Transitioning to a narrow path: The impact of fear of falling in older adults

Background: Everyday ambulation requires navigation of variable terrain, transitions from wide to narrow pathways, and avoiding obstacles. While the effect of age on the transition to a narrow path has been examined briefly, little is known about the impact of fear of falling on gait during the transition to a narrow path. The purpose was to examine the effect of age and fear of falling on gait during transition to a narrow path. Methods: In 31 young, mean age = 25.3 years, and 30 older adults, mean age = 79.6 years, step length, step time, step width and gait speed were examined during usual and transition to narrow pathway using an instrumented walkway. Findings: During the transition to narrow walk condition, fearful older adults compared to young had a wider step width (0.06 m vs 0.04 m) prior to the narrow path and took shorter steps (0.53 m vs 0.72 m; p < 0.001). Compared to non-fearful older adults, fearful older adults walked slower and took shorter steps during narrow path walking (gait speed: 1.1 m/s vs 0.82 m/s; p = 0.01; step length: 0.60 m vs 0.47 m; p = 0.03). In young and non-fearful older adults narrow path gait was similar to usual gait. Whereas older adults who were fearful, walked slower (0.82 m/s vs 0.91 m/s: p = 0.001) and took shorter steps (0.44 m vs 0.53 m; p = 0.004) during narrow path walking compared to usual walking. Interpretation: Changes in gait characteristics with transitioning to a narrow pathway were greater for fear of falling than for age. (C) 2011 Elsevier B.V. All rights reserved.