Age-Related Changes in Gait and Obstacle Avoidance Capabilities in Older Adults: A Review

Abstract

Walking is a fundamental motor skill that significantly affects the level of independence in older adults today. Changes in gait and obstacle avoidance strategies have been well documented in the literature, and falling has been shown to be one of the most significant health care concerns in the elderly population today. Falls are a major contributor to the increasing morbidity rates seen in the older population, and in many cases, alterations in gait or stepping ability have played a significant role. This reviewexamines the specific changes seen in gait and obstacle avoidance in the elderly population and some of the underlying changes seen in sensory capability that play a role in safe and efficient ambulation in older adults. Normal gait (unassisted ambulation) will be presented, followed by an examination of the literature that has examined changes in performance factors associated with gait and obstacle avoidance strategies.

Keywords

gait obstacle balance health ADL’s

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References

Auvinet, B. , Berrut, G. , Touzard, C. , Moutel, L. , Collet, C. , Chaleil, D. , et al. (2003).Abnormalities in elderly fallers. Aging and Physical Activity, 11, 40-52.

Brach, J. S. , Berthold, R. , Craik, R. , VanSwearingen, J. M. , & Newman, A. B. (2001). Gait variability in community-dwelling older adults. Journal of the American Geriatrics Society, 49, 1646-1650.

Clark, R. D. , Lord, S. R. ,& Webster, I. W. (1993). Clinical parameters associated with falls in an elderly population. Gerontology, 39, 117-123.

Crowinshield, R. D. , Brand, R. A. ,& Johnston, R. C. (1979). The effects ofwalking velocity and age on hip kinematics and kinetics. Clinical Orthopedics and Related Research, 132, 140-144.

Englander, F. , Hodson, T. J. , & Terregrossa, R. A. (1996). Economic dimensions of slip and fall injuries. Journal of Forensic Science, 41(5), 733-746.

Hooyman, N. , & Kiyak, H. A. (1996). Social gerontology: A multidisciplinary perspective. Boston: Allyn & Bacon.

Hsieh-Ching, C. , Ashton-Miller, J. A. , Alexander, N. B. ,& Schultz, A. B. (1991). Stepping over obstacles: Gait patterns of healthy young and old adults. Journal of Gerontology, 46, M196-M205.

Hu, M. H. ,& Woollacott, M. H. (1994). Multisensory training of standing balance in older adults. I. Postural stability and one-leg stance balance. Journal of Gerontology, 49, M52-M61.

Judge, J. O. , King, M. B. , Whipple, R. , Clive, J. , & Wolfson, L. I. (1995). Dynamic balance in older persons: Effects of reduced visual and proprioceptive input. Journal of Gerontology, 50, M263-M270.

10.

Kaya, B. K. , Krebs, D. E. ,& Riley, P. O. (1998). Dynamic stability in elders: Momentum control in locomotor ADL. Journal of Gerontology, 53, M126-M134.

11.

Kovacs, C. , & Williams, K. (in press). Sensory training effects on obstacle avoidance in healthy older adults. Physical and Occupational Therapy in Geriatrics.

12.

Lamoureax, E. L. , Murphy, A. , Sparrow, A. ,& Newton, R. U. (2003). The effects of progressive resistance training on obstructed-gait tasks in community-living older adults. Journal of Aging and Physical Activity, 11, 98-110.

13.

Lamoureax, E. L. , Sparrow, A. , Murphy, A. , & Newton, R. U. (2002). The relationship between lower body strength and obstructed gait in community-dwelling older adults. Journal of the American Geriatrics Society, 50, 469-473.

14.

Lipsitz, L. A. , Jonsson, P. V. , Kelley, M. M. , & Koestner, J. S. (1991). Causes and correlates of recurrent falls in ambulatory frail elderly. Journal of Gerontology, 46, M114-M122.

15.

Luchies, C. W. , Wallace, D. , Pazdur, R. , Young, S. , & DeYoung, A. J. (1999). Effects of age on balance assessment using voluntary and involuntary step tasks. Journal of Gerontology, 54, M140-144.

16.

Manchester, D. , Woollacott, M. H. , Zederbauer-Hylton, M. ,& Marin, O. (1989). Visual, vestibular, and somatosensory contributions to balance control in the older adult. Journal of Gerontology, 44, M118-M127.

17.

Mbourou, G. A. , Lajoie, Y. , & Teasdale, N. (2003). Step length variability at gait initiation in elderly fallers and non-fallers, and young adults. Gerontology, 49, 21-26.

18.

Medell, J. O. , & Alexander, N. B. (2000). A clinical measure of maximal and rapid stepping in older women. Journal of Gerontology, 55, M429-M433.

19.

National Center for Health Statistics Vital Statistics System. (2000). Retrieved January 29, 2003, from www.cdc.gov/nchs/nvss.htm

20.

Patla, A. E. , Prentice, S. D. , Robinson, C. , & Neufeld, J. (1991). Visual control of locomotion: Strategies for changing direction and for going over obstacles.Journal of Experimental Psychology, 17, 603-634.

21.

Persad, C. C. , Giordani, B. , Hsieh-Ching, C. , Ashton-Miller, J. A. , Alexander, N. B. , Wilson, C.S. , et al. (1995). Neuropsychological predictors of complex obstacle avoidance in healthy older adults. Journal of Gerontology, 50, P272-P277.

22.

Prudham, D. , & Evans, J. G. (1981). Factors associated with falls in the elderly: A community study. Age and Aging, 10, 141-146.

23.

Rosengren, K. S. , McAuley, E. ,& Mihalko, S. L. (1998). Gait adjustments in older adults: Activity and efficacy influences. Psychology and Aging, 13, 375-386.

24.

Sattin, R. W. (1992). Falls among older persons: A public health perspective. Annual Reviews in Public Health, 13, 489-508.

25.

Sutherland, D. A. , Kauman, K. R. , & Moitoza, J. R. (1995). Kinematics of normal human walking. In J. Rose & J. G. Gamble (Eds.), Human walking(pp. 23-44). Baltimore: Williams & Wilkins.

26.

Tinetti, M. E. , Baker, D. I. , McAvay, G. , Claus, E. B. , Garrett, P. , Gottschalk, M. , et al. (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. The New England Journal of Medicine, 331, 821-826.

27.

Tinetti, M. E. , Speechley, M. ,& Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. The New England Journal of Medicine, 26, 1701-1707.

28.

van Emmerick, R. E. A. ,& vanWegen, E. E. H. (2002). On the functional aspects of variability in postural control. Exercise and Sport Science Reviews, 30, 177-183.

29.

Winter, D. (1991). The biomechanics of motor control of human gait: Normal, elderly, and pathological. Waterloo, Ontario, Canada: University of Waterloo Press.

30.

Wojcik, L. A. , Thelen, D. G. , Schultz, A. B. , Ashton-Miller, J. A. , & Alexander, N. B. (1999). Age and gender differences in single-step recovery from a forward fall. Journal of Gerontology, 54, M44-M50.

31.

Woollacott, M. H. (1986). Gait and postural control in the aging adult. In W. Bles & T. Brandt (Eds.), Disorders of posture and gait(pp. 325-336). Amsterdam: Elvesier.

32.

Woollacott, M. H. ,& Shumway-Cook, A. (2002). Attention and the control of posture and gait: A review of an emerging area of research. Gait and Posture, 16, 1-14.

33.

Woollacott, M. H. , & Tang, P. F. (1997). Balance control during walking in the older adult: Research and its implications. Physical Therapy, 6, 646-660.