Kinematic and motor variability and stability during gait: effects of age, walking speed and segment height

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Kang, Hyun Gu, 1978-

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To understand how falls occur during walking in older adults, we need to understand how the nervous system maintains stability, and how aging affects walking. Four studies were conducted to better understand the effect of age on gait. Older adults display higher gait variability compared to young adults, possibly because of their slower walking. We compared gait stability at multiple controlled walking speeds. Greater gait variability in healthy elderly existed independent of slower walking. Their diminished strength and flexibility partly explained this difference. To explain slower walking in the elderly, some have suggested that muscle weakness and stiffness may force people to walk slower. Others have suggested that people choose to walk slower to be more stable. We compared dynamic stability of gait at multiple speeds. Healthy older adults also exhibited more stability at slower speeds, yet walked at speeds comparable to young adults despite the lower strength and flexibility. Therefore, weakness and stiffness may not force healthy older adults to walk slower. The goal of the nervous system during walking may be to maintain stability of superior segments. We tested whether superior segments are more stable than inferior segments during walking. Superior segments exhibited less orbital stability during preferred walking speed, in contrast to previous suggestions. This highlighted the importance of trunk control during gait. The effects of aging on the fluctuations in the muscle activity during gait are not well understood. We quantified the stride-to-stride fluctuations of EMG as a measure of muscle activation patterns in state-space. Variability increased with speed except in the gastrocnemius. Orbital stability was less in older adults, suggesting that deviations in the EMG amplitude pattern were not readily corrected. Less local stability was seen in older adults, suggesting that older adults were more sensitive to perturbations. Together, these findings suggest that trunk control is important during gait. Strength and flexibility deficits help explain higher variability and lower stability in older adults. Future work will need to address the effect of strength interventions, neurophysiological decline on gait stability and fall risk.