Effects of Visually Augmented Gait Training on Foot-Ground Clearance: An Intervention to Reduce Tripping-Related Falls

Minimum toe clearance (MTC similar to 10-30 mm) is a hazardous mid-swing gait event, characterized by high-foot velocity (similar to 4.60 m.s(-1)) and single-foot support. This experiment tested treadmill-based gait training effects on MTC. Participants were 10 young (4 males and 6 females) and 10 older (6 males and 4 females) healthy ambulant individuals. The mean age, stature, and body mass for the younger group was 23 (2) years, 1.72 (0.10) m, and 67.5 (8.3) kg, and for older adults was 77 (9) years, 1.64 (0.10) m, and 71.1 (12.2) kg. Ten minutes of preferred speed treadmill walking (baseline) was followed by 20 minutes with MTC information (feedback) and 10 minutes without feedback (retention). There were no aging effects on MTC in baseline or feedback. The MTC in baseline for older adults was 14.2 (3.5) mm and feedback 27.5 (8.7) mm, and for the younger group, baseline was 12.7 (2.6) mm and feedback 28.8 (5.1) mm, respectively. Retention MTC was significantly higher for both groups, indicating a positive effect of augmented information: younger 40.8 (7.3) mm and older 27.7 (13.6) mm. Retention joint angles relative to baseline indicated that the young modulated joint angles control MTC differently using increased ankle dorsiflexion at toe off and modulating knee and hip angles later in swing closer to MTC.