The degree of misjudgment between perceived and actual gait ability in older adults

Abstract

Successful execution of motor tasks requires an integration of the perception of one's physical abilities and the perception of the task itself. Physical and cognitive decline associated with ageing may lead to misjudgments of these perceived and actual abilities and possibly to errors that may lead to balance loss. We aimed to directly quantify the degree to which older adults misjudge their actual gait ability. Twenty-seven older adults participated and were instructed to walk on a narrow path projected on a treadmill. We tested two paradigms to estimate the participants' perceived gait ability: a path width manipulation, in which participants had to indicate the smallest path width that they could walk on without stepping outside or losing balance (at given speed), and a treadmill speed manipulation, in which they had to indicate the maximum speed that they could use at a given path width. We determined their actual ability as the probability of stepping inside the path over a range of path widths and speeds. The path width paradigm seemed suitable for evaluating self-perception of actual gait ability and revealed that participants appeared to show a range of misjudgment towards either over- or underestimating their actual abilities. Better abilities appeared not associated with better judgment. Direct quantification of the degree of misjudgment provides insight in the interplay between cognition and physical abilities and can be of added value towards prevention of falls and promotion of healthy ageing.

Do Older Adults Select Appropriate Motor Strategies in a Stepping-Down Paradigm?

“…The second proposition that could explain the weak association between the strategy selected by participants and the actual ability to recover, is that older adults generally have an imprecise perception of their actual abilities in relation to the task at hand. This is in accordance with previous studies investigating the discrepancy between the perceived and actual step ability (Sakurai et al, 2013 , 2016 ; Kluft et al, 2016 , 2017 ), which found that approximately one-third of older adults either over-or underestimate their abilities, when explicitly asked for their perceived ability. However, in these studies, the perceived and actual ability measures were nevertheless significantly associated, in contrast with the present result.…”

“…Two studies compared the actual ability to perform tasks to judgements of one's ability to perform these tasks (Butler et al, 2015 ; Kluft et al, 2016 ). When crossing narrow planks, almost one-third of the participating older adults showed risky behavior (Butler et al, 2015 ).…”

“…Participants who chose a too narrow plank where more likely to fall in the upcoming year, showing the importance of such information for fall risk prediction models. In order to directly quantify the degree to which older adults misjudge their physical ability, we proposed a measure to evaluate the degree of misjudgment, and found that in most older adults perceived gait ability did not match their actual physical ability (Kluft et al, 2016 ). However, it is unclear whether this degree of misjudgment results in erroneous movement behavior.…”

A Comparative Study Between Self-Perception of Walking Ability, Balance and Risk of Fall with Actual Clinical Assessment

“…When we compared between the participant's clinical assessment and their own perception of walking ability, good agreement (kappa 0.702) was observed. Although this finding was consistent with a study by Aziz et al (2014), a recent work found a contrary result (Kluft et al 2017). Kluft et al reported that the actual performance of walking and self-perception among the elderly was different.…”

Falling upward with Parkinson’s disease

“…Cross-sectional data 25 for community dwelling older people, although not with PD, indicate that with composure, appropriate fear of falling can also be a benefit of falls. The fear reduces future falls risk by helping people, who commonly misjudge their actual gait ability at older ages, 26 not to overestimate their falls efficacy (ability to maintain their balance) amid their physical limitations. From this perspective, ‘falling is not an error, it is a skill’ 27 that experience of falling can develop to release the intrinsic capability of people to make change with which they feel at ease.…”