The impact of speed and time on gait dynamics

To determine the effects of speed on gait previous studies have examined young adults walking at different speeds; however, the small number of strides may have influenced the results. The aim of this study was to investigate the immediate and long-term impact of continuous slow walking on the mean, variability and structure of stride-to-stride measures. Fourteen young adults walked at a constant pace on a treadmill at three speeds (preferred walking speed (PWS), 90% and 80% PWS) for 30 min each. Spatiotemporal gait parameters were computed over six successive 5-min intervals. Walking slower significantly decreased stride length, while stride period and width increased. Additionally, stride period and width variability increased. Signal regularity of stride width increased and decreased in stride period. Persistence of stride period and width increased significantly at slower speeds. While several measures changed during 30 min of walking, only stride period variability and signal regularity revealed a significant speed and time interaction. Healthy young adults walking at slower than preferred speeds demonstrated greater persistence and signal regularity of stride period while spatiotemporal changes such as increased stride width and period variability arose. These results suggest that different control processes are involved in adapting to the slower speeds.     

Intraindividual Variability of Neuromotor Function Predicts Falls Risk in Older Adults and those with Type 2 Diabetes

This study was designed to examine the effect of increasing age and type 2 diabetes on the average responses and inter- and intraindividual variability of falls risk, reaction time, strength, and walking speed for healthy older adults and older persons with type 2 diabetes (T2DM). Seventy-five older individuals (controls) and 75 persons with T2DM aged between 50 and 79 years participated in the study. Assessments of falls risk, reaction time (RT), knee extension strength, and walking speed were conducted. The results revealed that advancing age for both control and T2DM groups was reflected by a progressive increase in falls risk, decreased leg strength and a decline (i.e., slowing) of reactions and gait speed. Conversely, the level of intraindividual variability for the RT, strength and gait measures increased with increasing age for both groups, with T2DM persons tending to be more variable compared to the healthy controls of similar age. In contrast to the intraindividual changes, measures of interindividual variability revealed few differences between the healthy elderly and T2DM individuals. Taken together, the findings support the proposition that intraindividual variability of neuromotor measures may be useful as a biomarker for the early detection of decline in physiological function due to age or disease.     

Keep your head down: Maintaining gait stability in challenging conditions

BackgroundPeripheral vision often deteriorates with age, disrupting our ability to maintain normal locomotion. Laboratory based studies have shown that lower visual field loss, in particular, is associated with changes in gaze and gait behaviour whilst walking and this, in turn, increases the risk of falling in the elderly. Separately, gaze and gait behaviours change and fall risk increases when walking over complex surfaces. It seems probable, but has not yet been established, that these challenges to stability interact.Research questionHow does loss of the lower visual field affect gaze and gait behaviour whilst walking on a variety of complex surfaces outside of the laboratory? Specifically, is there a synergistic interaction between the effects on behaviour of blocking the lower visual field and increased surface complexity?MethodsWe compared how full vision versus simulated lower visual field loss affected a diverse range of behavioural measures (head pitch angle, eye angle, muscle coactivation, gait speed and walking smoothness as measured by harmonic ratios) in young participants. Participants walked over a range of surfaces of different complexity, including pavements, grass, steps and pebbles.ResultsIn both full vision and blocked lower visual field conditions, surface complexity influenced gaze and gait behaviour. For example, more complex surfaces were shown to be associated with lowered head pitch angles, increased leg muscle coactivation, reduced gait speed and decreased walking smoothness. Relative to full vision, blocking the lower visual field caused a lowering of head pitch, especially for more complex surfaces. However, crucially, muscle coactivation, gait speed and walking smoothness did not show a significant change between full vision and blocked lower visual field conditions. Finally, head pitch angle, muscle coactivation, gait speed and walking smoothness were all correlated highly with each other.SignificanceOur study showed that blocking the lower visual field did not significantly change muscle coactivation, gait speed or walking smoothness. This suggests that young people cope well when walking with a blocked lower visual field, making minimal behavioural changes. Surface complexity had a greater effect on gaze and gait behaviour than blocking the lower visual field. Finally, head pitch angle was the only measure that showed a significant synergistic interaction between surface complexity and blocking the lower visual field. Together our results indicate that, first, a range of changes occur across the body when people walk over more complex surfaces and, second, that a relatively simple behavioural change (to gaze) suffices to maintain normal gait when the lower visual field is blocked, even in more challenging environments. Future research should assess whether young people cope as effectively when several impairments are simulated, representative of the comorbidities found with age.     

Are there common walking gait characteristics in patients diagnosed with late-onset Pompe disease?

Late-onset Pompe disease (LOPD) is a rare disease, defined as a progressive accumulation of lysosomal glycogen resulting in muscle weakness and respiratory problems. Anecdotally, individuals often have difficulties walking, yet, there is no three-dimensional data supporting these claims. We aimed to assess walking patterns in individuals with LOPD and compare with healthy individuals. Kinematic, kinetic and spatiotemporal data were compared during walking at a self-selected speed between individuals with LOPD (n = 12) and healthy controls (n = 12). Gait profile scores and movement analysis profiles were also determined to indicate gait quality. In comparison with healthy individuals, the LOPD group demonstrated greater thoracic sway (96%), hip adduction angles (56%) and pelvic range of motion (77%) and reduced hip extensor moments (36%). Greater group variance for the LOPD group were also observed. Individuals with LOPD had a slower (15%) walking speed and reduced cadence (7%). Gait profile scores were 37% greater in the LOPD group compared to the healthy group. Proximal muscular weakness associated with LOPD disease is likely to have resulted in a myopathic gait pattern, slower selected walking speeds and deviations in gait patterns. Although individuals with LOPD presented with some common characteristics, greater variability in gait patterns is likely to be a result of wide variability in phenotype spectrum observed with LOPD. This is the first study to examine walking in individuals with LOPD using instrumented gait analysis and provides an understanding of LOPD on walking function which can help orientate physiotherapy treatment for individuals with LOPD.     

Altered visual and somatosensory feedback affects gait stability in persons with multiple sclerosis

Persons with multiple sclerosis (PwMS) often report problems due to sensory loss and have an inability to appropriately reweight sensory information. Both of these issues can affect individual’s ability to maintain stability when walking under challenging conditions. The purpose of the current study was to determine how gait stability is adapted when walking under challenging sensory conditions where vision and somatosensation at the feet is manipulated. 25 healthy adults and 40 PwMS (15 fallers, 25 non-fallers) walked on a treadmill at their preferred normal walking speed under 3 conditions: normal walking, altered vision using goggles that shifted visual field laterally, and altered somatosensation using shoes with compliant foam soles. Inertial measurement united recorded acceleration at the lumbar and right ankle, and acceleration variability measures were calculated including root mean square (RMS), range, sample entropy (SaEn), and Lyapunov exponents (LyE). A gait stability index (GSI) was calculated using each of the four variability measures as the ratio of lumbar acceleration variability divided by foot acceleration variability in the frontal and sagittal planes. The sagittal and frontal GSI_RMS were larger in the somatosensory condition compared to the normal and visual conditions (p < 0.001). The frontal GSI_SaEn was greater in the visual condition compared to the somatosensory condition (p = 0.021). The frontal and sagittal GSI_LyE was greater in the somatosensory condition compared to the normal and visual conditions (p < 0.002). The current study showed that HC, MS non-fallers and MS fallers largely adapted to altered sensory feedback during walking in a similar manner. However, MS faller subjects may be more reliant on visual feedback compared to MS non-fallers and HC subjects.     

The Effect of External and Internal Focus of Attention on Gait Variability in Older Adults

Internal focus of attention on a movement or focusing on an external target are both strategies that can affect motor performance. The authors explored whether manipulating subjects' focus of attention while walking would alter gait variability, a measure reflecting consistency of gait and associated with the risk of falling in older adults. Twenty community-living older adults participated in the study and were tested while focusing their attention on (a) gait consistency (internal focus) or (b) metronome beats (external focus). In both conditions gait variability increased (i.e., worsened p < .05) or did not change. No benefit was found in instructing subjects to focus on gait consistency or metronome beats. Such instructions may actually have distracted and interfered with the execution of gait.     

Measures of dynamic stability: Detecting differences between walking overground and on a compliant surface

Numerous measures of dynamic stability have been proposed to gauge fall risk in the elderly, including stride interval variability and variability of the center of mass. However, these measures have been deemed inadequate because they do not take into account temporal information. Therefore, research on the measurement of dynamic stability has turned to other analysis methods such as stride interval dynamics and the maximum Lyapunov exponent. Stride interval dynamics reflect the statistical persistence of an individual’s stride interval time series and the Lyapunov exponent quantifies local dynamic stability – the sensitivity of the system to infinitesimal perturbations. In this study, we compare the ability of these measurement tools to detect changes between overground and compliant-surface walking, a condition known to affect stability, to determine their aptness as measures of dynamic stability. Fourteen able-bodied participants completed three 15 min walks, two overground and one on a compliant surface. Our results show that the Lyapunov exponent may be more sensitive to gait changes than stride interval dynamics and gait variability measures.     

Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking

Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk - gait dynamics - may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status. Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomotion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.     

Gait control in children with attention-deficit/hyperactivity disorder

The current profile of gait control in children with ADHD is incomplete and predominately based on children walking forward at a self-selected pace. There are no studies of potential gait deficits in this clinical population when walking in different directions in combination with varying rates of stepping that are freely selected and entrained to an external stimulus. The purpose of the current study was to address this lack of information by assessing gait of children aged 7–17 years with (n = 17) and without (n = 26) ADHD. Participants walked forward and backward along an electronically instrumented carpet at a self-selected stepping rate and in synchrony to a metronome that dictated an increased and decreased stepping rate. Using repeated measures analysis of covariance (ANCOVA) to assess spatiotemporal gait parameters, results showed that children with ADHD exhibited a significantly exaggerated, toes ‘turned out,’ foot position for all walking conditions compared to typically developing children. When walking backward, children with ADHD produced an increased step width, higher stepping cadence, and increased velocity. Additionally, coefficient of variation ratios indicated that children with ADHD produced greater variability of velocity, cadence, and step time for all walking conditions, and greater variability for stride length when walking at an increased stepping rate. Results were interpreted in terms of clinical significance and practical ramifications that inform rehabilitation specialists in designing therapies that ameliorate the reported gait deficits.     

Evaluating dynamic similarity of fixed,self-selected and anatomically scaled speeds in non-linear analysis of gait during treadmill running

ObjectivesThe aim of this study is to evaluate how speed affects non-linear measures of variability. Fixed and self-selected speeds were compared to an anatomically scaled speed calculated based on leg length to evaluate which provided a more reproducible result between subjects.MethodsSixteen subjects ran on a treadmill at a fixed, scaled and self-selected speed and at ±10% in each case. Kinematic data were collected for two minutes at 250 Hz for each trial. Sample entropy (SaEn) and maximum Lyapunov exponents (LyE) were calculated from the sagittal knee and hip joint angles to evaluate regularity of gait and local stability. These nonlinear measures were compared to evaluate the dynamic similarity of the movement in each case, and to evaluate speed as a confounding variable in non-linear analysis.ResultsAn anatomically scaled speed shows more dynamic similarity than a fixed or self-selected speed with the lowest observed coefficient of variation for each measure. This was found to be statistically significant for both nonlinear measures of the hip (SaEn p = 0.038; LyE p = 0.040). Speed was not found to be a confounding variable in non-linear analysis of running gait of a healthy population (η² < 0.05).ConclusionsChanges in speed by ±10% do not significantly affect stability and variability of gait for healthy participants, suggesting that they make adaptations to ensure optimal gait variability.Anatomically scaled speeds provide a more reliable methodology for both linear and non-linear analysis by providing a definitive protocol, suggesting it could replace self-selected or fixed speeds in future research.     

Local Dynamic Stability of the Locomotion of Lower Extremity Joints and Trunk During Backward Upslope Walking

Backward slope walking was considered as a practical rehabilitation and training skill. However, its gait stability has been hardly studied, resulting in its limited application as a rehabilitation tool. In this study, the effect of walking direction and slope grade were investigated on the local dynamic stability of the motion of lower extremity joints and trunk segment during backward and forward upslope walking (BUW/FUW). The local divergence exponents (λ_S) of 16 adults were calculated during their BUW and FUW at grades of 0%, 5%, 10%, and 15%. Mean standard deviation over strides (MeanSD) was analyzed as their gait variability. Backward walking showed larger λ_S for the abduction-adduction and rotational angles of knee and ankle on inclined surface than forward walking, while λ_S for hip flexion-extension angle at steeper grades was opposite. No grade effect for any joint existed during BUW, while λ_S increased with the increasing grade during FUW. As to the trunk, walking direction did little impact on λ_S. Still, significant larger λ_S for its medial-lateral and vertical motion were found at the steeper grades during both FUW and BUW. Results indicate that during BUW, the backward direction may influence the stability of joint motions, while the trunk stability was challenged by the increasing grades. Therefore, BUW may be a training tool for the stability of both upper and lower body motion during gait.     

Investigation of factors impacting mobility and gait in Parkinson disease

Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n = 114) were tested in one session ‘off’ medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking. The predictors analyzed were age, gender, disease severity, balance, balance confidence, fall history, self-reported physical activity, and executive function. Multiple regression models were used to assess the relationships between predictors and outcomes. The predictors, in different combinations for each outcome measure, explained 55.7% to 66.9% of variability for mobility and 39.5% to 52.8% for gait velocity. Balance was the most relevant factor (explaining up to 54.1% of variance in mobility and up to 45.6% in gait velocity). Balance confidence contributed to a lesser extent (2.0% to 8.2% of variance) in all models. Age explained a small percentage of variance in mobility and gait velocity (up to 2.9%). Executive function explained 3.0% of variance during forward walking only. The strong predictive relationships between balance deficits and mobility and gait impairment suggest targeting balance deficits may be particularly important for improving mobility and gait in people with PD, regardless of an individual’s age, disease severity, fall history, or other demographic features.     

No bridge too high: Infants decide whether to cross based on the probability of falling not the severity of the potential fall

Do infants, like adults, consider both the probability of falling and the severity of a potential fall when deciding whether to cross a bridge? Crawling and walking infants were encouraged to cross bridges varying in width over a small drop‐off, a large drop‐off, or no drop‐off. Bridge width affects the probability of falling, whereas drop‐off height affects the severity of the potential fall. For both crawlers and walkers, decisions about crossing bridges depended only on the probability of falling: As bridge width decreased, attempts to cross decreased, and gait modifications and exploration increased, but behaviors did not differ between small and large drop‐off conditions. Similarly, decisions about descent depended on the probability of falling: Infants backed or crawled into the small drop‐off, but avoided the large drop‐off. With no drop‐off, infants ran straight across. Results indicate that experienced crawlers and walkers accurately perceive affordances for locomotion, but they do not yet consider the severity of a potential fall when making decisions for action.     

Variability in trunk and pelvic movement of transfemoral amputees using a C-leg system compared to healthy controls

ObjectiveGait variability is a measure of gait disturbance, and therefore constitutes a useful parameter for gait assessment as well as planning of therapeutic and medical interventions. To date, variability during walking has not been adequately analyzed in amputees. The aim of this examination was to evaluate trunk and pelvic movement variability in transfemoral amputees. The effect of different types of walking surfaces on variability in trunk and pelvic movement was also studied.MethodThis prospective clinical examination compares 20 transfemoral amputees (17 ♂, 42 ± 16 years; 3 ♀, 48 ± 3 years) with a group of 20 age and mass matched healthy controls regarding the extent of variability in trunk and pelvic movement. Kinematic data of trunk and pelvic movement during walking on level, uneven ground and slope was captured by eight infrared cameras (Vicon Nexus ™, Oxford, UK). Variability in trunk and pelvic movement was analyzed. Univariate ANCOVA and ANOVA with repeated measures and post hoc tests were used for statistical comparison. Fall history was retrospectively collected from medical history to assess the association between falls and variability in trunk and pelvic movement.ResultsTrunk and pelvic movement variability in amputees was significantly higher during walking on uneven ground and slope compared to healthy controls (p ≤ 0.05). Variability in trunk and pelvic movement was increased during walking on uneven ground and slope compared to even ground for both groups (p ≤ 0.05).ConclusionAmputees showed increased trunk and pelvic movement variability during walking on uneven ground and slope, indicating an affected gait pattern in comparison to healthy controls. Therefore, trunk and pelvic movement variability could be a potential marker for gait quality with diagnostic implications.     

Age and walking conditions differently affect domains of gait

IntroductionAnalysing gait in controlled conditions that resemble daily life walking could overcome the limitations associated with gait analysis in uncontrolled real-world conditions. Such analyses could potentially aid the identification of a walking condition that magnifies age-differences in gait. Therefore, the aim of the current study was to determine the effects of age and walking conditions on gait performance.MethodsTrunk accelerations of young (n = 27, age: 21.6) and older adults (n = 26, age: 68.9) were recorded for 3 min in four conditions: walking up and down a university hallway on a track of 10 m; walking on a specified path, including turns, in a university hallway; walking outside on a specified path on a pavement including turns; and walking on a treadmill. Factor analysis was used to reduce 27 computed gait measures to five independent gait domains. A multivariate analysis of variance was used to examine the effects of age and walking condition on these gait domains.ResultsFactor analysis yielded 5 gait domains: variability, pace, stability, time & frequency, complexity, explaining 64% of the variance in 27 gait outcomes. Walking conditions affected all gait domains (p < 0.01) but age only affected the time & frequency domain (p < 0.05). Age and walking conditions differently affected the domains variability, stability, time & frequency. The largest age-differences occurred mainly during straight walking in a hallway (variability: 31% higher in older adults), or during treadmill walking (stability: 224% higher, time&frequency: 120% lower in older adults).ConclusionWalking conditions affect all domains of gait independent of age. Treadmill walking and walking on a straight path in a hallway, were the most constrained walking conditions in terms of limited possibilities to adjust step characteristics. The age by condition interaction suggests that for the gait domains variability, stability, and time & frequency, the most constrained walking conditions seem to magnify the age-differences in gait.     

Age-dependent variability in spatiotemporal gait parameters and the walk-to-run transition

Adolescents tend to exhibit more variability in their gait patterns than adults, suggesting a lack of gait maturity during this period of ongoing musculoskeletal growth and development. However, there is a lack of consensus over the age at which mature gait patterns are achieved and the factors contributing to gait maturation. Therefore, the purpose of this study was to investigate gait control and maturity in adolescents by determining if differences existed between adolescents and adults in a) the amount of spatiotemporal variability of walking and running patterns across a range of speeds, and b) how swiftly gait patterns are adapted to increasing gait speed during the walk-to-run transition. Forty-six adolescents (10–12-year-olds, n = 17; 13–14-year-olds, n = 12; and 15–17-year-olds, n = 17) and 12 young adults completed an incrementally ramped treadmill test (+0.2 km·h⁻¹ every 30 s) to determine the preferred transition speed (PTS) during a walk-to-run transition. Age-related differences in the variability of stride lengths and stride durations were assessed across 4 speeds (self-selected walking speed, PTS − 0.06 m·s⁻¹, PTS + 0.06 m·s⁻¹, PTS + 0.83 m·s⁻¹). Repeated measures ANOVAs (p < 0.05) compared coefficients of variation for these spatiotemporal parameters, while a one-way ANOVA compared the numbers of gait transitions and speed increments used to identify PTS between the adolescent groups and young adults. Compared to adults, 10–12yo exhibited more spatiotemporal variability during all gait conditions, while 13–17yo only exhibited more variability at PTS + 0.06 m·s⁻¹. No age-dependent pattern was observed in PTS values, but 10–12yo completed more gait transitions over more speed increments than 15–17yo and adults. The development of mature gait patterns is thus a progressive process, with walking maturing at an earlier age than running. As 10-12yo were unable to swiftly adapt gait patterns to the changing task demands, their control mechanisms of gait may not have fully matured yet.     

Sensorimotor synchronization during gait is altered by the addition of variability to an external cue

Sensorimotor synchronization has been used in the rehabilitation of gait, yet much remains unknown regarding the optimal use of this technique. The purpose of this study was to test the hypothesis that adding small amounts of variability to the motion of a vertically oscillating treadmill would affect the behavior of healthy walkers. Sixteen young adults walked on a treadmill and pneumatically actuated platform for one control trial (no oscillation) and eight trials in which the walking surface oscillated in the vertical direction under different conditions of variability. During the oscillation trials, the mean frequency of oscillation was equal to the preferred step frequency of the participant, but each individual cycle period was allowed to vary within a pre-determined range from 0% (no variability) to ±25% (high variability) of the mean cycle period. The amount of variance of each cycle period within each condition was drawn randomly from a white noise generator. Synchronization was improved when a small amount of noise was added to the platform motion but synchronization significantly decreased at higher levels of noise. Coefficient of variation of stride duration was relatively unchanged at lower levels of variability, but increased significantly at higher levels of variability. Statistical persistence of stride duration was significantly reduced during all trials with vertical oscillation relative to normal walking, but was not significantly altered by variability in the treadmill oscillation. These results suggest that the addition of a small amount of random variability to the cycle period of an oscillator may enhance sensorimotor synchronization of gait to an external signal. These data may have implications for the use of synchronization in a therapeutic setting.     

Dual-task costs of texting while walking forward and backward are greater for older adults than younger adults

Cognitive-motor dual-tasking involves concurrent performance of two tasks with distinct cognitive and motor demands and is associated with increased fall risk. In this hypothesis-driven study, younger (18–30 years, n = 24) and older (60–75 years, n = 26) adults completed six walking tasks in triplicate. Participants walked forward and backward along a GAITRite mat, in isolation or while performing a verbal fluency task. Verbal fluency tasks involved verbally listing or typing on a smartphone as many words as possible within a given category (e.g., clothes). Using repeated measures MANOVA models, we examined how age, method of fluency task (verbal or texting), and direction of walking altered dual-task performance. Given that tasks like texting and backward walking require greater cognitive resources than verbal and forward walking tasks, respectively, we hypothesized older adults would show higher dual-task costs (DTCs) than younger adults across different task types and walking directions, with degree of impairment more apparent in texting dual-task trials compared to verbal dual-task trials. We also hypothesized that both age groups would have greater DTCs while walking backward than while walking forward, regardless of task.Independent of age group, velocity and stride length were reduced for texting compared to the verbal task during both forward and backward walking; cadence and velocity were reduced while walking forward compared to walking backward for the texting task; and stride length was reduced for forward walking compared to backward walking during the verbal task. Younger adults performed better than older adults on all tasks with the most pronounced differences seen in velocity and stride length during forward-texting and backward-texting. Interaction effects for velocity and stride length while walking forward indicated younger adults performed better than older adults for the texting task but similarly during the verbal task. An interaction for cadence during the verbal task indicated younger adults performed better than older adults while walking backward but similarly while walking forward.In summary, older adults experienced greater gait decrement for all dual-task conditions. The greater declines in velocity and stride length in combination with cadence being stable suggest reductions in velocity during texting were due to shorter strides rather than a reduced rate of stepping. Contrary to our hypotheses, we found greater DTCs while walking forward rather than backward, which may be due to reduced gait performance during single-task backward walking; thus, further decrements with dual-tasking are unlikely. These findings underscore the need for further research investigating fall risk potential associated with texting and walking among aging populations and how interventions targeting stride length during dual-task circumstances may improve performance.     

Stability and variability may respond differently to changes in walking speed

In gait research it has often been assumed that variability and stability are negatively correlated, where increases in variability are assumed to equate with increases in instability. The purpose of this paper is to illustrate that variability does not always equate with stability. To proof this point, a method was developed to directly assess stability and variability during the application of a visual perturbation at different walking speeds. Walking variability was measured by using the average standard deviation of the knee joint angle across the gait cycle. Walking stability was measured by the recovery time of the knee joint angle trajectory from the distortion induced by a visual perturbation that was delivered at the beginning of the stance phase. Five participants were required to walk at six different velocities on a treadmill (0.67, 0.80, 0.94, 1.07, 1.21, and 1.34 m/s). The coefficients of intraclass correlations for the experiment were 83% and 80% for the calculated stability and variability, respectively. The calculated stabilities were not sensitive to changes in walking speed (p>0.98). The calculated variability however decreased with increases in walking speed (p=0.004). No significant correlation between variability and stability was observed (r=-0.002). We suggest that gait stability is independent of variability during locomotion and should thus be measured independently.     

Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults

Dual-task related gait changes have been previously reported for healthy older adults, suggesting that gait control requires attention. Compared to balance control, the involvement of attention in the control of the rhythmic stepping mechanism, as reflected by stride time variability, is not well known. In particular, under dual-task, the relative contributions of a second, attention-demanding task and changes in walking speed remain unclear. Thus, the aims of this study were (1) to assess whether walking with a slow-selected speed or walking while performing an attention-demanding task affected stride time variability in a sample of healthy older participants, and (2) to establish whether stride time variability under dual-task conditions is related either to the decrease of walking speed or the simultaneous attention-demanding task, or to both. Forty-five healthy older participants performed four experimental conditions: (1) walking at a normal self-selected speed, (2) walking at a slow self-selected speed, (3) performing a verbal fluency task when sitting on a chair, and (4) performing the verbal fluency task while walking at self-selected walking speed. Gait parameters were recorded across 15 meters, using Physilog. Results showed a significant dual-task related decrease in mean values of stride velocity, as well as a significant increase in mean values and coefficients of variation of stride time. These dual-task related changes in stride time were explained by the simultaneous performance of the verbal fluency task, the decrease of gait speed and the variability between participants. Although a relationship exists between decreased walking speed and increased stride time variability, the dual-task related increase of stride time variability was also significantly associated with the attention-demanding task, suggesting some attentional control for the rhythmic stepping mechanism of walking in healthy older adults.