This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Older adults with 'high level gait disorders' have abnormal gait and an excessive fear of falling; however, clinical neuro-motor examination typically does not reveal any obvious underlying impairment. We are characterizing the changes in gait dynamics in this population compared to aged-matched controls and studying the effects of different interventions. These patients walk more slowly, with increased stride-to-stride variability and impaired gait dynamics. Many of these changes are associated with fear of falling. Of note, among the patients with high level gait disorders, about 50% reported falling. Fear of falling, gait speed, gait variability and many other measures were similar in those subjects who reported falling and those who did not. Of note, a fractal scaling index of gait was successful in discriminating between fallers from non-fallers. Ongoing work is directed at further assessing risk of falling in these elderly fallers with high level gait disorders, developing new techniques for quantitatively characterizing gait in these patients, determining the mechanisms responsible for the gait changes and fear of falling, and evaluating the effects of different interventions.
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