Spatio-temporal gait variables predicted incident disability.
Takehiko Doi, Sho Nakakubo, Kota Tsutsumimoto and 4 others
PMID 32000793WHAT IT FOUND
In 4121 Japanese older adults, slower walking, shorter stride, slower steps, and more variable stride were associated with later need for long-term care support.
More abnormal gait measures meant higher risk.
Key findings
01After adjustment, gait speed had a hazard ratio of 0.83 per 0.1 m/s, stride length 0.77 per 0.1 m, cadence 0.99 per step/min, and stride length variability 1.10 per 1% for incident disability.
02At study-specific cut-offs, the low-function group had adjusted hazard ratios of 2.06 for gait speed, 2.17 for stride length, 1.49 for cadence, and 1.46 for stride length variability.
03Having 4 low-function gait measures was associated with 36.4% incident disability and an adjusted hazard ratio of 3.72 compared with having 0.
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
The outcome was any new Long-Term Care Insurance certification, so it did not identify whether disability was mainly mobility, cognition, or upper and lower limb dependence. The study observed people over time and did not test an intervention, so it cannot show that improving gait would prevent disability. Participants were independent community-dwelling older adults, and people already needing care, with stroke, Parkinson's disease, Alzheimer's disease, severe cognitive impairment, or missing data were excluded. The cut-off values were derived in this cohort and may not apply to other settings; the paper notes they were higher than common gait speed cut-offs. Gait analysis methods vary, so the same variables from different devices or protocols may not have the same predictive value.
Declared interests
The article lists funding from the Ministry of Health, Labour and Welfare, the Japan Society for the Promotion of Science, and the National Center for Geriatrics and Gerontology. The supplied text does not state author conflicts of interest.
The easy way to misread this
Do not treat the 1.10 m/s gait speed cut-off as a universal threshold. It was derived in independent community-dwelling Japanese older adults, and the paper notes these cut-offs may be higher than those used in other studies.