Gait variability while dual-tasking: fall predictor in older inpatients?

Kressig, Reto W.; Herrmann, François; Grandjean, Raphael; Michel, Jean‐Pierre; Beauchet, Olivier

doi:10.1007/bf03324758

Cited by 103 publications

(103 citation statements)

References 37 publications

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“…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.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

333

281

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Falls not only present a considerable health threat, but the resulting treatment and loss of working days also place a heavy economic burden on society. Gait instability is a major fall risk factor, particularly in geriatric patients, and walking is one of the most frequent dynamic activities of daily living. To allow preventive strategies to become effective, it is therefore imperative to identify individuals with an unstable gait. Assessment of dynamic stability and gait variability via biomechanical measures of foot kinematics provides a viable option for quantitative evaluation of gait stability, but the ability of these methods to predict falls has generally not been assessed. Although various methods for assessing gait stability exist, their sensitivity and applicability in a clinical setting, as well as their cost-effectiveness, need verification. The objective of this systematic review was therefore to evaluate the sensitivity of biomechanical measures that quantify gait stability among elderly individuals and to evaluate the cost of measurement instrumentation required for application in a clinical setting. To assess gait stability, a comparative effect size (Cohen's d ) analysis of variability and dynamic stability of foot trajectories during level walking was performed on 29 of an initial yield of 9889 articles from four electronic databases. The results of this survey demonstrate that linear variability of temporal measures of swing and stance was most capable of distinguishing between fallers and non-fallers, whereas step width and stride velocity prove more capable of discriminating between old versus young (OY) adults. In addition, while orbital stability measures (Floquet multipliers) applied to gait have been shown to distinguish between both elderly fallers and non-fallers as well as between young and old adults, local stability measures (ls) have been able to distinguish between young and old adults. Both linear and nonlinear measures of foot time series during gait seem to hold predictive ability in distinguishing healthy from fall-prone elderly adults. In conclusion, biomechanical measurements offer promise for identifying individuals at risk of falling and can be obtained with relatively low-cost tools. Incorporation of the most promising measures in combined retrospective and prospective studies for understanding fall risk and designing preventive strategies is warranted.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

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

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

333

281

View full text Add to dashboard Cite

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“…This documents the strong connection between motor performance, cognition and fall risk. Gait performance assessed during dual task conditions represents a marker for fall risk as well as cognitive disorders such as dementia (Amboni, Barone, & Hausdorff, 2013;Kressig, Herrmann, Grandjean, Michel, & Beauchet, 2008; Montero-Odasso, Verghese, Beauchet, & Hausdorff, 2012;Verghese et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Imaging gait analysis: An fMRI dual task study

et al. 2017

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“…4,14 The aging process is accompanied by alterations in the spatial and temporal parameters of gait, 14 such as reductions in gait speed and step length, as well as increases in step variability, double support time and step width, 4,12,15 all of which have been correlated with a higher incidence of falls. 5,6,[16][17][18][19][20][21] An assessment of these parameters is generally used to identify abnormalities in an individual's gait. 22 While several gait parameters (reduced speed, reduced step length and increased double support time) can reflect impairment and are correlated with a fear of falls, step variability is the indicator that provides the best representation of postural instability.…”

Section: Introductionmentioning

confidence: 99%

“…24 Greater step variability (greater gait irregularity) in isolation, without the need to perform a simultaneous task, has also been shown to be a strong fall predictor among community-dwelling elderly individuals. 16 Step time addresses the control and regularity of the rhythm of gait.…”

Section: Introductionmentioning

confidence: 99%

Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters

Gomes

Teixeira-Salmela

Freitas

et al. 2016

Rev. bras. geriatr. gerontol.

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Introduction: The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives: To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method: Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results: A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway® system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion: The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.

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Gait variability while dual-tasking: fall predictor in older inpatients?

Abstract: ABSTRACT. Background and aims: Increased gait variability is associated with a high risk of falling in old- (OR 13.3, p=0.018 for usual walking; OR 8.6, (Aging Clin Exp Res 2008; 20: 123-130)

Cited by 103 publications

References 37 publications

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

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

Imaging gait analysis: An fMRI dual task study

Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters

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