Identification of gait domains and key gait variables following hip fracture

BMC Geriatrics

Jorunn L. Helbostad³  Rolf Moe-Nilssen¹  Kristin Taraldsen²  Espen F. Ihlen²  Thorlene Egerton²  Pernille Thingstad² 

[1] Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 7491, Norway;Department of Clinical Services, St. Olav University Hospital, Trondheim, Norway

关键词: Rehabilitation;    Factor analysis;    Hip fracture;    Gait;   

Others  :  1233966
DOI  :  10.1186/s12877-015-0147-4

 received in 2015-07-07, accepted in 2015-11-12,  发布年份 2015

【 摘 要 】

Background

Restoration of gait is an important goal of rehabilitation after hip fracture. Numerous spatial and temporal gait variables have been reported in the literature, but beyond gait speed, there is little agreement on which gait variables should be reported and which are redundant in describing gait recovery following hip fracture. The aims of this study were to identify distinct domains of gait and key variables representing these domains, and to explore how known predictors of poor outcome after hip fracture were associated with these key variables.

Methods

Spatial and temporal gait variables were collected four months following hip fracture in 249 participants using an electronic walkway (GAITRite®). From the initial set of 31 gait variables, 16 were selected following a systematic procedure. An explorative factor analysis with oblique (oblimin) rotation was performed, using principal component analysis for extraction of factors. Unique domains of gait and the variable best representing these domains were identified. Multiple regression analyses including six predictors; age, gender, fracture type, pain, global cognitive function and grip strength were performed for each of the identified key gait variables.

Results

Mean age of participants was 82.6 (SD = 6.0) years, 75 % were women, and mean gait speed was 0.6 (SD = 0.2) m/sec. The factor analysis revealed four distinct gait domains, and the key variables that best represented these domains were double support time, walk ratio, variability of step velocity, and single support asymmetry. Cognitive decline, low grip strength, extra capsular fracture and male gender, but not pain or age, were significant predictors of impaired gait.

Conclusions

This work proposes four key variables to represent gait of older people after hip fracture. These core variables were associated with known predictors of poor outcome after hip fracture and should warrant further assessment to confirm their importance as outcome variables in addition to gait speed.

【 授权许可】

   
2015 Thingstad et al.

【 图 表 】

Fig. 1.

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