Effect Of Activity-related Pain On Gait Characteristics During 4-meter Usual-pace Walking Across The Lifespan

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PURPOSE: Recent literature suggests activity-related pain in older adults may play a role in gait impairment and lead to declines in mobility that pose threat to older adult independence. While research shows this to be a function of adopting slower but more variable physical movements, the underlying mechanism is unclear. The purpose of this study was to test whether activity-related pain during walking plays a role in gait impairments that may be responsible for slower, more varied walking typically experienced by older adults. METHODS: 16 young (26.7±6.2 yrs), 44 middle-aged (54.5±6.7 yrs), and 40 older adults (72.6±6.1 yrs) were asked to walk 4-meters at a usual pace over a computerized gait analysis system. Gait characteristics were averaged over three trials. Self-reported pain was measured using the Borg CR10 pain scale immediately following four separate walking tasks of various intensity (5-8 min duration each). Average scores were then used to categorize people into either a pain (n=57) or no pain category (n=43). Among those reporting pain, the average self-reported scores across all activities ranged from 0.1 to 4.3 with a mean of 1.0±1.0. Regression models were used to estimate the difference of gait characteristics between those with and without pain during different walking scenarios. RESULTS: In middle-aged adults, individuals with pain had a faster gait cycle time than individuals without pain (1.2±0.1 vs 1.1±0.1 s, p=0.036), but there was no difference between those reporting pain and those not in young (p=0.622) or older adults (p=0.668). Additionally, no difference was found in walking speed, step length differential, or average base of support between individuals with and without pain across all age categories (p>0.05). CONCLUSION: While individuals with pain did have faster gait cycle than individuals without pain in middle-aged adults, this effect was not observed among older adults. However, the similarity in walk speed between individuals with and without pain in older adults may suggest the use of strategies to compensate for the walking-related pain and maintain gait characteristics. Future work is needed to investigate mid-age differences in gait cycle due to pain and possible gait-maintenance strategies as aging with pain occurs.