Reduced hip extension during walking: Healthy elderly and fallers versus young adults

Objectives: To test the hypothesis that reduced hip extension range during walking, representing a limiting impairment of hip tightness, is a consiste nt dynamic finding that (1) occurs with increased age and (2) is exaggerate d in elderly people who fall. Design: Using a 3-dimensional optoelectronic motion analysis system, we com pared full sagittal plane kinematic (lower extremity joint motion, pelvic m otion) data during walking between elderly and young adults and between eld erly fallers and nonfallers. Comparisons were also performed between comfor table and fast walking speeds within each elderly group. Setting: A gait laboratory. Participants: Twenty-three healthy elderly subjects, 16 elderly fallers (ot herwise healthy elderly subjects with a history of recurrent falls), and 30 healthy young adult subjects. Main Outcome Measures: All major peak joint angle and pelvic position value s. Results: Peak hip extension was the only leg joint parameter measured durin g walking that was both significantly lower in elderly nonfallers and falle rs than in young adult subjects and was even lower in elderly fallers compa red with nonfallers tall p <.05). Peak hip extension +/- standard deviation during comfortable walking speed averaged 20.4<degrees> +/- 4.0 degrees fo r young adults? 14.3 degrees +/- 4.4 degrees for elderly nonfallers, and 11 .1 degrees +/- 4.8 degrees for elderly fallers. Peak hip extension did not significantly improve when elderly subjects walked fast. Conclusion: An isolated and consistent reduction in hip extension during wa lking in the elderly, which is exaggerated in fallers, implies the presence of functionally significant hip tightness, which may limit walking perform ance. Overcoming hip tightness with specific stretching exercises is worthy of investigation as a simple intervention to improve walking performance a nd to prevent falls in the elderly.