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Relationship Between Head-Turn Gait Speed and Lateral Balance Function in Community-Dwelling Older Adults

      Highlights

      • Head-turn gait speed is affected to a greater extent than self-selected gait speed in older individuals with diminished lateral balance stability and at greater risk of falls.
      • The balance tolerance limit has the potential to be a marker of balance ability in older individuals.
      • Prospective studies are need to examine whether head-turn gait speed can differentiate future fallers from nonfallers.

      Abstract

      Objective

      To determine and compare gait speed during head-forward and side-to-side head-turn walking in individuals with lower versus greater lateral balance.

      Design

      Cross-sectional study.

      Setting

      University research laboratory.

      Participants

      Older adults (N=93; 42 men, 51 women; mean age ± SD, 73 ± 6.08y) who could walk independently.

      Main Outcome Measures

      (1) Balance tolerance limit (BTL), defined as the lowest perturbation intensity where a multistep balance recovery pattern was first evoked in response to randomized lateral waist-pull perturbations of standing balance to the left and right sides, at 6 different intensities (range from level 2: 4.5-cm displacement at 180cm/s2 acceleration, to level 7: 22.5-cm displacement at 900cm/s2 acceleration); (2) gait speed, determined using an instrumented gait mat; (3) balance, evaluated with the Activities-specific Balance Confidence Scale; and (4) mobility, determined with the Timed Up and Go (TUG).

      Results

      Individuals with low versus high BTL had a slower self-selected head-forward gait speed and head-turn gait speed (P=.002 and P<.001, respectively); the magnitude of difference was greater in head-turn gait speed than head-forward gait speed (Cohen's d=1.0 vs 0.6). Head-turn gait speed best predicted BTL. BTL was moderately and positively related (P=.003) to the ABC Scale and negatively related (P=.017) to TUG.

      Conclusions

      Head-turn gait speed is affected to a greater extent than head-forward gait speed in older individuals with poorer lateral balance and at greater risk of falls. Moreover, head-turn gait speed can be used to assess the interactions of limitations in lateral balance function and gait speed in relation to fall risk in older adults.

      Keywords

      List of abbreviations:

      ABC (Activities-specific Balance Confidence), BOS (base of support), BTL (balance tolerance limit), COM (center of mass), DGI (Dynamic Gait Index), TUG (Timed Up and Go)
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