Article

Turning during ambulation is a common movement in everyday life, but
complex and challenging for older adults. Balance control through trunk movement
provides a stable platform during walking, thus it is an essential component of
safe and efficient turning during walking in elderly individuals. OBJECTIVES: To
investigate the effects of balance control during square turning (ST) and
semicircular turning (SCT) on gait velocity, center of mass (COM) acceleration,
and energy expenditure in elderly women. DESIGN: Cross-sectional design. SETTING:
Village community center. PARTICIPANTS: Twenty community-dwelling elderly women
capable of independent walking were enrolled in the study. METHODS: Participants
walked at a self-selected speed along a marked path that included 2 types of
turns (the path was divided into 3 segments: straight, turning, and straight
return), while fitted with an accelerometer attached over the L3 spinous process.
MAIN OUTCOME MEASUREMENTS: Differences in gait velocity, normalized COM
acceleration, and energy expenditure were analyzed using paired t-tests for
comparisons between ST and SCT tasks and using a one-way repeated-measures
analysis of variance for within tasks. RESULTS: During the ST task, which was
characterized by the use of a less-stable balance maintenance strategy, gait
velocity and vertical COM acceleration were lower (P < .05), whereas greater
medial-lateral COM acceleration (P < .05) and energy expenditure (P < .001) were
observed during turning and return straight stages compared with the SCT task.
For both tasks, velocity during turning stage was the slowest, among the 3
stages, the straight stage was the fastest (P < .05). For the SCT task, the
anterior-posterior COM acceleration during the straight stage was significantly
higher than during the turning stage, and the vertical COM acceleration during
the straight stage was significantly lower than during the return-straight stage
(P < .05). In both tasks, the energy expenditure of the turning stage was
significantly higher than in the straight and return straight stage (P </= .001),
and in the return straight stage was higher than the straight stage-only ST task
(P < .05). CONCLUSIONS: We suggest that elderly individuals participate in
balance and gait training using a variety of turns, including turns requiring
medial-lateral and vertical COM balance control, to prevent falls and to improve
energy efficiency of walking. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS