Differential Gait Patterns by History of Falls and Knee Pain Status in Healthy Older Adults: Results From the Baltimore Longitudinal Study of Aging

in Journal of Aging and Physical Activity
Restricted access

Purchase article

USD $24.95

Student 1 year subscription

USD $76.00

1 year subscription

USD $101.00

Student 2 year subscription

USD $144.00

2 year subscription

USD $189.00

Consideration of knee pain can be crucial for identifying fall-related gait patterns. While walking, gait parameters at usual speed were examined in persons with different falls and knee pain status. A total of 439 adults aged 60–92 years participated in this study. Persons with a history of falls had a wider stride width (p = .036) and longer double support time (p = .034) than nonfallers. In the absence of knee pain, fallers had longer double support time than nonfallers (p = .012), but no differences in double support time by history of falls were observed in participants with knee pain. With slower gait speed, fallers with knee pain have narrower stride width and larger hip range of motion (p = .027 and p = .001, respectively). Results suggest the importance of considering knee pain in fall studies for better understanding the fall-related differential gait mechanisms and for designing fall prevention intervention strategies.

Ko is with the Dept. of Mechanical Engineering, Chonnam National University, Yeosu, South Korea. Jerome is with the Dept. of Kinesiology, Towson University, Towson, MD, USA. Simonsick, Studenski, and Ferrucci are with Clinical Research Branch, National Institute on Aging (NIA/NIH), Baltimore, MD, USA.

Address author correspondence to Seung-uk Ko at seunguk.ko@gmail.com.
Journal of Aging and Physical Activity
Article Sections
References
  • AlexanderB.H.RivaraF.P. & WolfM.E. (1992). The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 82(7) 10201023. PubMed ID: 1609903 doi:10.2105/AJPH.82.7.1020

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BartonC.J.LevingerP.WebsterK.E. & MenzH.B. (2011). Walking kinematics in individuals with patellofemoral pain syndrome: A case–control study. Gait and Posture 33(2) 286291. PubMed ID: 21194952 doi:10.1016/j.gaitpost.2010.11.022

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BauermeisterS.SuttonG.Mon-WilliamsM.WilkieR.GravesonJ.CracknellA.BunceD. (2017). Intraindividual variability and falls in older adults. Neuropsychology 31(1) 2027. PubMed ID: 27831695 doi:10.1037/neu0000328

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BindawasS.M. (2016). Relationship between frequent knee pain, obesity, and gait speed in older adults: Data from the Osteoarthritis Initiative. Clinical Interventions in Aging 11237244. PubMed ID: 26955266 doi:10.2147/CIA.S100546

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ChangS.Y.LinY.J.HsuW.C.HsiehL.F.LinY.H.ChangC.C.ChenL.F. (2016). Exercise alters gait pattern but not knee load in patients with knee osteoarthritis. BioMed Research International 201612. Article ID 7468937. PubMed ID:27725941

    • Crossref
    • Search Google Scholar
    • Export Citation
  • EspyD.D.YangF.BhattT. & PaiY.C. (2010). Independent influence of gait speed and step length on stability and fall risk. Gait and Posture 32(3) 378382. PubMed ID: 20655750 doi:10.1016/j.gaitpost.2010.06.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • GimmonY.RiemerR.RashedH.ShapiroA.DebiR.KurzI. & MelzerI. (2015). Age-related differences in pelvic and trunk motion and gait adaptability at different walking speeds. Journal of Electromyography and Kinesiology 25(5) 791799. PubMed ID: 26091623 doi:10.1016/j.jelekin.2015.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • GrodzinskyA.J.LevenstonM.E.JinM. & FrankE.H. (2000). Cartilage tissue remodeling in response to mechanical forces. Annual Review of Biomedical Engineering 2691713.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • JavaidM.K.KiranA.GuermaziA.KwohC.K.ZaimS.CarboneL.Health ABC Study. (2012). Individual magnetic resonance imaging and radiographic features of knee osteoarthritis in subjects with unilateral knee pain: The health, aging, and body composition study. Arthritis and Rheumatism 64(10) 32463255. PubMed ID: 22736267 doi:10.1002/art.34594

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KitayuguchiJ.KamadaM.HamanoT.NabikaT.ShiwakuK.KamiokaH.MutohY. (2015). Association between knee pain and gait speed decline in rural Japanese community-dwelling older adults: 1-year prospective cohort study. Geriatrics & Gerontology International 16(1) 5564. PubMed ID: 25611950 doi:10.1111/ggi.12432

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KoS.U.GunterK.B.CostelloM.AumH.MacDonaldS.WhiteK.N.HayesW.C. (2007). Stride width discriminates gait of side-fallers compared to other-directed fallers during overground walking. Journal of Aging and Health 19(2) 200212. PubMed ID: 17413131 doi:10.1177/0898264307299308

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KoS.U.HausdorffJ.M. & FerrucciL. (2010). Age-associated differences in the gait pattern changes of older adults during fast-speed and fatigue conditions: Results from the Baltimore longitudinal study of ageing. Age and Ageing 39(6) 688694. PubMed ID: 20833863 doi:10.1093/ageing/afq113

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KoS.U.LingS.M.SchreiberC.NesbittM. & FerrucciL. (2011). Gait patterns during different walking conditions in older adults with and without knee osteoarthritis—results from the Baltimore Longitudinal Study of Aging. Gait & Posture 33(2) 205210. PubMed ID: 21145241 doi:10.1016/j.gaitpost.2010.11.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KoS.U.SimonsickE.M. & FerrucciL. (2015). Gait energetic efficiency in older adults with and without knee pain: Results from the Baltimore Longitudinal Study of Aging. Age 37(1) 9754. PubMed ID: 25666574 doi:10.1007/s11357-015-9754-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • LeveilleS.G.JonesR.N.KielyD.K.HausdorffJ.M.ShmerlingR.H.GuralnikJ.M.BeanJ.F. (2009). Chronic musculoskeletal pain and the occurrence of falls in an older population. Journal of the American Medical Association 302(20) 22142221. PubMed ID: 19934422 doi:10.1001/jama.2009.1738

    • Crossref
    • Search Google Scholar
    • Export Citation
  • LordS.R.LloydD.G. & LiS.K. (1996). Sensori-motor function, gait patterns and falls in community-dwelling women. Age and Ageing 25(4) 292299. PubMed ID: 8831874 doi:10.1093/ageing/25.4.292

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McAlindonT.E.SnowS.CooperC. & DieppeP.A. (1992). Radiographic patterns of osteoarthritis of the knee joint in the community: The importance of the patellofemoral joint. Annals of the Rheumatic Diseases 51(7) 844849. PubMed ID: 1632657 doi:10.1136/ard.51.7.844

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MirandaH.Viikari-JunturaE.MartikainenR. & RiihimakiH. (2002). A prospective study on knee pain and its risk factors. Osteoarthritis Cartilage 10(8) 623630. PubMed ID: 12479384 doi:10.1053/joca.2002.0796

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MorelandJ.D.RichardsonJ.A.GoldsmithC.H. & ClaseC.M. (2004). Muscle weakness and falls in older adults: A systematic review and meta-analysis. Journal of the American Geriatrics Society 52(7) 11211129. PubMed ID: 15209650 doi:10.1111/j.1532-5415.2004.52310.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MortazaN.Abu OsmanN.A. & MehdikhaniN. (2014). Are the spatio-temporal parameters of gait capable of distinguishing a faller from a non-faller elderly? European Journal of Physical and Rehabilitation Medicine 50(6) 677691. PubMed ID: 24831570

    • Search Google Scholar
    • Export Citation
  • O’ReillyS.C.MuirK.R. & DohertyM. (1996). Screening for pain in knee osteoarthritis: Which question? Annals of the Rheumatic Diseases 55(12) 931933. doi:10.1136/ard.55.12.931

    • Crossref
    • Search Google Scholar
    • Export Citation
  • PanY. & JacksonR.T. (2008). Ethnic difference in the relationship between acute inflammation and serum ferritin in US adult males. Epidemiology and Infection 136(3) 421431.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • PeatG.McCarneyR. & CroftP. (2001). Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Annals of the Rheumatic Diseases 60(2) 9197. PubMed ID: 11156538 doi:10.1136/ard.60.2.91

    • Crossref
    • Search Google Scholar
    • Export Citation
  • SchrackJ.A.ZipunnikovV.SimonsickE.M.StudenskiS. & FerrucciL. (2016). Rising energetic cost of walking predicts gait speed decline with aging. The Journals of Gerontology. Series A Biological Sciences and Medical Sciences 71(7) 947953. PubMed ID: 26850913 doi:10.1093/gerona/glw002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • SterlingD.A.O’ConnorJ.A. & BonadiesJ. (2001). Geriatric falls: Injury severity is high and disproportionate to mechanism. Journal of Trauma-Injury Infection and Critical Care 50(1) 116119. doi:10.1097/00005373-200101000-00021

    • Crossref
    • Search Google Scholar
    • Export Citation
  • StudenskiS.PereraS.PatelK.RosanoC.FaulknerK.InzitariM.GuralnikJ. (2011). Gait speed and survival in older adults. Journal of the American Medical Association 305(1) 5058. PubMed ID: 21205966 doi:10.1001/jama.2010.1923

    • Crossref
    • Search Google Scholar
    • Export Citation
  • SwanenburgJ.de BruinE.D.UebelhartD. & MulderT. (2010). Falls prediction in elderly people: A 1-year prospective study. Gait and Posture 31(3) 317321. PubMed ID: 20047833 doi:10.1016/j.gaitpost.2009.11.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • TasS.GuneriS.BakiA.YildirimT.KaymakB. & ErdenZ. (2014). Effects of severity of osteoarthritis on the temporospatial gait parameters in patients with knee osteoarthritis. Acta Orthopaedica et Traumatologica Turcica 48(6) 635641. PubMed ID: 25637727 doi:10.3944/AOTT.2014.13.0071

    • Crossref
    • Search Google Scholar
    • Export Citation
  • TaylorM.E.DelbaereK.MikolaizakA.S.LordS.R. & CloseJ.C. (2013). Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. Gait and Posture 37(1) 126130. PubMed ID: 22832468 doi:10.1016/j.gaitpost.2012.06.024

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thaler-KallK.PetersA.ThorandB.GrillE.AutenriethC.S.HorschA. & MeisingerC. (2015). Description of spatio-temporal gait parameters in elderly people and their association with history of falls: Results of the population-based cross-sectional KORA-Age study. BMC Geriatrics 1532. PubMed ID: 25880255 doi:10.1186/s12877-015-0032-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VergheseJ.HoltzerR.LiptonR. B. & WangC. (2009). Quantitative gait markers and incident fall risk in older adults. The Journals of Gerontology. Series A Biological Sciences and Medical Sciences 64(8) 896901. PubMed ID: 19349593 doi:10.1093/gerona/glp033

    • Crossref
    • Search Google Scholar
    • Export Citation
Article Metrics
All Time Past Year Past 30 Days
Abstract Views 90 90 22
Full Text Views 14 14 4
PDF Downloads 3 3 0
Altmetric Badge
PubMed
Google Scholar
Cited By