Indicators of mobility capacity can be obtained from self-report, professional assessment or observed performance. Mobility may be one of a constellation of domains that link multiple outcomes associated with aging and has been proposed as a core indicator of frailty 8,13. Assessment of Fear of Falling 209 1 V. Although most falls do not result in injury, the fact that residents with dementia fall more often than their counterparts without dementia leaves them with a higher overall risk of sustaining injurious falls over time. In rodent muscle, power outputs decline with aging approximately 30% in absolute terms and 20% on a per-unit-muscle-mass basis.
The rectus femoris and vastus lateralis work independently during initial swing phase, with the rectus femoris activity directly correlated to walking speed 6. Wallace, Lower Extremity Function and Subsequent Disability: Consistency Across Studies, Predictive Models, and Value of Gait Speed Alone Compared With the Short Physical Performance Battery , The Journals of Gerontology Series A: Biological Sciences and Medical Sciences , 55 , 4 , M221 , 2000. Outcomes were change in dual task costs of walking, physical performance, simple reaction time, executive functions, divided attention, fear of falling and fall rate. Multidimensional Fall-Risk Assessment 177 4 References 181 4 10. Genu recurvatum in spastic cerebral palsy.
Interventions for Fear of Falling. No notable gender differences in reaction times have been reported. Philadelphia: Lippincott, Williams and Wilkins, 2001. Lastly, we suggest how assessments of executive function and attention could be applied in the clinical setting as part of the process of identifying and understanding gait disorders and fall risk. Blomsterwall E, Svantesson U, Carlsson U, et al.
These changes occur even in the absence of overt diseases. Therapy with Botulinum Toxin, edited by Joseph Jankovic and Mark Hallett 26. J Geriatr Psych Neurol 2003; 16:53—58. In certain cases, a modern laboratory may also be used to address important clinical questions, but 58 Riley and Kerrigan generally today, routine assessment is not performed in the lab. Arch Phys Med Rehabil 1993; 74:400—406. This can be seen as a reduction in the external hip adductor moment, which ordinarily occurs in the stance period. Several studies have suggested that gait abnormalities can already be present in the early stages of cognitive decline, even before dementia has been diagnosed.
The etiology of these disorders in older adults is frequently multifactorial, and a full assessment must consider a number of different sensorimotor levels via standard medical e. Warren Magnuson Professor Chair, Department of Neurology University of Washington School of Medicine Seattle, Washington Kapil Sethi, M. Bone-on-bone forces during loaded and unloaded walking. Dynamic balance control may be characterized using such parameters as gait speed, double-support time and base of support width 27,36. Seven- to 10-outcomes of decompressive surgery for degenerative lumbar spinal stenosis. Miszko Department of Physical Education and Sports Studies, The University of Georgia, Prescriptive Health, Inc. Gait Assessments and Interventions: A Glimpse into the Future.
Koller and George Paulson 35. Known conditions causing severe gait impairment, such as hemiplegia and severe hip or knee disease, are frequently not mentioned in these neurological referral populations. Recent studies exploring the effect of age on thresholds for sensing ankle rotations show that healthy adults can sense quite small rotations in the sagittal and frontal planes under the weight-bearing conditions of upright stance. In long-term care, many people are not ambulatory. Treatment of Parkinsonian Gait Disturbances. Metabolic Function It may be desirable to assess the energy cost of walking.
Handbook of Essential Tremor and Other Tremor Disorders, edited by Kelly E. Arch Phys Med Rehabil 2002; 83:1370—1373. Common Gait Disturbances: A Clinical Overview. Consequently, there is a need to identify biomarkers that can facilitate early detection, diagnosis, and progression of dementia. J Child Neurol 2007 Mar;22:264-276.
New opportunities for prevention and treatment are evolving rapidly. Self-report also depends on the insight and accuracy of the respondent, sometimes a problem in the presence of cognitive or affective disorders. Preventive Medicine, 48, 247- 249. Kinematics may be obtained if the treadmill is positioned in the motion capture system viewing volume. A wearable system to assist walking of Parkinson s disease patients. Feasibility and measurement properties of the functional reach and timed up and go tests in the Canadian Study of Health and Aging.
Effects of a foot drop neuroprosthesis on functional abilities, social participation, and gait velocity. Best Clinical Practice Models to Reduce Falls. Usual and Maximal Gait Speed Over relatively short distances e. Professor of Neurology Harvard University School of Medicine Beth Israel Deaconess Medical Center Boston, Massachusetts William C. Laboratory-based Evaluation of Gait Disorders: High Tech.