Journal of GERIATRIC Physical Therapy 1 Copyright © 2014 The Section on Geriatrics of the American Physical Therapy Association Functional Predictors of Stair-Climbing Speed in Older Adults INTRODUCTION (original) (raw)
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Functional Predictors of Stair-climbing Speed in Older Adults
Background and Purpose: Falls on stairs are a common cause of injury and death among older adults. Although stair climbing is a component of some instruments that assess activities of daily living, normal speeds for safe stairway ambulation have not been established. Furthermore, little is known about which components of functional mobility are most highly associated with stair-climbing speed. The purposes of this study were to determine the range of normal stair-climbing speeds for ambulatory, community-dwelling older adults and identify which functional mobility tests could best explain this speed. Methods: Twenty men and 34 women older than 65 years completed 6 functional mobility tests, including timed heel rises, timed chair stands, functional reach, one-legged stance time (OLST), a timed step test (alternately touching a step 10 times), and self-selected gait speed. Participants were then timed as they ascended and descended a fl ight of 8 to 10 steps. Combined ascent-descent times were used to calculate stair-climbing speed in steps per second.
Kinematic and kinetic characteristics of stepping over a 10-cm-high obstacle in older adults
Aino Journal, 2010
The purpose of this research was to clarify the common responses shared by a high-falldown-risk group of older adults and develop an exercise-learning program to prevent falls. [Subjects] Thirty-four subjects were chosen from those who use the daycare program of a nursing home at least once a week. [Methods] All subjects were categorized in longer or shorter-MSL groups. Ninety-second stepping from two force plates to a 10-cmhigh box was executed under three conditions. The locus length of the COP, toe-obstacle distance, and step length were used as experimental data. [Results] The coefficient between the MSL and COP was from 0.69 to 0.73. The shorter-MSL group showed smaller COP movements in the A-P direction and a smaller toe-obstacle distance between the single stepping and stepping with the visual task and between the single stepping and stepping with the auditory task. No significant difference was noted in the step length between the two groups. [Conclusion] The shorter-MSL group was easily affected by the dual-task, suggesting that the shorter-MSL group has a high risk of falling when negotiating obstacles. Stepping exercise with the dual-task using the COP movements as a feedback index may be useful for older adults who have a smaller MSL.
Is there an effect of stair negotiation on subsequent gait kinetics in elderly women?
Research on Biomedical Engineering, 2019
Purpose Stair negotiation is among the basic tasks performed by older adults. This daily activity characterized by climbing and descending stairs represents a complex challenge due to alteration of motor control by aging. The purpose of this study was to evaluate the effects of stair negotiation on elderly gait kinetics. Methods Thirty-three physically active women (70.48 ± 6.66 years) participated in the study, who underwent a biomechanical assessment of gait in three conditions: (1) baseline, (2) post climbing stairs, and (3) post descending stairs. Ground reaction forces were measured using eight platforms and analyzed using a routine developed in Octave. Several kinetic and temporal parameters were calculated for later statistical analysis. A one-way repeated measure ANOVA with Bonferroni post hoc was used to compare between conditions. Results There were no differences between the studied conditions comparing the vertical and anteroposterior ground reaction forces peaks, the impulses from these forces, the duration of the support phase, the walking speed, and in several calculated symmetry indexes from the obtained parameters. Conclusion The stair negotiation, both in ascending and descending conditions, does not influence gait biomechanics in physically active older women. These results reinforce the importance of physical activity in this population as a strategy to preserve gait performance and avoiding falls, as well as strengthening the use of kinetic gait evaluation as a way of studying clinically relevant situations in elderly patients.
Variation in Stair Performance among Adults Aged 55 and Older in A 14 Month Follow-Up
Journal of gerontology and geriatric research, 2014
Objective: To analyze variation in stair performance among adults aged 55 years and older in a 14 month followup study. Methodology: A population-based cohort study in Cambe, a city located in the state of Parana, Brazil. The variables analyzed were age, gender, educational level, socioeconomic profile, depression, obesity, and diabetes. Self-reported ability to go up and down stairs was assessed at baseline and end of follow up. Results: Four hundred and four individuals were analyzed (164 men, 240 women) with median age of 65.6 years. Difficulty in going up or down stairs was 36.5% at baseline and 37.5% after a 14.3 month follow-up period. Depressive, obese and female individuals, as well as the ones with lower educational and socioeconomic status more frequently experienced difficulty in stair performance. Most negative variations in ability to go up or down stairs were identified among male, depressive, and obese individuals (-7.9%, -6.1%, and 2.8% respectively). Conclusions: Th...
Physical & Occupational Therapy in Geriatrics, 2007
The principal aim of this study was to measure balance ability in healthy older persons (n = 26) and institutionalized geriatric patients (n = 19) by two commonly used tests. A secondary aim was to investigate the relationship between balance and gait within the same groups. Timed Up-and-Go (TUG), Functional Reach (FR), gait velocity, step length, step width, and cadence were measured. The performance in TUG, FR, and gait velocity got worse in the older age groups; this worsened performance was related to both age and state of ill-health. Gait velocity was significantly correlated to TUG and FR in both healthy older people (r = Ϫ0.67; r = 0.78) and geriatric patients (r = Ϫ0.57; r = 0.50), and to step length and cadence in both groups. The high correlation of gait velocity to FR in healthy older people and to step length and cadence in both groups indicates that clinical
Journal of Electromyography and Kinesiology, 2009
Older people may operate much closer to their maximum capabilities than young adults when ascending stairs due to their lower maximum musculoskeletal capabilities. The purpose of this study was to establish the joint moment and range of motion demands of stair ascent relative to maximum capabilities in elderly and young adults. Fifteen elderly (mean age 75 years) and 17 young adult (mean age 25 years) participants ascended a purpose-built 4-step staircase with force platforms embedded into the steps and kinematic data was acquired using motion capture. Maximum musculoskeletal capabilities were assessed using a dynamometer. This study showed for the first time that stair ascent approaches the joint moment limits at the ankle in both young and older participants ($90%). One of the most important and novel findings of this study was that elderly people were only capable of meeting the high demands by adopting a number of alternative strategies not observed in young adults: (i) applying the joint moments differently than young adults across the knee and ankle, (ii) translocating energy from the knee to the ankle, thereby enhancing the ankle joint moment upon maximum demand and (iii) by enabling the plantarflexors to act over a more favourable portion of the moment-angle relation upon maximum ankle joint moment demand. The elderly displayed a more cautious strategy to optimize positional stability during stair ascent, by maintaining a smaller separation between the centre of mass and centre of pressure in the frontal plane. It seems that elderly people may meet the demands of unaided stair ascent by adopting a number of alternative strategies to compensate for their reduced musculoskeletal capabilities.
Background: falling is a major health problem. Objective: to investigate the predictive value for falls of the maximum step length and gait speed. Design: a prospective cohort study. Setting: geriatric outpatient clinic. Subjects: three hundred and fifty-two community-dwelling older persons screened by their general practitioner. Methods: maximum step length and gait speed were recorded as part of a comprehensive geriatric assessment. One-year follow-up was performed using the fall telephone system. Results: one hundred and thirty-six (39%) of all subjects (mean age: 76.2 years, standard deviation: 4.3, 55% female), fell at least once, of whom 96 were injured. Predictive values for any falls of both maximum step length and gait speed were low (area under the curve (AUC): 0.53 and 0.50) and slightly better for recurrent falls (maximum step length AUC: 0.64 and gait speed AUC: 0.59). After adding age, gender and fall history to the prediction model, the AUC was 0.63 for maximum step length and 0.64 for gait speed, and for recurrent falls, the AUC was 0.69 both for maximum step length and gait speed. The prediction of fall-related injuries showed similar results. A higher maximum step length score indicated a lower likelihood for falls (hazards ratio 0.36; 95% confidence interval 0.17-0.78). Conclusions: maximum step length and gait speed as single-item tools do not have sufficient power to predict future falls in community-dwelling older persons.
Health, Balance, and Walking as Correlates of Climbing Steps
Journal of Aging and Physical Activity, 2008
The aim of this study was to investigate walking and health among woman age 75 yr or older, in the associations between the highest step up performed without support by an individual and balance, walking, and health among women age 75+. Records of the highest step, balance, walking, and health were made for 307 women age 75–93 yr living in the community. Eighty percent managed to climb steps higher than 20 cm. There was a statistically significant negative relationship between age and stair-climbing capacity. The highest steps registered were significantly and independently associated with a short time on the timed up-and-go test, long functional reach, low body weight, lack of perceived difficulty walking outdoors, low number of “missteps” when walking in a figure of 8, longer time in one-leg stance, ability to carry out tandem stance, no walking aids outdoors, and not being afraid of falling. These variables together explained 67% of the variance in the step-height score.