[Gait analysis and tailored exercise prescription in older adults].

Examining gait characteristics in older adults enhances our understanding of movement control in this population and helps to better target preventive interventions. Walking is a highly automated, regular motor behavior that is mostly controlled by subcortical locomotor brain regions. With increasing age, walking requires higher levels of attention and thus more cortical involvement in motor control. This can affect gait regularity by increasing stride-to-stride variability that is characteristically high among fallers. A growing number of clinical gait analysis systems is now available to determine gait variability and thus the falling risk in older adults. Interventions targeting high gait variability in older adults need to consider basic principles of motor learning. Previously common and automatic gait patterns have to be relearned and again brought up to a highly automated level of motor control. Regular walking exercise, and particularly T'ai Chi with its emphasis on sequenced, slow, and highly controlled movements, might be helpful in this relearning process. Further research is needed to explore other interventions that could favorably affect stride-to-stride variability of older adults.

[1]  D. Winter,et al.  Biomechanical walking pattern changes in the fit and healthy elderly. , 1990, Physical therapy.

[2]  S. Simon Gait Analysis, Normal and Pathological Function. , 1993 .

[3]  S. Wolf,et al.  Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training , 1996, Journal of the American Geriatrics Society.

[4]  Hidetada Sasaki,et al.  Relationship between falls and stride length variability in senile dementia of the Alzheimer type. , 1996, Gerontology.

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

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

[7]  S. Wolf,et al.  Exploring the basis for Tai Chi Chuan as a therapeutic exercise approach. , 1997, Archives of physical medicine and rehabilitation.

[8]  T. Gill Preventing Falls: To Modify the Environment or the Individual? , 1999, Journal of the American Geriatrics Society.

[9]  K. Doya,et al.  Parallel neural networks for learning sequential procedures , 1999, Trends in Neurosciences.

[10]  R W Sattin,et al.  Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty , 2001, Journal of the American Geriatrics Society.

[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. Wolf,et al.  Exploring Guidelines for the Application of T'ai Chi to Patients With Stroke , 2001 .

[13]  M. Morris,et al.  Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. , 2003, Gait & posture.

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

[15]  J. Judge,et al.  Balance training to maintain mobility and prevent disability. , 2003, American journal of preventive medicine.