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Background Although some gait parameters from inertial sensors have been shown to be associated with important clinical issues, because of controversial results, it remains uncertain which parameters for which axes are clinically valuable. Following the idea that a comprehensive score obtained by summing various gait parameters would sensitively reflect declines in gait performance, we developed a scoring method for community-dwelling older adults, the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score). The aim of this study was to examine the internal consistency and the construct validity of this method. Methods In this cross-sectional study, the gait performance of 378 community-dwelling older people (mean age = 71.7 ± 4.2 years, 210 women) was assessed using inertial sensors attached to the heel and lower trunk. Participants walked along a 15-m walkway, and accelerations, angular velocity, and walking time were measured. From these data, walking speed, mean stride time, coefficients of variation of stride time and swing time, and autocorrelation coefficients and harmonic ratios of acceleration in vertical, mediolateral, and anteroposterior directions at the lower trunk were calculated. Scoring was performed based on quartile by gender (i.e., scored from 0 to 3) for each of the 10 gait parameters. The C-GAITS score was the sum of these scores (range: 0–30). Lower extremity strength, balance function, fall history, and fear of falling were also assessed. Results An exploratory factor analysis revealed that the C-GAITS score yielded four distinct factors explaining 57.1% of the variance. The Cronbach’s alpha coefficient was 0.77. A single linear regression analysis showed a significant relationship between total C-GAITS score and walking speed (adjusted R 2 = 0.28). Results from bivariate comparisons using unpaired t-tests showed that the score was significantly related to age (p = 0.002), lower extremity strength (p = 0.007), balance function (p

Background Fear of falling (FoF) is common in community-dwelling older adults. FoF and increased walking speed are associated with lower trunk oscillation during gait in older adults. We hypothesized that older adults with FoF would struggle to walk safely when instructed to walk faster than usual. Methods Participants included 260 community-dwelling older adults aged over 65 years (mean age = 71.9 ± 3.9 years) who were able to walk independently without an assistive device. Participants were instructed to walk along a 15-m smooth horizontal walkway at self-selected normal and fast gait speeds. During the middle 10 m of the walk, oscillation of the lower trunk and stride times were measured with two accelerometers. We examined associations between gait variables, including harmonic ratio (HR) in vertical, mediolateral (HR-ML) and anteroposterior (HR-AP) directions as indicators of smoothness of lower trunk oscillation, as well as stride time variability (STV) and FoF. Results Gait-speed- and STV- adjusted models showed that FoF was significantly associated with HR-ML in the normal-gait condition (HR-ML: β = - .135, p = .040), while FoF was significantly associated with HR-AP in the fast-gait condition (HR-AP: β = - .154, p = .017). Conclusions FoF-related changes in gait vary with gait speed. In older adults with FoF, lower trunk oscillation was less smooth in the lateral direction when they walked at their usual pace. In addition, lower trunk oscillation was also less smooth in the direction of travel when they walked at a faster pace than their usual walking speed.

Background The toe flexor muscles perform a crucial function to control foot movement and assist with propulsive force when walking. However, the association between toe flexor strength and spatio-temporal gait parameters is largely unknown. Spatiotemporal gait parameters represent gait characteristics, and are good measures of the functional status and degree of safe ambulation among community-dwelling older adults. Herein, we examined the association between the toe flexor strength and spatiotemporal gait parameters in community-dwelling older adults. Methods Ninety-three community-dwelling older people (mean age: 73.2 ± 4.2 years, 53 women) participated in this study. The strength of the toe flexor muscles was assessed using a toe strength measuring instrument and a strain gauge. The measurements were performed once on each foot, and the average of the right and left was used in the analysis. Gait analysis was performed on a 15-m walkway under usual- and fast-pace conditions. The medial 10-m walking time was measured and walking speed was calculated. Acceleration and angular velocity of the right heel were measured using a wireless miniature sensor unit and used to compute cadence, percent of swing time in gait cycle (%swing time), and stride length. Results In multiple regression analyses adjusted for age, sex, body height, body weight, and hand grip strength, no associations between toe flexor strength and spatiotemporal gait parameters at usual pace were found. Conversely, under the fast-pace condition, decreased toe flexor strength was significantly associated with slower walking speed (β = 0.22, p = 0.049), lower%swing time (β = 0.34, p = 0.009), and shorter stride length (β = 0.22, p = 0.011) after adjustment. Conclusion In community-dwelling older people, decreased strength of toe flexor was correlated with slower walking speed, shorter periods of single-limb support phase, and shorter stride length during fast-pace walking. These data provide further support for an important role of toe flexor muscles in walking. Electronic supplementary material The online version of this article (doi:10.1186/1743-0003-11-143) contains supplementary material, which is available to authorized users.