Citation

Singh H, Sanders O, McCombe Waller S, Bair WN, Beamer B, Creath RA, Rogers MW. Arch. Phys. Med. Rehabil. 2017; 98(10): 1955-1961.

Affiliation

Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD 21201. Electronic address: mrogers@som.umaryland.edu.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.apmr.2017.05.006

PMID

28610969

Abstract

OBJECTIVE: To determine and compare gait speed during head-forward and side-to-side head-turn walking in individuals with lower versus greater lateral balance.

DESIGN: Cross-sectional study SETTING: University research laboratory PARTICIPANTS: Ninety-three older adults (42 men and 51 women) aged 73 ± 6.08 years who could walk independently participated in this study. MAIN OUTCOME MEASURES: 1) 'balance tolerance limit' (BTL), defined as the lowest perturbation intensity where a multistep balance recovery pattern was first evoked in response to randomized lateral waist-pull perturbations of standing balance to the left and right sides, at six different intensities (range from level two: 4.5 cm displacement at 180cm/s(2) acceleration to level seven: 22.5 cm displacement at 900cm/s(2) acceleration), 2) gait speed, 3) balance, and 4) mobility using an instrumented gait mat, Timed-Up-and-Go (TUG) and Activities-Specific Confidence (ABC) scale, respectively.

RESULTS: Individuals with low versus high BTL had slower self-selected head-forward gait speed (HFGS) and head-turn gait speed (HTGS) (p = 0.002 and p < 0.001, respectively); the magnitude of difference was greater in HTGS than HFGS (Cohen's d = 1.0 versus 0.6). HTGS best predicted BTL. BTL was moderately and positively related (p = 0.003) to the ABC and negatively related (p = 0.017) to TUG.

CONCLUSIONS: HTGS is affected to a greater extent than HFGS in older individuals with poorer lateral balance and at greater risk of falls. Moreover, HTGS can be used to assess the interactions of limitations in lateral balance function and gait speed in relation to fall risk in older adults.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

Balance; Falls; Gait; Mobility; Older adults