Objective To explore the gait characteristics under single- and dual-task conditions and their relationships with the history of fall among community-dwelling elderly people, in order to provide a reference for the prevention of falls in this population. Methods From September 2015 to June 2016, we enrolled a convenience sample of 268 community-dwelling elderly people from 3 communities in Hefei city based on the inclusion and exclusion criteria of this study. Data were analyzed for 252 participants. According to history of fall, they were divided into non-fallers (134 cases), fallers A group (77 cases) and fallers B (41 cases). We used Demographic Questionnaire, Barthel Scale, Mini-Mental State Examination (MMSE), handgrip strength test, Timed Up and Go Test (TUGT) and 10-meter walk test under single-task and dual-task conditions with IDEEA LifeGait to collect the demographic data, Barthel Index, mental status, handgrip strength, comprehensive mobility and balance ability, and gait parameters at usual speed and in dual-task walking of the three groups. Results The distribution of age, exercising status, level of fear of falling, Barthel Index, handgrip strength and results of TUGT differed significantly between the groups (P<0.05). Compared with 10-meter walk test under single-task conditions, during 10-meter walk test under dual-task conditions, all the participants showed slower speed, lower cadence, shorter step length, shorter stride length, weaker ground impact and weaker foot fall except pre-swing angle in fallers B (P<0.05). During the 10-meter walk test under single-task conditions, three groups displayed significant different speed, step length, stride length, degree of foot fall, and pre-swing angle(P<0.05), in particular, compared with non-fallers and fallers A, fallers B had significant slower speed, shorter step length, shorter stride length , weaker foot fall and smaller pre-swing angle (P<0.05). During the 10-meter walk test under dual-task conditions, three groups demonstrated obviously different step length, stride length, weaker ground impact and degree of foot fall (P<0.05), in particular, fallers B showed significant slower speed, shorter step length, weaker ground impact and weaker foot fall compared with other two groups (P<0.05). Conclusion The gait characteristics of community-dwelling elderly people during 10-meter walk test under single- and dual-task conditions were significantly different. During 10-meter walk test under dual-task conditions, those with a history of falls within the past year showed slower speed, shorter step length, weaker ground impuct and weaker foot fall. Therefore, we can conclude that gait parameters are helpful to recognize elderly people with a history of fall.%目的 探讨社区老年人常速行走和双重任务行走的步态特征及其与跌倒的关系,为社区老年人跌倒的预防提供参考依据.方法 采取方便抽样法,于2015年9月—2016年6月抽取合肥市3所社区268例老年人为研究对象,最终有效样本为252例.按照过去跌倒史情况,将其分为未跌倒组134例、跌倒组A 77例与跌倒组B 41例,采用一般情况调查表、Barthel指数评定量表、简易智能精神状态检查量表(MMSE)、手握力测试、计时起立行走测试(TUGT)、常速行走和双重任务行走的步态测试收集相关指标,并进行3组的比较.结果 3组老年人年龄、运动锻炼情况、害怕跌倒情况、Barthel指数、手握力、TUGT结果的比较,差异有统计学意义(P<0.05).与常速行走相比,3组老年人双重任务行走时步速慢、步频低、步长短、步幅小、地面冲击与落脚强度弱、离地时脚的角度小(除跌倒组B外),差异有统计学意义(P<0.05).常速步行3组老年人的步速、步长、步幅、落脚强度、离地时脚的角度比较,差异有统计学意义(P<0.05).两两比较显示,与未跌倒组、跌倒组A相比,跌倒组B步速慢、步长短、步幅小、落脚强度弱、离地时脚的角度小,差异有统计学意义(P<0.05).双重任务行走3组老年人的步速、步长、地面冲击、落脚强度比较,差异有统计学意义(P<0.05);两两比较显示,与未跌倒组、跌倒组A相比,跌倒组B步速慢、步长短、地面冲击和落脚强度弱,差异有统计学意义(P<0.05).结论 社区老年人常速行走和双重任务行走的步态特征存在差异,双重任务行走时1年内有跌倒史的老年人步速慢、步长短、地面冲击和落脚强度弱,步态特征对跌倒史有一定的鉴别作用.
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