Hollander Karsten, Petersen Evi, Zech Astrid, Hamacher Daniel
MSH Medical School Hamburg, Hamburg, Germany.
Department of Sports, Physical Education and Outdoor Life, University of South-Eastern Norway, Norway.
Gait Posture. 2022 Jun;95:284-291. doi: 10.1016/j.gaitpost.2021.04.024. Epub 2021 Apr 15.
Gait stability and variability measures in barefoot and shod locomotion are frequently investigated in younger but rarely in older adults. Moreover, most studies examine gait measures in laboratory settings instead of real-life settings.
How are gait stability and variability parameters affected by footwear compared to barefoot walking in younger and older adults as well as under indoor vs. outdoor conditions?
Healthy younger (<35 years) and older adults (>65 years) participated in the randomised within-subject study design. Participants conducted consecutive 25 m walking trials barefoot and with standardised footwear inside and outside. Inertial measurement units were mounted on the participant's foot and used to calculate local dynamic stability (LDS), velocity and minimal toe clearance (MTC), stride length and stride time, including variabilities for these parameters. Linear mixed models were calculated.
Data of 32 younger (17 female, 15 male, age: 30 ± 4 years) and 42 older participants (24 female, 18 male, age: 71 ± 4 years) were analysed. MTC variability was higher in shod conditions compared to barefoot (p = 0.048) and in outdoor conditions (p < 0.001). LDS was different between age groups (p < 0.001). Gait velocity and MTC were higher in shod and outdoor conditions (both p < 0.001). Stride length and time were higher in shod conditions (both p < 0.001) and different between outdoor vs. indoor (longer stride length and shorter stride time outdoor, both (p < 0.001) as well as age groups (shorter stride length (p < 0.021) and stride time in older adults (p < 0.001).
Results suggest that gait stability and variability in older and younger adults are acutely affected by footwear vs. barefoot and indoor vs. outdoor walking conditions, indicating a high adaptiveness of these parameters to different experimental conditions. Consequently, future studies should be careful with generalising results obtained under certain conditions. Findings stress the clinical potential of barefoot walking.
在年轻人中，经常会研究赤脚和穿鞋行走时的步态稳定性和变异性指标，但在老年人中却很少见。此外，大多数研究是在实验室环境而非现实生活环境中检测步态指标。
与年轻人和老年人在室内与室外条件下的赤脚行走相比，鞋类如何影响步态稳定性和变异性参数？
健康的年轻人（<35岁）和老年人（>65岁）参与了随机的受试者内研究设计。参与者在室内外分别进行连续25米的赤脚和穿着标准化鞋类的行走试验。惯性测量单元安装在参与者的脚上，用于计算局部动态稳定性（LDS）、速度和最小脚趾间隙（MTC）、步幅和步幅时间，包括这些参数的变异性。计算线性混合模型。
分析了32名年轻人（17名女性，15名男性，年龄：30±4岁）和42名老年人（24名女性，18名男性，年龄：71±4岁）的数据。与赤脚相比，穿鞋条件下的MTC变异性更高（p = 0.048），在室外条件下也是如此（p < 0.001）。年龄组之间的LDS不同（p < 0.001）。穿鞋和室外条件下的步态速度和MTC更高（均p < 0.001）。步幅和步幅时间在穿鞋条件下更高（均p < 0.001），室外与室内不同（室外步幅更长，步幅时间更短，均p < 0.001），年龄组之间也不同（老年人步幅更短（p < 0.021），步幅时间更短（p < 0.001）。
结果表明，年轻人和老年人的步态稳定性和变异性会受到鞋类与赤脚以及室内与室外行走条件的显著影响，这表明这些参数对不同实验条件具有高度适应性。因此，未来的研究在推广特定条件下获得的结果时应谨慎。研究结果强调了赤脚行走的临床潜力。
