July 2015

Step width, length variables may help predict fall-related risks in older adults

In the moment: Gait

Step width (SW), step length (SL), and a ratio of the two variables may help predict falls and fall-related injuries in older adults with and without diabetic peripheral neuropathy (DPN), according to research from the University of Michigan in Ann Arbor.

The investigators used optoelectronic kinematic techniques to assess walking on smooth and uneven surfaces in 27 participants (aged 50-85 years, 12 women) with a spectrum of peripheral nerve function, ranging from normal to moderately severe DPN (n = 16).

In the following year, 17 individuals (62.9%) fell and 12 (44.4%) sustained a fall-related injury. All but one of the individuals with DPN sustained a fall. Compared with nonfallers, fallers demonstrated slower walking speed, greater SW, shorter SL, and a greater step width to step length ratio (SW:SL) on both surfaces. SW:SL on an uneven surface was the strongest predictor of falls and fall-related injuries.

The results were epublished in June by the American Journal of Physical Medicine and Rehabilitation. The data suggest older individuals with diabetes who are at increased fall risk sacrifice speed and efficiency for stability on uneven surfaces, the authors noted.


Zurales K, DeMott TK, Kim H, et al. Gait efficiency on an uneven surface is associated with falls and injury in older subjects with a spectrum of lower limb neuromuscular function: A prospective study. Am J Phys Med Rehabil 2015 Jun 5. [Epub ahead of print]

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