Identification of Side-Fallers from Gait Measurements

Abstract

Falls by older adults are the leading cause of injuries and trauma-related hospital admissions in the United States. Moreover, falls cause more than 90% of all hip fractures in the U.S. Most injurious falls occur while walking and the majority of hip fractures occur from a fall in the sideways direction. PURPOSE Our aim was to identify side fallers by evaluating spatial and temporal parameters of gait for elderly individuals. METHODS We recruited 139 adults over the age of 70 who were living in retirement communities in Oregon (107 females and 32 males, mean age 83.3 ± 5.6 years). A portable electronic walkway system (Gait Rite; CIR Systems, New Jersey, 07012) was used to obtain the baseline gait characteristics of participants at entry. Subjects were then followed prospectively for two years while fall characteristics were recorded. RESULTS We found no differences in gait variability by fall direction; however side-fallers exhibited narrower stride widths compared to “other-directed” fallers (0.157 ± 0.006 meters vs. 0.182 ± 0.006 meters, respectively; p= .027). Stride widths did not differ between other-direction-fallers and non-fallers. CONCLUSIONS With age, individuals develop adaptive strategies such as reducing walking speed and stride length and increasing stride width to enhance side-to-side (medial-lateral) stability. Our results indicate that elderly individuals who fall to the side exhibit decreased stride widths compared to “other-directed” fallers and non-fallers. Thus, stride width may provide a key metric that can be utilized to distinguish side-fallers from the larger population of fallers. Supported by the National Institutes of Health, AR40321-12.