Balance Confidence Is Related to Walking Parameters in Different Outdoor Environments in Older Adults

Perceived balance confidence may influence stability of gait among older adults and be pronounced in varied environments. This cross-sectional study investigated associations between balance confidence and outdoor walking parameters in various environments as well as differences in these parameters among older adults with varying levels of balance confidence.

Older adults (N = 39, women 67%, mean age 76) walked outdoors on level, uphill, and downhill with their self-selected normal speed. Walking parameters (stride, stance, and swing durations and cadence) and their variance were assessed using inertial measurement units on the lower back and shanks. Balance confidence was evaluated using the activities-specific balance confidence scale (ABC). Additionally, physical activity, self-rated health, falls in past year, anthropometrics, walking speed on level, short physical performance test (SPPB), and Timed Up and Go (TUG) were recorded.

Balance confidence positively correlated with cadence on level (r_s = 0.439, p = 0.005) and uphill (r_s = 0.336, p = 0.049), negatively with cadence variability downhill (r_s = -0.424, p = 0.007) and stride duration on level (r_s = -0.436, p = 0.006) and uphill (r_s = -0.335, p = 0.049). The high balance confidence group (ABC ≥80, n = 32) had 7-8% higher cadence in all environments, 7-8% shorter stride duration uphill and downhill, walked 0.14 m/s faster on level and showed less variability in walking parameters uphill compared to the lower balance confidence group (ABC <80, n = 7).

In older adults, differences in walking parameters can be seen when using the balance confidence as a differentiating factor. Self-rated balance confidence combined with an uphill walking test may give an indication of varying walking patterns in older adults.