Falls risk detection based on spatiotemporal parameters of three-dimensional gait analysis in healthy adult women from 50 to 70 years old

Gervásio, Flávia Martins; Santos, Guilherme Augusto; Ribeiro, Darlan Martins; Menezes, Ruth Losada de

doi:10.1590/1809-2950/15661923042016

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ORIGINAL RESEARCH • Fisioter. Pesqui. 23 (4) • Dec 2016 • https://doi.org/10.1590/1809-2950/15661923042016 copy

Falls risk detection based on spatiotemporal parameters of three-dimensional gait analysis in healthy adult women from 50 to 70 years old

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The aim of this study was to compare and correlate spatiotemporal parameters that would indicate falls risk. Thirty-five healthy women without a history of falls in the previous year were selected. Five spatiotemporal parameters were collected from right (R) and left (L) lower limbs using three-dimensional gait analysis. Two groups: young women (20-40 years) and adult/older women (50-70 years) were analyzed. The comparisons between the groups differed in R (p=0.003) and L (p=0.002) stride length, R (p=0.008) and L (p=0.001) step length, L stance period (p=0.008), R step period (p=0.049), L double support time (p=0.003), step width (p=0.005), L loading response time (p=0.001), R (p=0.001) and L (p=0.001) pre-swing time. Gait cycle percentage data also showed statistical difference in L stance (p=0.001), L swing (p=0.001), L single support (p=0.025), L loading response (p=0.001), R (p=0.014) and L (p=0.001) pre-swing. Linear regression indicated that step and stride length increased 18% and gait velocity increased 20% with age variation. The results propose that functional measures (velocity, step and stride length) decrease as age increases, while stability measures (stance, double support and pre-swing time) increase. These findings suggest that women aged between 50-70 years may have falls risk. Women aged 50-60 are usually considered as having low falls risk.

Keywords:
Gait; Accidental Falls; Women’s Health; Middle Age; Biomedical Technology

Gait parameters (unit of measurement)	Description
Step length (meters)	Anteroposterior distance from the initial contact of one foot until the contact of the other foot.
Stride length (meters)	Anteroposterior distance between two consecutive steps of one foot.
Base width (meters)	Perpendicular distance to the line of progression between the points of contact of the feet.
Cadence (steps/minute)	Number of steps per minute.
Step period (second)	The period of time taken from the initial contact of one foot to the initial contact of the other foot.
Stride period (second)	The period of time between the initial contacts of two consecutive steps of the same foot.
Stance period (second)	The period of time between the initial contact of one foot to the moment the same foot leaves the ground.
Swing period (second)	The period of time between the moment one foot leaves the ground and the initial contact of the same foot.
Single support time (second)	The period of time when only one foot is in contact with the ground.
Double support time (second)	The period of time when both feet are in contact with the ground.
Cyclic parameters (percentage)	Corresponds to all the events of a gait cycle measured in percentage.
Gait velocity (meters/second)	Distance covered in a certain period of time.

Anthropometric variables	Average (SD)		Shapiro-Wilk	T-test (p<0.05)
Anthropometric variables	Young women	Adults/older adults	Young woman/ adult-older adult
Age (years)	28.5 (5.66)	61.2 (6.99)	0.07/0.14	< 0.001*
Weight (kilograms)	54.7 (7.88)	59.7 (8.87)	0.70/0.35	0.073
Height (meters)	1.59 (0.06)	1.56 (0.06)	0.04*/0.58	0.125
Body mass index (kg/m²)	21.7 (2.96)	24.5 (3.04)	0.40/0.39	0.007*

Gait variables	Average/Median/(SD)		CI (95%)		>p
Gait variables	Young women	Adults and older adults	Upp.	Low.
Stride length R (m)	1.30 ± 0.07	1.20 ± 0.08	1.33	1.16	0.003
Stride length L (m)	1.31 ± 0.07	1.21 ± 0.09	1.34	1.16	0.002
Step length R (m)	0.67 ± 0.04	0.61 ± 0.05	0.69	0.58	0.008
Step length L (m)	0.64 ± 0.04	0.59 ± 0.04	0.66	0.57	0.001
Stance period L (s)	0.64 ± 0.04	0.39 ± 0.02	0.66	0.38	0.008
Step period R (s)	0.54 ± 0.03	0.55 ± 0.02	0.56	0.52	0.049
Double support L (s)	0.24 ± 0.03	0.28 ± 0.04	0.31	0.22	0.003
Base width L (m)	0.12*	0.1*	0.13	0.08	0.005¹
Loading response L (m)	0.14 ± 0.01	0.16 ± 0.01	0.17	0.14	0.001
Pre-swing R (s)	0.14 ± 0.01	0.16 ± 0.01	0.17	0.14	0.001
Pre-swing L (s)	0.10 ± 0.02	0.12 ± 0.02	0.14	0.09	0.011
Stance period L (%GC)	61.26 ± 1.24	63.27 ± 1.88	64.27	60.66	0.001
Swing period L (%GC)	38.74 ± 1.23	36.72 ± 1.88	39.34	35.72	0.001
Single support period L (%GC)	37.68 ± 1.14	36.64 ± 1.44	38.23	35.87	0.025
Loading response time L (%GC)	13.67 ± 0.82	14.94 ± 1.11	15.54	13.28	>0.001
Pre-swing period R (%GC)	13.76 ± 0.88	15.11 ± 1.28	15.79	13.34	0.001
Pre-swing period L (%GC)	9.90 ± 1.80	11.68 ± 2.26	12.89	9.04	0.014

Spatiotemporal gait parameters	R	R²(%)	(p<0.05)
Stride length R	0.44	0.195	0.002
Stride length L	0.42	0.184	0.003
Step length R	0.43	0.189	0.003
Step length L	0.4	0.155	0.007
Stance period R	0.41	0.171	0.005
Stance period L	0.48	0.234	0.001
Double support period R	0.48	0.237	0.001
Double support period L	0.6	0.368	<0.001
Pre-swing period R	0.62	0.386	<0.001
Pre-swing period L	0.53	0.288	<0.001
Pre-swing R in percentage of the cycle	0.56	0.324	<0.001
Pre-swing L in percentage of the cycle	0.53	0.285	<0.001
Average velocity	0.45	0.204	0.002

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E-mail: revfisio@usp.br

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[1] Corresponding author: Flávia Gervásio - State University of Goiás - Dr. Claudio de Almeida Borges Movement Laboratory, Goiânia, Goiás, Brazil. - flavia.gervasio@hotmail.com; gervasio.flavia@gmail.com. - (62)98176-0363. Rua Córdoba n.326, apto. 1503, Parque Amazônia, Goiânia-Goiás, Brazil.