Is foot clearance influenced by different types of dual task in once-only faller community-dwelling older adults?

Abstract

BackgroundTripping is one of the main causes of falls in older adults and has an important association with minimum toe clearance (MTC). MTC variability while performing alternating (ADT) or concurrent (CDT) dual-task activities may be a useful gait parameter to differentiate once-only fallers from non-faller older adults. Research questionIs the MTC variability influenced by ADT and CDT in once-only faller community-dwelling older adults? MethodsTwenty-two community-dwelling older adults with a self-report of up to one fall in the last 12 months were allocated to the fallers group and 38 to the non-fallers group. Gait data were collected by two foot-worn inertial sensors (Physilog® 5, GaitUp, Lausanne, Switzerland). MTC mean magnitude and variability, as well as the stride-to-stride variability, stride time and length, lower limb peak angular velocity, and foot forward linear speed at the MTC instant, were calculated across approximately 50 gait cycles for each participant and condition using the GaitUp Analyzer software (GaitUp, Lausanne, Switzerland). The statistical analyzes were performed in the Statistical Package for the Social Sciences (SPSS), v.22.0, using generalized mixed linear models, adopting an alpha of 5%. Results and SignificanceNo interaction effect was observed; however, faller participants reduced the MTC variability (standard deviation) [(mean difference, MD = −0.099 cm; confidence interval, 95%CI = −0.183 to −0.015)], regardless of the condition. CDT compared to a single task (only gait) reduced the mean magnitude of the foot forward linear speed (MD=−0.264 m/s; 95%CI=−0.462 to −0.067), peak angular velocity (MD = −25.205 degrees/s; 95%CI = −45.507 to −4.904), and gait speed (MD = −0.104 m/s; 95%CI = −0.179 to −0.029), regardless of the group. These results suggest that MTC variability, regardless of condition, may be a promising gait parameter to differentiate once-only faller community-dwelling older adults from non-fallers.