The identification of fall risk through tests of mediolateral stability during gait

Abstract

Introduction: Many falls in older adults are due to a loss of mediolateral stability during gait. This investigation examines if a simple beam-walking task can assess fall risk in older adults by taxing mediolateral control during gait.

Material and methods: 50 older adults (65-96 yrs.) and 20 younger adults (20-35 yrs.) walked along three 6 m long beams (12, 9 and 6 cm wide). Distance walked, number of steps and velocity were recorded. Participants also completed the Narrow Path Walking Test on a computerized gait mat and walked unrestricted across the mat. The number of falls in the 6 months pre- and post-testing were recorded.

Results: The beam data revealed significant differences between fallers and non-fallers in distance walked and number of steps taken on the 9 cm beam but not on the other beam widths. The coefficient of variation (CV) for step time and step length for unrestricted walking and for the NPWT were also significantly different between fallers and non-fallers. Falls in the 6 months before testing was not correlated with gait velocity but was significantly correlated with the number of steps and the distance walked on the 9 cm beam and with step length and step time CV. Falls in the 6 months following testing were strongly correlated with distance walked on the 9 cm beam.

Conclusion: This research suggests that examining an older adult's ability to walk on a 9 cm wide beam might contribute significantly to the assessment of that person's fall risk.

Keywords: Fall risk; Gait; Mediolateral stability.