Predicting fall risk through step width variability at increased gait speed in community dwelling older adults

Area of Science:

• Gerontology
• Biomechanics
• Clinical Gait Analysis

Background:

• Falls are a major health concern for community-dwelling older adults, leading to injury and reduced independence.
• Spatiotemporal gait parameters and their variability are increasingly recognized as indicators of fall risk.
• Identifying reliable predictors of fall risk is crucial for developing effective fall prevention strategies.

Purpose of the Study:

• To investigate the relationship between spatiotemporal gait variables, gait variability, and fall risk in older adults.
• To identify key gait predictors of fall risk.
• To explore the role of gait variability at different walking speeds in predicting fall risk.

Main Methods:

• 303 community-dwelling older adults were categorized into fall-risk and non-fall-risk groups using Short Physical Performance Battery (SPPB) scores.
• Spatiotemporal gait variables (stance phase time, double stance time, stride length, step width, velocity, cadence) and their coefficient of variation (CV) were measured using treadmill-based analysis.
• Measurements were taken at preferred walking speed and at a 20% increased speed.

Main Results:

• The fall-risk group exhibited significantly longer stance and double stance times, and reduced stride length, velocity, and cadence compared to the non-fall-risk group at both speeds.
• The fall-risk group showed significantly higher coefficient of variation (CV) for most gait variables.
• Step width variability was notably higher in the fall-risk group and demonstrated greater discriminative power at increased walking speed.

Conclusions:

• Gait variability, particularly step width variability, is a critical predictor of fall risk in older adults.
• Increased gait variability at higher walking speeds is a potential early indicator for fall risk assessment.
• Treadmill-based gait analysis can effectively identify gait alterations associated with fall risk in older populations.