Does the balance strategy during walking in elderly persons show an association with fall risk assessment?

Abstract

The primary objective of this study was to clarify whether balance evaluation during walking in elderly people was related to fall risk assessment; the second objective was to clarify the difference in balance strategy between young and elderly people based on the balance evaluation through a gait cycle. Thirty healthy young adults and 25 healthy elderly adults participated. All participants performed walking at their preferred speed and at a fast speed. Based on the margin of stability (MoS), balance during a gait cycle was divided into medial/lateral and anterior/posterior direction (ML/AP-MoS). Positive/negative integral values of ML-MoS were defined as ML-MoS_POS/ML-MoS_NEG, and the average of AP-MoS over the gait cycle was defined as AP-MoS_mean. The fast/preferred ratio of AP-MoS_mean/ML-MoS_POS (AP-MoS_mean (Fast/Preferred)/ML-MoS_POS (Fast/Preferred)) and the fast-preferred difference of ML-MoS_NEG (ML-MoS_NEG (Fast-Preferred)) were compared between groups. ML/AP-MoS at the preferred/fast gait was also compared between 12 gait events and groups. The Japanese version of the Mini-Balance Evaluation Systems Test (J-Mini-BESTest), the Japanese version of the Activities-specific Balance Confidence Scale (J-ABC scale), and the number of falls in the past year were obtained from all subjects. ML-MoS_POS (Fast/Preferred), ML-MoS_NEG (Fast-Preferred), and AP-MoS_mean (Fast/Preferred) were significantly correlated with J-Mini-BESTest. Gait balance evaluation based on MoS may reflect an individual's balance function. In fast gait, ML-MoS at foot flat and toe off and AP-MoS at just before heel strike were highly likely to be gait events to identify elderly adults with balance disorders.