Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
Sensors (Basel). 2022 Dec 22;23(1):101. doi: 10.3390/s23010101.
Gait quality characteristics obtained from daily-life accelerometry are clinically relevant for fall risk in older adults but it is unknown whether these characteristics are responsive to changes in gait quality. We aimed to test whether accelerometry-based daily-life gait quality characteristics are reliable and responsive to changes over one year in older adults who experienced a fall or an exercise intervention. One-week trunk acceleration data were collected from 522 participants (65-97 years), at baseline and after one year. We calculated median values of walking speed, regularity (sample entropy), stability (logarithmic rate of divergence per stride), and a gait quality composite score, across all 10-s gait epochs derived from one-week gait episodes. Intraclass correlation coefficients (ICC) and limits of agreement (LOA) were determined for 198 participants who did not fall nor participated in an exercise intervention during follow-up. For responsiveness to change, we determined the number of participants who fell ( = 209) or participated in an exercise intervention ( = 115) that showed a change beyond the LOA. ICCs for agreement between baseline and follow-up exceeded 0.70 for all gait quality characteristics except for vertical gait stability (ICC = 0.69, 95% CI [0.62, 0.75]) and walking speed (ICC = 0.68, 95% CI [0.62, 0.74]). Only walking speed, vertical and mediolateral gait stability changed significantly in the exercisers over one year but effect sizes were below 0.2. The characteristic associated with most fallers beyond the LOA was mediolateral sample entropy (4.8% of fallers). For the exercisers, this was gait stability in three directions and the gait quality composite score (2.6% of exercisers). The gait quality characteristics obtained by median values over one week of trunk accelerometry were not responsive to presumed changes in gait quality after a fall or an exercise intervention in older people. This is likely due to large (within subjects) differences in gait behaviour that participants show in daily life.
从日常活动加速度计获得的步态质量特征与老年人的跌倒风险具有临床相关性，但尚不清楚这些特征是否对步态质量的变化有反应。我们旨在测试在经历跌倒或运动干预的老年人中，基于加速度计的日常生活步态质量特征是否可靠且能够随时间变化。在基线和一年后，从 522 名参与者（65-97 岁）中收集了一周的躯干加速度数据。我们在所有 10 秒步态期间，计算了所有步态阶段的行走速度、规律性（样本熵）、稳定性（每步的对数发散率）和步态质量综合评分的中位数。在没有跌倒也没有参与运动干预的 198 名参与者中，确定了组内相关系数（ICC）和一致性界限（LOA）。对于在随访期间跌倒（= 209）或参与运动干预（= 115）的参与者，我们确定了超出 LOA 的参与者数量。除垂直步态稳定性（ICC = 0.69，95％CI [0.62，0.75]）和行走速度（ICC = 0.68，95％CI [0.62，0.74]）外，所有步态质量特征的基线和随访之间的 ICC 均超过 0.70。在一年中，仅锻炼者的行走速度、垂直和内外侧步态稳定性发生了明显变化，但效应大小低于 0.2。与 LOA 相比，跌倒者最相关的特征是内外侧样本熵（4.8％的跌倒者）。对于锻炼者，这是三个方向的步态稳定性和步态质量综合评分（2.6％的锻炼者）。在老年人中，一周躯干加速度计中位数获得的步态质量特征对跌倒或运动干预后预期的步态质量变化没有反应。这可能是由于参与者在日常生活中表现出的步态行为存在较大（个体内）差异所致。
