Gait Variability Using Waist- and Ankle-Worn Inertial Measurement Units in Healthy Older Adults

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Abstract

Gait variability observed in step duration is predictive of impending adverse health outcomes among apparently healthy older adults and could potentially be evaluated using wearable sensors (inertial measurement units, IMU). The purpose of the present study was to establish the reliability and concurrent validity of gait variability and complexity evaluated with a waist and an ankle-worn IMU. Seventeen women (age 74.8 (SD 44) years) and 10 men (73.7 (4.1) years) attended two laboratory measurement sessions a week apart. Their stride duration variability was concurrently evaluated based on a continuous 3 min walk using a force plate and a waist- and an ankle-worn IMU. Their gait complexity (multiscale sample entropy) was evaluated from the waist-worn IMU. The force plate indicated excellent stride duration variability reliability (intra-class correlation coefficient, ICC = 0.90), whereas fair to good reliability (ICC = 0.47 to 0.66) was observed from the IMUs. The IMUs exhibited poor to excellent concurrent validity in stride duration variability compared to the force plate (ICC = 0.22 to 0.93). A good to excellent reliability was observed for gait complexity in most coarseness scales (ICC = 0.60 to 0.82). A reasonable congruence with the force plate-measured stride duration variability was observed on many coarseness scales (correlation coefficient = 0.38 to 0.83). In conclusion, waist-worn IMU entropy estimates may provide a feasible indicator of gait variability among community-dwelling ambulatory older adults.

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Gait and cognition: a complementary approach to understanding brain function and the risk of falling.

Manuel Montero-Odasso, Joe Verghese, Olivier Beauchet … (2012)

Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults, but increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are interrelated in older adults. Quantifiable alterations in gait in older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single- and dual-task testing and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This article reviews the importance of the interrelationship between gait and cognition in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunction and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. A potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through nonpharmacological and pharmacological treatments is also presented. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful in identifying older adults at risk of experiencing mobility decline, falls, and progression to dementia. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

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Gait variability: methods, modeling and meaning

Jeffrey M. Hausdorff (2005)

The study of gait variability, the stride-to-stride fluctuations in walking, offers a complementary way of quantifying locomotion and its changes with aging and disease as well as a means of monitoring the effects of therapeutic interventions and rehabilitation. Previous work has suggested that measures of gait variability may be more closely related to falls, a serious consequence of many gait disorders, than are measures based on the mean values of other walking parameters. The Current JNER series presents nine reports on the results of recent investigations into gait variability. One novel method for collecting unconstrained, ambulatory data is reviewed, and a primer on analysis methods is presented along with a heuristic approach to summarizing variability measures. In addition, the first studies of gait variability in animal models of neurodegenerative disease are described, as is a mathematical model of human walking that characterizes certain complex (multifractal) features of the motor control's pattern generator. Another investigation demonstrates that, whereas both healthy older controls and patients with a higher-level gait disorder walk more slowly in reduced lighting, only the latter's stride variability increases. Studies of the effects of dual tasks suggest that the regulation of the stride-to-stride fluctuations in stride width and stride time may be influenced by attention loading and may require cognitive input. Finally, a report of gait variability in over 500 subjects, probably the largest study of this kind, suggests how step width variability may relate to fall risk. Together, these studies provide new insights into the factors that regulate the stride-to-stride fluctuations in walking and pave the way for expanded research into the control of gait and the practical application of measures of gait variability in the clinical setting.

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Does the evaluation of gait quality during daily life provide insight into fall risk? A novel approach using 3-day accelerometer recordings.

Talia Herman, David M. Dorfman, Jeffrey M. Hausdorff … (2013)

Many approaches are used to evaluate fall risk. While their properties and performance vary, most reflect performance at a specific moment or are based on subjective self-report. To quantify fall risk in the home setting using an accelerometer. Seventy-one community-living older adults were studied. In the laboratory, fall risk was assessed using performance-based tests of mobility (eg, Timed Up and Go) and usual walking abilities were quantified. Subsequently, subjects wore a triaxial accelerometer on their lower back for 3 consecutive days. Acceleration-derived measures were extracted from segments that reflected ambulation. These included total activity duration, number of steps taken, and the amplitude and width at the dominant frequency in the power spectral density, that is, parameters reflecting step-to-step variability. Afterwards, self-report of falls was collected for 6 months to explore the predictive value. Based on a history of 2 or more falls, subjects were classified as fallers or nonfallers. The number of steps during the 3 days was similar (P = .42) in the fallers (7842.1 ± 6135.6) and nonfallers (9055.3 ± 6444.7). Compared with the nonfallers, step-to-step consistency was lower in the fallers in the vertical axis (amplitude fallers, 0.58 ± 0.22 psd; nonfallers, 0.71 ± 0.18 psd; P = .008); in the mediolateral axis, step-to-step consistency was higher in the fallers (P = .014). The 3-day measures improved the identification of past and future falls status (P < .005), compared to performance-based tests. Accelerometer-derived measures based on 3-day recordings are useful for evaluating fall risk as older adults perform daily living activities in their everyday home environment.

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Author and article information

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Journal ID (nlm-ta): Sensors (Basel)

Journal ID (iso-abbrev): Sensors (Basel)

Journal ID (publisher-id): sensors

Title: Sensors (Basel, Switzerland)

Publisher: MDPI

ISSN (Electronic): 1424-8220

Publication date (Electronic): 18 May 2020

Publication date Collection: May 2020

Volume: 20

Issue: 10

Electronic Location Identifier: 2858

Affiliations

[1 ]Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; henrikki.j.pirkola@ 123456student.jyu.fi (H.P.); vesa.linnamo@ 123456jyu.fi (V.L.)

[2 ]Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; laura.i.karavirta@ 123456jyu.fi (L.K.); taina.rantanen@ 123456jyu.fi (T.R.)

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[* ]Correspondence: timo.rantalainen@ 123456jyu.fi

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Timo Rantalainen https://orcid.org/0000-0001-6977-4782

Laura Karavirta https://orcid.org/0000-0003-1372-2304

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Publisher ID: sensors-20-02858

DOI: 10.3390/s20102858

PMC ID: 7287584

PubMed ID: 32443507

SO-VID: bdf7cea2-8cf5-4a9b-bb0e-5c12fd1a38eb

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Gait Variability Using Waist- and Ankle-Worn Inertial Measurement Units in Healthy Older Adults

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Most cited references 25

Gait and cognition: a complementary approach to understanding brain function and the risk of falling.

Gait variability: methods, modeling and meaning

Does the evaluation of gait quality during daily life provide insight into fall risk? A novel approach using 3-day accelerometer recordings.

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