Gait analysis, the study of a person’s walking pattern, is a crucial health indicator that has gained recognition as the sixth vital sign, especially in the context of elderly health care. Beyond its apparent role in assessing mobility, gait analysis can offer invaluable insights into an individual’s overall health and serve as an early warning system for various medical conditions and functional declines. With regular screening and new technologies, clinicians can act swiftly to improve patient outcomes.

Gait as a Critical Indicator of Health

While specific tests can offer valuable insights into certain aspects of mobility, such as strength or flexibility, gait analysis captures the dynamic interplay of these factors. Gait is a complex and integrated process that involves multiple systems, including musculoskeletal, cardiovascular and neurological. By observing an individual’s gait, we gain a window into their overall functional status, as it reflects not only the performance of individual joints and muscles but also their ability to coordinate and participate in different activities.

“Gait analysis is especially useful when trying to assess functional mobility in older adults with cognitive impairments. Walking is a more natural and automatic activity. I can ask my patients to walk with much less instruction than it takes to complete a different standardized test—which helps differentiate between their ability to follow commands and their actual mobility,” explains William Dieter, PT, DPT, GCS, FSOAE and Senior Director of Clinical Services at FOX Rehabilitation.

This holistic approach to mobility assessment through gait analysis enables healthcare professionals to identify subtle abnormalities, monitor for changes and develop precisely tailored interventions that comprehensively address the multifaceted nature of an individual’s mobility and overall health. Leading organizations, including FOX Rehabilitation, are already leveraging technology to improve the way care is delivered. By capturing objective mobility baselines and continuously monitoring real-world status over time, clinicians have greater visibility than ever before.

One key metric in gait analysis is walking speed, measured in meters per second (m/s). Even minor decreases in walking speed can have profound health implications. Research has shown that for every 0.1 m/s decrease in gait speed, there is an 8% increase in the risk of cardiovascular disease.¹ Moreover, the risk of mortality among the elderly increases by 12% with each 0.1 m/s decrease in gait speed.¹ These statistics highlight the profound importance of monitoring gait as a predictor of overall health. Gait speed is also closely linked to frailty, a condition characterized by decreased physiological reserve and increased vulnerability to adverse health outcomes. Frailty is a common concern among the elderly and is associated with a higher risk of falls, hospitalization and disability.

Beyond cardiovascular health and frailty, gait analysis can serve as an early warning sign for neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease. These conditions often manifest subtle changes in a person’s gait, particularly speed and variability, before more noticeable symptoms appear.^2,3 Parkinson’s disease, for instance, is characterized by motor symptoms including tremors, rigidity and bradykinesia. Gait analysis can detect alterations in gait patterns, such as reduced arm swing and shuffling steps, which may precede other clinical signs of the disease. There is also research to suggest that gait abnormalities may precede cognitive decline by several years and thus should be monitored for change over time.⁴ Early detection through gait analysis allows for timely intervention and enhanced management of these progressive conditions, significantly improving the quality of life for these individuals.

Routine Gait Analysis Must Become the New Norm

The routine integration of gait analysis into elderly rehabilitation programs has the potential to significantly enhance healthcare outcomes. Through the routine integration of gait analysis into elderly rehabilitation programs, clinicians can establish an objective mobility baseline and conduct regular analysis to identify and address gait abnormalities. This proactive approach aids patients in regaining independence, minimizing fall risks and enhancing their overall quality of life. Additionally, gait analysis offers a valuable means of tracking the effectiveness of interventions and making data-driven decisions about patient care. This evidence-based approach ensures that treatment plans are tailored to the individual needs of each patient, optimizing the likelihood of successful outcomes.

In the realm of gait analysis, recent technological advances are transforming elderly health care. Innovations such as wearable devices, AI-driven analysis and mobile applications enable continuous monitoring of gait patterns, expanding care to meet patients wherever they are. These mobile solutions offer real-time insights into patient mobility and health. AI algorithms enhance data interpretation, making assessments more detailed and efficient. These innovations hold promise for earlier intervention and improved outcomes in elderly rehabilitation.

Beyond capturing patient function, quantitative gait and mobility assessments are excellent motivational and educational tools for clinicians. With tangible outcomes, clinicians can share this information easily with patients, caregivers and other members of the care team. This approach helps boost patient autonomy and engagement in their treatment, promoting a more active lifestyle, which is the key to optimizing mobility in the long run. “Objective gait analysis is actually a powerful motivator. Patients love to see their hard work pay off. It keeps them engaged and working with their clinician toward their goals,” says Dieter. “Patients also feel more confident when they know someone is regularly monitoring their mobility and is making decisions based on their current status.”

Gait analysis is proving to be a vital tool in elderly health care, offering insights into overall health, frailty status and early signs of disease processes. With the help of novel technology, we’re now able to capture gait and mobility beyond mere observational analysis. For the elderly population, maintaining mobility and preventing falls are paramount, and thorough gait analysis serves as a key indicator and predictor of these outcomes. As we continue to recognize the importance of gait as the sixth vital sign, we’re witnessing a healthcare delivery transformation—a shift towards a more proactive and effective approach—that has the potential to redefine the way we age and experience health care for the better.

References:

1. Veronese N, Stubbs B, Volpato S, et al. Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies. J Am Med Dir Assoc. 2018 Nov;19(11):981-988.e7. doi: 10.1016/j.jamda.2018.06.007.
2. Chastan N, Bair WN, Resnick SM, Studenski SA, Decker LM. Prediagnostic markers of idiopathic Parkinson’s disease: Gait, visuospatial ability and executive function. Gait Posture. 2019 Feb;68:500-505. doi: 10.1016/j.gaitpost.2018.12.039.
3. Collyer TA, Murray AM, Woods RL, et al. Association of Dual Decline in Cognition and Gait Speed With Risk of Dementia in Older Adults. JAMA Netw Open. 2022;2;5(5):e2214647.
4. Skillbäck T, Blennow K, Zetterberg H, et al. Slowing gait speed precedes cognitive decline by several years. Alzheimers Dement. 2022;18(9):1667-1676.