Assessment of balance during gait at a self-elected speed in healthy youngsters, elderly persons who do not fall and elderly persons with a high risk of falls
Keywords:
POSTURAL BALANCE, GAIT, ACCIDENTAL FALLSAbstract
Introduction: balance depends on keeping the projection of the center of body mass within the limits of the support basis, although its assessment is usually performed by means of cinematic variability.
Objectives: to analyse balance during gait at a self-elected speed in three populations using different approaches.
Method: the groups analysed were: healthy youngsters, elderly who do not fall and elderly who fall. We calculated speed, time variability, angle variability of knee and balance during gait cycles through a tridimensional cinematic analysis. To directly calculate balance we defined a variable considering the projection of the center of body mass. Results of the cinematic variables were compared between groups using ANOVA (a=0,05). Similarly we compared average, maximum and minimum values of the direct balance estimation between groups for simple support and double cycle stages.
Results: cycle speed was similar in elderly persons. Time variability of cycle was low and angle variability was high in healthy youngsters, while these variables evidenced no difference between the elderly persons groups. During the simple support stage average and minimum balance values for the group of people who fall were significantly different if compared to the other groups.
Conclusions: direct estimation of balance during the simple support stage appears as a potential tool to identify individuals with a risk of falls.
References
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(2) Perry BC. Falls among the elderly living in high-rise apartments. J Fam Pract 1982; 14(6): 1069-73.
(3) Myers AH, Baker SP, Van Natta MC, Abbey H, Robinson EG. Risk factors associated with falls and injuries among elderly institutionalized persons. Am J Epidemiol 1991; 133(11): 1179-90.
(4) Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319(26): 1701-7.
(5) Tinetti ME, Mendes de León CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol 1994; 49(3): M140-7.
(6) Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 1997; 337(18): 1279-84.
(7) Wolf SL, Barnhart HX, Kutner NG, Mc Neely E, Coogler C, Xu T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computarized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative studies of Intervention Techniques. J Am Geriatr Soc 1996; 44(5): 489-97.
(8) Kangas M, Vikman I, Wiklander J, Lindgren P, Nyberg L, Jämsä T. Sensitivity and specificity of fall detection in people aged 40 years and over. Gait Posture 2009; 29(4): 571-4.
(9) Wall C 3RD, Wrisley DM, Statler KD. Vibrotactile tilt feedback improves dynamic gait index: a fall risk indicator in older adults. Gait Posture 2009; 30(1): 16-21.
(10) Nickens H. Intrinsic factors in falling among the elderly. Arch Intern Med 1985; 145(6): 1089-93.
(11) Krebs DE, Goldvasser D, Lockert JD, Portney LG, Gill-Body KM. Is base of support greater in unsteady gait? Phys Ther 2002; 82(2): 138-47.
(12) Maki BE. Gait changes in older adults: predictions of falls or indicators of fear? J Am Geriatr Soc 1997; 45(3): 313-20.
(13) Helderscheit BC. Movement variability as a clinical measure for locomotion. J Appl Biomech. 2000; 16(4): 419-27.
(14) Hausdorff JM. Gait variability: methods, modelling and meaning. J Neuroeng Rehabil 2005; 20(2): 19.
(15) Dubost V, Kressing RW, Gonthier R, Herrmann FR, Aminian K, Najafi B, et al. Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults. Hum Mov Sci 2006; 25(3): 372-82.
(16) Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: A 1 year prospective study. Arch Phys Med Rehabil 2001; 82(8): 1050-6.
(17) Beauchet O, Allali G, Berrut G, Dubost V. Is low lower-limb kinematic variability always an index of stability? Gait Posture 2007; 26(2): 327-8.
(18) Winter DA. Anatomy, biomechanics and control of balance during standing and walking. Waterloo, Ont: Waterloo Biomechanics, 1995.
(19) Alexander RM. Stability and manoeuvrability of terrestrial vertebrates. Integr Comp Biol 2002; 42(1): 158-64.
(20) Gehlsen GM, Whaley MH. Falls in the elderly: part I, gait. Arch Phys Med Rehabil 1990; 71(10): 735-8.
(21) Howe TE, Rochester L, Jackson A, Banks PM, Blair VA. Exercise for improving balance in older people. Cochrane Database of Syst Rev 2007; 17(4): 1-107.
(22) Yamasaki M, Sasaki T, Tsuzki S, Torii M. Stereotyped pattern of lower limb movement during level and grade walking on treadmill. Ann Physiol Anthropol 1984; 3(4): 291-6.
(23) Figueroa PJ, Leite NJ, Barros RM. A flexible software for tracking of markers used in human motion analysis. Comput Methods Programs Biomed 2003; 72(2): 155-65.
(24) Winter DA. Biomechanics and motor control of human movement. 2nd ed. Toronto: Wiley Interscience, 1990.
(25) Pavol MJ, Owings TM, Grabiner MD. Body segment inertial parameter estimation for the general population of elder adults. J Biomech 2002; 35(5): 707-12.
(26) Jensen RK, Fletcher P. Distribution of mass to the segments of elderly males and females. J Biomech 1994; 27(1): 89-96.
(27) Dempster WT, Gaughran GRL. Properties of body segments based on size and weight. Am J Anat 1967; 120(1): 33-54.
(28) Nelson ME, Layne JE, Bernstein MJ, Nuernberger A, Castaneda C, Kaliton D, et al. The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol A Biol Sci Med Sci 2004; 59 (2): 154-60.
(29) Johansson G, Jarnlo G. Balance training in 70-year-old women. Physiother Theory Pract 1991; 7(2): 121-5.
(30) Donskoi D, Zatsiorsky VM. Biomecánica de los ejercicios físicos. La Habana: Pueblo y Educación, 1988.
(31) Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990; 19(2): 136-41.
(32) Beauchet O, Dubost V, Herrmann FR, Kressig RW Stride-to-stride variability while backward counting among healthy young adults. J Neuroeng Rehabil 2005; 2: 26.
(33) Hausdorff JM, Edelberg HK, Mitchell SL, Goldberg AL, Wei, JY. Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil 1997; 78(3): 278-83.
(34) Schaafsma JD, Giladi N, Balash Y, Bartels AL, Gurevich T, Hausdorff JM. Gait dynamics in Parkinson's disease: relationship to Parkinsonian features, falls and response to levodopa. J Neurol Sci 2003; 212(1-2): 47-53.
(35) Sheridan PL, Solomont J, Kowall N, Hausdorff JM. Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer's disease. J Am Geriatr Soc 2003; 51(11): 1633-7.
(36) Gabell A, Nayak US. The effect of age on variability in gait. J Gerontol 1984; 39(6): 662-6.
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Published
2011-09-30
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Fábrica CG, Rey A, González PV, Santos D, Ferraro D. Assessment of balance during gait at a self-elected speed in healthy youngsters, elderly persons who do not fall and elderly persons with a high risk of falls. Rev. Méd. Urug. [Internet]. 2011 Sep. 30 [cited 2024 Nov. 24];27(3):147-54. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/382
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