Older women take shorter steps during backwards walking and obstacle crossing

Abstract

Background: Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks.

Objective: The purpose of this study was to determine gender differences in two common adaptive tasks.

Methods: Walking performance was assessed from 54 age and gender matched participants (72 ± 5 yrs.) while they completed forward walking (FW), OBS and BW. Gait outcomes and the distance of the lead foot and the trail foot from the obstacle were normalized by leg length and assessed using multivariate analysis of variance. Additionally, performance in a battery of clinical physical and cognitive measures as well as self-reported activity levels were associated with adaptive gait behavior.

Results: Gait speed and step width were not different between genders in any walking task. Compared to FW and OBS, women only decreased step length in BW, resulting in significantly shorter step lengths than men in OBS (p = 0.02) and BW (p = 0.04), a conservative walking strategy. Women crossed the obstacle in a manner that may limit recovery steps in case of a trip: stepping closer to the obstacle during approach without increasing trail toe-clearance. The Timed Up and Go mobility test, Short Physical Performance Battery, and Trail Making Test of processing speed and executive function were associated with gender differences in adaptive gait patterns.

Conclusion: The findings revealed that older adult women adapt walking in a way that might predispose them to tripping or falling (i.e. shorter steps and closer obstacle approach). Gender differences in adaptive walking are related to functional test performance and processing speed. Clinicians should consider targeting step length during adaptive walking tasks in women that may be at risk of mobility impairments.

Keywords: Adapting; Aging; Cognition; Gait; Mobility.

Conflict of interest statement

Conflict of Interest

The authors confirm no conflict of interest exists

Published by Elsevier Inc.

Figures

Figure 1.

Depiction of lead and trail foot placement outcomes for obstacle crossing (OBS) conditions. The lead foot is the first to cross the obstacle, represented in grey. The trail foot is the second limb to cross the obstacle, represented in black. The foot placement outcomes for obstacle crossing were based on distance from the obstacle and defined as lead foot approach and trail foot approach, lead toe clearance and trail toe clearance, and lead foot landing and trail foot landing.

Figure 2.

Women step closer to obstacles than men. 2a) Obstacle crossing foot placement results for men and women showing women approached the obstacle more closely. Presented as non-normalized mean values for distance from obstacle (mm) and standard error. See supplemental data for corrections by leg length. 2b) Icons represent step outcomes: approach distance for lead and trail foot, crossing toe-clearance for lead and trail foot, and landing distance for lead and trail foot; lead foot=grey, trail foot=black. Asterisk indicates significant group differences p