Effects of direction cue time and walking speed on spatial-temporal gait adaptations in healthy older and young adults upon approach of turns.

Autor: Torre D; SUNY Downstate Health Sciences University, School of Health Professions, Physical Therapy Program, Brooklyn, NY, USA. Electronic address: dennis.torre@downstate.edu., Parasher RK; Amar Jyoti Institute of Physiotherapy, Department of Physiotherapy, Karkardooma, Vikas Marg, Delhi, India. Electronic address: kamlakarr744@gmail.com., Nair P; Samuel Merritt University, Doctor of Physical Therapy Program, Oakland, CA, USA. Electronic address: pnair@samuelmerritt.edu., Pinto Zipp G; Seton Hall University, Department of Interprofessional Health Sciences and Health Administration, Center for Interprofessional Education in Health Sciences, School of Health and Medical Sciences, South Orange, NJ, USA. Electronic address: genevieve.zipp@shu.edu.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2024 Sep; Vol. 113, pp. 427-435. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1016/j.gaitpost.2024.07.300
Abstrakt: Background: Hurrying and turning are each associated with falls in older adults. Losing balance sideways when turning increases the likelihood of hip fracture. Yet 99 % of failures when turning unexpectedly have been traced to an inability to curb forward momentum regardless of age.
Research Question: Do age-based differences exist in spatial-temporal gait adaptations related to medial-lateral (M-L) balance and posterior-anterior (P-A) propulsion upon approach of turns relative to continuing straight, across walking speeds and whether direction is known in advance?
Methods: Healthy young (n=10) and older adults (n = 10) walked at preferred and fast test speeds while randomly cued for direction either early upon initiating gait or late 1-2 steps before entering a spatially defined turning area. An instrumented 4.6 m carpet recorded spatial-temporal changes up to the penultimate footfall prior to turning 90 0 or continuing straight.
Results: When approaching the turning zone across interactions of walking test speed, cue time and direction, other than stride-length being shorter in older adults, both age-groups showed similar adjustments in gait speed and stride-length in managing P-A deceleration perturbations, and similar adaptations in right and left heel-to-heel base of support (BOS) in managing M-L balance destabilizing forces. A three-way interaction (p<.027) suggests a similar foot strategy of BOS narrowing may be used approaching turns relative to straight walks when direction is cued early walking fast (p<.020) and late walking preferred speed (p<.014).
Significance: The findings were interpreted within the context of regulating center of mass acceleration and processing environmental regulatory conditions to maintain a personal space safety margin. The study supports that in otherwise healthy older adults, gait training for turns include practice to not only manage perturbations which accelerate the body sideways but also those which decelerate forward progression.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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