Gait disorders in old age are a risk factor for falls and are associated with increased morbidity, mortality, loss of independent living, disability and altered quality of life. The assessment of gait characteristics in older adults has enhanced our understanding of the mechanisms of gait disorders, which have been helpful in developing preventive and curative interventions. Currently, advanced technology has changed the practice of gait analysis because it surpasses the limits of clinical observation (i.e., visual observation and standardized test) of gait and is easily accessible and feasible. There is however a lack of consensus on which gait parameters to assess and their clinical relevance, concerning data acquisition, standardized data…
International experts working in a network of two different consortiums proposed “Guidelines for assessment of gait and reference values for spatiotemporal gait parameters in older adults”. They identified items of standardized information and merged databases including spatiotemporal gait assessments and clinical information from 954 healthy older adults (mean age 72.8 ± 4.8 years, 45.8% women). They selected three categories of information (demographics, clinical features and gait characteristics) for the development of gait assessment guideline.
For the gait characteristics minimal dataset, they suggest 3 assessments: a subjective perception with a graduated answer (“Do you have any difficulty walking?”), a visual observation of gait during habitual walking with a binary answer (yes vs. no) to the question “Are there gait abnormalities during physical examination?” and a measurement of TUG test score and gait speed (distance divided by ambulation time) when walking a distance of 4 m at a steady-state pace.
For the gait characteristics full dataset , they recommend three additional walking conditions; a fast walk at a maximum speed, and two dual-task conditions, in which the patient is instructed to walk normally while (a) counting backwards by ones starting from 50 and (b) to enumerate animal names. It is necessary to underscore that the spatiotemporal gait analysis based on the recorded footfalls should be performed in a reproducible, quiet, well-lit environment, with patients wearing their own footwear.
These guidelines will enable clinicians and researchers to better interpret gait parameters provided by objective measurement systems like our PhysiGait tool and facilitate the ability to work together and think broadly effectively in the field of gait disorders and aging.
Keywords: gait, ageing, guidelines, reference values