Joint movements associated with minimum toe clearance variability in older adults during level overground walking.
BACKGROUND
Approximately one-third of falls are caused by the swing foot contacting an object or the ground, resulting in a trip. The increased incidence of trip-related falls among older adults may be explained by greater within-person minimum toe clearance (MTC) variability.


RESEARCH QUESTION
Will kinematic variability at any of the 6 major joints in the lower limbs, individually or in combination, be associated with MTC variability?


METHODS
This cross-sectional study investigated whether single or multiple joint movements best explained MTC variability in older adults. Twenty healthy older adults (7 males, 13 females; mean age = 71.3 ± 7.2 years) were recruited. Participants were fitted with a modified Cleveland Clinic marker set and walked for 50 trials at self-selected speeds over a 7-meter walkway (with a rest at 25 trials) while 6 infrared cameras recorded kinematics.


RESULTS
Seven joint movements were evaluated, and swing hip flexion-extension variability was the only joint movement significantly associated with MTC variability (r = 0.577, p = 0.008) and explained 29.6% (adjusted R2) of the variance of MTC variability in older adults (F (1, 18) = 8.897, p = 0.008).


SIGNIFICANCE
Identifying the joint movement/s associated with inconsistencies in toe clearance will improve our understanding of endpoint control in older adults and may lead to the development of effective trip prevention strategies.
['Carter|Sylvester C|SC|', 'Batavia|Mitchell Z|MZ|', 'Gutierrez|Gregory M|GM|', 'Capezuti|Elizabeth A|EA|']
D000058:Accidental Falls D000368:Aged D001696:Biomechanical Phenomena D003430:Cross-Sectional Studies D005260:Female D005684:Gait D006801:Humans D008297:Male D014034:Toes D016138:Walking
Minimum toe clearance Falls Tripping Foot clearance