Gait Disorders and Falls

Abstract

Since approximately 30% of persons over the age of 65 fall each year, prevention of falls is a very important topic. Gait disorders and diminished ability to walk safely are associated with an increased risk of falling. In older adults, falls commonly lead to injuries, institutionalization, and early death. The resultant decline in activities of daily living further contributes to loss of mobility and independence. Gait analysis using the dual-task paradigm (e.g., walking and carrying a cup of tea) offers a sensible tool for detecting older persons prone to falling. Changes in gait patterns due to simultaneously performing a secondary attention-demanding task are interpreted as interference by competing demands for attentional resources in gait control. Exercise interventions such as Jaques-Dalcroze eurhythmics address these attentional properties and aim to decrease such interference. To fully stress physical capacities in older adults, not only does automaticity of walking have to be trained, but also simultaneous performance of additional tasks. Exercise interventions for fall prevention should focus on developing basic skeletal muscle strength as a prerequisite to training gait automaticity in dual or multiple task situations. Recommendations for further research center on new approaches to combine exercises with additional tasks to improve gait and functionality in older adults.