PURPOSE: The main purpose of the study was to establish a gait speed cut-off value to predict foot pain and the risk of falls among community-dwelling older adults. PATIENTS AND METHODS: In this cross-sectional study, one-hundred and twenty White older women speaking Croatian (mean ± SD age 71.02 ± 6.78 years, height 161.77 ± 6.23 cm, weight 70.29 ± 12.97 kg, body mass index 26.79 ± 4.42 kg/m2) were recruited. The prevalence of foot pain was assessed by a single-item question and the risk of falls by the Downtown Fall Risk Index with a proposed cut-off value of "low risk" (<3 points) vs "high risk" (≥3 points) of falls. Self-selected gait speed (the independent variable) was estimated with a pressure platform (Zebris Company, Munich, Germany). RESULTS: Mean gait speed was 0.95 m/s. Of the total sample, 53.30% and 33.30% reported foot pain and had higher risk of falls. For foot pain and the risk of falls, gait speed cut-off values were 0.88 m/s and 0.85 m/s (area under the curve = 0.80 and 0.83, standard error = 0.043 and 0.043, p < 0.001). Sensitivity for foot pain and the risk of falls was 66.20% and 85.90% and specificity was 84.80% and 69.00%. Slower gait speed was associated with higher prevalence of foot pain (OR = 10.92, 95% CI 4.28 to 27.89, p < 0.001) and higher risk of falls (OR = 13.59, 95% CI 5.45 to 33.87, p < 0.001). CONCLUSION: Proposed gait speed values of 0.88 m/s and 0.85 m/s may be used in clinical settings to predict foot pain and the risk of falls among community-dwelling older women.

Faculty of Kinesiology Department of General and Applied Kinesiology University of Zagreb Zagreb Croatia

Faculty of Sports Studies Department of Sports Motorics Masaryk University Brno Czech Republic

RECETOX Faculty of Science Masaryk University Brno Czech Republic

See more in PubMed

Menz HB. Foot Problems in Older People: Assessment and Management. 1st ed. New York: Churchill Livingstone; 2008.

Menz HB. Biomechanics of the ageing foot and ankle: a mini - review. Gerontology. 2015;61:381. doi:10.1159/000368357 PubMed DOI

Menz HB, Dufour AB, Casey VA, et al. Foot pain and mobility limitations in older adults: the Framingham Foot Study. J Gerontol A Biol Sci Med Sci. 2013;68:1281–1285. doi:10.1093/gerona/glt048 PubMed DOI PMC

Riskowski JL, Hagedorn TJ, Dufour AB, Hannan MT. Functional foot symmetry and its relation to lower extremity physical performance in older adults: the Framingham Foot Study. J Biomech. 2012;45:1796–1802. doi:10.1016/j.jbiomech.2012.04.019 PubMed DOI PMC

Thomas MJ, Roddy E, Zhang W, Menz HB, Hannan MT, Peat GM. The population prevalence of foot and ankle pain in middle and old age: a systematic review. Pain. 2011;152:2870–2880. doi:10.1016/j.pain.2011.09.019 PubMed DOI

Ogawa EF, Shi L, Bean JF, et al. Chronic pain characteristics and gait in older adults: the MOBILIZE Boston Study II. Arch Phys Med Rehabil. 2020;101:418–425. doi:10.1016/j.apmr.2019.09.010 PubMed DOI PMC

Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Foot pain, plantar pressures, and falls in older people: a prospective study. J Am Geriatr Soc. 2010;58:1936–1940. doi:10.1111/j.1532-5415.2010.03061.x PubMed DOI

Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006;12:290–295. doi:10.1136/ip.2005.011015 PubMed DOI PMC

Leveille SG, Bean J, Bandeen-Roche K, Jones R, Hochberg M, Guralnik JM. Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc. 2002;50:671–678. doi:10.1046/j.1532-5415.2002.50161.x PubMed DOI

Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: A prospective study. J Gerontol A Biol Sci Med Sci. 2006;61A:866–870. doi:10.1093/gerona/61.8.866 PubMed DOI

Ferrucci L, Guralnik JM, Buchner D, et al. Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women’s Health and Aging Study. J Gerontol A Biol Sci Med Sci. 1997;52:275–285. doi:10.1093/gerona/52A.5.M275 PubMed DOI

Dumurgier J, Elbaz A, Ducimetière P, Tavernier B, Alpérovitch A, Tzourio C. Slow walking speed and cardiovascular death in well - functioning older adults: prospective cohort study. BMJ. 2009;339:4460. doi:10.1136/bmj.b4460 PubMed DOI PMC

Hausdorff JM. Gait dynamics, fractals and falls: findings meaning in the stride-to-stride fluctuations of human walking. Hum Mov Sci. 2007;26:555–589. doi:10.1016/j.humov.2007.05.003 PubMed DOI PMC

Riskowski JL, Hagedorn TJ, Dufour AB, Hannan MT. Associations of region-specific foot pain and foot biomechanics: the Framingham Foot Study. J Gerontol A Biol Sci Med Sci. 2015;70:1281–1288. doi:10.1093/gerona/glv067 PubMed DOI PMC

Quach L, Galica AM, Jones RN, et al. The nonlinear relationship between gait speed and falls: the MOBILIZE Boston Study. J Am Geriatr Soc. 2011;59:1069–1073. doi:10.1111/j.1532-5415.2011.03408.x PubMed DOI PMC

Kyrdalen IL, Thingstad P, Sandvik L, Ormstad H. Associations between gait speed and well-known fall risk factors among community-dwelling older adults. Physiother Res Int. 2019;24:1743. doi:10.1002/pri.1743 PubMed DOI

Tay MA, Poh M, Lee LH, Ismail NH. Normative gait speed and its relation to falls in the community dwelling elderly in Singapore. Physiother. 2015;101:1493–1494. doi:10.1016/j.physio.2015.03.1471 DOI

Samah ZA, Nordin NAM, Shahar S, Singh DKA. Can gait speed test be used as a falls risk screening tool in community dwelling older adults? A review. Polish Ann Med. 2016;23:61–67. doi:10.1016/j.poamed.2015.04.007 DOI

Callisaya ML, Blizzard L, Schmidt MD, et al. Gait, gait variability and the risk of multiple incident falls in older people: a population-based study. Age Aging. 2011;40:481–487. doi:10.1093/ageing/afr055 PubMed DOI

Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050–1056. doi:10.1053/apmr.2001.24893 PubMed DOI

Beauchet O, Allali G, Annweiler C, et al. Does change in gait while counting backward predict the occurrence of a first fall in older adults? Gerontology. 2008;54:217–223. doi:10.1159/000127318 PubMed DOI

Van Swearingen JM, Paschal KA, Bonino P, Chen TW. Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the physical performance test of function. J Gerontol A Biol Sci Med Sci. 1998;53:457–464. doi:10.1093/gerona/53A.6.M457 PubMed DOI

Kasović M, Štefan L, Zvonař M. Domain-specific and total sedentary behavior associated with gait velocity in older adults: the mediating role of physical fitness. Int J Environ Res Public Health. 2020;17:593. doi:10.3390/ijerph17020593 PubMed DOI PMC

Kasović M, Štefan L, Zvonar M. Self-reported vs. measured physical fitness in older women. Clin Interv Aging. 2020;15:425–430. doi:10.2147/CIA.S240156 PubMed DOI PMC

Awale A, Hagedorn TJ, Dufour AB, Menz HB, Casey VA, Hannan MT. Foot function, foot pain, and falls in older adults: the Framingham Foot Study. Gerontology. 2017;63:318–324. doi:10.1159/000475710 PubMed DOI PMC

Rosendahl E, Lundin-Olsson L, Kallin K, Jensen J, Gustafson Y, Nyberg L. Prediction of falls among older people in residential care facilities by the Downton index. Aging Clin Exp Res. 2003;15:142–147. doi:10.1007/BF03324492 PubMed DOI

Van der Leeden M, Dekker JHM, Siemonsma PC, Lek-Westerhof SS, Steultjens MP. Reproducibility of plantar pressure measurements in patients with chronic arthritis: A comparison of one-step, two-step, and three-step protocols and an estimate of the number of measurements required. Foot Ankle Int. 2004;25:739–744. doi:10.1177/107110070402501008 PubMed DOI

McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276–282. doi:10.11613/BM.2012.031 PubMed DOI PMC

Eggermont LH, Penninx BW, Jones RN, Leveille SG. Depressive symptoms, chronic pain, and falls in older community-dwelling adults: the MOBILIZE Boston Study. J Am Geriatr Soc. 2012;60:230–237. doi:10.1111/j.1532-5415.2011.03829.x PubMed DOI PMC

Henriksen M, Graven – Nielsen T, Aaboe J, Andriacchi TP, Bliddal H. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain. Arthritis Care Res (Hoboken). 2010;62:501–509. doi:10.1002/acr.20033 PubMed DOI

Sawa R, Doi T, Misu S, et al. The severity and number of musculoskeletal pain associated with gait in community-dwelling elderly individuals. Gait Posture. 2017;54:242–247. doi:10.1016/j.gaitpost.2017.03.013 PubMed DOI

Cruz-Almeida Y, Rosso A, Marcum Z, et al. Associations of musculoskeletal pain with mobility in older adults: potential cerebral mechanisms. J Gerontol A Biol Sci Med Sci. 2017;72:1270–1276. doi:10.1093/gerona/glx084 PubMed DOI PMC

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Spatio-Temporal Gait Parameters in Association with Medications and Risk of Falls in the Elderly

Normative Data for Gait Speed and Height Norm Speed in ≥ 60-Year-Old Men and Women