The effect of an incline walking surface and the contribution of balance on spatiotemporal gait parameters of older adults.

摘要

The effect of an incline walking surface and the contribution of balance to changes in gait patterns on inclines, particularly in older adults, have not been well-defined in the literature. This study aims to examine the effects of such inclines on spatiotemporal parameters of healthy older adults. Secondarily, this study identifies adaptations made in spatiotemporal parameters of healthy older adults with balance impairments on level and incline surfaces.;Seventy-eight active, older adults participated in this study (mean age, 77.8; SD, 4.8). The Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) were used in this study to assess overall stability. A third measure, the Gait Stability Ratio (GSR), was calculated directly from output measures provided by the GaitRiteRTM computerized walkway system. Acting as their own controls, all subjects walked five times each on a level surface and an inclined walkway. Dependent t-tests were used to determine statistical significance between level and incline surfaces for cadence, step length and velocity. A repeated measures ANOVA was performed to determine differences in means for the higher risk subgroups comparing their level and incline walking patterns. The level of significance was set at p = 0.05.;Results of this study indicate that cadence, step length and velocity significantly decreased on inclines while GSR increased relative to subjects' level ground walking patterns. While cadence and velocity support previous incline studies with younger subjects, the decrease in step length suggests a different pattern adapted by older adults on inclines (Kawamura et al., 1991; McIntosh et al., 2005). In the higher risk subgroups, only the results from the repeated measures ANOVA using the DGI showed a significant increase is GSR on the inclined surface indicating decreased stability relative to level ground.;These findings are important and have significant clinical value. Increased GSR measured on inclines indicates more time spent in double support and suggests the primary goal, even in healthy adults, is stability. These results suggest that clinicians incorporate more challenging balance activities for healthy older adults such as dual tasks and varying terrain obstacle courses.