The spatial parameters of gait and their association with falls, functional decline and death in older adults: a prospective study

Abstract

Association between spatial gait parameters and adverse health outcomes in the elderly has not been sufficiently studied. The goal of this study is to evaluate whether the stride length or the step width predict falls, functional loss and mortality. We conducted a prospective cohort study on a probabilistic sample of 431 noninstitutionalized, older-than-64-years subjects living in Spain, who were followed-up for five years. In the baseline visit, spatial gait parameters were recorded along with several control variables, with special emphasis on known medical conditions, strength, balance and functional and cognitive capacities. In the follow-up calls, vital status, functional status and number of falls from last control were recorded. We found that a normalized-to-height stride length shorter than 0.52 predicted recurrent falls in the next 6 months with 93% sensitivity and 53% specificity (AUC: 0.72), and in the next 12 months with 81% sensitivity and 57% specificity (AUC: 0.67). A normalized stride length <0.5 predicted functional loss at 12 months with a sensitivity of 79.4% and specificity of 65.6% (AUC: 0.75). This predictive capacity remained independent after correcting for the rest of risk factors studied. Step-with was not clearly related to functional loss or falls. Both shorter normalized stride length (OR1.56; AUC: 0.62; p < 0.05) and larger step width (OR1.42; AUC: 0.62; p < 0.05) were associated with risk of death at 60 months; however, none of them remained as independent predictor of death, after correcting for other risk factors. In summary, spatial gait parameters may be risk markers for adverse outcomes in the elderly. Step length is independently associated with functional loss and falls at one year, after correction for numerous known risk factors.

Validation of a Laser Ranged Scanner-Based Detection of Spatio-Temporal Gait Parameters Using the aTUG Chair

“…Based on this research, the WR can detect older people with a risk of falling who show normal gait speed. Step length, on the other hand, is associated with functional loss and falls [ 40 ]. This demonstrates the potential benefits of including additional gait parameters in a mobility analysis of older people.…”

“…Dibble et al (2006) reported an improved inter-tester reliability [38] when using automated measurements. Furthermore, as gait parameters such as cadence [39] or step length [40] can provide additional information on functional ability, automated systems should be able to identify such parameters. However, the use of such technical measurement systems have their own challenges.…”

Effects of stretching exercises on human gait: a systematic review and meta-analysis

“…evaluations by clinicians(e.g. the Tinetti test 4 or the timed up and go test 5 ), but, it can be further objectified with biomechanical analysis in a laboratory 2 . Kinetics variables (the forces that cause the body to move) must be collected in a laboratory environment with force plates (e.g.…”

“…The loss of gait or its alteration with pathological conditions are known to be related to mortality, especially in the elderly (e.g. 4,5), stressing the importance of addressing gait disorders in physiotherapy. Gait requires body propulsion and balance control for safe progression, two "subtasks" that require the coordination of multiple skeletal muscles and the integration of sensory information arising from the vestibular, visual and somatosensory systems [6][7][8] .…”

Metabolic Syndrome and Physical Performance: The Moderating Role of Cognition among Middle-to-Older-Aged Adults

“…A good deal of research demonstrates a close association between cognitive decline and mobility limitation (Ambrose et al, 2010;Mielke et al, 2013;Pedersen et al, 2014;Rodriguez-Molinero et al, 2019). For example, walking may seem like a simple task but it is quite complex.…”