Geriatric Department, Liège University Hospital, C.H.U. site NDB, Route de Gaillarmont, 600, 4032, Chênée, Belgium.
INTELSIG Laboratory, Department of Electrical Engineering and Computer Science, University of Liège, Liège, Belgium.
Aging Clin Exp Res. 2019 Aug;31(8):1057-1067. doi: 10.1007/s40520-019-01210-w. Epub 2019 May 8.
Given the potential consequences of falls among older adults, a major challenge is to identify people at risk before the first event. In this context, gait parameters have been suggested as markers of fall risk.
To examine, among older people, the prospective relationship between gait patterns assessed in comfortable and challenging walking conditions, and future fall(s).
A total of 105 adults older than 65 years, living independently at home and without a recent fall history were included in a 2-year, longitudinal, observational study. All underwent physical and functional assessment. Gait speed, stride length, frequency, symmetry and regularity and Minimum Toe Clearance (MTC) were recorded in comfortable (CW), fast (FW) and dual task walking (DTW) conditions. Gait parameter changes occurring between CW and FW and between CW and DTW were calculated and expressed in percent. DTW cost was calculated as the change of DTW relative to CW. Fall events were recorded using fall diaries. Comparisons according to fall occurrence were performed by means of univariate analysis and multivariate binary logistic regression analysis.
Two-year follow-up was available for 96 participants, of whom 35 (36.5%) fell at least once. Comparative analysis showed that future fallers had shorter FW stride length and higher symmetry DTW cost than non-fallers (p < 0.05). Binary logistic regression analysis showed that each additional percent of stride symmetry cost was associated with an increase in future fall risk (odds ratio 1.018, 95% Confidence Interval (CI) 1.002-1.033; p = 0.027).
Our results confirm the association between a symmetry decrease in DTW and future fall(s). Indeed in this study, the mean symmetry DTW cost in fallers is almost 20% higher than in non-fallers, meaning a fall risk that is around 36% higher than among non-fallers.
This exploratory study shows the usefulness of considering gait parameters, particularly symmetry in challenging walking conditions, for early identification of future fallers.
鉴于老年人跌倒的潜在后果，主要挑战是在首次事件发生之前识别出处于风险中的人群。在这种情况下，步态参数已被认为是跌倒风险的标志物。
在老年人中，检查在舒适和挑战行走条件下评估的步态模式与未来跌倒之间的前瞻性关系。
共有 105 名年龄在 65 岁以上、独立居住在家且无近期跌倒史的成年人参加了一项为期 2 年的纵向观察研究。所有参与者都接受了身体和功能评估。在舒适（CW）、快速（FW）和双重任务行走（DTW）条件下记录了步行速度、步长、频率、对称性和规律性以及最小脚趾间隙（MTC）。计算了 CW 和 FW 之间以及 CW 和 DTW 之间的步态参数变化，并以百分比表示。DTW 成本是通过 DTW 相对于 CW 的变化来计算的。使用跌倒日记记录跌倒事件。通过单变量分析和多元二项逻辑回归分析对根据跌倒发生情况进行比较。
96 名参与者中有 2 年的随访数据，其中 35 名（36.5%）至少跌倒过一次。对比分析表明，未来跌倒者的 FW 步长较短，DTW 对称性成本较高（p<0.05）。二元逻辑回归分析显示，步长对称性成本每增加 1%，未来跌倒风险就会增加（优势比 1.018，95%置信区间 1.002-1.033；p=0.027）。
我们的结果证实了 DTW 对称性降低与未来跌倒之间的关联。事实上，在这项研究中，跌倒者的 DTW 对称性平均成本比非跌倒者高出近 20%，这意味着跌倒风险比非跌倒者高出约 36%。
这项探索性研究表明，考虑步态参数，特别是在挑战行走条件下的对称性，对于早期识别未来跌倒者是有用的。
