Shiu-Ling Chiu1, Li-Shan Chou. 1. Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, Eugene, OR 97403-1240, USA.
Abstract
BACKGROUND: Walking requires coordination among multiple joints. Little is known about the association between the coordination ability and fall risks in elderly adults. This study investigated variability of inter-joint coordination in elderly adults and determined its correlation to clinical balance measures. METHODS: Gait analyses of 15 non-fallers and 15 fallers were performed during walking. Continuous relative phase, derived from phase angles of two adjacent joints, was used to assess the inter-joint coordination. Variability of inter-joint coordination was calculated as the average standard deviation of all points on the ensemble continuous relative phase curve over a gait cycle, namely the deviation phase. Outcomes from three clinical balance tests, including Berg Balance Test, Dynamic Gait Index and Timed Up-and-Go, were examined. FINDINGS: No significant group differences were detected in hip-knee deviation phase values after accounting for differences in walking speeds. For the knee-ankle deviation phase, fallers demonstrated significantly greater values in the stance phase but smaller values in the swing phase. The hip-knee deviation phase values demonstrated a negative correlation with Dynamic Gait Index, and the knee-ankle deviation phase values had a negative correlation with Dynamic Gait Index and a positive correlation with Timed Up-and-Go time. INTERPRETATION: Excessive variability of the supporting limb and reduced variability of the swing limb in knee-ankle inter-joint coordination of fallers may contribute to their risk of imbalance or tripping during walking. Compared to Berg Balance Test and Timed Up-and-Go, Dynamic Gait Index scores might be more sensitive to reflect declines in inter-joint coordination during walking.
BACKGROUND: Walking requires coordination among multiple joints. Little is known about the association between the coordination ability and fall risks in elderly adults. This study investigated variability of inter-joint coordination in elderly adults and determined its correlation to clinical balance measures. METHODS: Gait analyses of 15 non-fallers and 15 fallers were performed during walking. Continuous relative phase, derived from phase angles of two adjacent joints, was used to assess the inter-joint coordination. Variability of inter-joint coordination was calculated as the average standard deviation of all points on the ensemble continuous relative phase curve over a gait cycle, namely the deviation phase. Outcomes from three clinical balance tests, including Berg Balance Test, Dynamic Gait Index and Timed Up-and-Go, were examined. FINDINGS: No significant group differences were detected in hip-knee deviation phase values after accounting for differences in walking speeds. For the knee-ankle deviation phase, fallers demonstrated significantly greater values in the stance phase but smaller values in the swing phase. The hip-knee deviation phase values demonstrated a negative correlation with Dynamic Gait Index, and the knee-ankle deviation phase values had a negative correlation with Dynamic Gait Index and a positive correlation with Timed Up-and-Go time. INTERPRETATION: Excessive variability of the supporting limb and reduced variability of the swing limb in knee-ankle inter-joint coordination of fallers may contribute to their risk of imbalance or tripping during walking. Compared to Berg Balance Test and Timed Up-and-Go, Dynamic Gait Index scores might be more sensitive to reflect declines in inter-joint coordination during walking.
Authors: Mark V Paterno; Adam W Kiefer; Scott Bonnette; Michael A Riley; Laura C Schmitt; Kevin R Ford; Gregory D Myer; Kevin Shockley; Timothy E Hewett Journal: Clin Biomech (Bristol, Avon) Date: 2015-09-02 Impact factor: 2.063