Can minimum toe clearance predict community-based trips by older adults?
Marco A Avalos, Noah J Rosenblatt
PMID 37852886WHAT IT FOUND
Laboratory measurements of minimum toe clearance did not predict how often older adults tripped in the community once fall history was accounted for.
A prior history of falls was a much stronger predictor, suggesting standard gait metrics may miss real-world trip risk.
Key findings
01Minimum toe clearance measures from level-ground walking did not significantly predict community trip rates after accounting for fall history.
02Fall history was a strong independent predictor of trip rates, while sex and BMI were not significant in the final model.
03Having multiple trips did not significantly increase the risk of trip-related falls during level ground walking.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Participants were required to have either a normal BMI or an obese BMI; those with overweight BMI (25.0–29.9 kg/m2) were excluded, limiting generalizability. MTC was measured only during level-ground walking in a laboratory without obstacles, which may not reflect how people adapt their gait in complex community environments. The study used a single marker to estimate toe clearance, which may not accurately capture the true minimum distance between the shoe and the ground. The number of steps analyzed varied widely (34–200), and it is unclear if this was sufficient to reliably capture variability in MTC.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume that low or variable minimum toe clearance in the clinic means a patient is at high risk of tripping in real life. This study found that fall history, not gait biomechanics, was the primary predictor of community trips.