Increased gait unsteadiness in community-dwelling elderly fallers

J M Hausdorff, H K Edelberg, S L Mitchell, A L Goldberger, J Y Wei
Archives of Physical Medicine and Rehabilitation 1997, 78 (3): 278-83

OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers.

STUDY DESIGN: Retrospective, case-control study.

SETTING: General community.

PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group.

MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk.

RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p < .0002). In contrast, walking speed of the elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects.

CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

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