Gait variables differentiating fallers from nonfallers.

Purpose: This study examined the qualitative and quantitative differences between 2 groups of older adults, fallers and nonfallers. We compared walking differences during overground walking to a task of obstacle clearance.

Methods: Forty-eight community dwelling older adults (18 fallers and 30 nonfallers) participated. The mean age of the participants was 78.1 +/- 7.2 years (fallers) and 75.8 +/- 5.1 years (nonfallers). Walking differences within and between fallers and nonfallers during a single visit for 6 conditions were examined: (1) baseline walking, (2) slow walking, (3) fast walking, and (4) 5 cm obstacle clearance - approach, during, and exit. Quantitative differences of temporal-spatial walking measures were analyzed using a multifactorial ANOVA adjusted for age, gender, height, and BMI with a Scheffe correction (p < 0.05) applied for multiple testing. Qualitative data were analyzed using Chi-square fisher's exact test.

Results: There were interaction effects for group by walking condition for single support (p = 0.002) and step length (p = 0.05), while 1st double support approached significance (p = 0.06). Main Group effects were found during the comfortable walk (p < 0.001-0.05) for all 7 gait variables. Qualitatively, the fallers demonstrated increased knee flexion during both over ground walking (c2 = 9.01 ; p < 0.006), and the fallers consistently took several small steps immediately prior to the obstacle clearance (c2 = 8.42 ; p = 0.007).

Conclusion: There were significant differences in quantitative and qualitative walking characteristics differentiating fallers from nonfallers during over-ground walking at different velocities and during obstacle clearance.