Coordination of trunk and foot acceleration during gait is affected by walking velocity and fall history in elderly adults

Abstract

Background: Falling is a significant concern for many elderly adults but identifying individuals at risk of falling is difficult, and it is not clear how elderly adults adapt to challenging walking.

Aims: The aim of the current study was to determine the effects of walking at non-preferred speeds on the coordination between foot and trunk acceleration variability in healthy elderly adults with and without fall history compared to healthy young adults.

Methods: Subjects walked on a treadmill at 80% to 120% of their preferred walking speed while trunk and foot accelerations were recorded with wireless inertial sensors. Variability of accelerations were measured by root mean square, range, sample entropy, and Lyapunov exponent. The gait stability index was calculated using each variability metric in the frontal and sagittal plane by taking the ratio of trunk acceleration variability divided by foot acceleration variability.

Results: Healthy young adults demonstrated larger trunk accelerations relative to foot accelerations at faster walking speeds compared to elderly adults, but both young and elderly adults show similar adaption to their acceleration regularity. Between group differences showed that elderly adult fallers coordinate acceleration variability between the trunk and feet differently compared to elderly non-fallers and young adults.

Discussion: The current results indicate that during gait, elderly fallers demonstrate more constrained, less adaptable trunk movement relative to their foot movement and this pattern is different compared to elderly non-fallers and healthy young.

Conclusions: Coordination between trunk and foot acceleration variability plays an important role in maintaining stability during gait.