Walking In Elderly People Research Articles

The elderly’s preference for the outdoor environment in Fragrant Hills Nursing Home, Beijing: Interpreting the visual-behavioural relationship

The outdoor environment in nursing homes provides various opportunities for elderly citizens’ daily activities, which is closely linked to their health and well-being. The elderly’s preference for the outdoor environment in health-care settings is a major issue but has not been adequately investigated. This study aimed to explore the elderly’s visual and behavioural preference and the relationship in between. We used the methods of Visitor-Employed Photography and Behaviour Mapping, and Pearson Correlation Coefficient was then used to explore the relationship between visual and behavioural preference. We categorized the visual preference into two domains – content-based attributes referring to landscape elements and subtle details, and spatial configurations which form a sense of spatiality. We found that the outdoor environment of content-based attributes and that of spatial configurations interacted with each other on shaping the elderly’s visual preference, in which plants also played a significant role. The behavioural preference for dynamic and static spaces (referring to spaces where elderly people walk through or stay for a while respectively) varied according to the content of their daily activities. The correlation between visual and behavioural preference highlighted the important implications of visual preference for outdoor environment of spatial configurations, especially with positive evaluations, on behavioural preference for both dynamic and static spaces. In the combination of interdisciplinary methods and techniques, this study contributes to evoking new comprehensive understanding on the visual-behavioural relationship for space annotation for both researchers and designers in the future.

Does the balance strategy during walking in elderly persons show an association with fall risk assessment?

The primary objective of this study was to clarify whether balance evaluation during walking in elderly people was related to fall risk assessment; the second objective was to clarify the difference in balance strategy between young and elderly people based on the balance evaluation through a gait cycle. Thirty healthy young adults and 25 healthy elderly adults participated. All participants performed walking at their preferred speed and at a fast speed. Based on the margin of stability (MoS), balance during a gait cycle was divided into medial/lateral and anterior/posterior direction (ML/AP-MoS). Positive/negative integral values of ML-MoS were defined as ML-MoSPOS/ML-MoSNEG, and the average of AP-MoS over the gait cycle was defined as AP-MoSmean. The fast/preferred ratio of AP-MoSmean/ML-MoSPOS (AP-MoSmean (Fast/Preferred)/ML-MoSPOS (Fast/Preferred)) and the fast-preferred difference of ML-MoSNEG (ML-MoSNEG (Fast-Preferred)) were compared between groups. ML/AP-MoS at the preferred/fast gait was also compared between 12 gait events and groups. The Japanese version of the Mini-Balance Evaluation Systems Test (J-Mini-BESTest), the Japanese version of the Activities-specific Balance Confidence Scale (J-ABC scale), and the number of falls in the past year were obtained from all subjects. ML-MoSPOS (Fast/Preferred), ML-MoSNEG (Fast-Preferred), and AP-MoSmean (Fast/Preferred) were significantly correlated with J-Mini-BESTest. Gait balance evaluation based on MoS may reflect an individual’s balance function. In fast gait, ML-MoS at foot flat and toe off and AP-MoS at just before heel strike were highly likely to be gait events to identify elderly adults with balance disorders.

Development of Robotic Cane for Assisting Elderly People's Walk on Uneven Terrain

Development of Robotic Cane for Assisting Elderly People's Walk on Uneven Terrain

Predictive neuromechanical simulations indicate why walking performance declines with ageing.

Although the natural decline in walking performance with ageing affects the quality of life of a growing elderly population, its physiological origins remain unknown. By using predictive neuromechanical simulations of human walking with age-related neuro-musculo-skeletal changes, we find evidence that the loss of muscle strength and muscle contraction speed dominantly contribute to the reduced walking economy and speed. The findings imply that focusing on recovering these muscular changes may be the only effective way to improve performance in elderly walking. More generally, the work is of interest for investigating the physiological causes of altered gait due to age, injury and disorders. Healthy elderly people walk slower and energetically less efficiently than young adults. This decline in walking performance lowers the quality of life for a growing ageing population, and understanding its physiological origin is critical for devising interventions that can delay or revert it. However, the origin of the decline in walking performance remains unknown, as ageing produces a range of physiological changes whose individual effects on gait are difficult to separate in experiments with human subjects. Here we use a predictive neuromechanical model to separately address the effects of common age-related changes to the skeletal, muscular and nervous systems. We find in computer simulations of this model that the combined changes produce gait consistent with elderly walking and that mainly the loss of muscle strength and mass reduces energy efficiency. In addition, we find that the slower preferred walking speed of elderly people emerges in the simulations when adapting to muscle fatigue, again mainly caused by muscle-related changes. The results suggest that a focus on recovering these muscular changes may be the only effective way to improve performance in elderly walking.

Intrinsic group behaviour: Dependence of pedestrian dyad dynamics on principal social and personal features.

Being determined by human social behaviour, pedestrian group dynamics may depend on “intrinsic properties” such as the purpose of the pedestrians, their personal relation, gender, age, and body size. In this work we investigate the dynamical properties of pedestrian dyads (distance, spatial formation and velocity) by analysing a large data set of automatically tracked pedestrian trajectories in an unconstrained “ecological” setting (a shopping mall), whose apparent physical and social group properties have been analysed by three different human coders. We observed that females walk slower and closer than males, that workers walk faster, at a larger distance and more abreast than leisure oriented people, and that inter-group relation has a strong effect on group structure, with couples walking very close and abreast, colleagues walking at a larger distance, and friends walking more abreast than family members. Pedestrian height (obtained automatically through our tracking system) influences velocity and abreast distance, both growing functions of the average group height. Results regarding pedestrian age show that elderly people walk slowly, while active age adults walk at the maximum velocity. Groups with children have a strong tendency to walk in a non-abreast formation, with a large distance (despite a low abreast distance). A cross-analysis of the interplay between these intrinsic features, taking in account also the effect of an “extrinsic property” such as crowd density, confirms these major results but reveals also a richer structure. An interesting and unexpected result, for example, is that the velocity of groups with children increases with density, at least in the low-medium density range found under normal conditions in shopping malls. Children also appear to behave differently according to the gender of the parent.

Improve elderly people's sit-to-stand ability by using new designed additional armrests attaching on the standard walker

BackgroundMore and more elderly problems come to our life and the elderly health care become more important. Elderly people with lower extremities weakness usually use walkers to assist in walking. Although the commercial standard walkers (N-type) can improve elderly people's walking ability, users sometimes take risk of falling when using the standard walkers to perform sit-to-stand (STS). The purpose of this study is to design an additional armrest which can be attached to a standard walker for users performing STS more easily and evaluate it with clinical assessments and a body worn sensor. MethodsThe combination of the walker and the new armrest design are referred to as a better type (B-type). Clinical assessments and a motion analysis were performed on 34 elderly people (age, 83 ± 6 y/o) with a Five Times Sit-to-Stand Test (FTSST), a satisfaction survey and an inertial measurement unit (IMU) attached to the trunk to measure the acceleration data when using B-type and N-type during STS. ResultsThe FTSST result shows that the B-type can reduce about 5 s spending time of elderly people during STS and 63.7% of subjects were more satisfied on the B-type than the N-type. According to the IMU, the result reveals that the B-type can provide subjects higher peak–peak anterio-posterior acceleration, peak flexion acceleration and peak extension acceleration during STS. ConclusionThere is a better assistance during STS when using our new armrests design combined with the commercial product which could provide larger acceleration to perform sit-to-stand.

TRANSPORT VELOCITY OF VULNERABLE PEOPLE FOR TSUNAMI EVACUATION

In case of Tsunami, vulnerable people must shelter from it by themselves under difficult conditions. Other people's help is essential for them to evacuate as fast as possible. Considering transportation methods is one of the most important issues against a disaster. The purpose of this study is to compare transportation velocity and to obtain fundamental data, evacuation supporter carry vulnerable people by using transportation instruments. We carried out running experiments with three kinds of instruments, (A) a rollator, (B) a transport chair, and (C) a wheelchair. A rollator was installed assistant equipment (Patent No. 5802342) in this experiment because it did not have transportation function fundamentally. The experiments proceeded in three different inclination lanes; steep slope inclination average was 12.99%, gentle slope 6.77%, and flat 0%. Each lane's distance was as follows; steep slope was 100m, gentle 200m and flat 1, 000m respectively. The subjects of this experiment were 31 female students, the age group between 18 and 26. We did pre-questionnaire on individual attribute and ex facto questionnaire on physical burden to the role of evacuation supporters. Every vulnerable people's weight was adjusted to 62.04kg with dumbbells. Every subject watched the video of the Tsunami to image the situation and do practical experiment before the trials. Each trial was video-recorded to measure transportation velocity and observe their movement. Average velocity of (C) a wheelchair was 0.91m/s, (B) a transport chair 0.85m/s, and (A) a rollator 0.77m/s in steep slope, (C) 1.28m/s, (B) 1.14m/s and (A) 0.91m/s in gentle slope, (C) 1.87m/s, (B) 1.58m/s and (A) 1.18m/s. In the order of transportation velocity was a wheelchair, a transport chair and a rollator in every inclination. According to questionnaire, the subject with experience taking part in sports before made a better record than whom without such experiences. Physical burden in gentle slope and flat with a wheelchair was least but then a rollator was added loads. There were few differences in three instruments in steep slope. Especially a rollator had big physical burden within three of them and difficulty to handle. However, as a result of this experiment, rollator's average velocity was faster than that elderly people walk with a rollator under own power. Therefore, evidently having help from evacuation supporters more efficient than pushing it by themselves for elderly usually uses a rollator. Finally, the study presented here clearly demonstrated that making use of transportation instruments such as a wheelchair, a transport chair and a rollator with evacuation supporter's help enable vulnerable people to run away from Tsunami swiftly. We propose that vulnerable people should deploy transportation instruments against a disaster.

Comparison of Walking in Elderly People and Adults Using a Walker Aid with a Pocket Attachment

PURPOSE: This study aims to examine the impact of the location of a walker-aid pocket that is attached to the walker while walking. METHODS: The research subjects included 10 male adults and 10 elderly people. The subjects used a two-wheeled walker for the walking analysis, and a firm velcro-type pocket that can be attached to the walker aid was used for weight loading. The size of the external loads was set at 2kg, which corresponds to approximately 2.5% of the mean body weight of the subjects. The pocket was attached to the left, center, and right sides of the walker aid. Stride length, stride, step width, and time were investigated according to the location change. RESULTS: No statistical differences were observed in all the walking factors among the adults and elderly people regardless of the changes in the location of the walker pocket. In cases of no weight and the 2kg walker pocket, stride length and strides were longer for the adults, while the step width was greater and walking time was longer for the elderly people. CONCLUSION: The weight of the walker pocket turn out to retard walking speed, although the location of the walker pocket is not affect walking with the walker-aid.

Motion control of walking assistant robot based on comfort

– A walking assistant robot can help elderly people walk around independently, which could improve the life quality of the elderly and benefit our aging society. Ensuring the elderly person's walking comfort with such a robot is very important. At present, the majority of walking assistant robot research does not focus on this field. The purpose of this paper is to examine the requirements of comfortable walking and outline the design of a motion control algorithm for a walking assistant robot, Walkmate III, based on comfort., – During walking, the walking assistant robot should be able to capture the intent of user, guide the user and move at the same pace as the user. Usually, force or haptic interface is used to detect the user's walking intention. The motion control system then transforms the forces applied by the user into the robot's motion. By surveying the elderly people at a nursing home, the authors find that this transformation is important to the walking comfortableness and should be carefully designed. In this paper, the model of walking assisting process with such kind of walking assistant robot is derived at first. Based on this model, a new motion control algorithm is then designed., – The elderly hoped that, in all topographic conditions, only small forces were needed to drive the walker during walking. Also, good maneuverability was also very important for a walker, to offer the user comfort, which meant the walking assistant robot should be able to respond to the input forces quickly and precisely. Currently widely‐used motion control algorithms cannot satisfy all those requirements. In this paper, a new motion control algorithm is proposed, which can get a fast and precise response to the input forces and the input forces needed to drive the robot are kept at a preferred small level, so that the user will not feel tired during walking. Furthermore, by modifying, force feedback can be realized to improve the comfortableness of walking., – The availability of walking assistant robot with improved walking comfortableness might encourage a wider adoption of robotics in our daily life. It could also benefit our aging society by improving the life quality of the elderly and reducing the pressure deriving from nursing labor shortages., – This paper is of value to engineers and researchers developing walking assistant robots for the elderly people.

족압패턴에 의한 보행보조기를 위한 입각기 감지기법

In this paper, we proposed a technique to recognize three states in stance phase of gait cycle. Walking assistive devices are used to help the elderly people walk or to monitor walking behavior of the disabled persons. For the effective assistance, they adopt an intelligent sensor system to understand user's current state in walking. There are three states in stance phase; Loading Response, Midstance, and Terminal Stance. We developed a foot pressure sensor using 24 FSRs (Force Sensing/Sensitive Resistors). The foot pressure patterns were integrated through the interpolation of FSR cell array. The pressure patterns were processed to get the trajectories of COM (Center of Mass). Using the trajectories of COM of foot pressure, we can recognize the three states of stance phase. The experimental results show the effective recognition of stance phase and the possibility of usage on the walking assistive device for better control and/or foot pressure monitoring.

Energetics of Walking in Elderly People: Factors Related to Gait Speed

Slow walking speed in elderly people predicts increased morbidity and mortality. We examined factors that may be associated with decreased habitual walking speed in older men and women. Older (range: 60-88 years, mean = 72.5 years) men (n = 25) and women (n = 24) were recruited. The Short Physical Performance Battery, body composition, VO(₂peak) on a treadmill, VO₂ and rated perceived exertion during 10 minutes of walking at habitual gait speed and at a walking speed of 0.9 m/s, muscle strength, and level of physical activity were measured. VO(₂peak) was strongly related to habitual gait speed (r = .744, p < .001) and remained significant even after controlling for age, muscle strength, and gender. Compared with the tertile of fastest walkers (mean gait speed, 1.37 ± 0.04 m/s), the tertile of slowest walkers (0.87 ± 0.02 m/s) were older (p < .001), shorter (p = .026), had lower lean body mass (p = .011), lower strength ( p < .001), less self-reported daily physical activity (p = .102), and higher relative (to VO(₂peak)) intensity during walking at their habitual speed (65.3% ± 3.9% vs 54.3% ± 2.1% of VO(₂peak), p = .013). VO(p₂eak) was strongly associated with habitual walking speed, suggesting that as aerobic capacity declines with age, the exertion associated with habitual gait speed increases. A slowing of walking speed may be a response to increased perception of exertion. The extent to which exercise training affects habitual gait speed and fatigue is not clear.

하지 저항운동을 통한 여성고령자 보행 시 하지관절 및 분절의 운동학적 차이

본 연구는 하지 저항운동 시 고령자 보행의 하지분절과 관절의 운동학적 차이를 분석하여 낙상예방을 위한 기초자료를 제공하는데 있다. 이를 위해 70대 이상 80세 이하의 여성 고령자 7명을 선정하여 3차원 영상분석을 실시하였다. 하지 분절과 관절의 3차원 위치좌표를 얻기 위해 ProReflex MCU(Qualisys, Sweden) 카메라를 사용하여, 100Hz/s로 촬영하였다. 촬영된 영상은 QTM(Qualisys, Sweden) 프로그램을 이용하여 위치좌표에 대한 원자료(raw data)를 얻었으며, Matlab 6.5 프로그램을 이용하여 3차원 각도를 산출한 결과, 다음과 같은 결론을 얻었다. 대퇴와 하퇴분절의 굴곡과 신전은 E5에서 운동 후 굴곡의 움직임이 크게 나타났으며, 발 분절은 E4에서 외번을 보이면서 통계적 차이를 나타냈다. 무릎관절은 운동 후 E4에서 굴곡을 보였고, 발목관절은 E3에서 내번, E4에서 외번의 움직임을 나타내면서 통계적인 차이(p<.05)를 보였다. The purpose of this study is to offer basic data for the fall prevention by analyzing the kinematic difference between the lower limb joints and the lower extremities in elderly people's walking given the lower-limb resistance exercises. For this, three-dimensional image analysis was carried out by selecting 7 elderly women from over 70s to under 80 years old. To obtain the three-dimensional location coordinates in the lower limb joints and the lower extremities, it shot with 100Hz/s by using MCU(Qualisys, Sweden) camera. The shot image gained raw data on the location coordinates by using QTM(Qualisys, Sweden). As a result of calculating three-dimensional angle by using program of Matlab 6.5, the following conclusions were obtained. Flexion and extension in the thigh and the lower-leg extremities were indicated to be big in motion of flexion after exercising at E5. Foot segment indicated statistical difference while showing eversion at E4. Knee joints showed flexion at E4 after exercising. Ankle joints showed statistical difference while indicating motion in inversion at E3 and in eversion at E4(p<.05).

The effect of complete dentures on body balance during standing and walking in elderly people

To investigate the influence of wearing complete dentures on postural control in standing and walking. Thirty-four edentulous patients participated in this study. All the subjects were wearing complete dentures, and the dentures were adjusted or replaced with new dentures when necessary. Measurements were performed under two conditions: wearing dentures and not wearing dentures. Standing stability was evaluated by the locus of center of mass, and gait stability was evaluated by the gait velocity, stride and gait cycle. In addition, gait stability was also evaluated by the maximum acceleration, maximum angle rate, lateral equilibrium, root mean square and harmonic ratio with a tri-axial accelerometer at a sampling rate of 66 Hz. Differences for the locus of center of mass, gait velocity, gait cycle and stride length were assessed with the paired t test (P<0.05). Other outcomes were compared with the Wilcoxon signed-rank test (P<0.05). With denture wear, the locus of center of mass was significantly shortened, and the gait velocity and harmonic ratio of the vertical angle rate were significantly increased; though other parameters showed no differences. Complete dentures produced an effect on the stability of edentulous patients under both static and dynamic conditions. These results indicate that wearing complete dentures may be an effective aid to maintain and improve balance and control for elderly people.

FOOT ANGLE AND FOOT WIDTH DURING NORMAL WALKING IN ELDERLY PEOPLE

FOOT ANGLE AND FOOT WIDTH DURING NORMAL WALKING IN ELDERLY PEOPLE

1P1-A09 高齢者歩行支援システムの開発

1P1-A09 高齢者歩行支援システムの開発

Energy cost of walking and gait instability in healthy 65- and 80-yr-olds

This study tested whether the lower economy of walking in healthy elderly subjects is due to greater gait instability. We compared the energy cost of walking and gait instability (assessed by stride to stride changes in the stride time) in octogenarians (G80, n = 10), 65-yr-olds (G65, n = 10), and young controls (G25, n = 10) walking on a treadmill at six different speeds. The energy cost of walking was higher for G80 than for G25 across the different walking speeds (P < 0.05). Stride time variability at preferred walking speed was significantly greater in G80 (2.31 +/- 0.68%) and G65 (1.93 +/- 0.39%) compared with G25 (1.40 +/- 0.30%; P < 0.05). There was no significant correlation between gait instability and energy cost of walking at preferred walking speed. These findings demonstrated greater energy expenditure in healthy elderly subjects while walking and increased gait instability. However, no relationship was noted between these two variables. The increase in energy cost is probably multifactorial, and our results suggest that gait instability is probably not the main contributing factor in this population. We thus concluded that other mechanisms, such as the energy expenditure associated with walking movements and related to mechanical work, or neuromuscular factors, are more likely involved in the higher cost of walking in elderly people.

Stride-dependent changes in gait of older people

Infrared computerized stroboscopic photometry was used to measure the kinematic profile of walking of 20 young adults and 20 neurologically healthy elderly people. Compared with the young adults, the elderly exhibited 17-20% reductions in the velocity of gait and length of stride. The elderly also exhibited comparable reductions in the maximum toe-floor clearance, arm swing, and rotations of the hips and knees, but these alterations in gait were attributable to the reduction in stride length, which may have non-neurological causes. The influence of reduced gait velocity and stride length on the other characteristics of walking must be considered when evaluating the pattern of walking in elderly people.