Gait initiation changes with ageing

NewsBot · Sep 27, 2013

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Gait initiation: The first four steps in adults aged 20–25 years, 65–79 years, and 80–91 years
B.C. Muir, S. Rietdyk, J.M. Haddad
Gait & Posture; Article in Press

Transitioning from standing to walking requires equilibrium to be maintained while a forward propulsive force is generated. The ability to manage these competing demands is compromised by the progressive sensory, neural and motor declines associated with aging. The purpose of this study was to establish the age-related changes in the first four steps of gait in three age groups: 20–25 years old (yo) (N=19), 65–79yo (N=11), and 80–91yo (N=18). Participants stood comfortably and then walked at a self-selected pace for 3.2m. Gait speed and step length (SL) both significantly decreased with each age category at each of the first four steps. However, the gait speed changes suggest that older groups control speed in a principled manner across the four steps, which was similar to the speed control of 20–25yo. With successive steps, 20–25yo demonstrated a progressive decrease in SL variability, but SL variability of the two older groups did not change. Step width (SW) did not change as a function of age, but SW variability was higher for the two older groups. Higher SL and SW variability may reflect more errors in foot placement and/or decreased center of mass control in the older groups. Further, it appears that AP COM control improves with successive steps in young adults while ML COM control decreases with successive steps in all age groups. When comparing the two older groups, healthy 80–91yo walked slower with a shorter SL, but did not demonstrate changes associated with falls (SL and/or SW variability).
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Highlights
•We establish the age-related changes in the first four steps of gait.
•Young adult group was compared to two groups: 65–79 years and 80–91 years old.
•All age groups appear to control speed in a principled manner across the four steps.
•Older groups had higher step length and step width variability.
•Healthy 80–91 year olds did not demonstrate gait changes associated with falls.
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Admin2 · Sep 27, 2013

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Gait instability associated with ageing

NewsBot · Aug 19, 2019

Comparison of foot kinetics and kinematics during gait initiation between young and elderly participants.
Satoh Y et al
J Phys Ther Sci. 2019 Jul;31(7):498-503
[Purpose] To investigate the differences in foot kinetics during gait initiation between young and elderly participants using a modified multi-segment foot model. [Participants and Methods] Twelve young (23.3 ± 2.4 years) and 12 elderly participants (73.3 ± 3.9 years) were included in this study. Gait initiation was measured using a three-dimensional motion analysis system. We calculated the kinetic and kinematic values using our modified multi-segment foot model and compared those values with the values calculated using Bruening et al.'s multi-segment foot model. Modified gait initiation values were also compared between the elderly and young participants. [Results] Our modified multi-segment foot model, created using the Software for Interactive Musculoskeletal Modeling, showed similar values to those reported by Bruening et al. When we compared gait initiation between the elderly participants and their younger counterparts, the elderly exhibited lower torque and power values in the ankle, tarsometatarsal, and metatarsophalangeal joints. Additionally, the elderly exhibited a lower torque ratio in the distal joint than in the proximal joint (torque ratio: ankle joint >tarsometatarsal joint >metatarsophalangeal joint). [Conclusion] The elderly participants had less speed, stride, foot joint movement, moment, and power than the young participants. Moreover, the ratio of joint moment was smaller in the elderly participants. In elderly patients whose walking speed has decreased, consideration of the kinetics of the foot is important when deciding physiotherapy intervention.

NewsBot · Mar 19, 2021

Gait initiation differences between overweight and normal weight individuals
Xingda Qu et al
Ergonomics. 2021 Mar 18;1-8

Accidental falls often occur during gait initiation. Excess body weight has been identified as a risk factor for accidental falls. This study aimed to examine the differences of gait initiation between overweight and normal-weight individuals. Fourteen overweight and 14 normal-weight young adults participated in the study. They were instructed to perform the gait initiation task under single-task and dual-task conditions. Dependent variables for the assessment of gait initiation included spatial-temporal measures and postural stability measures. The results showed that overweight could compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. Cognitive task interference with gait initiation was found to be similar between the overweight and normal weight groups. The findings from the present study can aid in better understanding the mechanisms associated with increased fall risks among overweight individuals. They also highlight the importance of overweight control in fall prevention. Practitioner summary: Overweight was found to compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. The findings highlight the importance of overweight control in fall prevention
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NewsBot · Jul 4, 2021

Foot and ankle biomechanics during walking in older adults: A systematic review and meta-analysis of observational studies
Fateme Pol et al
Gait Posture. 2021 Jun 26;89:14-24

Background: The foot and ankle complex undergoes significant structural and functional changes with advancing age.

Research question: The objective of this systematic review and meta-analysis was to synthesize and critique the research literature pertaining to foot and ankle biomechanics while walking in young and older adults.

Methods: Electronic databases (Web of Science, PubMed, Scopus and Embase) were searched from inception to April 2019 for cross-sectional studies which compared kinematics, kinetics and plantar pressure differences between young and older adults. Screening and data extraction were performed by two independent assessors, with disagreements resolved by consensus.

Results: A total of 39 articles underwent full-text screening, and 19 articles met the inclusion criteria and were included. Meta-analysis showed that older adults had less ankle joint plantar flexion (5 studies; weighted mean difference [WMD]: -5.15; 95 %CI: -6.47 to -3.83; P < 0.001) and less ankle joint power generation (6 studies; standardized mean difference [SMD]: -0.62; 95 %CI: -0.82 to -0.41; P < 0.001) during propulsion compared to young adults. These differences persisted in subgroup analyses comparing different walking speeds. Plantar pressure findings were highly variable due to differences in data collection protocols and meta-analysis was not possible.

Significance: Older adults have unique foot and ankle kinematics and kinetics during walking characterized by reduced ankle joint plantarflexion and power generation during propulsion.
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NewsBot · Oct 8, 2023

Age-associated changes in lower limb weight-bearing strategy during walking
Forouzan Foroughi et al
Gait & Posture; 6 October 2023

Background
As people age there is a proximal shift of joint moment generation from ankle, plantarflexion and knee extension toward hip extension and flexion moments. This, age-related redistribution has been documented in the context of propulsive force, generation during the push-off phase, with less evidence in the context of weight, bearing. Additionally, these sagittal plane joint moments have been a primary focus of, studies, though the hip frontal plane moment also contributes to vertical support but, has received less attention. Furthermore, how aging affects the relationships between, changes in sagittal and frontal joint moments and changes in vertical support force as, a function of walking speed remains unclear

Research question
How does aging affect the contributions of sagittal and frontal plane joint moments to, weight-bearing across different walking speeds?

Methods
Gait analysis was performed on 24 young and 17 healthy older subjects walked on the, treadmill at their preferred and 30% faster speeds. Stepwise linear regression analysis, was performed to determine the joint moments that predict the peak amplitudes of the, vertical ground reaction force (VGRF) across different walking speeds.

Results
Hip abduction and knee extension moments were the primary contributors to leading limb weight-bearing in young, whereas hip extension moment was the primary contributor in older adults. Ankle plantarflexion moment was the main contributor to trailing limb weight-bearing in young, and hip flexion moment was the main contributor in older adults. From preferred to faster walking speed, changes in knee extension moment were the primary contributor to changes in the trailing limb weight-bearing in young, whereas changes in hip extension moment were the primary contributor in older

adults.

Significance
These findings suggested that older and younger adults used different joint moment, contributions to produce leading limb and trailing limb vertical support forces across, different walking speeds.
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