Almidani Louay, Vargas José G, Yuan Zhuochen, Banerjee Seema, Chen Xindi, Diaz Mariah, Miller Rhonda, Mihailovic Aleksandra, Ramulu Pradeep Y
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA.
Sensors (Basel). 2025 Jun 13;25(12):3712. doi: 10.3390/s25123712.
To understand the impact of falls on gait in those with poor sight, we examined how gait changed after falls in older adults with varying degrees of visual impairment from glaucoma. Participants were classified as fallers or non-fallers based on prospective falls data from the first study year. Injurious fallers were those who suffered injuries from falls. The GAITRite Electronic Walkway characterized gait at baseline and three annual follow-ups. Parameters examined included stride length, variability in stride length (CV), stride velocity, stride velocity CV, base of support, base of support CV, and cadence. Longitudinal gait changes were assessed using generalized estimating equation models. Stride length significantly decreased in both fallers (β = -0.09 z-score unit/year) and non-fallers (β = -0.08 z-score unit/year), stride velocity slowed only among fallers (β = -0.08 z-score unit/year), and, in contrast, stride velocity CV decreased only among non-fallers (β = -0.07 z-score unit/year). No longitudinal differences were noted between groups. Additionally, no significant differences in gait metrics were observed between non-fallers, one-time fallers, and multiple fallers, nor between those with and without an injurious fall. Amongst older adults, and enriched for those with visual impairment, fallers and non-fallers adopted a more cautious gait over time, with similar gait changes across groups. Our results suggest that, in visual impairment, many falls may not lead to significant changes in gait.
为了解跌倒对视力不佳者步态的影响，我们研究了青光眼导致不同程度视力损害的老年人跌倒后步态如何变化。根据首个研究年度的前瞻性跌倒数据，将参与者分为跌倒者和非跌倒者。受伤跌倒者是指因跌倒而受伤的人。GAITRite电子步道在基线及随后三年每年对步态进行测定。所检测的参数包括步长、步长变异性（CV）、步速、步速CV、支撑面、支撑面CV和步频。使用广义估计方程模型评估步态的纵向变化。跌倒者（β = -0.09 z评分单位/年）和非跌倒者（β = -0.08 z评分单位/年）的步长均显著下降，只有跌倒者的步速减慢（β = -0.08 z评分单位/年），相反，只有非跌倒者的步速CV下降（β = -0.07 z评分单位/年）。两组之间未发现纵向差异。此外，在非跌倒者、单次跌倒者和多次跌倒者之间，以及有或无受伤跌倒者之间，未观察到步态指标的显著差异。在老年人中，尤其是视力受损者，跌倒者和非跌倒者随着时间的推移都采取了更谨慎的步态，各组之间的步态变化相似。我们的结果表明，在视力损害的情况下，许多跌倒可能不会导致步态的显著变化。
