Comparison of Gait of Young Men and Elderly Men potx

No significant differences were observed between the groups for step and stride length, velocity, ankle range of motion, vertical and horizontal excursions of the center of gravity, a

1989; 69:144-148.

PHYS THER

Daniel J Blanke and Patricia A Hageman

Comparison of Gait of Young Men and Elderly Men

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Comparison of Gait of Young Men and Elderly Men

The purpose of this study was to describe and compare the free-speed gait

characteristics of healthy young men with those of healthy elderly men Data

collection consisted of high-speed cinematography resulting in synchronized front

and side views of 24 healthy male volunteers, 12 between 20 and 32 years of age

and 12 between 60 and 74 years of age Young men were recruited to match the

elderly men on the basis of right-leg length Each subject participated in three

filmed trials of free-speed ambulation down a 14-m walkway The processed film

was analyzed for eight gait characteristics Differences in characteristics between

the two groups were examined using a correlated t test (p < 01) No significant

differences were observed between the groups for step and stride length, velocity,

ankle range of motion, vertical and horizontal excursions of the center of gravity,

and pelvic obliquity; however, the younger men demonstrated a significantly

larger stride width than the elderly men (p < 01) The results suggest that the two

populations of healthy adult men have similar gait characteristics [Blanke DJ,

Hageman PA Comparison of gait of young men and elderly men Phys Ther 69:

144-148, 1989.]

Key Words: Aging; Gait; Kinesiology/biomechanics, gait analysis

Daniel J Blanke Patricia A Hageman

Elderly people frequently use physical

therapy services to achieve their

maximal functional ability in motor

activities such as gait Clinicians are

interested in the normal gait

characteristics of all age groups,

especially the elderly population

Changes in walking patterns have been

reported as early as 60 years of age.1,2

Murray et al found that timing and

stride dimensions were not

systematically related to age in their

gait study of 60 men aged 20 to 65

years; however, the subjects 60 to 65

years of age differed from the younger

subjects in that they demonstrated

shorter step lengths and stride lengths,

decreased ankle extension, and decreased pelvic rotation.2 A gait analysis of 64 men aged 20 to 87 years divided into eight age groups revealed differences in the gait characteristics of stride length, cadence, vertical

oscillation of the head, and movements

of the shoulders and ankles in the three groups of men over 65 years of age when compared with the younger groups of men during free-speed gait.3 Gabell and Nayak found no significant differences between 32 healthy elderly adults (aged 61-87 years) and 32 healthy adults (aged 21-47 years) in their gait analysis of intercycle

variability of stride time, step length, and stride length.4

Several investigations and reports analyzed the gait characteristics of healthy men within a broad span of ages, including the elderly, to determine ranges of values for gait characteristics,5,6 establish relationships

of gait characteristics with speed,7,8 or compare the gait characteristics of healthy men with male populations with pathological conditions.9 These investigations, however, did not directly compare gait characteristics between the young and elderly men

Differences observed in the gait characteristics of elderly men when compared with young men were similar to those found in the gait characteristics of elderly women when compared with young women.10 Analysis of the gait patterns of men separate from our previous comparison

of gait characteristics between matched groups of healthy elderly women and

D Blanke, PhD, is Associate Professor, Department of Health, Physical Education, and Recreation,

University of Nebraska at Omaha, Sixtieth and Dodge St, Omaha, NE 68182

P Hageman, MS, PT, is Assistant Professor, Division of Physical Therapy Education, School of Allied

Health Professions, University of Nebraska Medical Center, 42nd and Dewey Ave, Omaha, NE

68105-1065 (USA) Address all correspondence to Mrs Hageman

This article was submitted February 16, 1988; was with the authors for revision for 12 weeks; and was

accepted August 25, 1988

healthy young women is necessary

because physiological differences have

been documented between the sexes.11

Because few studies have investigated

the differences between healthy elderly

men and healthy young men, additional

comparisons are needed Previous

studies attempted to compare groups

of men who were similar in height and

weight, although specific matching of

subjects between groups was not

completed.2,3

Based on the results of previous

research, we hypothesized that a

significant difference would exist

between the healthy young and healthy

elderly groups on eight gait

characteristics The purpose of this

study was to describe and compare the

free-speed gait characteristics of

matched groups of healthy elderly men

and healthy young men

Method

Subjects and Selection Procedure

Twenty-four male volunteers, 12

between 20 and 32 years of age and 12

between 60 and 74 years of age, were

accepted as subjects in this study Each

subject provided his informed consent

in accordance with the procedures of

the University of Nebraska Institutional

Review Board

All of the subjects were found to be

free of disabling physical conditions or

minor ailments that could affect or

influence locomotion based on a

medical review and an objective

examination by a licensed physical

therapist Specifically, the subjects were

without musculoskeletal or

neurological involvement or

medication for these conditions

One tester (PAH) took all measurements Height and mass were measured to provide descriptive characteristics for the groups An average of three independent measurements was used to determine values for leg length and for skinfold thickness, which were used to determine the percentage of body fat

Leg lengths were measured to ensure that each subject was without a leg-length discrepancy (±1.9 cm) as defined by Subotnick.12 This criterion is important because leg length is a major determinant of stride length.13

The percentage of body fat of each subject was determined using skinfold measurements to ensure that no subjects who were extremely lean or obese would be included in the study

Percentage of body fat for the young male subjects was calculated using the age-specific formula of Jackson and Pollock.14 All young male subjects were within one standard deviation of the average percentage of body fat (13.4%

± 6.0%) for 18- to 24-year-old men as reported by Jackson and Pollock.15 Subjects 60 years of age or older also were within one standard deviation of their age-specific average percentage of body fat (22.6% ± 4.1%).16

The elderly men meeting these criteria were tested first Young men meeting these criteria were recruited to match the elderly men on the basis of right-leg length The matching of right-leg lengths was within the same range suggested by Subotnick12 for leg-length discrepancies to achieve a close pairing of subjects between the young and elderly groups

Instrumentation

Data collection consisted of high-speed cinematography resulting in

synchronized front and side views of each subject's free-speed gait down a 14-m walkway The instrumentation, gait laboratory, and measurement methods for analysis have been described in detail previously.10,17,18 The front camera was a Photec IV* fitted with a 50-mm Nikon lens1" set 15.6 m from the walkway The side camera, a LoCam‡ fitted with a 25-mm Cosmicar lens,‡ was positioned 8 m from the center of the walkway Both cameras were set to run at 100 frames per second A 1-m reference scale and

a lighting device were placed in the view of both cameras to provide a common reference for distance and for synchronizing front and side film frames during the film analysis

The processed film was displayed on a Lafayette Dataviewer§ rear-projection system The desired measurements were made directly from the projected image A Numonics digitizer|| was used

in conjunction with the projection system to assign separate

X,Y-coordinate values for any landmark from both front- and side-view films The coordinate values for the

landmarks were stored in a computer# and used for calculating the variables The procedure described by

Sutherland and Hagy17 and validated in

1980 by Sutherland et al18 was followed

in this study to obtain the measurements with the processed film Reliability of the measurements taken from our processed film was high when test-retest results were compared during a pilot study The same

observer (PAH) made all of the test-retest measurements from the film, recording a maximum deviation of 2.5 degrees for rotational measurements and a maximum deviation of 2 cm for distance measurements

Gait variables measured from the side view included ankle plantar-flexion and dorsiflexion range of motion, velocity, step length, stride length, and vertical excursion of the center of gravity The front-view camera provided the data for determining stride width, lateral center-of-gravity excursion, and pelvic

obliquity

*Photomic Systems, Inc, 265 H Sobrante Way, Sunnyvale, CA 94086

† Nikon, Inc, 623 Stewart Ave, Garden City, NY 11530

‡ Redlake Corp, 1711 Dell Ave, Campbell, CA 95008

§ Lafayette Instrument Co, 3700 Sagamore Pky N, PO Box 5729, Lafayette, IN 47903

|| Numonics Corp, 418 Pierce St, Lansdale, PA 19446

# Model 4052, Tektronix, Inc, PO Box 500, Beaverton, OR 97077

Table 1 • Basic Descriptive Characteristics of Subject Groups (N = 24)

Variable

Age (yr)

Height (cm)

Mass (kg)

Body fat (%)

Leg length (cm)

Right

Left

Elderly Men (n = 12)

63.58 175.53 80.11 21.08

93.53 93.61

s

5.58 3.86 11.01 4.80

2.79 2.70

Range

(60.0-74.0) (168.2-179.7) (62.7-94.1) (15.4-28.7)

(87.1-98.0) (87.4-98.0)

Young Men (n = 12)

24.50 175.68 77.32 11.01

92.98 93.06

s

3.73 9.46 7.45 3.31 2.84 2.83

Range

(20.0-33.0) (151.1-185.4) (67.2-94.5) (4.6-16.5) (88.4-97.2) (88.8-97.3)

df

22

22

22

11

11

t

-0.05 0.72 5.94 a

1.96 1.31

Procedure

Each subject participated in one

45-minute testing session at the Gait

Analysis Laboratory at the University of

Nebraska at Omaha The required dress

included shorts and a sleeveless shirt

Tape markers were placed on

anatomical points of each subject for

easy reference on the processed film

The description and specific placement

of the markers have been described

previously.10,12,13

The subjects then walked barefoot

along the 14-m walkway The subjects

were requested to walk at what they

considered their natural pace when

walking down a sidewalk without

obstructions The first 4.75 m of the

walkway allowed each subject to

accelerate to his chosen walking speed

before reaching the filmed area The

area from which measurements were

taken was 3.25 m long, allowing one to

two gait cycles depending on the size

of the subject and his walking speed

The last 6 m of the walkway ensured

that each subject did not decelerate

until he had left the filming area Each

subject performed three trials

Data Analysis

Means and standard deviations were

calculated for all of the variables An

independent t test was used to

compare descriptive characteristics

between the groups Differences in the

gait characteristics between the two

groups were examined using a

correlated t test because the groups

were nonrandom and matched for leg length Significance was accepted at the .01 level

Results

No significant differences were found between the groups of men for either right or left leg-length comparisons, suggesting that the groups were well matched for leg length The elderly men had a higher percentage of body fat than the younger men Both groups, however, were within the normal range for percentage of body fat based on their age ranges The basic descriptive characteristics of both groups are reported in Table 1

No significant differences were found between the two groups for all

variables measured from the side view, including step length, stride length, ankle ROM, velocity, and vertical center-of-gravity excursion The gait characteristics from the side view are presented in Table 2

The elderly men demonstrated a

significantly smaller stride width (p <

.01) compared with the young men No significant differences were found between the groups for lateral excursion of the center of gravity or pelvic obliquity The values obtained for the gait characteristics measured from the film of the front-view camera are shown in Table 3

Discussion

This study resulted as a follow-up to a previous study comparing healthy

Table 2 Comparison of Subjects' Gait Characteristics Measured from Side-view

Camera (N = 24)

Variable

Step length (cm) Stride length (cm) Ankle range of motion (°) Velocity (cm/sec) Vertical center-of-gravity excursion (cm)

Elderly Men (n = 12)

94.17 189.58 19.08 138.93 7.42

s

11.99 23.39 4.96 23.41 4.21

Young Men (n = 12)

87.58 192.58 21.25 131.32 8.22

s

6.46 18.03 5.67 17.52 5.00

t a

1.49 -0.30 -0.85 0.77 0.37

a p < 01

a df= 11

elderly women with healthy young

women Data for the male subjects in

this study were compared and analyzed

separately from the previous study of

women because of the documented

physiological differences between the

sexes.11 We were interested in whether

the elderly men demonstrated the

same changes in gait that were

demonstrated by the elderly women

We were also interested in whether the

elderly men in our study demonstrated

the same changes in gait that were

found in elderly men by other authors

Specific comparison of the results of

many previous studies with data from

this study is limited because

normalization of gait measurements

with respect to body size is an

unresolved problem in human

locomotion research.13 Matching of the

young group with the elderly group in

our study using leg-length

measurements was considered crucial

because of the influence of leg length

on stride length.13

The values of step length and stride

length of the men in our study are

much greater than values published in

a study by Murray et al2 involving 60

men aged 20 to 65 years and in a study

by Kirtley et al7 of 10 male subjects 18

to 63 years of age walking at their

natural speed Larsson et al examined

the stride length of 32 male and female

subjects aged 20 to 70 years during

walking speeds classified as "Very

slow," "slow," "ordinary," "fast," and

"very fast."8 The mean values of stride

length from both groups of men in our

study are closest to the mean value of

stride length in the very fast category

(1.93 m) in the Larsson et al study.8

Compared with the results of other

studies, both groups of men in our

study demonstrated very long stride

lengths; however, the mean values of

velocity for both groups of men in this

study were smaller than the mean

values of velocity from other

studies.3,7,8 The conflicting results may

be attributed to the differences in the

population studied or methodologies

used for testing Velocity of walking

may result from many combinations of

stride length and cadence, explaining

the differences found between the

T a b l e 3 Comparison of Subjects' Gait Characteristics Measured from Front-view

Camera (N -24)

Variable

Lateral center-of-gravity excursion (cm) Stride width (cm) Pelvic obliquity (°)

Elderly Men (n = 12)

2.28

8.25 6.08

s

1.20 5.09 2.50

Young Men (n = 12)

1.70 10.80 7.42

$

.72 3.94 2.11

t a

1.23 -3.13 b

-1.55

studies High values of stride length reported from our subjects may be a result of longer leg lengths

The mean velocities of the elderly men and the young men during free-speed ambulation are similar to values published by Katoh et al9 of 32 male and female subjects ambulating at their chosen natural speed The velocity values of the men in this study are also similar to the values of 534 men during functional ambulation at locations such

as commercial, business, and residential areas.5 The similarity of results suggests that the men in our study selected a functional walking speed as their natural free-speed gait

Pelvic obliquity values of the men reported in the literature ranged from

5 to 8 degrees, which is similar to the findings in our study.3,18 Both groups oi men in this study maintained a lateral center-of-gravity excursion within the 5-cm range reported in the literature.13 The vertical excursion of the center of gravity for both groups of men in this study exceeded this 5-cm range The long stride lengths in relation to the moderate gait velocities may explain the larger values for vertical

center-of-gravity excursions

Significant differences were observed between the two groups of men in stride width; however, both groups demonstrated great variability in values

of stride width Gabell and Nayak4 reported similar findings in their study

of young subjects (21-47 years of age) and elderly subjects (66-84 years of

age) during gait Variability in values of stride width was also observed in our previous study of healthy elderly and healthy young women.10 Although the younger men in our study

demonstrated statistically larger values

of stride width than the elderly men, the mean stride-width values from both groups are within the range of 2.5 to 12.7 cm reported in the literature.3,6

No significant differences were observed between the two groups in this study for values of ankle

movement Murray et al, however, found slightly less excursion during ankle movement in subjects 60 to 65 years of age.2 Older men (aged 81-87 years) demonstrated significantly less ankle extension than younger men at the end of stance phase.3 Research findings of elderly women also showed decreased ankle movement.10

Caution is advised when applying the results of this study to other

populations because of the differences

in subject selection and measuring techniques A true random sampling of the age groups may not have been represented because of the small sample size Subjects' motivation and ability to follow instructions may have influenced the results Despite our adherence to the guidelines established for subject selection, some subjects may have had an undiagnosed or

unrecognized pathological condition that affected their gait

adf = 11

b p < 0 1

Clinical Implications

This study of the linear and temporal

aspects of the gait patterns of healthy

young men and healthy elderly men

may assist physical therapists who use

gait characteristics to evaluate a

patient's progress The degree that a

pathological condition would further

affect the gait characteristics of both

groups is beyond the scope of this

study

The results of this comparison of

healthy elderly men with healthy young

men contrast with the results of a

previous study that used the same

methodology and compared matched

groups of healthy elderly women with

healthy young women.10 The gait

characteristics between the two groups

of men did not differ, whereas the

healthy elderly women demonstrated a

smaller step and stride length, a slower

walking speed, less pelvic obliquity,

and less ankle movement than the

healthy young women These

conflicting results may be attributed to

the documented physiological

differences between the sexes,11

suggesting that the aging process affects

healthy women differently than healthy

men It is unclear whether physical

activity affected the results in both

studies Although the studies of men

and women involved healthy subjects,

the elderly men were more likely to

report participation in vigorous

activities (eg, Softball and hunting) than

the elderly women who participated in

an earlier study

Further study of gait characteristics in the elderly population is needed before definitive conclusions may be made about the effects of aging on gait

Future research could focus on the relationship of physical activity to the gait characteristics observed

Conclusions

The effects of aging were not observed

The young men and the elderly men did not demonstrate significant differences in seven of the eight gait characteristics examined (ie, step length, stride length, ankle ROM, velocity, vertical and horizontal excursions of the center of gravity, and pelvic obliquity) Although the young men demonstrated significantly larger values in stride width than the elderly men, the values of stride width for both groups were within the range

published for the healthy population

The statistically different values were not clinically relevant

References

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322-324, 1981

2 Murray M, Drought B, Ross C, et al: Walking patterns of normal men J Bone Joint Surg [Am]

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3 Murray M, Kory R, Clarkson B: Walking patterns in healthy old men J Gerontol

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4 Gabell A, Nayak V: The effect of age on variability in gait J Gerontol 39:662-666, 1984

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PA, Temple University Press, Rehabilitation Research and Training Center # 8 , 1979

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12 Subotnik S: The short leg syndrome J Am Podiatr Med Assoc 66:720-723, 1976

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14 Jackson A, Pollock M: Generalized equations for predicting body density in men Br J Nutr 40: 497-504, 1978

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17 Sutherland D, Hagy J: Measurement of gait movements from motion picture film J Bone Joint Surg [Am] 54:787-797, 1972

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1989; 69:144-148.

PHYS THER

Daniel J Blanke and Patricia A Hageman

Comparison of Gait of Young Men and Elderly Men

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