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Bridging the Gap between Clinical and Behavioural Gerontology Part I: Promoting Late-Life ...

Editor's Choice - Free Access

Laboratory Review: The Role of Gait Analysis in Seniors’ Mobility and Fall Prevention

Bridenbaugh S.A. · Kressig R.W.

Author affiliations

Department of Acute Geriatrics, University Hospital of Basel, Basel, Switzerland

Corresponding Author

Dr. Stephanie A. Bridenbaugh

Basel Mobility Center, Acute Geriatrics

University Hospital Basel

Schanzenstrasse 55, CH–4031 Basel (Switzerland)

Tel. +41 61 328 6882, Fax +41 61 265 3883, E-Mail bridenbaughs@uhbs.ch

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Gerontology 2011;57:256–264

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Abstract

Walking is a complex motor task generally performed automatically by healthy adults. Yet, by the elderly, walking is often no longer performed automatically. Older adults require more attention for motor control while walking than younger adults. Falls, often with serious consequences, can be the result. Gait impairments are one of the biggest risk factors for falls. Several studies have identified changes in certain gait parameters as independent predictors of fall risk. Such gait changes are often too discrete to be detected by clinical observation alone. At the Basel Mobility Center, we employ the GAITRite electronic walkway system for spatial-temporal gait analysis. Although we have a large range of indications for gait analyses and several areas of clinical research, our focus is on the association between gait and cognition. Gait analysis with walking as a single-task condition alone is often insufficient to reveal underlying gait disorders present during normal, everyday activities. We use a dual-task paradigm, walking while simultaneously performing a second cognitive task, to assess the effects of divided attention on motor performance and gait control. Objective quantification of such clinically relevant gait changes is necessary to determine fall risk. Early detection of gait disorders and fall risk permits early intervention and, in the best-case scenario, fall prevention. We and others have shown that rhythmic movement training such as Jaques-Dalcroze eurhythmics, tai chi and social dancing can improve gait regularity and automaticity, thus increasing gait safety and reducing fall risk.

© 2010 S. Karger AG, Basel


References

  1. Lewin R: Human Evolution. An Illustrated Introduction, ed 3. Cambridge, Blackwell Scientific, 1993, pp 208.
  2. Hausdorff JM, Zemany L, Peng C, Goldberger AL: Maturation of gait dynamics: stride-to-stride variability and its temporal organization in children. J Appl Physiol 1999;86:1040–1047.
  3. Woollacott M, Shumway-Cook A: Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002;16:1–14.
  4. Beauchet O, Berrut G: Gait and dual-task: definition, interest, and perspectives in the elderly (in French). Psychol Neuropsychiatr Vieil 2006;4:215–225.
    External Resources
  5. Laessoe U, Hoeck HC, Simonsen O, Voigt M: Residual attentional capacity amongst young and elderly during dual and triple task walking. Hum Mov Sci 2008;27:496–512.
  6. Winter DA, Patla AE, Frank JS, Walt SE: Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther 1990;70:340–347.
  7. Menz HB, Lord SR, Fitzpatrick RC: Age-related differences in walking stability. Age Ageing 2003;32:137–142.
  8. Inouye SK, Studenski S, Tinetti ME, Kuchel GA: Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55:780–791.
  9. Tinetti ME, Kumar C: The patient who falls: ‘it’s always a trade-off’. JAMA;303:258–266.
  10. Dellinger AM, Stevens JA: The injury problem among older adults: mortality, morbidity and costs. J Safety Res 2006;37:519–522.
  11. Centers for Disease Control and Prevention: Falls among older adults: fact sheets. 2009. http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.
  12. Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG: Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist 1994;34:16–23.
  13. Hausdorff JM, Rios DA, Edelberg HK: Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 2001;82:1050–1056.
  14. Alexander BH, Rivara FP, Wolf ME: The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health 1992;82:1020–1023.
  15. Sterling DA, O’Connor JA, Bonadies J: Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma 2001;50:116–119.
  16. Rubenstein LZ: Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35(suppl 2):ii37–ii41.
    External Resources
  17. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ: Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997;26:189–193.
  18. Scott V, Votova K, Scanlan A, Close J: Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute care settings. Age Ageing 2007;36:130–139.
  19. Maki BE: Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc 1997;45:313–320.
  20. Hausdorff JM, Edelberg HK, Mitchell SL, Goldberger AL, Wei JY: Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil 1997;78:278–283.
  21. Clarkson BH: Absorbent paper method for recording foot placement during gait: suggestion from the field. Phys Ther 1983;63:345–346.
  22. Wilkinson MJ, Menz HB: Measurement of gait parameters from footprints: a reliability study. Foot 1997;7:19–23.
    External Resources
  23. Kressig RW, Beauchet O: Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res 2006;18:174–176.
  24. Helbostad JL, Moe-Nilssen R: The effect of gait speed on lateral balance control during walking in healthy elderly. Gait Posture 2003;18:27–36.
  25. Lundin-Olsson L, Nyberg L, Gustafson Y: ‘Stops walking when talking’ as a predictor of falls in elderly people. Lancet 1997;349:617.
  26. Tombu M, Jolicoeur P: A central capacity sharing model of dual-task performance. J Exp Psychol Hum Percept Perform 2003;29:3–18.
  27. Huang HJ, Mercer VS: Dual-task methodology: applications in studies of cognitive and motor performance in adults and children. Pediatr Phys Ther 2001;13:133–140.
  28. Abernethy B: Dual-task methodology and motor skills research: some applications and methodological constraints. J Hum Mov Stud 1988;14:101–132.
    External Resources
  29. Yogev-Seligmann G, Hausdorff JM, Giladi N: The role of executive function and attention in gait. Mov Disord 2008;23:329–342, quiz 472.
  30. Pashler H: Dual-task interference in simple tasks: data and theory. Psychol Bull 1994;116:220–244.
  31. Sheridan PL, Solomont J, Kowall N, Hausdorff JM: Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer’s disease. J Am Geriatr Soc 2003;51:1633–1637.
  32. Allali G, Kressig RW, Assal F, Herrmann FR, Dubost V, Beauchet O: Changes in gait while backward counting in demented older adults with frontal lobe dysfunction. Gait Posture 2007;26:572–576.
  33. Dubost V, Kressig RW, Gonthier R, Herrmann FR, Aminian K, Najafi B, Beauchet O: Relationships between dual-task-related changes in stride velocity and stride time variability in healthy older adults. Hum Mov Sci 2006;25:372–382.
  34. Snijders AH, Verstappen CC, Munneke M, Bloem BR: Assessing the interplay between cognition and gait in the clinical setting. J Neural Transm 2007;114:1315–1321.
  35. Bloem BR, Valkenburg VV, Slabbekoorn M, van Dijk JG: The multiple tasks test: strategies in Parkinson’s disease. Exp Brain Res 2001;137:478–486.
  36. Beauchet O, Kressig RW, Najafi B, Aminian K, Dubost V, Mourey F: Age-related decline of gait control under a dual-task condition. J Am Geriatr Soc 2003;51:1187–1188.
  37. Verghese J, Buschke H, Viola L, Katz M, Hall C, Kuslansky G, Lipton R: Validity of divided attention tasks in predicting falls in older individuals: a preliminary study. J Am Geriatr Soc 2002;50:1572–1576.
  38. Beauchet O, Dubost V, Gonthier R, Kressig RW: Dual-task-related gait changes in transitionally frail older adults: the type of the walking-associated cognitive task matters. Gerontology 2005;51:48–52.
  39. Bloem BR, Steijns JA, Smits-Engelsman BC: An update on falls. Curr Opin Neurol 2003;16:15–26.
  40. Kressig RW, Herrmann FR, Grandjean R, Michel JP, Beauchet O: Gait variability while dual-tasking: fall predictor in older inpatients? Aging Clin Exp Res 2008;20:123–130.
  41. Beauchet O, Dubost V, Allali G, Gonthier R, Hermann FR, Kressig RW: ‘Faster counting while walking’ as a predictor of falls in older adults. Age Ageing 2007;36:418–423.
  42. Ebersbach G, Dimitrijevic MR, Poewe W: Influence of concurrent tasks on gait: a dual-task approach. Percept Mot Skills 1995;81:107–113.
  43. Kressig RW, Allali G, Beauchet O: Long-term practice of Jaques-Dalcroze eurhythmics prevents age-related increase of gait variability under a dual task. J Am Geriatr Soc 2005;53:728–729.
  44. Trombetti A: Music-based multitask exercises (Jaques-Dalcroze eurhythmics) improves gait and balance and reduces fall risk in the elderly. Presented at the 4th European GAITRite Meeting, Basel, 2009.
  45. Verghese J: Cognitive and mobility profile of older social dancers. J Am Geriatr Soc 2006;54:1241–1244.
  46. Lavery LL, Studenski SA: Tai chi, falls, and the heritage of jags. J Am Geriatr Soc 2003;51:1804–1805.
  47. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T: Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996;44:489–497.
  48. Tinetti ME, Richman D, Powell L: Falls efficacy as a measure of fear of falling. J Gerontol 1990;45:P239–P243.
  49. Molinari M, Leggio MG, de Martin M, Cerasa A, Thaut M: Neurobiology of rhythmic motor entrainment. Ann NY Acad Sci 2003;999:313–321.
  50. Hayden R, Clair AA, Johnson G, Otto D: The effect of rhythmic auditory stimulation (RAS) on physical therapy outcomes for patients in gait training following stroke: a feasibility study. Int J Neurosci 2009;119:2183–2195.
  51. Assal F, Allali G, Kressig RW, Herrmann FR, Beauchet O: Galantamine improves gait performance in patients with Alzheimer’s disease. J Am Geriatr Soc 2008;56:946–947.

Article / Publication Details

First-Page Preview
Abstract of Bridging the Gap between Clinical and Behavioural Gerontology Part I: Promoting Late-Life ...

Published online: October 27, 2010
Issue release date: April 2011

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 1

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: https://www.karger.com/GER


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