Relationships between gait properties on soft surfaces, physical function, and fall risk for the elderly

Shinichi Demura,Shunsuke Yamaji,Sohee Shin,Shinji Takahashi

doi:10.4236/aar.2013.22008

Abstract

The plantar aspect change caused by contact with soft surfaces creates and unstable gait and increases the risk of falling, especially in the elderly. This study aimed to analyze gait property by three-dimensional motion analysis on soft and normal surfaces and to clarify the relationship with physical function and fall risk. Twenty-four older people aged 65-88 years old and living independently without any assistive device (7 men, 17 women) performed 5 m of walking with own maximal speed on normal and soft surface walkways. The soft surface walkway used was a low rebound urethane foam mattress. The three-dimensional kinematic gait analysis by sixteen anatomic points was used to evaluate gait property on both walkways. The gait property on soft surfaces tended to be swinging up and down in each joint and to largely lean left and right as compared with the normal surface. Moreover, it tended to decrease in a step length and to increase in a step width. All gait parameters on soft surfaces correlated significantly with functional reach. On the other hand, that on normal surface correlated significantly with leg strength. Gait properties on soft surfaces which changes in plantar aspect during foot contact differs from those on normal surfaces. Walking on soft surfaces may cause an unanticipated inverted pendulum sway supporting a foot contact point because of the disturbance by a sagging walkway; in short, requiring more effort to keep a body balanced. In conclusion, gait on the soft surfaces requires balance ability (functional reach) rather than leg strength.

Highlights

Prolongation of independent life for the elderly and control of the marked increased rate of medical expenses are key tasks in Japan, which has become a super aging society
This study examined whether the gait properties and their relationship with the fall risk score and leg functions differ between those on the soft surface which changes the plantar aspect during foot contact and on the normal surface
Takenaka and Uechi [16] reported that sex differences were not found in walking velocity and fall self-efficacy scale for people 61 - 91 years of age

Summary

Introduction

Prolongation of independent life for the elderly and control of the marked increased rate of medical expenses are key tasks in Japan, which has become a super aging society. Mobility is one of the most basic skills necessary to keep an independent daily life. Their falls bring about serious problems related to the decline of quality of life, such as the bedridden state caused by bone fractures, and the decline of activity range and volume due to the fear of falling. It was reported that more than one third of the elderly over 70 years of age living independently in communities experience a fall at least once a year, and their fall occur during walking or transfer movement [1]. The risk of falling increases when a person lacks the ability to adapt to surface environment changes (e.g. tilt, difference in floor height, slipperiness, and hardness change) [2,3,4]

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Conclusion