Assessing Gait In Older Adults Flashcards
using the picture on the other side, review the gait cycle
what is considered the average gait velocity for healthy adults?
- men → 1.32 m/s
- women → 1.27 m/s
- healthy aging → 1.0 m/s
- needed to safely cross street → >1.2 m/s
what gait speed is considered a mark of fraility?
walking slower than 0.8 m/s
list the spatial and temporal parameters of gait
- spatial
- step length
- stride length
- step width
- temporal
- speed/velocity
- single and double support time
- swing/stance time
- cadence
- stride time
list common temporal gait changes with age
- decreased self-selected gait speed
- increased stance time and double-limb support time
list common spatial gait changes with aging
- decreased step and stride length
- increased step width (not a universal finding across studies)
list kinematic/postural gait changes with age
- decreased excursion of movement at lower extremity joints
- decreased reliance on ankle kinetics and power
- less upright posture
T/F: slower gait speed is a defining feature of fraility
TRUE
T/F: slow speed increases likelihood of CHI transitioning to MCI and CHI transitioning to death
TRUE
T/F: slower speeds have no predictive value pertaining to cognitive performance
FALSE
what is the impact of dual task on gait speed?
multiple studies show significant gait speed decrease in person with MCI and PD
what is the impact of complex dual tasks on gait parameters?
- sig decreased gait velocity
- increased stride time
- increased stride time variability in MCI and AD groups compared to healthy controls
list cognitive domains that have a critical impact on gait
- Attention
- memory/learning
- language
- executive function
- complex attention
- social cognition
- perceptual
- motor function
what is MCRS?
Motoric Cognitive Risk Syndrome → slowed gait and subjective cog impairment
2-3x more likely to develop dementia than those without MRCS
a gait speed of ≥1.2 m/s is predicative of what?
extremely fit
can cross street safely
a gait speed of ≥1.0 m/s is predictive of what?
healthy older population with lower risk of hospitalization or adverse health events
independent in ADLs
a gait speed of <1.0 m/s is predicative of what?
- increased risk for cognitive decline within 5 years
- increased risk for death and hospitalization within 1 year
a gait speed of <0.8 m/s is predicative of what?
- increased risk of mortality and mobility/ADL disability at 2 years
- limited community ambulator
what is a gait speed of <0.7 m/s predicative of?
- increased risk of death, hospitalization, institutionalization and falls
what is a gait speed of <0.4 m/s predicative of?
- functional dependence, severe walking disability
what is a gait speed of <0.2 predicative of?
- extremely frail
- highly dependent
T/F: clinical gait training must include more than walking from point A to B?
TRUE
what to consider when assessing gait in your geriatric patients
- level ground walking vs stair negotiation
- gait speed
- other gait parameters
- outcome measures
describe what is required in stair negotiation
- requires greater ROM and muscle strength
- ascending vs descending
- usual pace walking speed and SLS stance time best indicators of stair climbing speed
- increasing safety:
- handrails, step-to pattern, AD, physical assist
how much of an increase in gait speed impacts disability?
an increase in as little as 0.1 m/s can reduce disability and mortality
impact of backward walking and fall risk
backward walking slower than 4.0 m/s may increase fall risk
impact of dual task on gait variability
dual task = increased gait variability which leads to decreased postural stability
