Clinical utility of gait stability measures: Selection and preliminary evaluation of the margin of stability

Abstract

Introduction: gait-related falls account for most falls in the elderly. The identification of individuals at risk of falling due to unstable gait requires clinically feasible measures that can detect impairments in gait. Our obiective was to : (1) assess the feasibility for clinical implementation of existing gait stability measures and selected measures to detect gait impairments. Methods: Nine measures were assessed for clinical feasibility, with only the margin of stability(MOS) being selected for evaluation. Ground reactions and motion of the lower body were recorded in fifteen non-disabled and three disabled participants during treadmil walking. Media-lateral MOS was calculated and compared between the non-disabled and disabled participants to evaluate its ability to detect gait impairments. Results: MOS values at heel strike(HS) and at the point between HS and contralateral toe-off with minimum MOS deviated between participants with lower limb impaiments and non-disabled participants. Conclusion: MOS at HS demonstrated the greatest potential to assess fall risk. Additional work is required before MOS can be recommanded for clinical use.

Keywords

• falls gait stability
• margin of stability
• clinical assessment
• ground reactions
• lower body kinematics