Toward ambulatory balance assessment: estimating variability and stability from short bouts of gait

Kimberley S van Schooten, Sietse M Rispens, Petra J M Elders, Jaap H van Dieën, Mirjam Pijnappels
Gait & Posture 2014, 39 (2): 695-9
Stride-to-stride variability and local dynamic stability of gait kinematics are promising measures to identify individuals at increased risk of falling. This study aimed to explore the feasibility of using these metrics in clinical practice and ambulatory assessment, where only a small number of consecutive strides are available. The concurrent validity and reliability were assessed compared to more continuous walking. Twenty young adults walked continuously for 500 m, as well as 36 bouts of 20 m while wearing an accelerometer (DynaPort MiniMod) on the trunk. Within-day reliability was high for stride time variability, mediolateral trunk variability and local dynamic stability, while between-day reliability was low for both variability estimates and moderate for local dynamic stability. Stride time variability and mediolateral trunk variability were increased when walking short bouts and did not correlate well with the longer walking trials. Local dynamic stability did correlate highly between the long and short bouts trials, and 15 bouts of eight strides appeared to be sufficient for valid estimation. These results imply task-specific differences and low reliability of variability estimates rendering them unsuitable for application to short bouts of gait, while local dynamic stability can be readily employed.

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