Effects of an Inclined Walking Surface and Balance Abilities on Spatiotemporal Gait Parameters of Older Adults.

BACKGROUND AND PURPOSE:: To date, few studies have investigated how walking patterns on inclines change in healthy older adults. The purpose of the study was to examine the effects of an inclined walking surface and balance abilities on various spatiotemporal gait parameters of healthy older adults. METHODS:: Seventy-eight self-reported independent community ambulators (mean age, 77.8 years; SD, 4.8) participated in this study. After completing the Berg Balance Scale and Dynamic Gait Index (DGI), all participants were asked to walk on the GaitRite on level and inclined surfaces (10° slope). Dependent t tests were used to determine statistical significance between level and inclined surfaces for cadence, step length, velocity, and gait stability ratio (GSR). GSR is a measure of the degree of adaptation an individual makes to increase stability during gait derived from a ratio of cadence/velocity. A 2 × 2 analysis of variance was performed to determine differences in means among the higher-risk participants (as determined by the Berg Balance Scale and Dynamic Gait Index) comparing their level and incline walking patterns. The level of During incline walking a significant decrease occurred in mean step length, 63.1(8.8) cm, P = ≤ 0.001, mean cadence, 111.6 (8.9) step/min, P = 0.01 and mean normalized velocity, 1.4 (0.23), P = ≤ 0.001. However, mean GSR increased on inclines, 1.62 (0.22) steps/m, P = 0.004. Main effects were evident for both walking surface and fall risk for all gait parameters tested. RESULTS:: During incline walking a significant decrease occurred in mean step length, 63.1(8.8) cm, P = < 0.001, mean cadence, 111.6 (8.9) step/min, P = 0.01 and mean normalized velocity, 1.4 (0.23), P = < 0.001. However, mean GSR increased on inclines, 1.62 (0.22) steps/m, P = 0.004. Main effects were evident for both walking surface and fall risk for all gait parameters tested. CONCLUSIONS:: Healthy older adults adopt a more stable gait pattern on inclines decreasing velocity and spending more time in the double support despite the increased physiological demands to perform this task. Clear changes were evident between level and incline surfaces regardless of fall risk as defined by 2 different objective balance measures.