The influence of fear of falling on gait and balance in older people

Miriam F Reelick, Marianne B van Iersel, Roy P C Kessels, Marcel G M Olde Rikkert
Age and Ageing 2009, 38 (4): 435-40

BACKGROUND: fear of falling (FoF) has great impact on functioning and quality of life of older people, but its effects on gait and balance are largely unknown.

METHODS: we examined FoF in 100 participants aged >or=75 years, using the Activities-specific Balance Confidence scale. Participants with a mean score <67% were assigned to the FoF group. We quantified gait and balance during walking at the preferred velocity with and without a cognitive dual task (arithmetic task and verbal fluency), using an electronic walkway (Gaitrite) and a trunk accelerometer (SwayStar). Primary outcome measures were gait velocity, stride-length and stride-time variability, as well as mediolateral angular displacement and velocity.

RESULTS: gait velocity was significantly lower (P < 0.05) and stride-length and stride-time variability were significantly higher (P < 0.05) in the FoF group. However, after standardisation for gait velocity, differences became non-significant. Mediolateral angular displacement and velocity were not associated with FoF. We found no difference between the FoF and no-FoF group with respect to the dual-task effect on gait and balance variables.

CONCLUSIONS: the lower gait velocity in the FoF group may be a useful adaptation to optimise balance, rather than a sign of decreased balance control. The ability to attend to a secondary task during walking is not influenced by FoF.

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