Proactive gait strategies to mitigate risk of obstacle contact are more prevalent with advancing age

Abstract

The purposes of this study were to determine if healthy older adults adopt strategies to decrease the likelihood of obstacle contact, and to determine how these strategies are modified as a function of advancing age. Three age groups were examined: 20-25 yo (N = 19), 65-79 yo (N = 11), and 80-91 yo (N = 18). Participants stepped over a stationary, visible obstacle on a walkway. Step length and gait speed progressively decreased with advancing age; the shorter step length resulted in closer foot placement to the obstacle and an associated increased risk of obstacle contact. Lead (first limb to cross the obstacle) and trail (second) limb trajectories were examined for behavior that mitigated the risk of contact. (1) Consistent trail foot placement before the obstacle across all ages allowed space and time for the trail foot to clear the obstacle. (2) To avoid lead limb contact due to closer foot placement before and after the obstacle, the lead toe was raised more vertically after toe-off, and then the foot was extended beyond the landing position (termed lead overshoot) and retracted backwards to achieve the shortened step length. Lead overshoot progressively increased with advancing age. (3) Head angle was progressively lower with advancing age, an apparent attempt to gather more visual information during approach. Overall, a series of proactive strategies were adopted to mitigate risk of contact. However, the larger, more abrupt movements associated with a more vertical foot trajectory and lead overshoot may compromise whole body balance, indicating a possible trade-off between risk of contact and stability.

Keywords: Adaptive gait; Advancing age; Obstacle; Older adults; Proactive gait strategies.