Responsiveness of Daily Life Gait Quality Characteristics over One Year in Older Adults Who Experienced a Fall or Engaged in Balance Exercise

Sabine Schootemeijer; Roel H A Weijer; Marco J M Hoozemans; Kim Delbaere; Mirjam Pijnappels; Kimberley S van Schooten

doi:10.3390/s23010101

Responsiveness of Daily Life Gait Quality Characteristics over One Year in Older Adults Who Experienced a Fall or Engaged in Balance Exercise

Sensors (Basel). 2022 Dec 22;23(1):101. doi: 10.3390/s23010101.

Authors

Sabine Schootemeijer^{1

2}, Roel H A Weijer^{1

3}, Marco J M Hoozemans¹, Kim Delbaere^{4

5}, Mirjam Pijnappels¹, Kimberley S van Schooten^{4

5}

Affiliations

¹ Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
² Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
³ Department of Neurology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
⁴ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney 2031, Australia.
⁵ School of Population Health, University of New South Wales, Sydney 2052, Australia.

Abstract

Gait quality characteristics obtained from daily-life accelerometry are clinically relevant for fall risk in older adults but it is unknown whether these characteristics are responsive to changes in gait quality. We aimed to test whether accelerometry-based daily-life gait quality characteristics are reliable and responsive to changes over one year in older adults who experienced a fall or an exercise intervention. One-week trunk acceleration data were collected from 522 participants (65-97 years), at baseline and after one year. We calculated median values of walking speed, regularity (sample entropy), stability (logarithmic rate of divergence per stride), and a gait quality composite score, across all 10-s gait epochs derived from one-week gait episodes. Intraclass correlation coefficients (ICC) and limits of agreement (LOA) were determined for 198 participants who did not fall nor participated in an exercise intervention during follow-up. For responsiveness to change, we determined the number of participants who fell (n = 209) or participated in an exercise intervention (n = 115) that showed a change beyond the LOA. ICCs for agreement between baseline and follow-up exceeded 0.70 for all gait quality characteristics except for vertical gait stability (ICC = 0.69, 95% CI [0.62, 0.75]) and walking speed (ICC = 0.68, 95% CI [0.62, 0.74]). Only walking speed, vertical and mediolateral gait stability changed significantly in the exercisers over one year but effect sizes were below 0.2. The characteristic associated with most fallers beyond the LOA was mediolateral sample entropy (4.8% of fallers). For the exercisers, this was gait stability in three directions and the gait quality composite score (2.6% of exercisers). The gait quality characteristics obtained by median values over one week of trunk accelerometry were not responsive to presumed changes in gait quality after a fall or an exercise intervention in older people. This is likely due to large (within subjects) differences in gait behaviour that participants show in daily life.

Keywords: accelerometry; accidental falls; activity monitoring; aged; exercise; locomotion; mobility; wearable devices.

MeSH terms

Activities of Daily Living
Aged
Exercise Therapy
Gait*
Humans
Walking
Walking Speed*

Grants and funding

This research received no external funding. Roel Weijer and Mirjam Pijnappels were supported by a VIDI grant (no. 91714344) from the Dutch Organization for Scientific Research (NWO). Sabine Schootemeijer received the AMS Innovation grant and a travel grant from the Faculty of Behavioural and Movement Sciences. Kim Delbaere was supported by the National Health and Medical Research Council (Australia). Kim van Schooten was supported by a Human Frontier Science Program fellowship.