Changes in step-width during dual-task walking predicts falls.

The aim was to evaluate whether gait pattern changes between single- and dual-task conditions were associated with risk of falling in older people. Dual-task cost (DTC) of 230 community living, physically independent people, 75 years or older, was determined with an electronic walkway. Participants were followed up each month for 1 year to record falls. Mean and variability measures of gait characteristics for 5 dual-task conditions were compared to single-task walking for each participant. Almost half (48%) of the participants fell at least once during follow-up. Risk of falling increased in individuals where DTC for performing a subtraction task demonstrated change in mean step-width compared to single-task walking. Risk of falling decreased in individuals where DTC for carrying a cup and saucer demonstrated change compared to single-task walking in mean step-width, mean step-time, and step-length variability. Degree of change in gait characteristics related to a change in risk of falling differed between measures. Prognostic guidance for fall risk was found for the above DTCs in mean step-width with a negative likelihood ratio of 0.5 and a positive likelihood ratio of 2.3, respectively.

Findings suggest that changes in step-width, step-time, and step-length with dual tasking may be related to future risk of falling. Depending on the nature of the second task, DTC may indicate either an increased risk of falling, or a protective strategy to avoid falling.

Nordin E, Moe-Nilssen R, Ramnemark A, Lundin-Olsson L. Changes in step-width during dual-task walking predicts falls. Gait Posture. 2010 Apr 14, online article ahead of print

Related posts:

1. Balance, attention, and dual-task performance during walking after brain injury: associations with falls history.
2. Effects of task-oriented circuit class training on walking competency after stroke: a systematic review.
3. Volitional Muscle Strength in the Legs Predicts Changes in Walking Speed Following Locomotor Training in People With Chronic Spinal Cord Injury
4. Gait Biomechanics, Spatial and Temporal Characteristics, and the Energy Cost of Walking in Older Adults With Impaired Mobility.
5. Interventions for preventing falls in older people in nursing care facilities and hospitals.