Falls in the healthy elderly: predisposing causes.
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Biomedical subjects
Publications and source records attributed to A Gabell.
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The intercycle variability in gait of two temporal parameters (stride time and double-support time) and the step-to-step variability of two spatial parameters (step length and stride width) were assessed in 64 healthy adults, 32 aged 21 to 47 and 32 aged 66 to 84. For all parameters the median values of the coefficient of variation did not differ significantly between the two groups. They were below 6% for step length and stride time but much higher for stride width and double-support time (between 17 and 27%). These differences in variability are discussed in relation to the control systems involved. Step length and stride time are thought to be determined predominantly by the gait-patterning mechanism, whereas stride width and double-support time may be determined predominantly by balance-control mechanisms. The results suggest that, in both age groups, the gait-patterning mechanisms are more consistent in their operation than are the balance-control mechanisms and that increased variability in gait should not be regarded as a normal concomitant of old age.
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Assessment of old people in a gait laboratory requires consideration of certain problems which in younger people either do not arise or are of lesser importance. The problems relate to the apparatus used, the footwear worn and the gait to be observed. These matters are discussed and solutions offered.
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Three age- and symptom-matched groups of patients with a hypermobility score of 5-9, 3-4, and 0-2 (controls), respectively, were examined for clinical and echocardiographic evidence of mitral valve prolapse and other stigmata of a collagen disorder. Mitral valve prolapse, a reduced upper segment/lower segment mitral ratio, reduced skin thickness, spinal anomalies, and a history of fracture were found to be significantly commoner among the hypermobile patients than the controls. The data suggest that the so-called hypermobility syndrome, far from being a benign locomotor disorder of healthy persons, may be a forme fruste of a hereditary disorder of connective tissue.