Fear of falling and gait parameters in older adults with and without fall history

Makino, Keitaro; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Suzuki, Takao; Shimada, Hiroyuki

doi:10.1111/ggi.13102

Cited by 68 publications

(53 citation statements)

References 33 publications

(43 reference statements)

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“…Previous research consistently identify impaired vision as an independent risk factor for falls (Gillespie et al, ; Lord et al, ), and association between lower gait speed and visual impairment is described in large populations (Swenor, Bandeen‐Roche, Munoz & West, ). Elderly with fear of falling seems to walk slower (Makino et al, ). However, these studies used standardized and validated tools assessing vision function and fear of falling.…”

Section: Discussionmentioning

confidence: 99%

Associations between gait speed and well‐known fall risk factors among community‐dwelling older adults

Kyrdalen

Thingstad

Sandvik

et al. 2018

Physiotherapy Res Intl

195

102

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Section: Discussionmentioning

confidence: 99%

Associations between gait speed and well‐known fall risk factors among community‐dwelling older adults

Kyrdalen

Thingstad

Sandvik

et al. 2018

Physiotherapy Res Intl

195

102

View full text Add to dashboard Cite

show abstract

“…Factors, such as multisensory integration contribute to alterations in the control of balance (Oie et al, 2002;Peterka, 2002). Moreover, emotions, such as fear of falling also alter the gait parameters (Maki, 1997;Makino et al, 2017), providing further evidence that muscle strength is not the only factor leading to slowed gait.…”

Section: Introductionmentioning

confidence: 97%

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

Fettrow

Reimann

Grenet

et al. 2019

Front. Sports Act. Living

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We have previously identified three balance mechanisms that young healthy adults use to maintain balance while walking. The three mechanisms are: (1) The lateral ankle mechanism, an active modulation of ankle inversion/eversion in stance; (2) The foot placement mechanism, an active shift of the swing foot placement; and (3) The push-off mechanism, an active modulation of the ankle plantarflexion angle during double stance. Here we seek to determine whether there are changes in neural control of balance when walking at different cadences and speeds. Twenty-one healthy young adults walked on a self-paced treadmill while immersed in a 3D virtual reality cave, and periodically received balance perturbations (bipolar galvanic vestibular stimulation) eliciting a perceived fall to the side. Subjects were instructed to match two cadences specified by a metronome, 110 bpm (High) and 80 bpm (Low), which in this experiment, led to faster and slower gait speeds, respectively. The results indicate that subjects altered the use of the balance mechanisms at different cadences. The lateral ankle mechanism was used more in the Low condition, while the foot placement mechanism was used more in the High condition. There was no difference in the use of the push-off mechanism between cadence conditions. These results suggest that neural control of balance is altered when gait characteristics, such as cadence change, suggesting a flexible balance response that is sensitive to the constraints of the gait cycle. We speculate that the use of the balance mechanisms may be a factor resulting in well-known characteristics of gait in populations with compromised balance control, such as slower gait speed in older adults or higher cadence in people with Parkinson's disease.

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“…While considerable evidence has linked diabetes to cortical damage in areas linked to neuropsychiatric and executive functions [ 15 ], the degree to which neuropsychological and cognitive disturbances influence gait and function in those with diabetes remains largely unknown. Moreover, older adults with diabetes may suffer from an increased fear of falling and loss of balance confidence [ 16 ], which could exacerbate gait disturbances regardless of somatosensory loss [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Multitasking in older adults with type 2 diabetes: A cross-sectional analysis

et al. 2017

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Background and purposeDeficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability.MethodsWe performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM. Multitasking was examined via the ambulatory Walking and Remembering Test (WART) and seated Pursuit Rotor Test (PRT). Self-selected normal and fast walking speed and stride length variability were quantitatively measured, and self-reported functional ability was assessed via the Late Life Function and Disability Index (LLFDI).ResultsParticipants with DM walked slower and took more steps off path when multitasking during the WART. No between-group differences in multitasking performance were observed on the PRT. Multitasking performance demonstrated little correlation with gait and functional ability in either group.Discussion and conclusionsOlder adults with DM appear to perform poorly on an ambulatory measure of multitasking. However, we analyzed a relatively small, homogenous sample of older adults with and without type 2 DM and factors such as peripheral neuropathy and the use of multiple comparisons complicate interpretation of the data. Future research should explore the interactions between multitasking and safety, fall risk, and function in this vulnerable population. Clinicians should recognize that an array of factors may contribute to gait and physical dysfunction in older adults with type 2 diabetes, and be prepared to assess and intervene appropriately.

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Fear of falling and gait parameters in older adults with and without fall history

Abstract: The present results suggest that spatial and temporal gait parameters are influenced by FOF, even in the absence of fall history. The assessment of FOF might be helpful for better understanding of age-related changes in gait control. Geriatr Gerontol Int 2017; 17: 2455-2459.

Cited by 68 publications

References 33 publications

Associations between gait speed and well‐known fall risk factors among community‐dwelling older adults

Associations between gait speed and well‐known fall risk factors among community‐dwelling older adults

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

Multitasking in older adults with type 2 diabetes: A cross-sectional analysis

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