Gait Stability and Its Influencing Factors in Older Adults

Abstract

A stable gait pattern is a prerequisite to successfully master various activities of daily living. Furthermore, reduced gait stability is associated with a higher risk of falling. To provide specific intervention strategies to improve gait stability, gaining detailed knowledge of the underlying mechanism and influencing factors is of utmost importance. The effects of relevant influencing factors on gait stability are poorly examined, yet. Therefore, the aim of the current study was to quantify the effects of various influencing factors on gait stability. In a cross-sectional study, we assessed dynamic gait stability and relevant influencing factors in 102 older adults (age >65 years). In addition to dynamic gait stability (largest Lyapunov exponent [LLE] and gait variability measures) during normal over-ground (single-task: ST) and dual-task (DT) walking, we registered the following influencing factors: health status (SF12), pain status (painDETECT, SES), fear of falling (falls efficacy scale), depression (CES-D), cognition performance (Stroop test), physical activity (Freiburger Fragebogen zur körperlichen Aktivität), proprioception (joint position sense), peripheral sensation (mechanical and vibration detection threshold), balance performance (static balance on force plate) and muscular fitness (instrumented sit-to-stand test). We used a principal components regression to link the identified principal components with the gait stability and gait variability responses. The four principal components “strength and gender” (e.g., p = 0.001 for LLE during ST), “physical activity” (e.g., p = 0.006 for LLE during ST), “pain” (e.g., p = 0.030 for LLE during DT) and “peripheral sensation” (e.g., p = 0.002 for LLE during ST) were each significantly associated with at least two of the analyzed gait stability/variability measures. The dimension “balance” was a significant predictor in only one gait measure. While “proprioception” tends to correlate with a gait variability measure, we did not find a dependency of mental health on any gait measure. In conclusion, the participants' ability to recover from small perturbations (as measured with the largest Lyapunov exponent) seems to be related to gender and strength, the amount of physical activity the participants spent every week, peripheral sensation and pain status. Since the explained variance is still rather low, there could be more relevant factors that were not addressed, yet.

Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents

“…Gait parameters and LLE have been shown to depict reasonable construct and convergent validity (Bruijn et al 2013 ). In this study, we report stride time variability (sd) and LDS, as these parameters have been shown to be related to physical activity and balance performance in healthy and fall-prone older adults (Hamacher et al 2018 ; Hausdorff 2007 ), and have been used to characterize changes in gait due to diminished visual feedback (Hamacher et al 2016 ).…”

Measuring Gait Stability in People with Multiple Sclerosis Using Different Sensor Locations and Time Scales

“…As a basis to analyze the LDE, we reconstructed a state-space based on the threedimensional gyroscope (angular velocity) data which resulted in the highest effects in comparing the LDE of older vs. younger adults [13] and was, therefore, used in several studies (e.g., [26,27]). Since we used the calibrated gyroscope data outputted from the proprietary sensor fusion algorithm, we did not additionally implement any protocol to correct for time-dependent sensor errors.…”

Effects of 8 Weeks of Balance Training, Virtual Reality Training, and Combined Exercise on Lower Limb Muscle Strength, Balance, and Functional Mobility Among Older Men: A Randomized Controlled Trial

“…ower limb muscle strength, balance, and functional mobility are commonly occurring modifiable falls risk factors that are interrelated. 18 Deficits in 1 or more of these falls risk factors can have serious implications for older adults, such as increased risk for falls and fall-related injuries, greater dependency on others, diminished quality of life, and an increased likelihood of hospital stays. 6,12,50,55 For these reasons, multiple risk factors should be collected to better capture falls risk.…”