Advertisement
Original article| Volume 89, ISSUE 12, P2293-2296, December 2008

The Reliability and Validity of Measures of Gait Variability in Community-Dwelling Older Adults

      Abstract

      Brach JS, Perera S, Studenski S, Newman AB. The reliability and validity of measures of gait variability in community-dwelling older adults.

      Objective

      To examine the test-retest reliability and concurrent validity of variability of gait characteristics.

      Design

      Cross-sectional study.

      Setting

      Research laboratory.

      Participants

      Older adults (N=558) from the Cardiovascular Health Study.

      Interventions

      Not applicable.

      Main Outcome Measures

      Gait characteristics were measured using a 4-m computerized walkway. SD determined from the steps recorded were used as the measures of variability. Intraclass correlation coefficients (ICC) were calculated to examine test-retest reliability of a 4-m walk and two 4-m walks. To establish concurrent validity, the measures of gait variability were compared across levels of health, functional status, and physical activity using independent t tests and analysis of variances.

      Results

      Gait variability measures from the two 4-m walks demonstrated greater test-retest reliability than those from the single 4-m walk (ICC=.22–.48 and ICC=.40–.63, respectively). Greater step length and stance time variability were associated with poorer health, functional status and physical activity (P<.05).

      Conclusions

      Gait variability calculated from a limited number of steps has fair to good test-retest reliability and concurrent validity. Reliability of gait variability calculated from a greater number of steps should be assessed to determine if the consistency can be improved.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), CHS (Cardiovascular Health Study), IADLs (instrumental activities of daily living), ICC (intraclass correlation coefficient)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Maki B.E.
        Gait changes in older adults: predictors of falls or indicators of fear?.
        J Am Geriatr Soc. 1997; 45: 313-320
        • Hausdorff J.M.
        • Rios D.A.
        • Edelberg H.K.
        Gait variability and fall risk in community-living older adults: a 1-year prospective study.
        Arch Phys Med Rehabil. 2001; 82: 1050-1056
        • Brach J.S.
        • Berlin J.E.
        • VanSwearingen J.M.
        • Newman A.B.
        • Studenski S.A.
        Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed.
        J Neuroeng Rehabil. 2005; 2: 21
        • Brach J.S.
        • Studenski S.
        • Perera S.
        • VanSwearingen J.M.
        • Newman A.B.
        Gait variability and the risk of incident mobility disability.
        J Gerontol Med Sci. 2007; 62A: 983-988
        • Rothstein J.M.
        Measurement and Clinical Practice: Theory and application.
        in: Rothstein J.M. Measurement in physical therapy. Churchill Livingstone, New York1985: 1-46
        • Jette A.M.
        • Jette D.U.
        • Ng J.
        • Plotkin D.J.
        • Bach M.A.
        • The Musculokeletal Impairment (MSI) Study Group
        Are performance-based measures sufficiently reliable for use in multicenter trials?.
        J Gerontol. 1999; 54A: M3
        • Bohannon R.W.
        Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants.
        Age Aging. 1997; 26: 15-19
        • Tager I.B.
        • Swanson A.
        • Satariano W.A.
        Reliability of physical performance and self-reported functional measures in an older population.
        J Gerontol A Biol Sci Med Sci. 1998; 53A: M295-M300
        • McDonough A.L.
        • Batavia M.
        • Chen F.C.
        • Kwon S.
        • Ziai J.
        The validity and reliability of the GAITRite system's measurements: A preliminary evaluation.
        Arch Phys Med Rehabil. 2001; 82: 419-425
        • van Uden C.J.
        • Besser M.P.
        Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite).
        BMC Musculoskelet Disord. 2004; 17: 5-13
        • Owings T.M.
        • Grabiner M.D.
        Measuring step kinematic variability on an instrumented treadmill: how many steps are enough?.
        J Biomechanics. 2003; 36: 1215-1218
        • Monaghan K.
        • Delahunt E.
        • Caulfield B.
        Increasing the number of gait trial recordings maximises intra-rater reliability of the CODA motion analysis system.
        Gait Posture. 2007; 25: 303-315
        • Hausdorff J.M.
        • Nelson M.E.
        • Kaliton D.
        Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise.
        J Appl Physiol. 2001; 90: 2117-2129
        • Tell G.S.
        • Fried L.P.
        • Hermanson B.
        • Manolio T.A.
        • Newman A.B.
        • Borhani N.O.
        Recruitment of adults 65 years and older as participants in the cardiovascular health study.
        Ann Epidemiol. 1993; 3: 358-366
        • Fried L.P.
        • Borhani N.O.
        • Enright P.L.
        The cardiovascular health study:design and rationale.
        Ann Epidemiol. 1991; 1: 263-276
        • Walsh J.P.
        Foot fall measurement Technology.
        in: Craik R.L. Oatis C.A. GaitAnalysis: theory and application. Mosby-Year Book, Inc, St. Louis1995: 125-142
        • Hausdorff J.M.
        • Edelberg H.K.
        • Mitchell S.L.
        • Goldberger A.L.
        • Wei J.Y.
        Increased gait unsteadiness in community-dwelling elderly fallers.
        Arch Phys Med Rehabil. 1997; 78: 278-283
        • Owings T.M.
        • Grabiner M.D.
        Step width variability, but not step length variability or step time variability, discriminates gait of healthy young and older adults during treadmill locomotion.
        J Biomech. 2004; 37: 935-938
        • Fitti J.E.
        • Kovar M.G.
        National Health Interview Survey.
        Vital Health Stat. 1987; 21 (Publication DHHS (PHS) 87-1323): 1-115
        • Rosner B.
        Fundamentals of Biostatistics.
        4th ed. Duxbury Pr, Belmont1995
        • Blanke D.J.
        • Hageman P.
        Comparison of gait of young and elderly men.
        Phys Ther. 1989; 69: 144-148
        • Hageman P.A.
        • Blanke D.J.
        Comparison of gait of young women and elderly women.
        Phys Ther. 1986; 66: 1382-1387
        • Imms F.J.
        • Edholm O.G.
        Studies of gait and mobility in the elderly.
        Age Ageing. 1981; 10: 147-156
        • Lerner-Frankiel M.B.
        • Vargas S.
        • Brown M.
        • Krusel L.
        • Schoneberger W.
        Functional community ambulation: what are your criteria?.
        Clinical Management. 1986; 6: 12-15
        • Gabell A.
        • Nayak U.S.
        The effect of age and variability in gait.
        J Gerontol. 1984; 39: 662-666
        • Donelan J.M.
        • Shipman D.W.
        • Kram R.
        • Kuo A.D.
        Mechanical and metabolic requirments for active lateral stabilization in human walking.
        J Biomech. 2004; 37: 827-835