Relationship between head-turn gait speed and lateral balance function in community-dwelling older adults

Publication date: Available online 10 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Harshvardhan Singh, Ozell Sanders, Sandy McCombe Waller, Woei-Nan Bair, Brock Beamer, Robert A. Creath, Mark W. Rogers
ObjectiveTo determine and compare gait speed during head-forward and side-to-side head-turn walking in individuals with lower versus greater lateral balance.DesignCross-sectional studySettingUniversity research laboratoryParticipantsNinety-three older adults (42 men and 51 women) aged 73 ± 6.08 years who could walk independently participated in this study.Main Outcome Measures1) 'balance tolerance limit' (BTL), defined as the lowest perturbation intensity where a multistep balance recovery pattern was first evoked in response to randomized lateral waist-pull perturbations of standing balance to the left and right sides, at six different intensities (range from level two: 4.5 cm displacement at 180cm/s² acceleration to level seven: 22.5 cm displacement at 900cm/s² acceleration), 2) gait speed, 3) balance, and 4) mobility using an instrumented gait mat, Timed-Up-and-Go (TUG) and Activities-Specific Confidence (ABC) scale, respectively.ResultsIndividuals with low versus high BTL had slower self-selected head-forward gait speed (HFGS) and head-turn gait speed (HTGS) (p = 0.002 and p < 0.001, respectively); the magnitude of difference was greater in HTGS than HFGS (Cohen's d = 1.0 versus 0.6). HTGS best predicted BTL. BTL was moderately and positively related (p = 0.003) to the ABC and negatively related (p = 0.017) to TUG.ConclusionsHTGS is affected to a greater extent than HFGS in older individuals with poorer lateral balance and at greater risk of falls. Moreover, HTGS can be used to assess the interactions of limitations in lateral balance function and gait speed in relation to fall risk in older adults.



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