Increased gait unsteadiness in community-dwelling elderly fallers

Hausdorff, Jeffrey M.; Edelberg, Helen K.; Mitchell, Susan L.; Goldberger, Ary L.; Wei, Jeanne Y.

doi:10.1016/s0003-9993(97)90034-4

Cited by 520 publications

(469 citation statements)

References 31 publications

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“…To focus on the assessment of the dynamics of continuous, 'normal' walking and each participant's 'intrinsic' dynamics and to insure that the analysis was not influenced by atypical strides, a median filter was applied to each participant's time series to remove data points that were three standard deviations greater than or less than the median value (Hausdorff, Edelberg, Mitchell, Goldberger, & Wei, 1997;Hausdorff, Rios, & Edelberg, 2001). There is typically general agreement between the values obtained before and after application of the median filter, however, occasionally important differences occur that should be considered.…”

Section: Notes On Nomenclature and Data Collection Methodsmentioning

confidence: 99%

“…Subsequently, the generated time series of stride time (and/or swing time or other parameters) can then become the input to algorithms that quantify the dynamics. For example, stride time variability, the magnitude of the stride-to-stride fluctuations in the gait cycle duration, is calculated by determining the standard deviation (SD) or the coefficient of variation (CV) of each subject's stride time time series (Maki, 1997;Hausdorff, Edelberg et al, 1997;Hausdorff, Rios et al, 2001). Similar methods can be used to study the variability of other measures of gait timing (e.g., swing time).…”

Section: Notes On Nomenclature and Data Collection Methodsmentioning

confidence: 99%

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Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

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711

594

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Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

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Section: Notes On Nomenclature and Data Collection Methodsmentioning

confidence: 99%

Section: Notes On Nomenclature and Data Collection Methodsmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

Self Cite

711

594

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“…This suggested spatial gait variability is increased when individuals are forced to modulate spatial aspects of gait at their preferred temporal frequency when dealing with increasing gait interruptions. This has significant implications, particularly for older individuals, for whom increased gait variability has been linked to increased falls risk [5,6].…”

Section: Walking Path Configuration and Duration Effects On Gait Varimentioning

confidence: 99%

“…Due to its simplicity and close relation to activities of daily living, the 6MWT has been used to represent functional capacity in chronic obstructive pulmonary disease and total knee arthroplasty patients and older individuals [1][2][3]. Conversely, measures of gait variability are more specific indicators of the neural control of gait [4] and have been used to discriminate between older fallers and nonfallers and to predict older adults at risk of falling, a major health hazard in this population [5,6].…”

Section: Introductionmentioning

confidence: 99%

Manipulating walking path configuration influences gait variability and six-minute walk test outcomes in older and younger adults

et al. 2016

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The current study determined whether manipulations to walking path configuration influenced six-minute walk test (6MWT) outcomes and assessed how gait variability changes over the duration of the 6MWT in different walking path configurations. Healthy older (ODR) and younger (YNG) (n=24) adults completed familiarisation trials and five randomly ordered experimental trials of the 6MWT with walking configurations of; 5M, 10M and 15M straight lines, a 6m by 3m rectangle (RECT), and a figure of eight (FIG8). Six-minute walk distance (6MWD) and walking speed (m.s -1 ) were recorded for all trials and the stride count recorded for experimental trials. Reflective markers were attached to the sacrum and feet with kinematic data recorded at 100Hz by a nine-camera motion capture system for 5M, 15M and FIG8 trials, in order to calculate variability in stride and step length, stride width, stride and step time and double limb support time. Walking speeds and 6MWD were greatest in the 15M and FIG8 experimental trials in both groups (p<0.01).Step length and stride width variability were consistent over the 6MWT duration but greater in the 5M trial vs. the 15M and FIG8 trials (p<0.05). Stride and step time and double limb support time variability all reduced between 10 and 30 strides (p<0.01). Stride and step time variability were greater in the 5M vs. 15M and FIG8 trials (p<0.01). Increasing uninterrupted gait and walking path length results in improved 6MWT outcomes and decreased gait variability in older and younger adults.

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“…The trunk variability measures correctly classiWed 80% of the subjects into their respective group (sensitivity = 0.75, speciWcity = 0.85). By using pressure sensors in the shoe (HausdorV et al 1995), it could be demonstrated that gait inter-cycle variability is signiWcantly higher in faller than non-fallers and young subjects (HausdorV et al 1997). Moreover, using the same sensors, it could be demonstrated that the long-range variability in gait patterns is strongly related to degree of functional impairment (HausdorV et al 2001).…”

Section: Assessment Of Balance and Gaitmentioning

confidence: 99%

Mobility assessment in older people: new possibilities and challenges

2007

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A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies in the last decades, methods have become available that use body Wxed sensors (BFS) to measure aspects of human performance under real-life conditions. These methods are based on the use of miniaturised and integrated sensors in combination with lightweight, small measuring devices that both can be carried on the body without interfering with normal behaviour. This paper addresses the potential relevance of new technology for monitoring motor function in older people, thereby speciWcally focusing on mobility assessment. After a short introduction with background information about BFS based technology, this paper identiWes areas of particular relevance, and discusses the application of ambulatory techniques for long-term monitoring of daily physical activity, fall detectors, fall risk evaluation, and assessment of motor performance such as gait and balance control. Examples are given how these techniques can become clinically relevant, particularly in the context of fall interventions for older people.

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Increased gait unsteadiness in community-dwelling elderly fallers

Cited by 520 publications

References 31 publications

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Manipulating walking path configuration influences gait variability and six-minute walk test outcomes in older and younger adults

Mobility assessment in older people: new possibilities and challenges

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