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European Journal of Physical and Rehabilitation Medicine 2021 May 18

DOI: 10.23736/S1973-9087.21.06831-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effects of age, gender, frailty and falls on spatiotemporal gait parameters: a retrospective cohort study

Nicolas ROCHE 1 , Frédéric CHORIN 1, 2, Pauline GERUS 1, Maxime DESHAYES 2, 3, Olivier GUERIN 2, 4, Raphael ZORY 1, 5

1 LAMHESS, Université Côte d'Azur, Nice, France; 2 CHU, Service de médecine gériatrique et thérapeutique, Université Côte d'Azur, Nice, France;3 CHROME - Equipe APSY-v, Université de Nîmes, EA 7352 Nîmes, France ; 4 IRCAN, Université Côte d'Azur, Nice, France; 5 Institut Universitaire de France (IUF), Paris, France


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BACKGROUND: Many studies have explored spatial and temporal gait parameters in the elderly, and showed that frailty status, fall history, age, and gender may individually strongly influence these parameters. However, it appears necessary to investigate the confounding factors more deeply in order to better know the specific role of each of these factors impacting the evolution of gait with the increase of age.
AIM: The aim of the present study was to determine the influence of frailty status, fall history, age and gender on spatiotemporal gait parameters. We hypothesized that frailty was the factor that most influence gait parameters.
SETTING: This is a monocentric retrospective study performed at Nice University Hospital Center on older out-patients.
POPULATION: Older adults were included in the study. This study explored for the first time how frailty status, age, gender and history of falls impact the multiple spatiotemporal parameters of gait using linear mixed models (LMM).
RESULTS: 479 older adults (360 women and 119 men; 213 non-frail, 228 pre-frail and 38 frail; aged from 65 to 94 years; 403 non-fallers and 73 fallers). Frailty status explained fully: i) the gait speed; ii) the cadence: iii) the initial double contact: DS1; iv) the percentage of the single support phase v) the final double contact: DS2; v) the percentage of the swing phase of the gait cycle.
CONCLUSIONS: The results of this study allow a deeper understanding of the confounding factors since LMM highlighted the importance of frailty status for explaining all the spatiotemporal gait parameters.
CLINICAL REHABILITATION IMPACT: These results showed that to improve gait, clinical intervention should focus on reducing frailty status. It is also interesting to note that a history of falls explains none of the spatiotemporal gait parameters which suggests that it may be possible to improve gait in all frail subjects irrespective of their history of falls.


KEY WORDS: Locomotion; Frailty; Older subjects; Linear mixed model; Kinematics parameters

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