Title | Stance time and step width variability have unique contributing impairments in older persons. |
Publication Type | Journal Article |
Year of Publication | 2008 |
Authors | Brach, JS, Studenski, S, Perera, S, VanSwearingen, JM, Newman, AB |
Journal | Gait Posture |
Volume | 27 |
Issue | 3 |
Pagination | 431-9 |
Date Published | 2008 Apr |
ISSN | 0966-6362 |
Keywords | Aged, Aged, 80 and over, Biomechanical Phenomena, Female, Gait Disorders, Neurologic, Humans, Linear Models, Longitudinal Studies, Male, Neuropsychological Tests, Postural Balance, Range of Motion, Articular, Risk Factors, Signal Processing, Computer-Assisted |
Abstract | <p>Gait variability may have multiple causes. We hypothesized that central nervous system (CNS) impairments would affect motor control and be manifested as increased stance time and step length variability, while sensory impairments would affect balance and be manifested as increased step width variability. Older adults (mean+/-standard deviation (S.D.) age=79.4+/-4.1, n=558) from the Pittsburgh site of the Cardiovascular Health Study participated. The S.D. across steps was the indicator of gait variability, determined for three gait measures, step length, stance time and step width, using a computerized walkway. Impairment measures included CNS function (modified mini-mental state examination, Trails A and B, Digit Symbol Substitution, finger tapping), sensory function (lower extremity (LE) vibration, vision), strength (grip strength, repeated chair stands), mood, and LE pain. Linear regression models were fit for the three gait variability characteristics using impairment measures as independent variables, adjusted for age, race, gender, and height. Analyses were repeated stratified by gait speed. All measures of CNS impairment were directly related to stance time variability (p<0.01), with increased CNS impairment associated with increased stance time variability. CNS impairments were not related to step length or width variability. Both sensory impairments were inversely related to step width (p<0.01) but not step length or stance time variability. CNS impairments affected stance time variability especially in slow walkers while sensory impairments affected step width variability in fast walkers. Specific patterns of gait variability may imply different underlying causes. Types of gait variability should be specified. Interventions may be targeted at specific types of gait variability.</p> |
DOI | 10.1016/j.gaitpost.2007.05.016 |
Alternate Journal | Gait Posture |
PubMed ID | 17632004 |
PubMed Central ID | PMC2276116 |
Grant List | K23 AG026766-01 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States P30 AG024827-01 / AG / NIA NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States TG32 AG00181 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States U01 HL080295-01 / HL / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States TG 32AG00181 / AG / NIA NIH HHS / United States T32 AG000181-09 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States K23 AG026766 / AG / NIA NIH HHS / United States T32 AG000181 / AG / NIA NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States K23 AG026766-03 / AG / NIA NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States K23 AG026766-02 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |