The 3-m Backwards Walk and Retrospective Falls: Diagnostic Accuracy of a Novel Clinical Measure

Carter, Valerie; Jain, Tarang; James, Jodi; Cornwall, Mark; Aldrich, Anne; Heer, Hendrik D. de

doi:10.1519/jpt.0000000000000149

Cited by 54 publications

(66 citation statements)

References 28 publications

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“…Subjects walked on a marked line, stepping heel to toe, and wearing casual footwear [32]. A time >4.5 s is generally considered a likely indicator of having reported falling [33].…”

Section: Dynamic Balancementioning

confidence: 99%

Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women

Serrano-Checa

Hita‐Contreras

Jiménez-García

et al. 2020

IJERPH

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Gait, dynamic balance, and functional mobility problems are well-known fall risk factors. Furthermore, sleep disturbances, anxiety, and depression are prevalent among older women. This study aimed to analyze the associations of sleep quality, anxiety, and depression with functional mobility, gait speed, and dynamic balance in community-dwelling postmenopausal women aged ≥ 60 years. A total of 271 women (69.18 ± 5.69 years) participated in this study. Functional mobility (Timed Up-and-Go Test), dynamic balance (3-meter tandem walk test), gait speed (OptoGait® optical detection system), sleep quality (Pittsburgh Sleep Quality Index), and anxiety and depression (Hospital Anxiety and Depression Scale) were assessed. Our results showed that poor sleep efficiency and the use of sleeping medication were related to decreased gait speed (R2 = 0.072). Poor functional mobility was linked to depression and the use of sleeping medication (R2 = 0.159). Additionally, increased symptoms of anxiety and depression were associated with worsened dynamic balance (R2 = 0.127). In conclusion, poorer sleep quality is associated with slower gait speed and reduced functional mobility, which is also related, along with impaired dynamic balance, to higher levels of anxiety and depression.

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“…Subjects walked on a marked line, stepping heel to toe, and wearing casual footwear [32]. A time >4.5 s is generally considered a likely indicator of having reported falling [33].…”

Section: Dynamic Balancementioning

confidence: 99%

Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women

Serrano-Checa

Hita‐Contreras

Jiménez-García

et al. 2020

IJERPH

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“…32 Independent of gait speed, a shorter step length in FW brings the center of mass closer to the lead foot and promotes recovery from a slip. 32,35 A tendency to adopt shorter steps could relate to slower walking speed during BW in those at increased fall-risk, 16 which may be a compensatory strategy to enhance stability. 32,35 Shorter steps in OBS led women to step more closely to the obstacle, but they did not correspondingly increase toe-clearance to ensure obstacle clearance.…”

Section: Discussionmentioning

confidence: 99%

“…11 Slower BW speeds in women have been attributed to shorter stride lengths and wider steps, 11 but emerging evidence suggests slower speed in BW may reflect a higher risk of falling. 16,20 Gender differences are also noted in OBS where women cross obstacles more quickly, earlier in the stride cycle, at shorter distances, and with lower limb clearances. 21 This adaptive strategy may limit the ability for older women to recover balance in case of tripping over an obstacle.…”

Section: Introductionmentioning

confidence: 98%

“…Moreover, adaptive walking ability is associated with cognitive acumen in older adults, 14 but cognitive assessments are inconsistently included in previous studies. Despite the relevance of adaptive gait performance in detecting the risk of mobility-disability, 15 fall-risk, 16 and cognitive status, 14 the question remains if performance during adaptive walking behaviors, such as backwards walking (BW) and obstacle crossing (OBS), differs between genders in older age.…”

Section: Introductionmentioning

confidence: 99%

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Older women take shorter steps during backwards walking and obstacle crossing

Raffegeau

Kellaher

Terza

et al. 2019

Experimental Gerontology

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Background: Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks. Objective: The purpose of this study was to determine gender differences in two common adaptive tasks. Methods: Walking performance was assessed from 54 age and gender matched participants (72 ± 5 yrs.) while they completed forward walking (FW), OBS and BW. Gait outcomes and the distance of the lead foot and the trail foot from the obstacle were normalized by leg length and assessed using multivariate analysis of variance. Additionally, performance in a battery of clinical physical and cognitive measures as well as self-reported activity levels were associated with adaptive gait behavior. Results: Gait speed and step width were not different between genders in any walking task. Compared to FW and OBS, women only decreased step length in BW, resulting in significantly shorter step lengths than men in OBS (p = 0.02) and BW (p = 0.04), a conservative walking strategy. Women crossed the obstacle in a manner that may limit recovery steps in case of a trip: stepping closer to the obstacle during approach without increasing trail toe-clearance. The Timed Up and Go mobility test, Short Physical Performance Battery, and Trail Making Test of processing speed and executive function were associated with gender differences in adaptive gait patterns. Conclusion: The findings revealed that older adult women adapt walking in a way that might predispose them to tripping or falling (i.e. shorter steps and closer obstacle approach). Gender differences in adaptive walking are related to functional test performance and processing speed. Clinicians should consider targeting step length during adaptive walking tasks in women that may be at risk of mobility impairments.

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“…Weiter gilt, dass -in Hinblick auf eine zunehmend alternde Bevölkerung -die Leistungsfähigkeit des motorischen Systems besondere Bedeutung hat, vor allem zur Prophylaxe von Sturzereignissen [3,4] und der sozialen Teilhabe [5,6]. Speziell zur Testung der funktionsbezogenen Leistungsfähigkeit haben sich insbesondere Funktionstests etabliert, die durch ihre Praxisbezogenheit relevante und damit verwertbare Aussagen ermöglichen [7][8][9]. In der Sportwissenschaft sind jedoch weiterhin so genannte Maximalkrafttests (engl.…”

Section: Introductionunclassified

Untersuchungen zur Funktionskapazität von Rumpfmuskeln an gesunden Probanden unterschiedlicher Altersgruppen

Anders

Hübner

Faenger

2022

Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin

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ZusammenfassungDie Studie legt Normdaten für funktionsbezogene Kraft- und Aktivierungswerte während Flexion und Extension des Oberkörpers an gesunden Vergleichspersonen beiderlei Geschlechts in unterschiedlichen Altersgruppen vor. Dafür wurden jeweils 25 weibliche und männliche Personen in den Altersgruppen 20–40 Jahre (Junge), sowie 50–70 Jahre (Ältere) untersucht. Die Untersuchungen wurden in aufrechter Körperhaltung mit 100% des Oberkörpergewichts (90° Kippung), sowie während isometrischer Maximalkraftversuche, jeweils in Flexions- und Extensionsrichtung durchgeführt. Als funktionsbezogener Kraftwert wurde das Verhältnis zwischen den Werten während der Maximalkraftversuche und 100% Oberkörpergewichts- Halteübung als Oberkörper-Kraftverhältnis (OKKV), bzw. für das Oberflächen-EMG von Rumpfmuskeln als Muskel Aktivierungsverhältnis (MAV) bestimmt. Weiterhin wurde das Extensions- zu Flexionsverhältnis der maximalen Kraftwerte bestimmt (Ex-Flex-Ratio). Generell waren die funktionellen Kraftwerte der Männer (OKKV Extension, Junge: 2,37±0,36; Ältere: 2,12±0,55, OKKV Flexion, Junge: 1,95±0,36; Ältere: 1,94±0,46) signifikant höher als die der Frauen (OKKV Extension, Junge: 1,98±0,32; Ältere: 1,60±0,38, OKKV Flexion, Junge: 1,52±0,27; Ältere: 1,59±0,33). Im Altersvergleich konnten für beide Geschlechter nur für die ältere Gruppe und hier nur für die Extensions-OKKV signifikant niedrigere Werte nachgewiesen werden (p<0,01). Infolge dessen fiel die Ex-Flex-Ratio für die älteren Probanden ab, wies aber nur für die untersuchten Frauen signifikante Altersunterschiede auf (Männer, Junge: 1,24±0,02, Ältere: 1,12±0,28; Frauen, Junge: 1,33±0,26, Ältere: 1,03±0,27, p<0,01). Die MAV-Werte können seriös nur für die untersuchten Rückenmuskeln interpretiert werden. Die Werte waren hier erneut in der älteren Gruppe signifikant niedriger als in der jungen Gruppe. Geschlechtsunterschiede waren nur für den M. longissimus (w<m p<0,01, beide Altersgruppen), nicht aber für den M. multifidus nachweisbar. Im Wertevergleich zwischen OKKV und MAV konnten altersgruppenspezifische Unterschiede mit OKKV<MAV für die Jungen und OKKV>MAV für die älteren Probanden identifiziert werden. Anhand der vorgestellten Daten konnte ein funktioneller Kraftverlust der Rückenmuskulatur mit zunehmendem Alter bei gesunden Probanden nachgewiesen werden, nicht jedoch für die Bauchmuskulatur. Die ebenfalls ermittelten Oberflächen-EMG-Kennwerte geben Hinweise auf eine veränderte Faserzusammensetzung der Rückenmuskulatur für ältere Personen.

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The 3-m Backwards Walk and Retrospective Falls: Diagnostic Accuracy of a Novel Clinical Measure

Cited by 54 publications

References 28 publications

Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women

Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women

Older women take shorter steps during backwards walking and obstacle crossing

Untersuchungen zur Funktionskapazität von Rumpfmuskeln an gesunden Probanden unterschiedlicher Altersgruppen

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