INCREASED GAIT UNSTEADINESS IN COMMUNITY-DWELLING ELDERLY FALLERS

Objective: To test the hypothesis that quantitative measures of gait u nsteadiness are increased in community-dwelling elderly fallers. Study Design: Retrospective, case-control study. Setting: General community . Participants: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0yrs; n = 17) based on hi story; 22 young (age, 24.6 +/- 1.9yrs), healthy subjects also particip ated as a second reference group. Main Outcome Measures: Stride-to-str ide variability (standard deviation and coefficient of variation) of s tride time, stance time, swing time, and percent stance time measured during a 6-minute walk. Results: All measures of gait variability were significantly greater in the elderly fallers compared with both the e lderly nonfallers and the young subjects (p < .0002). In contrast, wal king speed of the elderly fallers was similar to that of the nonfaller s. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. Conclusions: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increa sed in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly. (C) 1997 by the A merican Congress of Rehabilitation Medicine and the American Academy o f Physical Medicine and Rehabilitation.