Gait Disorders and Falls

Since approximately 30% of persons over the age of 65 fall each year, prevention of falls is a very important topic. Gait disorders and diminished ability to walk safely are associated with an increased risk of falling. In older adults, falls commonly lead to injuries, institutionalization, and early death. The resultant decline in activities of daily living further contributes to loss of mobility and independence. Gait analysis using the dual-task paradigm (e.g., walking and carrying a cup of tea) offers a sensible tool for detecting older persons prone to falling. Changes in gait patterns due to simultaneously performing a secondary attention-demanding task are interpreted as interference by competing demands for attentional resources in gait control. Exercise interventions such as Jaques-Dalcroze eurhythmics address these attentional properties and aim to decrease such interference. To fully stress physical capacities in older adults, not only does automaticity of walking have to be trained, but also s...

[1]  M. E. Cress,et al.  Continuous-scale physical functional performance in healthy older adults: a validation study. , 1996, Archives of physical medicine and rehabilitation.

[2]  C. Annweiler,et al.  VITAMIN D DEFICIENCY–RELATED QUADRICEPS WEAKNESS: RESULTS OF THE EPIDÉMIOLOGIE DE L'OSTÉOPOROSE COHORT , 2009, Journal of the American Geriatrics Society.

[3]  L. Nyberg,et al.  “Stops walking when talking” as a predictor of falls in elderly people , 1997, The Lancet.

[4]  O. Beauchet,et al.  [T'ai chi in the elderly: practical aspects]. , 2003, Revue medicale de la Suisse romande.

[5]  M. Persson,et al.  Comparison of gait characteristics between older rolling walker users and older potential walker users. , 2009, Archives of gerontology and geriatrics.

[6]  Theo Mulder,et al.  Gait in ageing and associated dementias; its relationship with cognition , 2007, Neuroscience & Biobehavioral Reviews.

[7]  S B Roberts,et al.  Exercise training and nutritional supplementation for physical frailty in very elderly people. , 1994, The New England journal of medicine.

[8]  R Wytch,et al.  Instrumentation used in clinical gait studies: a review. , 1989, Journal of medical engineering & technology.

[9]  Rhonda Orr,et al.  Power training improves balance in healthy older adults. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[10]  Orthopaedic Surgeons Panel On Falls Prevention Guideline for the Prevention of Falls in Older Persons , 2001 .

[11]  Jeffrey M. Hausdorff,et al.  Gait variability and fall risk in community-living older adults: a 1-year prospective study. , 2001, Archives of physical medicine and rehabilitation.

[12]  S. Studenski,et al.  Physical Performance Measures in the Clinical Setting , 2003, Journal of the American Geriatrics Society.

[13]  Walter R. Frontera,et al.  Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial , 2008, Aging clinical and experimental research.

[14]  Nancy K Latham,et al.  Systematic review of progressive resistance strength training in older adults. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  K. Aminian,et al.  Dual-task-related gait changes in the elderly: does the type of cognitive task matter? , 2005, Journal of motor behavior.

[16]  Position Stand American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. , 2009, Medicine and science in sports and exercise.

[17]  Dwight Waddell,et al.  Temporal and spatial features of gait in older adults transitioning to frailty. , 2004, Gait & posture.

[18]  G. Fuller,et al.  Falls in the elderly. , 2000, American family physician.

[19]  Allon Goldberg,et al.  Gait disorders: search for multiple causes. , 2005, Cleveland Clinic journal of medicine.

[20]  J. Bauer,et al.  Sarcopenia and frailty: A clinician’s controversial point of view , 2008, Experimental Gerontology.

[21]  M. E. Cress,et al.  Physical activity programs and behavior counseling in older adult populations. , 2004, Medicine and science in sports and exercise.

[22]  R Honkanen,et al.  Times, places, and mechanisms of falls among the elderly. , 1991, Zeitschrift fur Gerontologie.

[23]  M. Woollacott,et al.  Attention and the control of posture and gait: a review of an emerging area of research. , 2002, Gait & posture.

[24]  Baseline indicators for measuring progress in preventing falls injury in older people , 2009, Australian and New Zealand journal of public health.

[25]  S. Studenski,et al.  Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? , 1998, Archives of physical medicine and rehabilitation.

[26]  Olivier Beauchet,et al.  Dual-Task-Related Gait Changes in , 2004, Gerontology.

[27]  Mark Latt,et al.  Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. , 2004, Gait & posture.

[28]  A. Shumway-cook,et al.  The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. , 1997, Physical therapy.

[29]  R. Lipton,et al.  Epidemiology of Gait Disorders in Community‐Residing Older Adults , 2006, Journal of the American Geriatrics Society.

[30]  R B Wallace,et al.  Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. , 1995, The New England journal of medicine.

[31]  R. Sattin Falls among older persons: a public health perspective. , 1992, Annual review of public health.

[32]  W. Renteln-Kruse,et al.  Arzneimittel und Stürze im Alter , 2009, Der Internist.

[33]  Olivier Beauchet,et al.  LONG‐TERM PRACTICE OF JAQUES‐DALCROZE EURHYTHMICS PREVENTS AGE‐RELATED INCREASE OF GAIT VARIABILITY UNDER A DUAL TASK , 2005, Journal of the American Geriatrics Society.

[34]  M. Woollacott,et al.  Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. , 2000, Physical therapy.

[35]  K. Delbaere,et al.  A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING , 2006, Acta clinica Belgica.

[36]  S. Chew,et al.  A systematic review of the effectiveness of Tai Chi on fall reduction among the elderly. , 2009, Archives of gerontology and geriatrics.

[37]  Karen Steger-May,et al.  Effects of Exercise Training on Frailty in Community‐Dwelling Older Adults: Results of a Randomized, Controlled Trial , 2002, Journal of the American Geriatrics Society.

[38]  Jeffrey M. Hausdorff,et al.  Dual‐tasking effects on gait variability: The role of aging, falls, and executive function , 2006, Movement disorders : official journal of the Movement Disorder Society.

[39]  Shobha S Rao Prevention of falls in older patients. , 2005, American family physician.

[40]  Steven L Wolf,et al.  Selected As the Best Paper in the 1990s: Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training , 2003, Journal of the American Geriatrics Society.

[41]  C. Becker,et al.  Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The Prevention of Falls Network Europe Consensus , 2005, Journal of the American Geriatrics Society.

[42]  B. E. Maki,et al.  Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear? , 1997, Journal of the American Geriatrics Society.

[43]  M. Woollacott,et al.  Changes in posture control across the life span--a systems approach. , 1990, Physical therapy.

[44]  D. Mash,et al.  Neuropathological and neuropsychological changes in "normal" aging: evidence for preclinical Alzheimer disease in cognitively normal individuals. , 1998, Journal of neuropathology and experimental neurology.

[45]  A S Duxbury,et al.  Gait disorders and fall risk: Detection and prevention , 2000, Comprehensive therapy.

[46]  Olivier Beauchet,et al.  Changes in gait while backward counting in demented older adults with frontal lobe dysfunction. , 2007, Gait & posture.

[47]  C. Bard,et al.  Attentional demands for static and dynamic equilibrium , 2004, Experimental Brain Research.

[48]  Ronald Hübner,et al.  Strategic capacity sharing between two tasks: evidence from tasks with the same and with different task sets , 2009, Psychological research.

[49]  John H Hollman,et al.  Age-related differences in dual task walking: a cross sectional study , 2008, Journal of NeuroEngineering and Rehabilitation.

[50]  Eli Carmeli,et al.  The biochemistry of aging muscle , 2002, Experimental Gerontology.

[51]  H. Minne,et al.  Vitamin D and Muscle Function , 2002, Osteoporosis International.

[52]  L. V. van Loon,et al.  Aging, exercise, and muscle protein metabolism. , 2009, Journal of applied physiology.

[53]  Kamiar Aminian,et al.  AGE‐RELATED DECLINE OF GAIT CONTROL UNDER A DUAL‐TASK CONDITION , 2003, Journal of the American Geriatrics Society.

[54]  D G Lloyd,et al.  The effect of exercise on gait patterns in older women: a randomized controlled trial. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[55]  M. Rogers,et al.  Methods to assess and improve the physical parameters associated with fall risk in older adults. , 2003, Preventive medicine.

[56]  E. Atlantis,et al.  Multi-modal exercise programs for older adults. , 2007, Age and ageing.

[57]  Jeffrey M. Hausdorff,et al.  Increased gait unsteadiness in community-dwelling elderly fallers. , 1997, Archives of physical medicine and rehabilitation.

[58]  R. Fitzpatrick,et al.  Age-related differences in walking stability. , 2003, Age and ageing.

[59]  J B Wong,et al.  Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials , 2009, BMJ : British Medical Journal.

[60]  O. Beauchet,et al.  Stride-to-stride variability while backward counting among healthy young adults , 2005, Journal of NeuroEngineering and Rehabilitation.

[61]  Gilles Berrut,et al.  Marche et double tâche : définition, intérêts et perspectives chez le sujet âgé , 2006 .

[62]  T. Oberg,et al.  Basic gait parameters: reference data for normal subjects, 10-79 years of age. , 1993, Journal of rehabilitation research and development.

[63]  M. E. Cress,et al.  Continuous-scale physical functional performance test: validity, reliability, and sensitivity of data for the short version. , 2005, Physical therapy.

[64]  Jeffrey M. Hausdorff,et al.  Influence of Executive Function on Locomotor Function: Divided Attention Increases Gait Variability in Alzheimer's Disease , 2003, Journal of the American Geriatrics Society.

[65]  S. Lord,et al.  Physical activity interventions to prevent falls among older people: update of the evidence. , 2004, Journal of science and medicine in sport.

[66]  T. Kennedy The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. , 1987, Danish medical bulletin.

[67]  O. Beauchet,et al.  Gait variability while dual-tasking: fall predictor in older inpatients? , 2008, Aging clinical and experimental research.

[68]  R. Masters,et al.  Reinvestment and Falls in Community-Dwelling Older Adults , 2008, Neurorehabilitation and neural repair.

[69]  A. N. Exton-smith,et al.  Falls in the elderly related to postural imbalance. , 1977, British medical journal.

[70]  Jeffrey M. Hausdorff Gait variability: methods, modeling and meaning , 2005, Journal of NeuroEngineering and Rehabilitation.

[71]  Arthur J. Nelson,et al.  The functional ambulation performance of elderly fallers and non-fallers walking at their preferred velocity , 1999 .

[72]  P. Harmer,et al.  Tai Chi and falls prevention in older people. , 2008, Medicine and sport science.

[73]  S. Brophy,et al.  Interventions for latent autoimmune diabetes (LADA) in adults. , 2011, The Cochrane database of systematic reviews.

[74]  Sabrina M. Tom,et al.  The Neural Correlates of Motor Skill Automaticity , 2005, The Journal of Neuroscience.

[75]  W. Frontera,et al.  Longitudinal changes in body composition in older men and women: role of body weight change and physical activity. , 2002, The American journal of clinical nutrition.

[76]  R. Cumming,et al.  Effective Exercise for the Prevention of Falls: A Systematic Review and Meta‐Analysis , 2008, Journal of the American Geriatrics Society.

[77]  Kristine Votova,et al.  Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute care settings. , 2007, Age and ageing.

[78]  A. Campbell,et al.  Risk factors for falls in a community-based prospective study of people 70 years and older. , 1989, Journal of gerontology.

[79]  G. V. I. Schenau Medicine and Sport Science : B. van Gheluwe and J. Atha (eds.), Current research in sports biomechanics. (Series eds.: M. Hebbelinck and R.J. Shephard) Vol. 25. Basel: Karger, 1987. , 1988 .

[80]  M. Fiatarone Singh,et al.  Effect of power-training intensity on the contribution of force and velocity to peak power in older adults. , 2008, Journal of aging and physical activity.

[81]  T. Hazell,et al.  Functional benefit of power training for older adults. , 2007, Journal of aging and physical activity.

[82]  G. Hunter,et al.  Effects of Resistance Training on Older Adults , 2004, Sports medicine.

[83]  A B Schultz,et al.  Stepping over obstacles: dividing attention impairs performance of old more than young adults. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[84]  M. Laurant,et al.  Effectiveness of physical activity interventions for older adults: a review. , 2002, American journal of preventive medicine.

[85]  H. Menz,et al.  Falls in Older People: Risk Factors and Strategies for Prevention , 2000 .

[86]  K. Aminian,et al.  Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults. , 2006, Human movement science.

[87]  S. Furner,et al.  Mortality, disability, and falls in older persons: the role of underlying disease and disability. , 1992, American journal of public health.

[88]  C. Annweiler,et al.  Vitamin D and muscle function: New prospects? , 2009, BioFactors.

[89]  S. Haleem,et al.  Mortality following hip fracture: trends and geographical variations over the last 40 years. , 2008, Injury.

[90]  Jeffrey M. Hausdorff,et al.  The Role of Higher-Level Cognitive Function in Gait: Executive Dysfunction Contributes to Fall Risk in Alzheimer’s Disease , 2007, Dementia and Geriatric Cognitive Disorders.

[91]  Mary C. Meyer,et al.  Maximal voluntary and functional performance levels needed for independence in adults aged 65 to 97 years. , 2003, Physical therapy.

[92]  Suzanne G. Leveille,et al.  Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[93]  R. Cumming,et al.  Quality of life related to fear of falling and hip fracture in older women: a time trade off study. , 2000, BMJ.

[94]  H. Pashler Dual-task interference in simple tasks: data and theory. , 1994, Psychological bulletin.

[95]  O. Beauchet,et al.  [Gait analysis and tailored exercise prescription in older adults]. , 2004, Zeitschrift fur Gerontologie und Geriatrie.

[96]  L. Rubenstein Falls in older people: epidemiology, risk factors and strategies for prevention. , 2006, Age and ageing.

[97]  M. Fiatarone Singh,et al.  Optimal load for increasing muscle power during explosive resistance training in older adults. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[98]  Sarah E Lamb,et al.  Interventions for preventing falls in older people living in the community. , 2012, The Cochrane database of systematic reviews.

[99]  Joseph A. Paradiso,et al.  Gait Analysis Using a Shoe-Integrated Wireless Sensor System , 2008, IEEE Transactions on Information Technology in Biomedicine.

[100]  Nancy K Latham,et al.  Progressive resistance strength training for improving physical function in older adults. , 2009, The Cochrane database of systematic reviews.

[101]  L. Rubenstein,et al.  The epidemiology of falls and syncope. , 2002, Clinics in geriatric medicine.

[102]  Luigi Ferrucci,et al.  Age-associated effects of a concurrent cognitive task on gait speed and stability during narrow-base walking. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[103]  S. Lord,et al.  Strength in the lower limbs, visual contrast sensitivity, and simple reaction time predict cognition in older women. , 1997, Psychology and aging.

[104]  Anne Moseley,et al.  A Randomized, Controlled Trial of Quadriceps Resistance Exercise and Vitamin D in Frail Older People: The Frailty Interventions Trial in Elderly Subjects (FITNESS) , 2003, Journal of the American Geriatrics Society.

[105]  R. Kressig,et al.  Die Rolle der Ganganalyse in therapeutischen Trainingsprogrammen von Betagten , 2004, Zeitschrift für Gerontologie und Geriatrie.

[106]  P. B. Baltes,et al.  Selektion, Optimierung und Kompensation in Doppelaufgaben , 2003, Der Nervenarzt.

[107]  Jeffrey M. Hausdorff,et al.  The role of executive function and attention in gait , 2008, Movement disorders : official journal of the Movement Disorder Society.

[108]  P. Haber,et al.  The Effects of Systematic Resistance Training in the Elderly , 2006, International journal of sports medicine.

[109]  E. van Rossum,et al.  Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. , 2007, Age and ageing.

[110]  Chris Todd,et al.  What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls? How should interventions to prevent falls be implemented? , 2004 .

[111]  M. Porter Power training for older adults. , 2006, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.