Obstacle-Crossing Speed and its Association With Fall Risk in Community-Dwelling Older Adults

The ability to cross obstacles declines with age, and obstacle-related falls are increasingly common among older adults. This study examined the association between obstacle-crossing performance and fall risk, and their distinct roles in older Korean adults.

In this observational study, 200 older adults (72.8 ± 5.6 years) participated. Obstacle performance was assessed with a gait analysis system, measuring obstacle-crossing speed and foot elevation while stepping over 5 cm, 10% of height, and 30-cm obstacles. Fall risk was evaluated using the Fall Risk Assessment system, which integrates sensory, neurological, balance, and musculoskeletal domains. Participants were classified as low or high risk based on Fall Risk Assessment scores. Independent t-tests compared obstacle performance between groups, and one-way analyses of variance examined age differences (65-69, 70-74, 75-79, ≥80 years).

At 5 cm and 10% height obstacles, foot elevation did not differ by group, whereas obstacle-crossing speed was higher in the low-risk group (p < .05). At 30 cm, both foot elevation (p = .003) and obstacle-crossing speed (p < .001) were greater in the low-risk group. Obstacle-crossing speed declined with age across all obstacles (p < .001), while foot elevation decreased with age only at 30 cm (p < .05).

Obstacle-crossing speed and foot elevation are associated with fall risk, and maintaining speed under higher demands may indicate gait adaptability. Significance/Implications: Measuring obstacle-crossing speed may improve fall risk screening and guide interventions to maintain mobility and independence in older adults.