Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls - Results from the Baltimore Longitudinal Study of Aging

Seung-Uk Ko; Gerald J Jerome; Eleanor M Simonsick; Luigi Ferrucci

doi:10.1016/j.gaitpost.2024.11.004

Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls - Results from the Baltimore Longitudinal Study of Aging

Gait Posture. 2024 Nov 13:115:82-85. doi: 10.1016/j.gaitpost.2024.11.004. Online ahead of print.

Authors

Seung-Uk Ko¹, Gerald J Jerome², Eleanor M Simonsick³, Luigi Ferrucci³

Affiliations

¹ Department of Mechanical Engineering, Chonnam National University, Yeosu, South Korea. Electronic address: seunguk.ko@gmail.com.
² College of Health Professions, Towson University, Towson, MD, USA.
³ Translational Gerontology Branch, National Institute on Aging (NIA/NIH), Baltimore, MD, USA.

PMID: 39566360
DOI: 10.1016/j.gaitpost.2024.11.004

Abstract

Background: Falls in older adults increase the risk of mobility loss. Proper understanding of gait mechanisms related to falls may provide novel solutions for maintaining mobility in older adults.

Research question: Identify fall-related gait patterns through analyzing alterations in gait parameters to walk faster than usual pace in older adults.

Methods: A Total of 519 participants (mean age = 73.12 years; 51.05 % female), including non-fallers (n = 396) and fallers (n = 123), aged 60-96 years were assessed in the Baltimore Longitudinal Study of Aging. Participants completed gait assessments at both usual and fast paces. Range of motions (ROM) for the hip, knee, and ankle joint in the sagittal plane and hip abductor ROM during normal and fast pace gait were measured by 3D motion capture system (Vicon 612). For all gait variables, percentage-changes (PC; (((fast-walking_parameter - usual-walking_parameter) /usual-walking_parameter)*100)) was calculated. Associations of PC for gait speed and PC for other gait parameters were compared between fallers and non-fallers.

Results: Compared to non-fallers, fallers walked with shorter stride, elongated double support time and shorter knee ROM in the faster pace walk (p = 0.044, p = 0.019, and p = 0.036, respectively). PCs of all gait related variables were significantly associated with PC of gait speed in non-fallers (ps < 0.005), while in the fallers, only PC for stride length, cadence, and hip ROM were associated with PC for gait speed (ps < 0.001).

Significance: Among non-fallers related PC for gait speed was associated with PC across gait parameters suggesting the use of similar biomechanical approaches in usual and fast gait. Compared to non-fallers, fallers demonstrated different mechanisms of transition from usual to fast gait. Evaluating speed-up strategies could provide insight into subtle yet important gait modifications in apparently well-functioning older adults that would help identify individuals at high risk of falling.

Keywords: BLSA gait lab; Falls; Speed-up strategies.