What happens before the first step? A New Approach to Quantifying Gait Initiation Using a Wearable Sensor.
Eran Gazit, Aron S Buchman, Robert Dawe and 4 others
PMID 31760316WHAT IT FOUND
A single lower-back sensor accurately measured gait initiation timing compared to a lab gold standard.
Older adults with fall history showed significantly longer reaction and preparation times than young adults, offering a feasible way to assess movement planning outside the clinic.
Key findings
01The wearable sensor algorithm showed good to excellent agreement with the gold standard walkway for all gait initiation measures except swing time.
02Older adults had significantly longer reaction times and anticipatory postural adjustment durations than young adults across most testing conditions.
03Gait initiation metrics were only weakly to modestly correlated with self-selected gait speed, suggesting they capture distinct aspects of mobility.
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 algorithm could not accurately measure the swing time of the first step. The study only compared young and older women, so results may not apply to men. The older adult group consisted specifically of idiopathic fallers, limiting generalizability to all older adults. The testing order (right, left, random) was not randomized, which could introduce bias. The sensor measured time only, not the magnitude or displacement of body weight shifts.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institutes of Health and non-U.S. government research support.
The easy way to misread this
Do not assume this sensor replaces gait speed measurement or predicts falls directly. The study validated the technical accuracy of the algorithm and showed age-related differences, but it did not test whether these specific initiation metrics predict future falls or respond to treatment.