Toe clearance and velocity profiles of young and elderly during walking on sloped surfaces

Abstract

Background. Most falls in older adults are reported during locomotion and tripping has been identified as a major cause of falls. Challenging environments (e.g., walking on slopes) are potential interventions for maintaining balance and gait skills. The aims of this study were: 1) to investigate whether or not distributions of two important gait variables [minimum toe clearance (MTC) and foot velocity at MTC (VelMTC)] and locomotor control strategies are altered during walking on sloped surfaces, and 2) if altered, are they maintained at two groups (young and elderly female groups). Methods. MTC and VelMTCdata during walking on a treadmill at sloped surfaces (+3°, 0° and -3°) were analysed for 9 young (Y) and 8 elderly (E) female subjects. Results. MTC distributions were found to be positively skewed whereas VelMTCdistributions were negatively skewed for both groups on all slopes. Median MTC values increased (Y = 33%, E = 7%) at negative slope but decreased (Y = 25%, E = 15%) while walking on the positive slope surface compared to their MTC values at the flat surface (0°). Analysis of Vel MTCdistributions also indicated significantly (p < 0.05) lower minimum and 25th percentile (Q1) values in the elderly at all slopes. Conclusion. The young displayed a strong positive correlation between MTC median changes and IQR (interquartile range) changes due to walking on both slopes; however, such correlation was weak in the older adults suggesting differences in control strategies being employed to minimize the risk of tripping. © 2010 Khandoker et al; licensee BioMed Central Ltd.