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Older women take shorter steps during backwards walking and obstacle crossing.

ABSTRACT: BACKGROUND:Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks. OBJECTIVE:The purpose of this study was to determine gender differences in two common adaptive tasks. METHODS:Walking performance was assessed from 54 age and gender matched participants (72?±?5?yrs.) while they completed forward walking (FW), OBS and BW. Gait outcomes and the distance of the lead foot and the trail foot from the obstacle were normalized by leg length and assessed using multivariate analysis of variance. Additionally, performance in a battery of clinical physical and cognitive measures as well as self-reported activity levels were associated with adaptive gait behavior. RESULTS:Gait speed and step width were not different between genders in any walking task. Compared to FW and OBS, women only decreased step length in BW, resulting in significantly shorter step lengths than men in OBS (p?=?0.02) and BW (p?=?0.04), a conservative walking strategy. Women crossed the obstacle in a manner that may limit recovery steps in case of a trip: stepping closer to the obstacle during approach without increasing trail toe-clearance. The Timed Up and Go mobility test, Short Physical Performance Battery, and Trail Making Test of processing speed and executive function were associated with gender differences in adaptive gait patterns. CONCLUSION:The findings revealed that older adult women adapt walking in a way that might predispose them to tripping or falling (i.e. shorter steps and closer obstacle approach). Gender differences in adaptive walking are related to functional test performance and processing speed. Clinicians should consider targeting step length during adaptive walking tasks in women that may be at risk of mobility impairments.

SUBMITTER: Raffegeau TE

PROVIDER: S-EPMC6771276 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Older women take shorter steps during backwards walking and obstacle crossing.

Raffegeau Tiphanie E TE Kellaher Grace K GK Terza Matthew J MJ Roper Jaimie A JA Altmann Lori J LJ Hass Chris J CJ

Experimental gerontology 20190426

<h4>Background</h4>Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks.<h4>Objective</h4>The purpose of this study was to determine gender ...[more]

PMID: 31034865

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Project description:BackgroundThe ability to walk at various speeds is essential to independence for older adults. Maintaining fast walking requires changes in spatial-temporal measures, increasing step length and/or decreasing step time. It is unknown how mobility affects the parameters that change between preferred and fast walking.Research questionHow does preferred walking performance and measures of strength and mobility relate to the approach (decreasing step time or increasing step length) older adults at risk for mobility disability use to maintain fast walking speeds?.MethodsPeak isokinetic dynamometry of knee and ankle and several mobility evaluations, including the Timed Up-and-Go, Short Physical Performance Battery, and Dynamic Gait Index, assessed mobility and strength in 57 participants, aged 65-80. Biomechanical gait analysis was used to analyze step length, step time, gait speed at preferred and fast gait speeds and ground reaction force during preferred walking. A score combining the differences between step length and time at fast and preferred speeds (Length-Time Difference) separated participants into two groups: (1) Length, representing a predominant increase in step length to walk fast and (2) Time, a predominant decrease in step time.ResultsThose who decreased step time to produce increased speed performed worse during repeated chair stands (p = .006) with no difference in isokinetic strength (p ≥ .15). During preferred walking, the Time group displayed increased propulsive impulse compared to the Length group (p = .007), despite no differences in preferred speed, step length, or time (p ≥ .50).SignificanceWhile kinetics of preferred walking differed between groups separated by Length-Time Difference, basic spatial-temporals of preferred walking did not in this homogenous population. Length-Time Difference relates to a common mobility assessment and could be easily calculated by clinicians to provide a quantitative and more sensitive measure of ambulatory performance.

Project description:BackgroundReduced push-off intensity during walking is thought to play an important role in age-related mobility impairment. We posit that an age-related shift toward shorter plantarflexor operating lengths during walking functionally limits force generation, and thereby the ability of those muscles to respond to increased propulsive demands during walking.Research questionTo determine whether gastrocnemius muscle fascicle lengths during normal walking: (1) are shorter in older than young adults, and (2) correlate with one's capacity to increase the propulsive demands of walking to their maximum.MethodsWe used in vivo cine B-mode ultrasound to measure gastrocnemius fascicle lengths in 9 older and 9 young adults walking at their preferred speed, their maximum speed, and with horizontal impeding forces that increased in a ramped design at 1%BW/s to their maximum. A repeated measures ANOVA tested for effects of age and walking condition, and Pearson correlations assessed the relation between fascicle outcomes and condition performance.ResultsA tendency toward shorter medial gastrocnemius muscle fascicle lengths in older versus young adults was not statistically significant. However, older adults walked with reduced peak fascicle shortening during all conditions compared to young adults - an outcome not explained by reduced muscle-tendon unit shortening and exacerbated during tasks with greater than normal propulsive demand. As hypothesized, we found a strong and significant positive correlation in older subjects between gastrocnemius fascicle lengths during normal walking and performance on the ramped impeding force condition (p = 0.005, r² = 0.704), even after controlling for isometric strength (p = 0.011, r² = 0.792) and subject stature (p = 0.010, r² = 0.700).SignificanceOur findings provide muscle-level insight to develop more effective rehabilitation techniques to improve push-off intensity in older adults and assistive technologies designed to steer plantarflexor muscle fascicle operating behavior during functional tasks.

Project description:Gait variability may serve as a sensitive and clinically relevant parameter to quantify adjustments in walking and the changes with aging and neurological disease. Variability of steps preceding obstacle avoidance (approach phase) are important for efficiency in the task, especially in people with Parkinson's disease (PD). However, variability of gait during the approach phase to obstacle avoidance in people with PD has been rarely reported, particularly when ambulating obstacles of different heights. The aim of the present study was to investigate the effects of obstacle height on step-to-step variability (step-to-step variability provides information on the variation between the "equivalent steps" for all trials, and walking variability (indicates the within-step variability of each, providing information about the modulations between the steps performed. of spatial-temporal parameters during the approach phase to obstacle avoidance in people with PD and neurologically healthy older people. Twenty-eight older people; 15 with PD and 13 neurologically healthy individuals (control group), participated in the study. Participants were instructed to walk at their preferred speed until the end of the pathway and to avoid the obstacle when it was present. Each subject performed 10 trials of the following tasks: unobstructed walking, low obstacle avoidance (3cm length, height equal ankle's height, 60 cm wide), intermediate obstacle (3cm length, low plus high obstacle height divided by 2, 60 cm wide) avoidance and high obstacle avoidance (3cm length, knee's height, 60 cm wide). The obstacle was positioned 4m from to the start position. The step-to-step and walking variability of the spatial-temporal parameters (acquiring with GAITRite®) of the four steps before obstacle avoidance were analyzed. MANOVAs were used to compare the data. PD group showed the characteristic gait deficits associated with PD. The obstacle increased the spatial-temporal variability (step-to-step and walking variability) during the approach phase to the obstacle. Specifically, both groups increased i) the step-to- step variability of the step length during low obstacle avoidance when compared to the other conditions; ii) the variability during low obstacle avoidance in the last step before obstacle (n-1) compared to higher obstacle avoidance; iii) variability during higher obstacle avoidance in further steps (n-3 and n-4). In conclusion, the presence of the obstacle during walking increased the variability of spatial-temporal parameters in older people with PD and the control group during the steps preceding obstacle avoidance. In addition motor planning (and motor adaptations) was initiated much earlier in the approach phase for the higher obstacle conditions compared to the low obstacle condition.

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Older women take shorter steps during backwards walking and obstacle crossing.

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Older women take shorter steps during backwards walking and obstacle crossing.

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