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Analysis of Free-Living Gait in Older Adults With and Without Parkinson’s Disease and With and Without a History of Falls: Identifying Generic and Disease-Specific Characteristics

Del Din, Silvia ; Galna, Brook ; Godfrey, Alan ; Bekkers, Esther M J ; Pelosin, Elisa ; Nieuwhof, Freek ; Mirelman, Anat ; Hausdorff, Jeffrey M ; Rochester, Lynn

The journals of gerontology. Series A, Biological sciences and medical sciences, 2019-03, Vol.74 (4), p.500-506 [Periódico revisado por pares]

US: Oxford University Press

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  • Título:
    Analysis of Free-Living Gait in Older Adults With and Without Parkinson’s Disease and With and Without a History of Falls: Identifying Generic and Disease-Specific Characteristics
  • Autor: Del Din, Silvia ; Galna, Brook ; Godfrey, Alan ; Bekkers, Esther M J ; Pelosin, Elisa ; Nieuwhof, Freek ; Mirelman, Anat ; Hausdorff, Jeffrey M ; Rochester, Lynn
  • Assuntos: Accelerometry ; Accidental Falls ; Aged ; Aged, 80 and over ; Case-Control Studies ; Falls ; Female ; Gait ; Gait - physiology ; Humans ; Independent Living ; Male ; Movement disorders ; Neurodegenerative diseases ; Older people ; Parkinson Disease - complications ; Parkinson Disease - physiopathology ; Parkinson's disease ; Postural Balance - physiology ; The Journal of Gerontology: Medical Sciences
  • É parte de: The journals of gerontology. Series A, Biological sciences and medical sciences, 2019-03, Vol.74 (4), p.500-506
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: Abstract Background Falls are associated with gait impairments in older adults (OA) and Parkinson’s disease (PD). Current approaches for evaluating falls risk are based on self-report or one-time assessment and may be suboptimal. Wearable technology allows gait to be measured continuously in free-living conditions. The aim of this study was to explore generic and specific associations in free-living gait in fallers and nonfallers with and without PD. Methods Two hundred and seventy-seven fallers (155 PD, 122 OA) who fell twice or more in the previous 6 months and 65 nonfallers (15 PD, 50 OA) were tested. Free-living gait was characterized as the volume, pattern, and variability of ambulatory bouts (Macro), and 14 discrete gait characteristics (Micro). Macro and Micro variables were quantified from free-living data collected using an accelerometer positioned on the low back for one week. Results Macro variables showed that fallers walked with shorter and less variable ambulatory bouts than nonfallers, independent of pathology. Micro variables within ambulatory bouts showed fallers walked with slower, shorter and less variable steps than nonfallers. Significant interactions showed disease specific differences in variability with PD fallers demonstrating greater variability (step length) and OA fallers less variability (step velocity) than their nonfaller counterparts (p < 0.004). Conclusions Common and disease-specific changes in free-living Macro and Micro gait highlight generic and selective targets for intervention depending on type of faller (OA-PD). Our findings support free-living monitoring to enhance assessment. Future work is needed to confirm the optimal battery of measures, sensitivity to change and value for fall prediction.
  • Editor: US: Oxford University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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