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Can minimum toe clearance predict community-based trips by older adults?

Marco A Avalos1, Noah J Rosenblatt1

  • 1Dr. William M. Scholl Colleg of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin Univerisity of Medicine and Science, 3333 Greenbay Road, North Chicago, IL 60604, USA.

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Minimum toe clearance (MTC) variability may predict tripping in older adults. However, lab-based MTC assessments might not fully capture real-world tripping risks beyond fall history.

Keywords:
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Area of Science:

  • Gerontology
  • Biomechanics
  • Gait Analysis

Background:

  • Tripping is a primary cause of falls in older adults.
  • Minimum toe clearance (MTC) is theoretically linked to tripping, but its predictive power for community-based trips is unclear.

Purpose of the Study:

  • To investigate the extent to which MTC and its variability predict the number of community-based trips in older adults.

Main Methods:

  • 51 older adults walked on a walkway, with MTC measured for each step.
  • Statistical analysis included calculating MTC variability (mean, median, IQR, SD, skewness, kurtosis).
  • Participants self-reported community trips over one year, analyzed using negative binomial regressions.

Main Results:

  • 28 participants reported at least one trip.
  • In initial analysis, MTC kurtosis and skewness predicted trip incidence.
  • These MTC measures lost significance when fall history was included, though kurtosis showed a trend (IRR 0.64, p=0.09).

Conclusions:

  • MTC variability shows potential for identifying older adults at higher risk of tripping.
  • Lab-based MTC assessment may lack ecological validity for predicting community trips beyond existing fall history.