Fall-related gait characteristics on the treadmill and in daily life

Abstract

Background: Body-worn sensors allow assessment of gait characteristics that are predictive of fall risk, both when measured during treadmill walking and in daily life. The present study aimed to assess differences as well as associations between fall-related gait characteristics measured on a treadmill and in daily life.

Methods: In a cross-sectional study, trunk accelerations of 18 older adults (72.3 ± 4.5 years) were recorded during walking on a treadmill (Dynaport Hybrid sensor) and during daily life (Dynaport MoveMonitor). A comprehensive set of 32 fall-risk-related gait characteristics was estimated and compared between both settings.

Results: For 25 gait characteristics, a systematic difference between treadmill and daily-life measurements was found. Gait was more variable, less symmetric, and less stable during daily life. Fourteen characteristics showed a significant correlation between treadmill and daily-life measurements, including stride time and regularity (0.48 < r < 0.73; p < 0.022). No correlation between treadmill and daily-life measurements was found for stride-time variability, acceleration range and sample entropy in vertical and mediolateral direction, gait symmetry in vertical direction, and stability estimated as the local divergence exponent by Rosenstein's method in mediolateral direction (r < 0.16; p > 0.25).

Conclusions: Gait characteristics revealed less stable, less symmetric, and more variable gait during daily life than on a treadmill, yet about half of the characteristics were significantly correlated between conditions. These results suggest that daily-life gait analysis is sensitive to static personal factors (i.e., physical and cognitive capacity) as well as dynamic situational factors (i.e., behavior and environment), which may both represent determinants of fall risk.

Fig. 1

Box plot of gait speed estimates for 10-s epochs in daily life. For all individual participants, the ranges from minimum to maximum (vertical lines), the 25th to 75th percentiles (black rectangles) and the median (black horizontal lines) are shown. The grey rectangles indicate 90 % to 110 % of the treadmill speed estimated by the estimator used for daily life data, which was the range used for the speed-matched analysis. For reference, the treadmill speed setting (1.2 m/s) is plotted as a horizontal grey line

Fig. 2

Scatter plots (blue dots) for estimated characteristics on the treadmill (x-axis) versus daily life (y-axis). A linear fit is plotted as a blue line