Fall‑related functional impairments in patients with neurological gait disorder

Scientific Reports, 2020 · DOI: https://doi.org/10.1038/s41598-020-77973-4 · Published: November 1, 2020

Simple Explanation

Falls are a significant concern for individuals with neurological disorders, leading to injuries. This study uses gait analysis to understand why these patients fall. The study found that specific walking characteristics, such as step length and gait variability, differ between neurological patients who fall and those who don't. Objective gait analysis can help identify patients at risk of falling, paving the way for rehabilitation programs that target walking deficits.

Study Duration

6 Months

Participants

58 patients with neurological gait disorders

Evidence Level

Not specified

Key Findings

1
Reduced step length at slow walking speed is the best single determinant of falls in neurological patients.
2
A combination of step length, CoP variability, swing phase asymmetry, and step width variability can classify fallers and non-fallers with high accuracy.
3
Gait pattern differences between fallers and non-fallers are accentuated at faster walking speeds, suggesting that higher speeds are more sensitive for detecting fall-related gait pathologies.

Research Summary

This study aimed to identify the principal postural and gait impairments associated with falls in patients with various neurological disorders. The strongest fall-related functional impairment was a reduction of right step length at slow walking speed, and the gait phenotype most strongly associated with falls included reduced step length, restricted mediolateral CoP variability, enhanced swing phase asymmetry, and increased variability of step width. The findings emphasize the most prominent locomotor determinants of falls and thus present potential key targets for future interventions aiming at preventing falls in neurological patients.

Practical Implications

Rehabilitation Strategies

Target specific gait parameters like step length and variability in rehabilitation programs.

Fall Risk Assessment

Utilize objective gait analysis for improved fall risk assessment in neurological patients.

Treatment Optimization

Monitor fall-related gait parameters to optimize treatments for gait disorders.

Study Limitations

1
Instrumented gait assessment on the treadmill might not allow to entirely transfer the findings to over ground walking.
2
Exclusion of subjects that were not able to walk unassisted at 3 km/h on the treadmill likely caused a bias towards good walkers.
3
Retrospective design of the fall questionnaire which might lead to an underestimation of fall incidents.

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