AAR  Vol.2 No.2 , May 2013
Relationships between gait properties on soft surfaces, physical function, and fall risk for the elderly
ABSTRACT
The plantar aspect change caused by contact with soft surfaces creates and unstable gait and increases the risk of falling, especially in the elderly. This study aimed to analyze gait property by three-dimensional motion analysis on soft and normal surfaces and to clarify the relationship with physical function and fall risk. Twenty-four older people aged 65-88 years old and living independently without any assistive device (7 men, 17 women) performed 5 m of walking with own maximal speed on normal and soft surface walkways. The soft surface walkway used was a low rebound urethane foam mattress. The three-dimensional kinematic gait analysis by sixteen anatomic points was used to evaluate gait property on both walkways. The gait property on soft surfaces tended to be swinging up and down in each joint and to largely lean left and right as compared with the normal surface. Moreover, it tended to decrease in a step length and to increase in a step width. All gait parameters on soft surfaces correlated significantly with functional reach. On the other hand, that on normal surface correlated significantly with leg strength. Gait properties on soft surfaces which changes in plantar aspect during foot contact differs from those on normal surfaces. Walking on soft surfaces may cause an unanticipated inverted pendulum sway supporting a foot contact point because of the disturbance by a sagging walkway; in short, requiring more effort to keep a body balanced. In conclusion, gait on the soft surfaces requires balance ability (functional reach) rather than leg strength.

Cite this paper
Demura, S. , Shin, S. , Takahashi, S. and Yamaji, S. (2013) Relationships between gait properties on soft surfaces, physical function, and fall risk for the elderly. Advances in Aging Research, 2, 57-64. doi: 10.4236/aar.2013.22008.
References
[1]   Lord, S.R. and Dayhew, J. (2001) Visual risk factors for falls in older people. Journal of American Geriatrics Society, 49, 508-515. doi:10.1046/j.1532-5415.2001.49107.x

[2]   Eke-Okoro, S.T. (2000) A critical point for the onset of falls in the elderly. A pilot study. Gerontology, 46, 88-92. doi:10.1159/000022140

[3]   Ferrandez, A.M., Pailhous, J. and Durup, M. (1990) Slowness in elderly gait. Experimental Aging Research, 16, 79-89. doi:10.1080/07340669008251531

[4]   Suzuki, T. (2003) Epidemiology and implications of falling among the elderly. Nippon Ronen Igakkai Zasshi, 40, 85-94. doi:10.3143/geriatrics.40.85

[5]   Van der Velde, N., Stricker, B.H., Pols, H.A. and van der Cammen, T.J. (2007) Withdrawal of fall-risk-increasing drugs in older persons: Effect on mobility test outcomes. Drugs and Aging, 24, 691-699. doi:10.2165/00002512-200724080-00006

[6]   Graham, R.C., Smith, N.M. and White, C.M. (2005) The reliability and validity of the physiological cost index in healthy subjects while walking on 2 different tracks. Archives of Physical Medicine and Rehabilitation, 86, 2041-2046. doi:10.1016/j.apmr.2005.04.022

[7]   Podsiadlo, D. and Richardson, S. (1991) The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of American Geriatrics Society, 39, 142-148.

[8]   Gill, J., Allum, J.H., Carpenter, M.G., Held-Ziolkowska, M., Adkin, A.L., Honegger, F. and Pierchala K. (2001) Trunk sway measures of postural stability during clinical balance tests: Effects of age. The Journals of Gerontology: Series A, 56, M438-M447. doi:10.1093/gerona/56.7.M438

[9]   Means, K.M. (1996) The obstacle course: A tool for the assessment of functional balance and mobility in the elderly. Journal of Rehabilitation Research and Development, 33, 413-429.

[10]   Rubenstein, L.Z., Josephson, K.R., Trueblood, P.R., Yeung, K. and Harker, J.O. (1997) The reliability and validity of an obstacle course as a measure of gait and balance in older adults. Aging, 9, 127-135.

[11]   Kerrigan, D.C., Lee, L.W., Nieto, T.J., Markman, J.D., Collins, J.J. and Riley, P.O. (2000) Kinetic alterations independent of walking speed in elderly fallers. Archives of Physical Medicine and Rehabilitation, 81, 730-735. doi:10.1016/S0003-9993(00)90101-1

[12]   Suzuki, T. (2000) Questionnaire for falls assessment of elderly people and its application. Health Assessment Manual. Kosei Kagaku Kenkyusho, Tokyo, 142-163.

[13]   Hellstrom, K. and Lindmark, B. (1999) Fear of falling in patients with stroke: A reliability study. Clinical Rehabilitation, 13, 509-517. doi:10.1191/026921599677784567

[14]   Ministry of Education, Culture, Sports, Science and Technology (1999) Guideline for new physical fitness test. http://www.mext.go.jp/a_menu/sports/stamina/03040901.htm

[15]   Demura, S. and Yamada, T. (2007) Simple and easy assessment of falling risk in the elderly by functional reach test using elastic stick. Tohoku Journal of Experimental Medicine, 213, 105-111. doi:10.1620/tjem.213.105

[16]   Takenaka, K. and Uechi, H. (2002) Development of falling self-efficacy scale for elderly people: The reliability and validity. Japan Journal of Physical Education, Health and Sport Sciences, 47, 1-13.

[17]   Yasumura, S., Haga, H., Nagai, H., Shibata, H., Iwasaki, K., Ogawa, Y., Ahiko, T., Ihara, K. and Sakihara, S. (1994) Risk factors for falls among the elderly living in a Japanese rural community. Nippon Koshu Eisei Zasshi, 41, 528-537.

[18]   Campbell, A.J., Spears, G.F. and Borrie, M.J. (1990) Examination by logistic regression modelling of the variables which increase the relative risk of elderly women falling compared to elderly men. Journal of Clinical Epidemiology, 43, 1415-1420. doi:10.1016/0895-4356(90)90110-B

[19]   Yasumura, S., Haga, H., Nagai, H., Suzuki, T., Amano, H. and Shibata, H. (1994) Rate of falls and the correlates among elderly people living in an urban community in Japan. Age Aging, 23, 323-327. doi:10.1093/ageing/23.4.323

[20]   Yasumura, S., Haga, H., Nagai, H., Shibata, H., Iwasaki, K., Ogawa, Y., Ahiko, T. and Ihara, K. (1991) Incidence of and circumstances related to falls among the elderly in a Japanese community. Nippon Koshu Eisei Zasshi, 38, 735-742.

[21]   Potter, J.M., Evans, A.L. and Duncan, G. (1995) Gait speed and activities of daily living function in geriatric patients. Archives of Physical Medicine and Rehabilitation, 76, 997-999. doi:10.1016/S0003-9993(95)81036-6

[22]   Means, K.M. and O’Sullivan, P.S. (2000) Modifying a functional obstacle course to test balance and mobility in the community. Journal of Rehabilitation Research and Development, 37, 621-632.

[23]   Shin, S. and Demura, S. (2011) Different step-over movement strategies for disturbance stimulations. Perceptual and Motor Skills, 113, 11-18. doi:10.2466/25.26.PMS.113.4.11-18

[24]   Clark, S., Iltis, P.W., Anthony, C.J. and Toews, A. (2005) Comparison of older adult performance during the functional-reach and limits-of-stability tests. Journal of Aging and Physical Activity, 13, 266-275.

[25]   Hageman, P.A. and Thomas, V.S. (2002) Gait performance in dementia: The effects of a 6-week resistance training program in an adult day-care setting. International Journal of Geriatric Psychiatry, 17, 329-334. doi:10.1002/gps.597

[26]   Jensen, J., Nyberg, L., Rosendahl, E., Gustafson, Y. and Lundin-Olsson, L. (2004) Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities. Aging Clinical and Experimental Research, 16, 283-292.

 
 
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