Local dynamic stability and variability of gait are associated with fall history in elderly subjects.

Gait parameters that can be measured with simple instrumentation may hold promise for identifying individuals at risk of falling. Increased variability of gait is associated with increased risk of falling, but research on additional parameters indicates that local dynamic stability (LDS) of gait may also be a predictor of fall risk. The objective of the present study was to assess the association between gait variability, LDS of gait and fall history in a large sample of elderly subjects. Subjects were recruited and tested at a large national fair. One hundred and thirty four elderly, aged 50-75, who were able to walk without aids on a treadmill, agreed to participate. After subjects walked on a treadmill, LDS (higher values indicate more instability) and variability parameters were calculated from accelerometer signals (trunk worn). Fall history was obtained by self-report of falls in the past 12 months. Gait variability and short-term LDS were, individually and combined, positively associated with fall history. In conclusion, both increased gait variability and increased short-term LDS are possible risk factors for falling in the elderly.

[1]  R. Schmidt.  Motor Schema Theory after 27 Years: Reflections and Implications for a New Theory , 2003, Research quarterly for exercise and sport.

[2]  P. Beek,et al.  Maximum Lyapunov exponents as predictors of global gait stability: a modelling approach. , 2012, Medical engineering & physics.

[3]  N. Nagelkerke,et al.  A note on a general definition of the coefficient of determination , 1991 .

[4]  Peter J. Beek,et al.  Statistical precision and sensitivity of measures of dynamic gait stability , 2009, Journal of Neuroscience Methods.

[5]  R. van Emmerik,et al.  On the Functional Aspects of Variability in Postural Control , 2002, Exercise and sport sciences reviews.

[6]  Jonathan B Dingwell,et al.  Influence of simulated neuromuscular noise on the dynamic stability and fall risk of a 3D dynamic walking model. , 2011, Journal of biomechanics.

[7]  F. Ando,et al.  Frequencies and circumstances of falls in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). , 2000, Journal of epidemiology.

[8]  Jaap H van Dieën,et al.  Sensitivity of trunk variability and stability measures to balance impairments induced by galvanic vestibular stimulation during gait. , 2011, Gait & posture.

[9]  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.

[10]  J. Dingwell,et al.  Influence of simulated neuromuscular noise on movement variability and fall risk in a 3D dynamic walking model. , 2010, Journal of biomechanics.

[11]  Cédric Annweiler,et al.  Gait Variability among Healthy Adults: Low and High Stride-to-Stride Variability Are Both a Reflection of Gait Stability , 2009, Gerontology.

[12]  D. Sternad,et al.  Local dynamic stability versus kinematic variability of continuous overground and treadmill walking. , 2001, Journal of biomechanical engineering.

[13]  M S Redfern,et al.  Biomechanics of slips , 2001, Ergonomics.

[14]  S. Studenski,et al.  Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed , 2005, Journal of NeuroEngineering and Rehabilitation.

[15]  N. Stergiou,et al.  Nonlinear dynamics indicates aging affects variability during gait. , 2003, Clinical biomechanics.

[16]  D. Sternad,et al.  Slower speeds in patients with diabetic neuropathy lead to improved local dynamic stability of continuous overground walking. , 2000, Journal of biomechanics.

[17]  Thurmon E Lockhart,et al.  Differentiating fall-prone and healthy adults using local dynamic stability , 2008, Ergonomics.

[18]  A. Hof,et al.  Assessment of spatio-temporal gait parameters from trunk accelerations during human walking. , 2003, Gait & posture.

[19]  Jonathan B Dingwell,et al.  Comparison of different state space definitions for local dynamic stability analyses. , 2009, Journal of biomechanics.

[20]  Jeffrey M. Hausdorff.  Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking. , 2007, Human movement science.

[21]  H. Kaiser.  A second generation little jiffy , 1970 .

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

[23]  Jonathan B Dingwell,et al.  Dynamic stability of superior vs. inferior segments during walking in young and older adults. , 2009, Gait & posture.

[24]  J. Dingwell,et al.  Effects of walking speed, strength and range of motion on gait stability in healthy older adults. , 2008, Journal of biomechanics.

[25]  J. Dingwell,et al.  Nonlinear time series analysis of normal and pathological human walking. , 2000, Chaos.

[26]  Richard E.A. van Emmerik,et al.  On the functional aspects of variability in postural control. , 2002 .

[27]  M. Bobbert,et al.  Push-off reactions in recovery after tripping discriminate young subjects, older non-fallers and older fallers. , 2005, Gait & posture.

[28]  Peter J Beek,et al.  The validity of stability measures: a modelling approach. , 2011, Journal of biomechanics.

[29]  J. Smit,et al.  Consequences of falling in older men and women and risk factors for health service use and functional decline. , 2004, Age and ageing.

[30]  P. Beek,et al.  The effects of arm swing on human gait stability , 2010, Journal of Experimental Biology.

[31]  P. Beek,et al.  Is slow walking more stable? , 2009, Journal of biomechanics.