Temporal Gait Parameters Research Articles

Identification of functional parameters for the classification of older female fallers and prediction of 'first-time' fallers.

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a 12-month follow-up period. Principal component analysis revealed that seven components derived from the 92 functional measures are sufficient to depict the spectrum of functional performance. Inclusion of only three components, related to mean and temporal variability of walking, allowed classification of fallers and non-fallers with a sensitivity and specificity of 74% and 76%, respectively. Furthermore, the results indicate that FTFs show a tendency towards the performance of fallers, even before their first fall occurs. This study suggests that temporal variability and mean spatial parameters of gait are the only functional components among the 92 measures tested that differentiate fallers from non-fallers, and could therefore show efficacy in clinical screening programmes for assessing risk of first-time falling.

Accuracy, sensitivity and specificity of five different methods for the estimation of gait temporal parameters using a single inertial sensor mounted on the lower trunk

Accuracy, sensitivity and specificity of five different methods for the estimation of gait temporal parameters using a single inertial sensor mounted on the lower trunk

Accuracy, sensitivity and robustness of five different methods for the estimation of gait temporal parameters using a single inertial sensor mounted on the lower trunk

In the last decade, various methods for the estimation of gait events and temporal parameters from the acceleration signals of a single inertial measurement unit (IMU) mounted at waist level have been proposed. Despite the growing interest for such methodologies, a thorough comparative analysis of methods with regards to number of extra and missed events, accuracy and robustness to IMU location is still missing in the literature. The aim of this work was to fill this gap. Five methods have been tested on single IMU data acquired from fourteen healthy subjects walking while being recorded by a stereo-photogrammetric system and two force platforms. The sensitivity in detecting initial and final contacts varied between 81% and 100% across methods, whereas the positive predictive values ranged between 94% and 100%. For all tested methods, stride and step time estimates were obtained; three of the selected methods also allowed estimation of stance, swing and double support time. Results showed that the accuracy in estimating step and stride durations was acceptable for all methods. Conversely, a statistical difference was found in the error in estimating stance, swing and double support time, due to the larger errors in the final contact determination. Except for one method, the IMU positioning on the lower trunk did not represent a critical factor for the estimation of gait temporal parameters. Results obtained in this study may not be applicable to pathologic gait.

Reliability of spatial–temporal gait parameters during dual-task interference in people with multiple sclerosis. A cross-sectional study

PurposeTo evaluate the reliability and minimum detectable change (MDC) of spatial–temporal gait parameters in subjects with multiple sclerosis (MS) during dual tasking. MethodThis cross-sectional study involved 25 healthy subjects (mean age 49.9±15.8 years) and 25 people with MS (mean age 49.2±11.5 years). Gait under motor-cognitive and motor–motor dual tasking conditions was evaluated in two sessions separated by a one-day interval using the GAITRite® Walkway System. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs), standard errors of measurement (SEM), and coefficients of variation (CV). MDC scores were computed for the velocity, cadence, step and stride length, step and stride time, double support time, the % of gait cycle for single support and stance phase, and base of support. ResultsAll of the gait parameters reported good to excellent ICCs under both conditions, with healthy subject values of >0.69 and MS subject values of >0.84. SEM values were always below 18% for both groups of subjects. The gait patterns of the people with MS were slightly more variable than those of the normal controls (CVs: 5.88–41.53% vs 2.84–30.48%). ConclusionsThe assessment of quantitative gait parameters in healthy subjects and people with MS is highly reliable under both of the investigated dual tasking conditions.

Effectiveness of task specific gait and balance exercise 4 months after hip fracture: protocol of a randomized controlled trial--the Eva-hip study.

Regular rehabilitation is not sufficient for regaining function after a hip fracture, and more targeted interventions for home-dwelling elderly hip-fracture patients are needed. This paper describes the protocol of a study assessing the effectiveness and cost effectiveness of a task specific progressive gait and balance exercise programme for hip-fracture patients, performed 4 months after the fracture. A single blind two-arm pragmatic randomised controlled trial was conducted with 142 hip-fracture patients randomized to a 10-week home-based exercise programme or to practice as usual 4 months following the surgery. Inclusion criteria were age >70 years and being home dwelling prior to the fracture. Exclusion criteria are life expectancy <3 months and inability to walk 10 m prior to the fracture. The content and organization of the programme was developed in collaboration between physiotherapy researchers and primary health-care physiotherapists. Participants were followed for 1 year post-surgery, evaluating short-term and long-term effects of the programme. The primary outcome is gait speed, and the secondary outcomes are spatial and temporal gait parameters, free living physical behaviour by activity monitoring, mobility performance, activities of daily living, fear of falling, cognitive function, depression and health-related quality of life. Cost-effectiveness analysis is planned. This paper describes a task specific exercise programme aimed to improve gait and balance after a hip fracture. Inclusion started in February 2011, and the last 1-year follow-up is performed in March 2014. Broad inclusion criteria and physiotherapy-guided home-based exercises may facilitate the participation from frail patients and thereby increase the generalizability of the findings. Development and completion of the intervention within routine clinical practice will enlighten the implementation of results into clinical practice. Results may add new insight into how physiotherapy can improve gait and thereby activity and functioning in everyday life and have implications on future content and organization of physiotherapy after a hip fracture.

Spatio-temporal gait characteristics in children with Tourette syndrome: a preliminary study.

Earlier studies had suggested that variability of stride length in gait is a pathological sign of basal ganglia disease. Some evidence implicates the involvement of the basal ganglia and related thalamocortical circuitry in Tourette syndrome (TS). To date, the gait of subjects with TS has only discussed in case reports. This investigation compared the spatial and temporal gait characteristics of a sample of children with TS (N=8) with those of healthy controls (HC; N=8). All children were instructed to walk under two speed conditions: "preferred" and "fastest." Gait parameters were measured using an electronic walkway. Spatial and temporal gait parameters were compared using a two-way (group)×(conditions) repeated measures ANOVA. The preliminary results suggested that similar to HC children, children with TS were capable of regulating temporal characteristics of gait based on walking speed. They also exhibited subtle gait anomalies such as irregular step length, as evidenced by significant differences in step length differential (p=0.003), detectable despite the small sample size. These findings warrant further investigation into the gait control of children with TS.

Ground reaction force adaptations to tripedal locomotion in dogs

To gain insight into the adaptive mechanisms to tripedal locomotion and increase understanding of the biomechanical consequences of limb amputation, this study investigated kinetic and temporal gait parameters in dogs before and after the loss of a hindlimb was simulated. Nine clinically sound Beagle dogs trotted on an instrumented treadmill and the ground reaction forces as well as the footfall patterns were compared between quadrupedal and tripedal locomotion.Stride and stance durations decreased significantly in all limbs when the dogs ambulated tripedally, while relative stance duration increased. Both vertical and craniocaudal forces were significantly different in the remaining hindlimb. In the forelimbs, propulsive force increased in the contralateral and decreased in the ipsilateral limb, while the vertical forces were unchanged (except for mean force in the contralateral limb). Bodyweight was shifted to the contralateral and cranial body side so that each limb bore ~33% of the dog's bodyweight. The observed changes in the craniocaudal forces and the vertical impulse ratio between the fore- and hindlimbs suggest that a nose-up pitching moment occurs during the affected limb pair's functional step. To regain pitch balance for a given stride cycle, a nose-down pitching moment is exerted when the intact limb pair supports the body. These kinetic changes indicate a compensatory mechanism in which the unaffected diagonal limb pair is involved. Therefore, the intact support pair of limbs should be monitored closely in canine hindlimb amputees.

178. Is Patient Uncertainty Associated with Outcomes in Systemic Lupus Erythematosus?

(group i), 12 participants with PsA and no history of dactylitis (group ii), and a control group of 12 participants (group iii) were recruited. Plantar pressure measurements were undertaken barefoot and in footwear. Peak plantar pressure and pressure time integral were analysed at the most common and second most common sites of dactylitis reported in the foot; 4th and 2nd toes, and 4th and 2nd metatarsophalangeal joints (MTP) of the left foot. Temporal and spatial parameters of gait were collected. Patient reported impairment and footwear (FISAP), and activity limitation and participant restriction (FISIF) were reported using the Foot Impact Scale for Rheumatoid Arthritis (FIS-RA). Results: PsA patients had a mean disease duration of 4.58 years in both groups, a mean FISIF score of 7.16 in group i and 6.83 in group ii compared with 0.41 in the control group, and a mean FISAP score of 8.75 in group i and 5.75 in group ii compared with 0.16 in the control group; ANOVA analysis and subsequent post-hoc testing using Games–Howell test yielded significance. In both domains of the FISRA there was a significant difference between both PsA groups compared with the control group; PsA group i P1⁄40.00 and PsA group ii P1⁄40.00 in the FISIF domain, PsA group i P1⁄40.03 and PsA group ii P1⁄40.05 in the FISAP domain. Mean plantar pressures measurements barefoot and in-shoe were not significant between groups. No significant differences were reported in spatial and temporal parameters of gait between groups. Conclusion: This is the first exploratory study to investigate the mechanical factors that may cause dactylitis in PsA. FIS-RA scores indicate PsA patients have significant limitations compared with controls, but a history of dactylitis does not worsen patient reported outcomes. Although no significant differences could be reported in plantar pressure data or gait variables, the study was underpowered. A subsequent power calculation indicates that 60 participants per group would be needed to power a larger study. Exploration of shear and friction in the forefoot may provide insight for a biomechanical trigger to dactylitis. Disclosure statement: The authors have declared no conflicts of interest.

Gait asymmetry and balance in hemiplegic stroke survivors

Objective To explore any correlation between gait asymmetry and the balance of hemiplegic stroke survivors.Methods Thirty patients with hemiplegia caused by stroke but who could walk more than 10 metres independently were recruited as the experimental group; 30 age-matched healthy elderly people served as the control group.An AL-600 gait analyzer was used to quantify the spatial and temporal gait parameters of all subjects.Gait asymmetry ratios were calculated.The 30 stroke patients were also assessed with the Berg balance scale (BBS).Two independent sample t-tests were used to compare the step length asymmetry (SLA),swing time asymmetry (SWTA) and STA (stance time asymmetry) ratios for the two groups and their average step widths.Pearson correlation coefficients were calculated relating the SLA,SWTA,STA,step width and BBS results.Results Among the experimental group,swing time and step length on the affected side were significantly different from the unaffected side,and stance time on the affected side was significantly shorter.The control group showed no such significant differences.All of the experimental group's average asymmetry ratios were significantly greater than those of the control group,as was their step width.Step width and BBS score were negative correlated,but step width was positively correlated with the step length and swing time asymmetry ratios.BBS scores were negatively correlated with the step length and swing time asymmetry ratios.Stance time asymmetry and step width showed no significant correlation with the BBS scores.Conclusion The gait of hemiplegic stroke patients is both spatially and temporally asymmetric,and a certain correlation exists between the degree of asymmetry and balance function. Key words: Stroke; Gait; Gait asymmetry; Balance; Hemiplegia

Temporal and spatial gait parameters in patients dependent on walking assistance after stroke: Reliability and agreement between simple and advanced methods of assessment

The aim of this study was to investigate the reliability of temporal and spatial gait parameters in patients dependent on walking assistance after severe stroke, and to examine agreement between simple and advanced methods. Twenty-one patients, admitted for in-patient multidisciplinary rehabilitation, were assessed repeatedly for walking function, both in a test corridor and a gait laboratory (3D camera system) before and after 11 weeks of rehabilitation. The test–retest reliability was examined using intraclass correlation (ICC1.1), and measurement error was reported by within-subject standard deviation (Sw). The agreement between different methods for assessing walking speed, cadence and step length was explored by Bland–Altman plots. High to excellent test–retest reliability was found between trials, both when assessed in the corridor (ICC: 0.93–0.99) and in the laboratory (ICC: 0.88–0.99). Agreement between methods was satisfactory at baseline and was higher after the rehabilitation period. Agreement was found to be slightly better at lower walking speeds and for shorter step lengths. The results implicate that temporal–spatial gait parameters may be measured reliably by both simple and advanced methods in dependent walkers after stroke. A high level of agreement was found between the two methods for walking speed, cadence and average step length at both test points.

Low-cost piezoelectric footswitch system for measuring temporal parameters during walking

Human walking is one of the most investigated biomechanical events, and gait analysis depends on accurate measurement of heel strike (HS) and toe off (TO). The purpose of this study was to construct and validate a low-cost footswitch system for the measurement of temporal gait parameters. Ten young healthy subjects participated of the validation and test of the footswitch system with two different footwear, Bland-Altman analysis showed 98% and 95% of validation data within the limits of agreement, for HS and TO respectively (mean difference of 16ms1ms and 20ms9ms) and the temporal parameters measured during treadmill walking at a speed of 4.5km.h-1 showed results similar to those found in the literature for normal walking. The outcomes confirm low CoVs for the instrumented athletic and instability shoe, respectively: (1.520.61)% and (1.900.73)% for contact time, (2.170.95)% and (2.570.95)% for balance time, (0.840.28)% and (1.120.53)% for stride time. The low-cost footswitch system described and validated in the present study has an important practical applicability, mostly for emerging and developing countries biomechanics labs. Keywords: Footswitch System, Gait Analysis, Locomotion, Low-Cost, Walk.

Influence of a Walking Aid on Temporal and Spatial Parameters of Gait in Healthy Adults

To determine the effect of using a walking aid on temporal and spatial parameters of gait when used for balance versus support on the dominant and nondominant hand side. Repeated measures observational study design. University gymnasium. Twenty-seven healthy male and female adults of mean ± standard deviation age 44.74 ± 10.00 years. Five walking conditions (C) were completed by all participants on the GAITRite pressure mat. Normal walking (C1), walking with a cane in the dominant hand (C2) and nondominant hand (C3) as if using for balance, walking with a cane in the dominant hand (C4) and nondominant hand (C5) while allowing approximately 10% of the body weight through the cane. Temporal measurements (swing time, stance time, single limb support time, double limb support time) as percentage of a gait cycle and the base of support for the left and the right foot for all 5 walking conditions. A significant difference (P < .001) was observed between C1, C2, and C3 in percentage swing time and percentage stance time of the ipsilateral side, and in percentage single limb support time of the contralateral side. The double limb support time was significantly different (P ≤ .04) for both ipsilateral and contralateral sides. Comparisons among C1, C4, and C5 demonstrated significance (P < .001) for all variables. Post hoc analysis showed significance between C1 and C4, and C1 and C5 for all variables except percentage stance time of the ipsilateral side and percentage single limb support of the contralateral side. In healthy adults, use of a cane for balance modifies swing and stance parameters of the ipsilateral side and does not affect the base of support formed by the feet. When used for support, the cane alters the swing and stance parameters, and also the base of support formed by the feet.

Early identification of declining balance in higher functioning older adults, an inertial sensor based method

Higher functioning older adults rarely have their balance assessed clinically and as such early decline in balance is not captured. Early identification of declining balance would facilitate earlier intervention and improved management of the ageing process. This study sought to determine if (a) a once off inertial sensor measurement and (b) changes in inertial sensor measurements one year apart can identify declining balance for higher functioning older adults. One hundred and nineteen community dwelling older adults (58 males; 72.5±5.8 years) completed a timed up and go (TUG) instrumented with inertial sensors and the Berg balance scale (BBS) at two time points, one year apart. Temporal and spatio-temporal gait parameters as well as angular velocity and turn parameters were derived from the inertial sensor data. A change in balance from baseline to follow-up was determined by sub-components of the BBS. Changes in inertial sensor parameters from baseline to follow-up demonstrated strong association with balance decline in higher functioning older adults (e.g. mean medial-lateral angular velocity odds ratio=0.2; 95% CI: 0.1–0.5). The area under the Receiver operating characteristic curve (AUC) ranged from 0.8 to 0.9, a marked improvement over change in TUG time alone (AUC 0.6–0.7). Baseline inertial sensor parameters had a similar association with declining balance as age and TUG time. For higher functioning older adults, the change in inertial sensor parameters over time may reflect declining balance. These measures may be useful clinically, to monitor the balance status of older adults and facilitate earlier identification of balance deficits.

Leg spasticity and ambulation in multiple sclerosis.

Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = −0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = −0.45), and walking velocity (P < 0.05, d = −0.53) and cadence (P < 0.05, d = −0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.

Immediate effects of rhythmic auditory stimulation with tempo changes on gait in stroke patients.

[Purpose] The aim of this study was to investigate the effects of tempo changes in rhythmic auditory stimulation (RAS) on gait in stroke patients. [Subjects] Forty-one chronic stroke patients who had had a stroke with more than 6 months previously were recruited for this study. [Methods] All participants were asked to walk under 5 different conditions in random order: (1) no RAS (baseline); (2) baseline-matched RAS (0%); and (3) −10%, (4) +10%, and (5) +20% of the baseline. A GAITRite system was used to evaluate the spatial and temporal parameters of gait. [Results] Compared with under the RAS 0% conditions, the gait velocity, cadence, and stride length on the affected side were significantly decreased under the RAS −10% conditions. Gait velocity and cadence were significantly improved, but gait symmetry was significantly decreased under the RAS +10% and +20% conditions compared with under the RAS 0% conditions. [Conclusion] A faster RAS tempo significantly improved gait velocity and cadence, and applying RAS significantly improved the gait symmetry of stroke patients.

The effects of a balance exercise program for enhancement of gait function on temporal and spatial gait parameters in young people with intellectual disabilities.

[Purpose] The aim of the study was to assess the effect of an 8-week balance exercise program for enhancement of gait function on temporal and spatial parameters of school aged children with intellectual disabilities. [Subjects] Forty young people with intellectual disabilities were assigned either to the balance exercise program for enhancement of gait function group (BG group, n=19) or the control group (n=21). [Methods] The BG group attended an 8-week balance exercise program for enhancement of gait function consisting of two sessions a week. Gait was assessed using temporal and spatial parameters. [Results] The balance exercise program resulted in significant improvements in participant performance in temporal and spatial parameters. [Conclusion] A balance exercise program for enhancement of gait function can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity programming for improving balance and gait.

Estimation of step-by-step spatio-temporal parameters of normal and impaired gait using shank-mounted magneto-inertial sensors: application to elderly, hemiparetic, parkinsonian and choreic gait.

BackgroundThe step-by-step determination of the spatio-temporal parameters of gait is clinically relevant since it provides an estimation of the variability of specific gait patterns associated with frequent geriatric syndromes. In recent years, several methods, based on the use of magneto-inertial units (MIMUs), have been developed for the step-by-step estimation of the gait temporal parameters. However, most of them were applied to the gait of healthy subjects and/or of a single pathologic population. Moreover, spatial parameters in pathologic populations have been rarely estimated step-by-step using MIMUs. The validity of clinically suitable MIMU-based methods for the estimation of spatio-temporal parameters is therefore still an open issue. The aim of this study was to propose and validate a method for the determination of both temporal and spatial parameters that could be applied to normal and heavily compromised gait patterns.MethodsTwo MIMUs were attached above each subject’s ankles. An instrumented gait mat was used as gold standard. Gait data were acquired from ten hemiparetic subjects, ten choreic subjects, ten subjects with Parkinson’s disease and ten healthy older adults walking at two different gait speeds. The method detects gait events (GEs) taking advantage of the cyclic nature of gait and exploiting some lower limb invariant kinematic characteristics. A combination of a MIMU axes realignment along the direction of progression and of an optimally filtered direct and reverse integration is used to determine the stride length.ResultsOver the 4,514 gait cycles analyzed, neither missed nor extra GEs were generated. The errors in identifying both initial and final contact at comfortable speed ranged between 0 and 11 ms for the different groups analyzed. The stride length was estimated for all subjects with less than 3% error.ConclusionsThe proposed method is apparently extremely robust since gait speed did not substantially affect its performance and both missed and extra GEs were avoided. The spatio-temporal parameters estimates showed smaller errors than those reported in previous studies and a similar level of precision and accuracy for both healthy and pathologic gait patterns. The combination of robustness, precision and accuracy suggests that the proposed method is suitable for routine clinical use.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-152) contains supplementary material, which is available to authorized users.

Total hip replacement with a collarless polished cemented anatomic stem: clinical and gait analysis results at ten years follow-up

The aim of this study was to determine outcomes of total hip replacement (THR) with the Lemania cemented femoral stem. A total of 78 THR patients were followed and compared to 17 "fit", healthy, elderly and 72 "frail" elderly subjects without THR, using clinical outcome measures and a portable, in-field gait analysis device at five and ten years follow-up. Forty-one patients (53%), mean age 83.4 years, available at ten years follow-up, reported very good to excellent satisfaction. Mean Harris Hip and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were 81.2 and 10.5 points, respectively, with excellent radiological preservation of proximal femur bone stock. Spatial and temporal gait parameters were close to the fit group and better than the frail group. Lemania THR demonstrated very good, stable clinical and radiological results at ten years in an older patient group, comparable to other cemented systems for primary THR. Gait analysis confirmed good walking performance in a real-life environment.

Gait control and executive dysfunction in early schizophrenia

Dysexecutive functioning, which is described as an enduring core feature of schizophrenia, has been associated with gait disorders. However, few studies have reported gait disorders in schizophrenia patients. The objective of this study was to examine the association between executive dysfunction and gait performance in recent-onset schizophrenia patients using the dual task paradigm. Thirty-two subjects participated to the study: 17 with recent-onset schizophrenia and 15 healthy age-matched controls. Executive functions were evaluated using the Frontal Assessment Battery, Stroop and Trail-Making tests. Mean values and coefficients of variation (CV) of the temporal gait parameters while single tasking (just walking) and while dual tasking (walking and forward counting, walking and backward counting, walking and verbal fluency) were measured using the SMTEC(®)-footswitch system. We focused on the CV of stride time as this measure has been shown to be the most representative parameter of higher gait control. A strong effect of the stride time was found in the group factor for the verbal fluency dual-task when compared to controls (Cohen's d mean=1.28 and CV=1.05). The effect was lower in the other dual tasks, and insignificant in the single task of walking. This study shows that patients exhibit higher stride-to-stride variability while dual tasking than controls. It also shows a stronger impact of verbal fluency on gait regularity compared to the other dual tasks revealing a relationship between the executive dysfunction and gait modification. Those results are in line with the idea that schizophrenia implies not only cognitive but also motor functioning and coordination impairment.

Improved walking ability in elderly with osteoporosis after participating in a balance training programme with dual- and multi-tasks

Introduction: Falls and fear of falling are common in the elderly population, and in combinationwith osteoporosis a fall can be very costly for both the society and for the individual. Aging and fear of falling has an impact on walking ability, and when adding a secondary task, cognitive or motor, the gait pattern is further altered [1]. Previous studies have shown that walking ability in elderly can be improved by balance training [2]. The aim of this study was to evaluate the effect of a three months progressive balance training with focus on dualand multi-tasks on spatial and temporal gait parameters in elderly with osteoporosis and self reported fear of falling. Patients/Materials And Methods: A total of 72 elderly (aged: 66–87years) subjectswith osteoporosis, self reported fear of falling and balance deficits were recruited by advertisement. Participants were randomized to either a training group (n=45) or to a control group (n=27). The training group participated in a progressive and highly challenging balance training program, with focus on dualand multi-cognitive and/or motor tasks, during 12 weeks, three times a week, 45min/session [2]. The control group was encouraged to continue with their usual activities, and were offered the same balance training at the end of the study. All subjects were assessed at baseline and directly after the intervention period. Gait parameters, i.e. velocity, cadence, step length, step width and double support phase were assessed using an instrumented walkway system (GAITRite). Participants walked at their preferred speed, as fast as they could without tripping and/or falling and at their preferred speed during a cognitive dual task (reciting every second letter of the alphabet). Each condition was performed six times and a mean value was used for analysis. For statistical calculations PASWStatistics version 19.0was used. AMixedmodel analysiswas performed on all gait parameters. Statistical significance was set to <0.05. Results: Analysis over time and between groups after the intervention revealed significant differences all in favour for the training group compared to the control group. At preferred speed, with and without a cognitive dual-task, a significant increase was seen in velocity (p=0.002 and p=0.034, respectively) and cadence (p=0.009 and p=0.029, respectively). The participants in the training group increased their velocity with 13% during the dual-task condition, resulting in similar velocity during both conditions at preferred speed. During gait at fast speed, significantly increased velocity (p=0.002), cadence (p=0.004) and step length (p=0.044) were seen in the training group. Discussion and conclusions: To participate in a three months progressive balance training programmewill significantly improve walking ability, especially under dualor multi-task conditions, in elderly with osteoporosis. This ability is important in daily life and may prevent hazardous falls, and also have positive impact on physical activity levels, contributing to a better general health. References