Comparison of gait patterns in elderly fallers and non-fallers

Kwon, Moonseok; Kwon, Yuri; Park, Yang-Sun; Kim, Jiwon

doi:10.3233/thc-174736

Cited by 65 publications

(58 citation statements)

References 36 publications

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“…Dual-task gait in Huntington's disease falls in other populations [45]. Although we did not find gait variability parameters to be associated with falls in the present study, perhaps due the low sample size, further prospective studies with larger subject numbers might find that increased gait variability may potentially serve as a marker or predictor of future fallers and thus have clinical utility.…”

Section: Movement Transition Movement Transition Movement Transitioncontrasting

confidence: 78%

The effects of dual-task cognitive interference on gait and turning in Huntington’s disease

et al. 2020

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Huntington's disease (HD) is characterized by motor, cognitive, and psychiatric dysfunction. HD progression causes loss of automaticity, such that previously automatic tasks require greater attentional resources. Dual-task (DT) paradigms and fast-paced gait may stress the locomotor system, revealing deficits not seen under single-task (ST). However, the impact of gait "stress tests" on HD individuals needs further investigation. Therefore, the aims of this study were to investigate whether: 1) fast-paced and dual-task walking uncover deficits in gait and turning not seen under single-task, 2) cognitive and gait outcomes relate to fall incidence, and 3) gait deficits measured with wearable inertial sensors correlate with motor symptom severity in HD as measured by the Unified Huntington's disease Rating Scaletotal motor score (UHDRS-TMS). Seventeen HD (55 ± 9.7 years) and 17 age-matched controls (56.5 ± 9.3 years) underwent quantitative gait testing via a 25m, two-minute walk test with APDM TM inertial sensors. Gait was assessed under a 1) ST, self-selected pace, 2) fastas-possible (FAP) pace, and 3) verbal fluency DT. The UHDRS-TMS and a cognitive test battery were administered, and a retrospective fall history was obtained. During ST, DT, and FAP conditions, HD participants demonstrated slower gait, shorter stride length, and greater lateral step and stride length variability compared to controls (p<0.00001 to 0.034). Significant dual-task costs (DTC) were observed for turns; HD participants took more time (p = 0.013) and steps (p = 0.028) to complete a turn under DT compared to controls. Higher UHDRS-TMS correlated with greater stride length variability, less double-support, and more swing-phase time under all conditions. Decreased processing speed was associated with increased gait variability under ST and FAP conditions. Unexpectedly, participant's selfreported falls did not correlate with any gait or turn parameters. HD participants demonstrated significantly greater DTC for turning, which is less automatic than straight walking, requiring coordination of body segments, anticipatory control, and cortical regulation. Turn complexity likely makes it more susceptible to cognitive interference in HD. (2020) The effects of dualtask cognitive interference on gait and turning in Huntington's disease. PLoS ONE 15(1): e0226827.Huntington's disease (HD) is an autosomal dominant, neurodegenerative disease caused by an expanded CAG repeat (�40 repeats, full-penetrance) in the gene for the huntingtin protein (HTT), though symptoms may also occur in some with CAG repeat lengths � 36 (reduced penetrance range) [1]. The expansion results in aggregation of insoluble mutant HTT (mHTT) in neurons, the most vulnerable being striatal medium spiny neurons (MSNs) of the basal ganglia [2]. Ultimately, the proteinaceous aggregates disrupt neuronal function, causing cell death and subsequent motor dysfunction [3]. The progression of HD results in gait and balance impairment which can lead to an increased fall risk [4]. In addition to...

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Section: Movement Transition Movement Transition Movement Transitioncontrasting

confidence: 78%

The effects of dual-task cognitive interference on gait and turning in Huntington’s disease

et al. 2020

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“…In our study, patients with INPH may also increase the stance phase and the double-support period to stabilize their inefficient gait control. It has been suggested that both the stance phase and double-limb support are stabilizing factors during normal gait in the elderly 47 .…”

Section: Discussionmentioning

confidence: 99%

Quantitative Gait Analysis and Cerebrospinal Fluid Tap Test for Idiopathic Normal-pressure Hydrocephalus

Lim

Park

et al. 2019

Sci Rep

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We investigated gait performance utilizing a quantitative gait analysis for 2 groups: (1) idiopathic normal-pressure hydrocephalus (INPH) patients who had a positive response to the cerebrospinal fluid tap test (CSFTT) and (2) healthy controls. The aims of the study were (1) to analyze the characteristics of gait features, (2) to characterize changes in gait parameters before and after the CSFTT, and (3) to determine whether there was any relationship between stride time and stride length variability and Frontal Assessment Battery (FAB) scores in INPH patients. Twenty-three INPH patients and 17 healthy controls were included in this study. Compared with healthy controls, the gait of INPH patients was characterized by lower velocity, shorter stride length, and more broad-based gait. Patients with INPH had a longer stance phase with increased double-limb support. Variability in stride time and stride length was increased in INPH patients. Stride time and stride length variability were correlated with FAB score. After the CSFTT, gait velocity, stride length, and step width significantly improved. There were significant decreases in stride time and stride length variability. These results suggest that the CSFTT for INPH patients might improve the so-called balance-related gait parameter (ie, step width) as well. Stride time and stride length variability also responded to the CSFTT. Association between FAB scores and both stride time and stride length variability suggests involvement of similar circuits producing gait variability and frontal lobe functions in INPH patients.

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“…From this list, and other variables especially in the U-turn (111), the developed algorithms will be able to provide a risk score combining static and dynamic measures. On the basis of previous results (112), it is likely that the analysis of temporo-spatial variables of gait can effectively distinguish fallers from non-fallers in elderly institutionalized population. The SEM and the MDC of gait velocity were measured at 6.5 and 18.1% at their maximum, respectively, while the variability of the other gait parameters could be higher (113).…”

Section: Discussionmentioning

confidence: 93%

Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study

Quijoux

Bertin-Hugault²,

Zawieja³

et al. 2021

Front. Digit. Health

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Introduction: While falls among the elderly is a public health issue, because of the social, medical, and economic burden they represent, the tools to predict falls are limited. Posturography has been developed to distinguish fallers from non-fallers, however, there is too little data to show how predictions change as older adults' physical abilities improve. The Postadychute-AG clinical trial aims to evaluate the evolution of posturographic parameters in relation to the improvement of balance through adapted physical activity (APA) programs.Methods: In this prospective, multicentre clinical trial, institutionalized seniors over 65 years of age will be followed for a period of 6 months through computer-assisted posturography and automatic gait analysis. During the entire duration of the follow-up, they will benefit from a monthly measurement of their postural and locomotion capacities through a recording of their static balance and gait thanks to a software developed for this purpose. The data gathered will be correlated with the daily record of falls in the institution. Static and dynamic balance measurements aim to extract biomechanical markers and compare them with functional assessments of motor skills (Berg Balance Scale and Mini Motor Test), expecting their superiority in predicting the number of falls. Participants will be followed for 3 months without APA and 3 months with APA in homogeneous group exercises. An analysis of variance will evaluate the variability of monthly measures of balance in order to record the minimum clinically detectable change (MDC) as participants improve their physical condition through APA.Discussion: Previous studies have stated the MDC through repeated measurements of balance but, to our knowledge, none appear to have implemented monthly measurements of balance and gait. Combined with a reliable measure of the number of falls per person, motor capacities and other precipitating factors, this study aims to provide biomechanical markers predictive of fall risk with their sensitivity to improvement in clinical status over the medium term. This trial could provide the basis for posturographic and gait variable values for these elderly people and provide a solution to distinguish those most at risk to be implemented in current practice in nursing homes.Trial Registration: ID-RCB 2017-A02545-48.Protocol Version: Version 4.2 dated January 8, 2020.

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Comparison of gait patterns in elderly fallers and non-fallers

Cited by 65 publications

References 36 publications

The effects of dual-task cognitive interference on gait and turning in Huntington’s disease

The effects of dual-task cognitive interference on gait and turning in Huntington’s disease

Quantitative Gait Analysis and Cerebrospinal Fluid Tap Test for Idiopathic Normal-pressure Hydrocephalus

Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study

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