Are the Spatio-temporal Parameters of Gait Capable of Distinguishing a Faller from a Non-faller Elderly?

Fall is a common and a major cause of injuries. It is important to find elderlies who are prone to falls. The majority of serious falls occur during walking among the older adults. Analyzing the spatio-temporal parameters of walking is an easy way of assessment in the clinical setting, but is it capable of distinguishing a faller from a non-faller elderly? Through a systematic review of the literature, the objective of this systematic review was to identify and summarize the differences in the spatio-temporal parameters of walking in elderly fallers and non-fallers and to find out if these parameters are capable of distinguishing a faller from a non-faller. All original research articles which compared any special or temporal walking parameters in faller and non-faller elderlies were systematically searched within the Scopus and Embase databases. Effect size analysis was also done to standardize findings and compare the gait parameters of fallers and non-fallers across the selected studies. The electronic search led to 5381 articles. After title and abstract screening 30 articles were chosen; further assessment of the full texts led to 17 eligible articles for inclusion in the review. It seems that temporal measurements are more sensitive to the detection of risk of fall in elderly people. The results of the 17 selected studies showed that fallers have a tendency toward a slower walking speed and cadence, longer stride time, and double support duration. Also, fallers showed shorter stride and step length, wider step width and more variability in spatio-temporal parameters of gait. According to the effect size analysis, step length, gait speed, stride length and stance time variability were respectively more capable of differentiating faller from non-faller elderlies. However, because of the difference of methodology and number of studies which investigated each parameter, these results are prone to imprecision. Spatio-temporal analysis of level walking is not sufficient and cannot act as a reliable predictor of falls in elderly individuals.