Article

Reduced ability to adapt gait, particularly under challenging
conditions, may be an important reason why older adults have an increased risk of
falling. This study aimed to identify cognitive, psychological and physical
mediators of the relationship between impaired gait adaptability and fall risk in
older adults. METHODS: Fifty healthy older adults (mean+/-SD: 74+/-7years) were
categorised as high or low fall risk, based on past falls and their performance
in the Physiological Profile Assessment. High and low-risk groups were then
compared in the gait adaptability test, i.e. an assessment of the ability to
adapt gait in response to obstacles and stepping targets under single and dual
task conditions. Quadriceps strength, concern about falling and executive
function were also measured. RESULTS: The older adults who made errors on the
gait adaptability test were 4.76 (95%CI=1.08-20.91) times more likely to be at
high risk of falling. Furthermore, each standard deviation reduction in gait
speed while approaching the targets/obstacle increased the odds of being at high
risk of falling approximately three fold: single task - OR=3.10,95%CI=1.43-6.73;
dual task - 3.42,95%CI=1.56-7.52. Executive functioning, concern about falling
and quadriceps strength substantially mediated the relationship between the gait
adaptability measures and fall risk status. CONCLUSION: Impaired gait
adaptability is associated with high risk of falls in older adults. Reduced
executive function, increased concern about falling and weaker quadriceps
strength contribute significantly to this relationship. Training gait
adaptability directly, as well as addressing the above mediators through
cognitive, behavioural and physical training may maximise fall prevention
efficacy.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

Langue : ANGLAIS