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


      • 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.



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


      Cross-sectional study.


      University research laboratory.


      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).


      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.


      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.


      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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