Gait features in different environments contributing to participation in outdoor activities in old age (GaitAge) : A study protocol for observational cross-sectional study

Abstract

Background:

The ability to walk is a key issue for independent old age. Optimizing older peoples’ opportunities for an autonomous and active life and reducing health disparities requires a better understanding of how to support independent mobility in older people. With increasing age, changes in gait parameters such as step length and cadence are common and have been shown to increase risk of mobility decline. However, gait assessments are typically based on laboratory measures, even though walking in a laboratory environment may be significantly different to walking in normal daily life or in outdoor environments.

Objective:

This project will study alterations in biomechanical features of gait comparing walking in laboratory, level outdoor and hilly outdoor environments. In addition, we will study the possible contribution of changes in gait between these environments to outdoor participation among older people.

Methods:

Participants of the study were recruited through senior organizations of Central Finland and university of third age, Jyväskylä. Inclusion criteria were: community-dwelling, aged over 70 years, able to walk at least 1 km without assistive devices, able to communicate, and living in central Finland. Exclusion criteria were: use of mobility devices, severe sensory deficit (vision, hearing), memory impairment (MMSE ≤ 23) and neurological conditions (e.g. stroke, Parkinson’s disease, multiple sclerosis). The study protocol included two research visits. First, indoor measurements were conducted, including interviews (participation, health, and demographics), physical performance tests (short physical performance battery (SPPB), Timed up-and-go, (TUG)) and motion analysis in a laboratory (3D Vicon and Next generation inertial measurement units, NGIMUs). Second, outdoor walking tests were conducted, including walking on level (sports track) and hilly (uphill, downhill) terrain, while movement was monitored via NGIMUs, pressure insoles, heart rate, and video data.

Results:

A total of 40 people (65% women, mean age 76.3 years) met the inclusion criteria and took part in the study. Data collection took place between May-September 2022. The first results will be published by the end of 2023.

Conclusions:

This multidisciplinary study will provide new scientific knowledge about how gait biomechanics are altered in varied environments, and how this influences opportunities to participate in outdoor activities for older people. Findings of this study will open possibilities for personalized interventions and rehabilitation to maintain health and functional capacity among older people.