Stride dynamics, gait variability and prospective falls risk in active community dwelling older women
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Background: Measures of walking instability such as stride dynamics and gait variability have been shown to identify future fallers in older adult populations with gait limitations or mobility disorders. This study investigated whether measures of walking instability can predict future fallers (over a prospective 12 month period) in a group of healthy and active older women. Methods: Ninety-seven healthy active women aged between 55 and 90 years walked for 7min around a continuous walking circuit. Gait data recorded by a GAITRite® walkway and foot-mounted accelerometers were used to calculate measures of stride dynamics and gait variability. The participant's physical function and balance were assessed. Fall incidence was monitored over the following 12 months. Results: Inter-limb differences (p≤0.04) in stride dynamics were found for fallers (one or more falls) aged over 70 years, and multiple fallers (two or more falls) aged over 55 years, but not in non-fallers or a combined group of single and non-fallers. No group differences were found in the measures of physical function, balance or gait, including variability. Additionally, no gait variable predicted falls. Conclusions: Reduced coordination of inter-limb dynamics was found in active healthy older fallers and multiple fallers despite no difference in other measures of intrinsic falls risk. Evaluating inter-limb dynamics may be a clinically sensitive technique to detect early gait instability and falls risk in high functioning older adults, prior to change in other measures of physical function, balance and gait.
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