Don’ t overlook your shoes as a possible contributor to an unsteady gait. Ill-fitting shoes with no support can cause you to shuffle your feet. related to leg length: Tall people take longer steps at a slower cadence, and short people take shorter steps at a faster cadence. The appearance of deceleration is not due to cadence but to shorter steps as a person ages. u Double stance time. The length of time a person has both feet on the ground while walking can double with age. A person with a longer double stance time may look as if he or she is walking on ice. u Walking posture. An upright walking position is normal in healthy older adults, although some people may tilt their pelvis forward with an inward curve in the lower back( known as lumbar lordosis) because of tight hip-flexor muscles, weak abdominal muscles, and increased abdominal fat. u Joint motion. Because ankle flexibility may be
reduced, gait may change slightly as the back foot lifts off the ground when walking. Older adults also have a limited range of motion in the hips. Age-related gait changes can result from a general reduction in fitness, including stiffness, loss of limb strength, a declining sense of balance, and less lung and heart capacity. On average, people with stronger legs or more range of motion in their ankles and hips walk faster. Walking speed has been linked to overall health and life expectancy: Fast walkers( defined as 1 meter per second, or 2.5 mph, or more) are more likely to outlive slower walkers. And having to stop walking while talking is a predictor of future falls.
The fear of falling can cause a gait change. Called cautious gait, this change in gait occurs in older adults who have already taken a stumble or who have poor vision. A person with cautious gait may have exaggerated agerelated gait changes and walk with careful, wide-legged movements and minimal arm movement. If a cautious gait isn’ t corrected, and fear of falling becomes obsessive, it can lead to a phobic gait disorder in which a person becomes completely unable to walk.
ABNORMAL GAIT CHANGES
A sudden change in gait with no apparent cause is not normal and needs to be evaluated by a doctor right away. Often, however, gait changes are more subtle and develop gradually as a result of a chronic medical condition.
An abnormal gait is rarely due to one single factor. Most gait disorders involve multiple contributing factors. For example, it’ s not uncommon for one person’ s gait to be impaired by a combination of joint pain,
32 February 2018 HEALTH & NUTRITION