Abstract
Considering that most of the falls in elderly population arise during walking, tests derived from walking performance would be desirable for comprehensive fall risk assessment. The analysis of spatial temporal parameters and the center of pressure displacement, which represents the interaction between the human body and the ground, would be beneficial. The aim of this study was to compare spatial temporal gait parameters and their variability and the variability of the center of pressure displacement between elderly fallers and nonfallers during gait at self-selected, defined and fast speeds. A prospective study design was used. At the baseline, measurements of ground reaction force during gait at self-selected, defined and fast walking speeds by two force plates were performed. In addition, the Tinetti balance assessment tool, the Falls Efficacy Scale-International and the Activities-Specific Balance Confidence Scale were used. Mean and coefficient of variation of spatial temporal gait parameters and standard deviations of center of pressure displacement during loading response, midstance, terminal stance and preswing phases were calculated. Comparison of the fallers and nonfallers exhibited no significant difference in clinical tool, scales or spatial temporal parameters. Compared to nonfallers’ increased variability of walking speed at self-selected and defined speed, step width at fast walking speed and center of pressure displacement during preswing phase in medial-lateral directions at defined walking speed was found in fallers. However, application of the Holm-Bonferroni procedure for multiple comparisons exhibited no significant effect of group in any of the gait parameters. In general, our study did not observe an effect of group (fallers vs. nonfallers) on variability of spatial temporal parameters and center of pressure movement during gait. However, walking speed, step width as well as standard deviation of COP displacement in the medial-lateral direction during preswing exhibited a certain potential for distinguishing between elderly fallers and nonfallers.
Highlights
In the scientific community, there is a growing body of research investigating procedures to determine fall risk
We did not find any significant difference between fallers and nonfallers for the Tinetti balance assessment tool, the Falls Efficacy Scale-International and the Activitiesspecific Balance Confidence Scale
Spatial temporal gait parameters variables showed no significant difference between elderly fallers and nonfallers for the three walking speeds (Table 2)
Summary
There is a growing body of research investigating procedures to determine fall risk. Clinical balance tests, such as the Berg Balance Scale [1], the Functional Reach Test [2], and the Timed ‘Up & Go’ test [2], are insufficient to predict fallers in the elderly population. Numerous studies have used an assessment of postural stability during standing with the assumption that postural stability has a direct relationship to fall history even though most falls are associated with movement activities. Some authors confirmed that postural stability measures can determine fallers and nonfallers in healthy older adults. Some authors reported no significant difference in postural stability measures between groups of fallers and nonfallers [2]
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