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Changes in step-width during dual-task walking predicts falls.

E Nordin1, R Moe-Nilssen, A Ramnemark

  • 1Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden. ellinor.nordin@physiother.umu.se

Gait & Posture
|April 20, 2010
PubMed
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Changes in gait patterns when performing two tasks simultaneously (dual-tasking) can predict fall risk in older adults. Specific gait changes may indicate increased or decreased likelihood of falling.

Area of Science:

  • Gerontology
  • Biomechanics
  • Neuroscience

Background:

  • Falls are a significant concern for older adults, impacting independence and quality of life.
  • Gait pattern alterations under dual-task conditions may reflect underlying neurological or biomechanical changes associated with fall risk.

Purpose of the Study:

  • To investigate the association between gait pattern changes during dual-tasking and the risk of falling in community-dwelling older adults.
  • To determine if dual-task cost (DTC) in gait characteristics can serve as a prognostic indicator for falls.

Main Methods:

  • 230 physically independent older adults (≥75 years) underwent gait analysis using an electronic walkway under single- and five dual-task conditions.
  • Dual-task cost (DTC) was calculated by comparing gait parameters (e.g., step-width, step-time, step-length variability) between single- and dual-task walking.

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  • Participants were prospectively followed for one year to record fall occurrences.

    • Main Results:

    • Nearly half (48%) of participants experienced at least one fall during the follow-up period.
    • Increased fall risk was associated with changes in mean step-width during a subtraction dual-task.
    • Decreased fall risk was linked to changes in mean step-width, mean step-time, and step-length variability during a cup-and-saucer carrying dual-task.
    • Prognostic values for mean step-width DTC included a negative likelihood ratio of 0.5 and a positive likelihood ratio of 2.3.

    Conclusions:

    • Gait pattern modifications, specifically in step-width, step-time, and step-length variability, during dual-tasking are associated with future fall risk in older adults.
    • The nature of the secondary task influences whether dual-task cost indicates an increased fall risk or a compensatory protective strategy.