Gait characteristics as risk factors for falling from trips induced in older adults

Abstract

Background: Falls are a significant source of morbidity and mortality in older adults, with up to 53% of these falls due to tripping. To aid in preventing trip-related falls, the factors that increase an individual's risk of falling following a trip must be identified. This study investigated whether an older adult's gait influences their risk of failing following a trip.

Methods: Trips were induced during gait in 79 healthy, safety-harnessed, community-dwelling older adults using a concealed, mechanical obstacle. Associations between selected gait kinematic characteristics, recorded during normal walking, and the likelihood of falling following the trip were determined using logistic regression.

Results: Older adults who walked faster, took more rapid steps, or took longer steps relative to their body height had a significantly increased likelihood of falling following the trip. Step width, average trunk flexion during gait, and the phase of gait in which the trip occurred did not affect the likelihood of falling. A multivariable logistic regression model correctly classified 89.8% of trip outcomes based on two gait characteristics: step time and step length. As predicted from their gait characteristics, the subjects, as a group, had a low likelihood of falling following a trip, but selected individuals had a high likelihood of falling.

Conclusions: The incidence of trip-related falls in healthy older adults is determined primarily by the frequency of tripping and not the ability to recover from a trip. Older adults can reduce their likelihood of falling following a trip by not hurrying while walking.