studies with faller category 4 [35] and faller category 1 [5,53] reported variability of step length, with ESs for step length with faller category 4 being considerably higher than that for faller category 1. None of the studies reporting gait variability incorporated a faller category 5 for their studies (figure 2).…”

“…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.…”

“…In this review, however, less than one-half of the articles reviewed accounted for gender differences [5,6,53,[63][64][65][66][67]72,74,80,84]. Four of the 10 FNF studies [5,53,72,74] and 10 of the 21 OY studies [6,34,63 -67,76,80,84] met this criterion and thus avoided introducing possible bias (even though none of the studies reported any gender interaction effects). FNF comparisons conducted by Hausdorff et al [5], Heitmann et al [72] and Maki [53] not only assessed gait stability in gender-matched cohorts but also in age-matched cohorts (table 3), thus avoiding any possible secondary bias.…”

Effect of ankle-foot orthosis on roll-over shape in adults with hemiplegia

“…Gabell and Nayak suggested that an increase in mean step width indicates a lack of compensation for disturbances causing instability [25]. Heitmann et al demonstrated a negative correlation between balance performance and step width means and variability in elderly females [26]. If step width indicates stability, then the significant decrease in step width that occurred when the AFO was worn might suggest improved stability.…”

Variability in the Timing of Stepping Movement.

“…In addition the variability of stride length was minimal at a certain speed and a certain cadence (Sekiya et al, 1997). In women aged over 60, variability in foot width was negatively correlated with balancing abil ity (Heitmann et al 1989). Further, in terms of energy consumption, there was a study on the optimal cadence of walking speed (Zarrugh and Radcliffe, 1978).…”