CLASSIFYING GAIT PATTERNS OF OLDER ADULTS BY MOVEMENT CONTROL AND BIOMECHANICAL FACTORS

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Purpose/Hypothesis: While gait patterns of older adults with mobility problems vary, the patterns are rarely used to plan interventions. The purpose of this study was to establish concurrent validity of a clinically useful classification system using gait and physical performance measures. Subjects: Community-dwelling male veterans (n=106; mean age, 76; SD, 7.1; range, 63–97 years) referred for mobility problems were videotaped for evaluation. All participants were independent in ambulation with a straight cane or no assistive device. Materials/Methods: All participants were videotaped for evaluation. We classified gait patterns using structured clinical observation and along movement control factors (consistent, inconsistent) and biomechanical factors (posture: usual, flexed, extended, crouched). Pairwise comparisons across various groups were performed to validate the gait classification using gait parameters (gait speed, step length, width and variability), lower extremity range of motion and muscle strength, physical function in ADL (Physical Performance Test, PPT) and gait abnormalities (GARS-M). Results: Consistent and inconsistent groups were different in gait speed (0.66 and 0.49m/s, respectively; p=0.003), step length (0.46 and 0.38m; p=0.008), step length variability (7.47% and 12.74%; p=0.043), the PPT (15.80 and 11.73; p<0.001) and GARS-M (5.83 and 10.66; p<0.001). Within both consistent and inconsistent groups, four groups defined by postural patterns, also differed in gait speed, step length, PPT and GARS-M scores (p<.05). Conclusions: Gait pattern classification based on movement control and biomechanical factors has good concurrent validity with respect to gait and physical performance measures of mobility. Clinical Relevance: The variability and postures determined by observation of gait by the therapists can be used to quickly identify and classify older adults with mobility problems in clinical settings, allowing for possible targeted interventions for specific gait deficits.