@article {1052, title = {Diabetes mellitus and gait dysfunction: possible explanatory factors.}, journal = {Phys Ther}, volume = {88}, year = {2008}, month = {2008 Nov}, pages = {1365-74}, abstract = {

BACKGROUND AND OBJECTIVE: Gait characteristics differ in individuals with diabetes compared with those without diabetes. Limited information regarding potential explanatory factors for this association exists. This study examined the association between diabetes and gait characteristics in older adults and explored potential explanatory factors.

DESIGN: A cross-sectional, observational study design was used.

METHODS: At the 1998-1999 clinic visit, 558 ambulatory older adults (mean age=79 years) from the Pittsburgh site of the Cardiovascular Health Study had an assessment of their gait characteristics, diabetes, health status, cognition, mood, lower-extremity circulation and sensation, vision, lower-extremity strength (force-producing capacity), physical activity, and body mass index (BMI). A series of linear regression models were developed to examine the association between diabetes and gait characteristics and to examine potential explanatory factors for the associations.

RESULTS: Diabetes was related to gait speed (beta=-.06 m/s); however, the association was partially explained by health status variables, cognition, mood, lower-extremity circulation and sensation, visual impairment, lower-extremity strength, physical activity, and BMI. Health status and lower-extremity strength each explained the greatest proportion of the association (beta reduced 66\% by each). Diabetes was related to step width (beta=.02 m), and the association could not be explained by the examined factors.

CONCLUSIONS: Diabetes was associated with gait alterations in older adults. Slowed gait speed appears to be secondary to the peripheral effect of the disease on other body systems. The effect of diabetes on step width was not explained in the analyses and may be related to peripheral motor nerve function or central influences of the disease, which could not be assessed in this study.

}, keywords = {Aged, Body Mass Index, Cognition, Cross-Sectional Studies, Diabetes Mellitus, Female, Gait, Geriatric Assessment, Health Status, Humans, Linear Models, Longitudinal Studies, Male, Multicenter Studies as Topic, Muscle Strength}, issn = {1538-6724}, doi = {10.2522/ptj.20080016}, author = {Brach, Jennifer S and Talkowski, Jaime B and Strotmeyer, Elsa S and Newman, Anne B} } @article {1058, title = {Impact of health perception, balance perception, fall history, balance performance, and gait speed on walking activity in older adults.}, journal = {Phys Ther}, volume = {88}, year = {2008}, month = {2008 Dec}, pages = {1474-81}, abstract = {

BACKGROUND AND PURPOSE: Disagreement currently exists regarding the contributions of various factors to physical activity in older adults. The purpose of this cross-sectional study was to investigate the simultaneous impact of psychological (health perception and balance perception) and physiological (gait speed, fall history, and balance performance) factors on walking activity in older adults.

SUBJECTS AND METHODS: This cross-sectional secondary data analysis included 2,269 community-dwelling older adults from the Cardiovascular Health Study. A series of simultaneous linear regression models were constructed to examine the association of walking activity with health and balance perception, gait speed, fall history, and balance performance after controlling for potential confounding factors.

RESULTS: Health and balance perception and gait speed were significantly related to walking activity after controlling for potential confounding factors. Participants who perceived both their health and their balance to be good walked more blocks per week than those who reported a discordant perception, who walked more than those who perceived both their health and their balance to be poor. Participants who walked at a normal speed walked more blocks per week than those who walked at a slow speed.

DISCUSSION AND CONCLUSION: The measure of physical activity used in this study included only walking, not other low- to moderate-intensity activities that are common in older adults. Health and balance perception and gait speed were associated with walking activity more so than fall history or balance performance after controlling for potential confounding factors.

}, keywords = {Accidental Falls, Aged, Aged, 80 and over, Attitude to Health, Cross-Sectional Studies, Female, Gait, Geriatric Assessment, Health Status, Humans, Male, Motor Activity, Multivariate Analysis, Perception, Postural Balance, Risk Assessment, Walking}, issn = {1538-6724}, doi = {10.2522/ptj.20080036}, author = {Talkowski, Jaime B and Brach, Jennifer S and Studenski, Stephanie and Newman, Anne B} }