PTOTOtherGait & posture2025

Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls - Results from the Baltimore Longitudinal Study of Aging.

Seung-Uk Ko, Gerald J Jerome, Eleanor M Simonsick and 1 others

PMID 39566360

WHAT IT FOUND

When asked to walk faster, healthy older adults who had recently fallen did not increase hip, knee, and ankle range of motion as much as those who had not fallen.

This subtle loss of movement reserve during acceleration may help identify fall risk earlier than usual walking speed alone.

Key findings

01Fallers had smaller knee range of motion during fast walking compared to non-fallers.

02In non-fallers, increasing gait speed was associated with increased hip, knee, and ankle range of motion; in fallers, these associations were absent.

03There were no differences in the overall percentage change of gait parameters from usual to fast walking between fallers and non-fallers.

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

Fall history was based on retrospective self-report, which can be inaccurate. The participants were generally healthy and high-functioning, so the findings may not apply to those with more severe mobility limitations or lower physical function. The study did not distinguish between single falls and multiple falls, which may have different risk profiles. The cross-sectional design cannot prove that the observed gait patterns cause falls, only that they are associated with a history of falling.

Declared interests

All authors declared no financial or personal relationships that could bias the work. The study was supported by the National Institute on Aging (Intramural).

The easy way to misread this

Do not interpret the lack of difference in overall percent change in gait speed as evidence that fallers and non-fallers walk identically. The key finding is in the specific kinematic associations: fallers did not link increased speed with the necessary increases in knee and ankle range of motion, suggesting a loss of movement reserve that is only visible when the task becomes challenging.

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