Erica Twardzik1, Kate Duchowny2, Amby Gallagher3, Neil Alexander4, Debra Strasburg4, Natalie Colabianchi5, Philippa Clarke6. 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA. Electronic address: etwardzi@umich.edu. 2. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. 3. University of Michigan School of Nursing, Ann Arbor, MI, USA. 4. Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Veterans Administration Ann Arbor Health Care System Geriatrics Research Education and Clinical Center (GRECC), Mobility Research Center, Ann Arbor, MI, USA. 5. Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. 6. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Abstract
BACKGROUND: A growing body of research has demonstrated relationships between built environment characteristics and outdoor mobility. However, most of this work has relied on composite scores of the built environment. RESEARCH QUESTION: Which properties of the outdoor built environment are associated with the greatest change in gait metrics in a real-world setting? METHODS: 25 community-dwelling adults from Southeast Michigan were equipped with mobile inertial measurement units and walked a 1300-meter outdoor course with varying environmental demands. Environmental properties were documented in sections of the course using the Senior Walking Environmental Assessment Tool. Gait speed, left foot cadence, and stride length were used to identify the built environment properties under which mobility was most challenged using linear mixed models. We hypothesized that subjects would adapt to demanding environments by decreasing gait speed, increasing cadence, and shortening stride length. RESULTS: Properties of the built environment were significantly associated with changes in gait speed, left foot cadence, and stride length. Properties that were most important for predicting gait speed included slope, sidewalk condition, and presence of holes. Sidewalk slope, bumps, and the presence of a curb cut were all significant predictors of left foot cadence. Mean stride length of the outdoor course was significantly associated with the section's condition, slope, holes, bumps, width, and the presence of grooves and bumps at a curb. SIGNIFICANCE: Associations between environmental properties and gait parameters were differential across the three mobility outcomes. When examining which properties of the built environment are challenging to navigate it is important to understand the relative influence of specific properties on gait metrics. Knowledge of which built environment properties are barriers for walking behavior is critical for the design of inclusive sidewalks and streets.
BACKGROUND: A growing body of research has demonstrated relationships between built environment characteristics and outdoor mobility. However, most of this work has relied on composite scores of the built environment. RESEARCH QUESTION: Which properties of the outdoor built environment are associated with the greatest change in gait metrics in a real-world setting? METHODS: 25 community-dwelling adults from Southeast Michigan were equipped with mobile inertial measurement units and walked a 1300-meter outdoor course with varying environmental demands. Environmental properties were documented in sections of the course using the Senior Walking Environmental Assessment Tool. Gait speed, left foot cadence, and stride length were used to identify the built environment properties under which mobility was most challenged using linear mixed models. We hypothesized that subjects would adapt to demanding environments by decreasing gait speed, increasing cadence, and shortening stride length. RESULTS: Properties of the built environment were significantly associated with changes in gait speed, left foot cadence, and stride length. Properties that were most important for predicting gait speed included slope, sidewalk condition, and presence of holes. Sidewalk slope, bumps, and the presence of a curb cut were all significant predictors of left foot cadence. Mean stride length of the outdoor course was significantly associated with the section's condition, slope, holes, bumps, width, and the presence of grooves and bumps at a curb. SIGNIFICANCE: Associations between environmental properties and gait parameters were differential across the three mobility outcomes. When examining which properties of the built environment are challenging to navigate it is important to understand the relative influence of specific properties on gait metrics. Knowledge of which built environment properties are barriers for walking behavior is critical for the design of inclusive sidewalks and streets.
Authors: Preeti Zanwar; Jinwoo Kim; Jaeyoon Kim; Michael Manser; Youngjib Ham; Theodora Chaspari; Changbum Ryan Ahn Journal: Front Public Health Date: 2021-03-11