Development and Decline of Upright Gait Stability

Iosa, Marco; Fusco, Augusto; Morone, Giovanni; Paolucci, Stefano

doi:10.3389/fnagi.2014.00014

Cited by 100 publications

(108 citation statements)

References 104 publications

(170 reference statements)

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“…More recently, many researchers have started to use less-expensive wearable and optoelectronic devices [5], devoting more attention to the entire locomotor system, including the upper body (not only lower limbs) [6], and highlighting the need of measuring few clinically meaningful benchmarks of human gait, such as stability, symmetry, and harmony [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Stability and Harmony of Gait in Patients with Subacute Stroke

et al. 2016

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Stroke affects many gait features, such as gait stability, symmetry, and harmony. However, it is still unclear which of these features are directly altered by primary damage, and which are affected by the reduced walking speed. The aim of this study was to analyze the above gait features in patients with subacute stroke with respect to the values observed in age- and speed-matched healthy subjects. A wearable triaxial accelerometer and an optoelectronic device were used for assessing the upright gait stability, symmetry of trunk movements, and harmonic structure of gait phases by means of the root-mean-square (RMS) acceleration of the trunk, harmonic ratio (HR), and gait ratios (GRs), respectively. For healthy subjects, results showed that RMS acceleration increased with speed, HR peaked at a comfortable speed, and GRs tended towards the theoretical value of the golden ratio for speeds >1 m/s. At matched speed conditions, patients showed higher instabilities in the latero-lateral axis (p = 0.001) and reduced symmetry of trunk movements (p = 0.002). Different from healthy subjects, antero-posterior and latero-lateral acceleration harmonics were coupled in patients (R = 0.507, p = 0.023). Conversely, GRs were not more altered in patients than in slow-walking healthy subjects. In conclusion, patients with stroke showed some characteristics similar to those of the elderly when the latter subjects walk slowly, and some altered characteristics, such as increased latero-lateral instabilities coupled with movements performed along the antero-posterior axis.

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Section: Introductionmentioning

confidence: 99%

Stability and Harmony of Gait in Patients with Subacute Stroke

et al. 2016

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“…Even more dramatic changes are noted beyond the sixth decade of life. Along with the functional impairments imposed by sarcopenia, are the associated escalations in health care costs, along with coincident rises in metabolic diseases (e.g., Type 2 diabetes, obesity) and a greater risk of falls (67). In the U.S., it is expected that those 65 years of age and over will comprise ϳ20% of the population, or ϳ72 million people, by the year 2030 (20).…”

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confidence: 99%

Mitochondria, Muscle Health, and Exercise with Advancing Age

2015

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Skeletal muscle health is dependent on the optimal function of its mitochondria. With advancing age, decrements in numerous mitochondrial variables are evident in muscle. Part of this decline is due to reduced physical activity, whereas the remainder appears to be attributed to age-related alterations in mitochondrial synthesis and degradation. Exercise is an important strategy to stimulate mitochondrial adaptations in older individuals to foster improvements in muscle function and quality of life.Heather N. Carter, Chris C. W. The process of aging exploits the malleable nature of skeletal muscle. The age-related loss of muscle mass was termed sarcopenia, based on the Greek (sarx, flesh) and (penia, poverty) in 1988 (139). Accompanying this loss are profound architectural and molecular changes that alter muscle quality and are manifested in functional limitations. Decreases in muscle fiber number as well as fiber cross-sectional area are both contributing factors to sarcopenia (92) and consequently adversely affect force production (strength) (46, 63) and endurance of the older individual (12). Muscle mass typically peaks in the mid-20s (12, 34,92), and thereafter several distinct phases of muscle loss have been identified. In the third to fifth decade of life, a slow rate of muscle mass loss is noted, amounting to ϳ10% in total (34,92). In later adulthood (Ͼ45 yr), the rate of muscle loss increases, with appraisals ranging between 0.5 and 1.4% per year (12, 34,69). Even more dramatic changes are noted beyond the sixth decade of life. Along with the functional impairments imposed by sarcopenia, are the associated escalations in health care costs, along with coincident rises in metabolic diseases (e.g., Type 2 diabetes, obesity) and a greater risk of falls (67). In the U.S., it is expected that those 65 years of age and over will comprise ϳ20% of the population, or ϳ72 million people, by the year 2030 (20). Since the proportion of older adults is increasing, continued research into the mechanisms of muscle loss is warranted, along with the investigation of therapeutic strategies that can mitigate muscle atrophy during aging. Mitochondria have been implicated as potential mediators of sarcopenia. Recently, it has been suggested that dysfunction of these organelles can be considered a feature of aging (105). However, considerable controversy exists regarding the extent to which muscle mitochondria may be dysfunctional with aging, and thereby contribute to the loss of this tissue. Thus the purpose of this review is to examine the literature with respect to mitochondrial content and function in muscle with advancing age, and provide a perspective on the effectiveness of endurance/aerobic exercise as an intervention for mitochondrial biogenesis and muscle homeostasis in older individuals. Structural Features of Muscle Relevant to SarcopeniaIn young, healthy individuals, skeletal muscle comprises ϳ40% of total body mass and is important for locomotion and whole body metabolism. Myosin ATPase histochemistry and electrop...

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“…Gait instability has been identified as a relatively consistent risk factor for falls, 19 and inactivity and comorbidity are strong predictors for falls in older individuals compared to active, ostensibly healthy age-matched controls. 20 Some underlying medical conditions, such as stroke and arthritis, are also recognized risk factors for falls.…”

Section: Discussionmentioning

confidence: 99%

A multicenter retrospective study on falls in elderly population. Epidemiology and impact on hospital workload in two Emergency Departments of Northern Italy

Cervellin¹,

Montali²,

Campaniello³

et al. 2014

Emerg Care J

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Aims of this study were to evaluate the incidence of falls in subjects aged ≥65 years in Parma Province (Northern Italy), and the burden of fall-related hospitalizations. All the Emergency Department (ED) visits for domestic or trivial falls were retrieved from the database of the two EDs of Parma Province during 2013. All cases were classified according to age and gender. Out of 129,898 total ED visits, 3720 (2.9%) were related to trivial falls in patients aged ≥65 years. Females accounted for 2648 visits and males for 1072. The absolute number of visits due to falls increased with age in both genders, with a peak between 80 and 84 yrs. When related with the actual number of residents by age groups, females showed a continuous increase, peaking at age >100 yrs, and males a continuous increase, peaking at age 95-99 yrs. Of these patients, 963 (25.9%) needed hospitalization, 605 in the orthopedic ward, 342 in medical wards, and 16 in specialist surgical units. In conclusion, falls represent a major cause of morbidity in the elderly in Northern Italy, representing 13.3% of the ED visits for people aged ≥65, with a high impact on hospital workload.

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Development and Decline of Upright Gait Stability

Cited by 100 publications

References 104 publications

Stability and Harmony of Gait in Patients with Subacute Stroke

Stability and Harmony of Gait in Patients with Subacute Stroke

Mitochondria, Muscle Health, and Exercise with Advancing Age

A multicenter retrospective study on falls in elderly population. Epidemiology and impact on hospital workload in two Emergency Departments of Northern Italy

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