The effects of age on medio-lateral stability during normal and narrow base walking

Schrager, Matthew A.; Kelly, Valerie E.; Price, Robert; Ferrucci, Luigi; Shumway-Cook, Anne

doi:10.1016/j.gaitpost.2008.02.009

Cited by 178 publications

(139 citation statements)

References 21 publications

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“…In fatigued conditions, Yentes and collaborators [22] observed that stride length was longer in patients with COPD (possibly due to increased tibialis anterior fatigability), and step width decreased with fatigue instead of increasing as in the healthy controls-the Authors ascribed opposite results obtained from previous observations to a different approach in computing step width [23]. Changes in step width were associated to fall risk [31,32]. Therefore, this pattern could be a sign of instability due to a smaller base of support, and can be explained by a reduced control of balance in the medio-lateral direction due to greater center of pressure and hip angular displacements [7,22,23,33].…”

Section: Spatiotemporal Parametersmentioning

confidence: 97%

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

et al. 2018

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Background: Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. Research question: Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. Methods: In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool. Results: Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level. Significance: A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD.

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Section: Spatiotemporal Parametersmentioning

confidence: 97%

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

et al. 2018

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“…The TWT test has been utilized as the dynamic walking balance component of several validated test batteries regarding fall prediction in the elderly, such as the Fullerton Advanced Balance Scale [3,4], the LIFE pilot study protocol [5], Good Walkers Test [6], and the EPIDOS Prospective Study balance protocol [7]. The TWT has been utilized as a test of dynamic walking balance to determine gait stability and pathological quantification including prediction of falls in the elderly population [3,9,[34][35][36][37][38][39][40], diagnose ataxia and other vestibular disorders [29,41], test for vertigo [42], tropical ataxic neuropathy [43], traumatic brain injury [40], peripheral neuropathy [44], and functional mobility [45][46][47][48]. The TWT is considered a clinically efficacious test of dynamic balance in medical text books [29,49] and for research purposes [2,50].…”

Section: Introductionmentioning

confidence: 99%

Concurrent validation of the tandem walk test as a measure of dynamic walking balance in a healthy population

Robertson¹,

Gregory²

2017

Phys Ther Rehabil

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Background: The purpose of this study was to determine the possible concurrent validity of the tandem walk test as a measure of dynamic walking balance. Methods: Forty-nine healthy participants, age range 20-75 years (mean age 40.1 ± 17.1 years), performed the ten step tandem walk test and two clinical tests of dynamic balance using the Biodex Balance System (Biodex Medical Systems, Shirley, NY) dynamic limits of stability protocol and measures of gait variability assessed through gait center of pressure, spatial, and temporal parameters derived from an instrumented treadmill (h/p/cosmos sports & medical gmbh, Nussdorf-Traunstein, Germany; Zebris FDM-T, Isny im Allgau, Germany). Results: A moderate-high correlation was demonstrated between the ten step tandem walk test eyes open and measures of gait variability, step width (r=0.64 p<0.05) and step time variability ( r=0.67 p<0.05), age (r=0.69 p<0.05), and Biodex Balance System dynamic limits of stability (r=0.81 p<0.05). A moderate relationship was found between the ten step tandem walk test eyes open and measures of gait center of pressure variability (r=0.52 p<0.05). Correlation coefficient values between the ten step tandem walk test eyes open and Biodex Balance System dynamic limits of stability, gait temporal, center of pressure, and spatial parameters demonstrated increased strength when adjusted for age. Conclusion: The ten step tandem walk test demonstrated a moderate to high relationship with clinical tests of dynamic balance: Biodex Balance System dynamic limits of stability and gait center of pressure, spatial, and time parameters in a healthy population demonstrating concurrent validity as an objective measure of dynamic walking balance in a healthy population between the ages of 20 and 75 years.

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“…For instance, in an effort to improve anterior -posterior balance, adults walk with a slower speed, shorter step length and greater stance time [26,27]. In order to enhance medial -lateral balance, adults walk with a wider step width by maintaining a larger distance between the heels or toes [26,28,29]. Together, changes in the mean magnitude of these parameters illustrate that individuals modify their gait patterns as a precaution to a future decrease in balance.…”

Section: Experiments 1: Introductionmentioning

confidence: 99%

Neuromuscular strategies for the transitions between level and hill surfaces during walking

Gottschall

Nichols

2011

Phil. Trans. R. Soc. B

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Despite continual fluctuations in walking surface properties, humans and animals smoothly transition between terrains in their natural surroundings. Walking transitions have the potential to influence dynamic balance in both the anterior -posterior and medial -lateral directions, thereby increasing fall risk and decreasing mobility. The goal of the current manuscript is to provide a review of the literature that pertains to the topic of surface slope transitions between level and hill surfaces, as well as report the recent findings of two experiments that focus on the neuromuscular strategies of surface slope transitions. Our results indicate that in anticipation of a change in surface slope, neuromuscular patterns during level walking prior to a hill are significantly different from the patterns during level walking without the future change in surface. Typically, the changes in muscle activity were due to co-contraction of opposing muscle groups and these changes correspond to modifications in head pitch. In addition, further experiments revealed that the neck proprioceptors may be an initial source of feedback for upcoming surface slope transitions. Together, these results illustrate that in order to safely traverse varying surfaces, transitions strides are functionally distinct from either level walking or hill walking independently.

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The effects of age on medio-lateral stability during normal and narrow base walking

Cited by 178 publications

References 21 publications

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review

Concurrent validation of the tandem walk test as a measure of dynamic walking balance in a healthy population

Neuromuscular strategies for the transitions between level and hill surfaces during walking

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