Gait In Elderly People Research Articles

Virtual rehabilitation is better than conventional physical therapy to improve the functionality of the gait in elderly people? Systematic review and meta-analysis

Virtual rehabilitation is better than conventional physical therapy to improve the functionality of the gait in elderly people? Systematic review and meta-analysis

Association between cognition and gait in elderly people: The putamen as a shared substrate

AbstractBackgroundCognitive impairment and gait disturbance are both prevalent in elderly people. However, few studies have focused on the underlying mechanisms in the relationship between cognition and gait. The aim of our study is to contrast the strength of correlations between each cognitive domain and gait parameters in a community‐dwelling population, as well as giving a new insight into the shared neuroimaging signature of cognitive impairment and gait disturbance.MethodIn the cross‐sectional population‐based Taizhou Imaging Study, 733 older adults with a mean (SD) age of 63.9 (3.1) years accepted brain MRI, neuropsychological tests and wearable gait tracking devices for quantitative gait analysis. Global cognitive function and individual cognitive domains (memory, executive function, language, visuospatial skill) were assessed using the Mini‐Mental State Examination, auditory verbal learning test (with>6 years of education), modified Fuld Object Memory Evaluation (with≤6 years of education), conflicting instructions task, clock drawing test and animal fluency test. Dementia and mild cognitive impairment (MCI) were diagnosed according to DSM‐5 criteria and the Petersen criteria. The volume of brain regions was analyzed by Freesurfer.ResultOf the 733 participants, 500 (68.2%) were cognitive normal, 182 (24.8%) were diagnosed as MCI, 51 (7.0%) were diagnosed as dementia. Gait parameters, including gait velocity, stride length and cadence, were significantly different among three cognition groups (P<0.001). In fully adjusted linear regression models, global cognitive function and each cognitive domain were significantly associated with gait parameters. Executive function demonstrated the strongest association with gait (β: 0.149‐0.206, P<0.001), which remained significant when adjusted for memory, language and visuospatial skill. The volume of putamen was the only region that was related to both executive function (β=0.103, P=0.007) and gait velocity (β=0.107, P=0.007). Mediation analysis confirmed a mediating role of putaminal atrophy in the association between executive function and gait velocity.ConclusionCognitive function is associated with gait performance in community‐dwelling elderly individuals. Executive function had the strongest association with gait among cognitive domains, which is supported by a shared substrate including putaminal atrophy. Future longitudinal studies with neuroimaging techniques are needed to further confirm our findings.

Parkinsonian gait in elderly people: Significance of the threshold value of two and more falls per year.

Parkinsonism in the elderly presents a major risk factor for recurrent falls (2 and more falls per year), which is associated with increased morbidity. The main objective was to investigate explanatory variables relating to the risk of being recurrent fallers (RF) in persons with parkinsonian gait. Seventy-nine among 172 eligible persons were enrolled in this prospective study, the findings of which were analyzed at 12 months. Motor and non-motor features, as well as follow-up interviews to identify falls, loss of ability to walk, fluctuating cognition, traumatic falls, all-cause hospitalizations and deaths were collated and results compared between non RF (zero and one fall per year) and RF. Bayesian model averaging was used to predict the probability of patients being RF from their medical history as well as from cognitive assessment, gait velocity, vision and posture. N=79, 0.58 men, 50% had Parkinson's disease, 14% other neurodegenerative parkinsonian syndrome, 23% vascular parkinsonism and 13% Lewy body disease, 58% were RF. Median age 81.2 years and median MMSE 25/30. A history of falls and of hallucinations, median odds ratio respectively 9.06 (CI 2.34-38.22), 4.21 (CI 1.04-18.67) were associated with the highest odds ratios along with fluctuating cognition and abnormal posture. Two or more falls a year was a relevant threshold to distinguish a population with a high risk of comorbidity. The whole history of falls, hallucinations and fluctuating cognition can be considered predictive of recurrent falls in elderly people with parkinsonian gait and provide a tracking tool for patient management.

Identifying the Effects of Assistive and Resistive Guidance on the Gait of Elderly People Using a Smart Walker.

Progression of technology has expanded applications of smart walkers in clinical fields. However, it is essential to investigate the effects of different types of gait guidance in order to introduce smart walkers more widely throughout these fields. The purpose of this study was to identify the effects of assistive and resistive guidance on the gait of elderly people using a smart walker. Gait parameters, surface electromyography of lower limb muscles, and trunk acceleration were measured. The assistive guidance force significantly increased gait speed, step length, and cadence while increasing trunk acceleration variability. The same amount of resistive guidance force did not change gait parameters; instead, however, it restrained the speed-dependent increase of trunk acceleration variability in the mediolateral direction. An analysis of muscle activity suggested that the lower limb muscle activity could be increased by varying gait parameters including speed, step length, and cadence.

Effect of a modified grip angle of a walker on the wrist deviation angle, muscle activation and palmar load during walker-assisted gait in elderly people.

[Purpose] The aim of this study was to develop a new handle holder by modifying the inclination of the existing handle holder to reduce load on the wrist joints. [Subjects and Methods] The subjects of this study consisted of 25 elderly people aged 65 years or older accustomed to a walker-assisted gait. Two types of handle holders ((1) standard handle holder (2) inclination handle holder) were applied to all subjects and their wrist joint movement and muscle activity were measured while they conducted 10 cycle walker-assisted gait. [Results] The use of an inclination handle holder during the walker-assisted gait decreased considerably the extensor carpi radialis longus activity and angles of the ulnar deviation and wrist extension. [Conclusion] Improvements in the overall structure of a walker may be a new tool for improving existing walker users but the replacement cost will be expensive. The inclination handle holder presented in this study decreases the burden on the wrist joints of walker users without any overall structural changes in the walker, thereby reducing the occurrence of musculoskeletal diseases of the wrist joint during the walker-assisted gait of elderly people.

Effect of speed on the weight transfer between legs during gait in elderly people

Effect of speed on the weight transfer between legs during gait in elderly people

The effects of balance training and ankle training on the gait of elderly people who have fallen.

[Purpose] The aim of this study was to examine the effects of balance training and muscle training around the ankle joints on the gait of elderly people who have experienced a fall. [Subjects] Twenty-six elderly people with a risk of falling and a Berg Balance Scale score of 37 to 50 points who had experienced a fall in the last year were randomly and equally assigned to either a balance training group or an ankle training group. The balance training group received training on a hard floor, training while maintaining balance on a cushion ball in a standing position, and training while maintaining balance on an unstable platform in a standing position; the ankle training group received training to strengthen the muscles around the ankle joints and conducted stretch exercise for the muscles around the ankle joints. [Results] There were significant changes in gait velocity, step length, and stride length in the balance training group after the intervention; there were significant changes in gait velocity, cadence, step time, cycle time, step length, and stride length in the ankle training group after the intervention. In a between-group comparison, the gait velocity of the balance training group showed a significant improvement compared with the ankle training group. [Conclusion] Both balance training and ankle joint training are effective in enhancing the gait ability of elderly people with a risk of falling; in particular, balance training is effective in improving the gait velocity of elderly people who have experienced a fall compared with ankle joint training.

The effects of isometric trunk exercises and dynamic trunk exercises on gait in elderly people.

The purpose of this study was to compare the effects of dynamic trunk exercises and isometric trunk exercises on gait in elderly people. [Subjects] This study randomly allocated 20 elderly people to an isometric trunk exercise group (n=10) and a dynamic trunk exercise group (n=10). The exercises were performed for 30 minutes three times a week for 12 weeks. Gait speed, stride length, cadence, and step width were measured at a normal pace using GAITRite. All groups were evaluated before and after 12 weeks. [Results] The isometric exercise group showed a significant change in gait velocity, cadence, and left and right step lengths. The dynamic trunk exercise group showed a significant change in gait velocity, cadence, left and right step lengths, left and right step times, and left and right stride lengths. Moreover, a comparison of the exercise effect between the two groups showed a significant difference in gait velocity. [Conclusion] The results of this study suggest that isometric trunk exercises and dynamic trunk exercises have a positive effect on gait function in elderly people. In particular, isometric trunk exercises are recommended to promote gait velocity.

2D47 歩行中の空間的注意分布に関する高齢者の特異的傾向(OS12-4:傷害とその予防・軽減のバイオメカニクス(4))

2D47 歩行中の空間的注意分布に関する高齢者の特異的傾向(OS12-4:傷害とその予防・軽減のバイオメカニクス(4))

Effects of Rollator Handle Type on Plantar Foot Pressure During Gait by Elderly Women

[Purpose] The purpose of this study was to investigate the effect of handle type, which is a fundamental element determining rollator type and the part that directly connects the user to a rollator, on the plantar foot pressure of elderly people during gait, and to examine how the gait of elderly people is affected by variation of the rollator handle. [Subjects] The subjects of this study were 12 elderly women over the age of 65 and 10 young adults who were given sufficient explanation about the objectives and method of this study and volunteered to participate in the study. [Methods] The elderly women learned how to use different types of rollators and performed gait without a rollator and with two types of rollators in a random order on a course that was 10 m long. The young adults, who served as the reference for the plantar foot pressure during gait, performed gait in the same manner without a rollator. [Results] The plantar foot pressure of the elderly people was compared with that of the young adults. The results show that there was a significant difference at the rearfoot, lateral midfoot, lateral forefoot, and hallux regions. The plantar foot pressure at the rearfoot and hallux regions was highest in the young adults, while it was lowest when the elderly used a rollator with a transverse handle. The plantar foot pressure at the lateral midfoot and lateral forefoot regions was highest when the elderly group did not use a rollator. [Conclusion] The results suggest that selective use of the handle type according to the purpose is important even though the use of a rollator assists the gait of the elderly regardless of the handle type. Moreover, the high dependency on the transverse handle rollator means that there can be a greater risk of falling down when grip on the handle is lost, and the vertical handle is more appropriate for gait training since it reduces dependency on the rollator during gait.

Effects of a robotic walking exercise on walking performance in community‐dwelling elderly adults

Reduced gait speed and stride length are characteristic of gait in elderly people and increase their dependency on assistance. We developed a robotic stride assistance system (SAS) to automatically control the walk ratio during walking. Our aim was to quantify the effects of a walking exercise with the SAS on walking performance and glucose metabolism during walking in community-dwelling elderly adults. For 3 months, 15 women (72-85 years old) performed the walking exercise twice weekly for 90 min/session. We assessed walking for 5 m at a comfortable speed before and after the intervention. Positron emission tomography with [(18)F]fluorodeoxyglucose (FDG) was used to assess muscle activity during an unassisted 50-min walk. Walking speed was improved by the intervention and FDG uptake by the gluteus minimus, gluteus medius and rectus femoris, and pelvic muscles (iliacus and gluteus muscles) were reduced. These results suggest that a walking intervention program using an applied robotic system is useful for improving the walking ability and the efficiency of muscle activities during walking in the elderly.

Equilíbrio e marcha de idosos residentes em instituições asilares do município de Catanduva, SP

RESUMO O presente trabalho tem como objetivos avaliar o equilíbrio e marcha de idosos institucionalizados e caracterizar os idosos que se apresentaram com alterações no equilíbrio e marcha segundo sexo, faixa etária, estados visual e auditivo. Este estudo, do tipo descritivo e de caráter transversal, foi realizado nas instituições asilares do município de Catanduva (SP), constituído de idosos de ambos os sexos. Os idosos foram responderam primeiramente a um questionário que trazia informações sobre identificação e condições de saúde. O equilíbrio e marcha foram avaliados através da Escala de Equilíbrio e Marcha de Tinetti. Foram avaliados 105 idosos, sendo 62 (59%) do sexo feminino e 43 (41%) do sexo masculino. A idade variou de 60 a 97 anos, com média de 79,2 +- (9,7) anos para o sexo feminino e 73,2 +- (9,3) anos para o sexo masculino. Houve associação entre dificuldade no equilíbrio e marcha e sexo feminino (p=0,003); faixa etária (p= 0,004) e dificuldade na visão (p= 0,008). Não houve diferença entre dificuldade no equilíbrio e marcha e deficiência auditiva. De acordo com os resultados, concluiu-se que entre os idosos residentes em asilos da cidade de Catanduva, os distúrbios do equilíbrio e marcha estão associados à idade avançada, sexo feminino e à deficiência visual.

Gait in the water: A comparison between young and elderly subjects

Purpose. To find differences, if any, between young and elderly people who walked in a pool.Method. Twenty young subjects (mean age 23.8 years, SD 3.6) and 20 elderly subjects (mean age 66.8, SD 3.8) were enrolled in a cross-sectional design study. Gait parameters were assessed by means of underwater video recording. Analysis of the playback allowed the assessment of speed, stance and swing duration with the aid of a digital clock with a 0.04% resolution. Length of step was also measured. Two-tail Student's t-test and Pearson's correlation coefficient were applied.Results. The mean speed was 1482 meters per hour (SD 207) in the younger population and 1366 meters per hour (SD 336) in the elderly. The mean stance duration was 1.60 s (SD 0.26) in the younger population and 1.59 s (SD 0.34) in the elderly. The mean swing duration was 1.16 s (0.22) in the younger population and 1.02 s (SD 0.26) in the elderly. The mean step length was 0.41 m (SD 0.05) in the younger population and 0.37 (SD 0.09) in the elderly. None of the differences was statistically significant.Conclusions. Gait in elderly people who walk in the water retains characteristics that are typical of younger participants. Hydrotherapy is therefore a suitable intervention for old people who are in a good state of fitness.

Evaluation of the Gait of Elderly People using an Assisting Cart (Gait on Slope)

As society ages, equipment for assisting walking is receiving increasing attention. We previously developed a cart to assist walking on flat surfaces and evaluated its effect on user muscular tension and energy consumption. In this paper, we determined energy consumption during slope walking based on a musculoskeletal model; 10% and 15% decreases of energy consumption are achieved with cart assistance in slope ascent and descent. We expect our evaluation to be useful for developing a practical walker.

Kinetic alterations independent of walking speed in elderly fallers

Objectives: To determine if joint kinetic gait alterations in fallers persist when they attempt to walk at a faster speed that is more comparable with nonfallers' comfortable walking speed.Design: Retrospective, case-control study. Stereophotogrammetric and force platform data were collected.Setting: A gait laboratory.Participants: Sixteen elderly subjects who had at least 2 falls in the last 6 months from an unclear cause and 23 elderly subjects with no history of repeated falls.Main Outcome Measures: Differences in all major peak joint kinetic (moment and power) values during the gait cycle between elderly nonfallers walking at comfortable speed and elderly fallers walking at (1) comfortable and (2) fast speed.Results: Statistically significant differences present at both comfortable and fast walking speeds were present in 4 sagittal plane parameters. There was an increase in peak external hip flexion moment in stance, a reduction in peak hip extension moment, a reduction in knee flexion moment in preswing, and a reduction in knee power absorption in preswing.Conclusion: The presence and persistence of 4 specific alterations in sagittal plane joint kinetics at both comfortable and fast walking speeds imply specific intrinsic pattern differences and allow for new insights into the mechanics of gait in elderly people who fall. The presence of these alterations also suggests they may serve as potential identifiable markers to detect those who may be at risk for falls.