Mirjam Pijnappels – Abstract

Adaptive, reactive and daily life gait in older populations.

Pijnappels, M
Department of Human Movement Sciences, Amsterdam, Netherlands

I am delighted to present at the First International Motor Impairment Conference in Sydney on adaptive, reactive and daily life gait in older populations.

I will give an overview of key areas of my research interests by presenting examples from experimental studies on expected and unexpected perturbations, as well as on ambulant gait quality measures derived from daily life activities with inertial sensors.

By attending my session, you will learn more about how adaptive, reactive and daily life gait measures discriminate between older persons with and without a risk of falling, but also have potential for monitoring quality of gait in more frail or patient populations.

I look forward to seeing you at the First International Motor Impairment Conference in Sydney, Australia this November 2018.

In our previous work at the department of Human Movement Sciences, we studied motor impairments by measuring adaptive and reactive responses of older adults to gait perturbations in experimental settings (e.g. tripping over obstacles), and showed that these discriminate fallers from non-fallers1. In addition, we investigated older adults’ gait behaviour in daily settings by ambulant measurements with accelerometry and found that daily gait quality characteristics (e.g. stability and variability measures) contribute to predicting future falls2,3. Despite the fact that motor and balance impairments increase the risk of falling; we noticed that older individuals do not always match their motor behaviour with their actual motor abilities. Such misjudgement might lead to inappropriate behaviour and therefore possibly falls or inactivity. In this presentation, I will extend on our previous work by giving some examples of studies in which we compared adaptive, reactive and daily life gait, in order to show matches between what people can do, think they can do and actually do. I will give an example of a expected and unexpected stepping down paradigm4, and on standardized versus distribution of daily life gait speed5. Future studies are needed to see whether such mismatches between actual and perceived motor abilities will lead to falls in daily life situations.

  1. Pijnappels M, Reeves ND, Maganaris CN, van Dieën JH. Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly. J Electromyogr Kinesiol, 2008; 18(2), 188-196.
  2. van Schooten KS, Pijnappels M, Rispens SM, Elders PM, Lips P, Daffertshofer A, Beek PJ van Dieën JH. Daily-life gait quality as predictor of falls in older people: a 1-year prospective cohort study. PlosONE 2016; 11(7).
  3. van Schooten KS, Pijnappels M, Rispens SM, Elders PM, Lips P, van Dieën JH. Ambulatory fall-risk assessment: Amount and quality of daily life gait predict falls in older adults. J Gerontol A Biol Sci Med Sci 2015; 70(5):608-15.
  4. Kluft N, Bruijn SM, van Dieën JH, Pijnappels M. Do older adults select appropriate motor strategies in a stepping down paradigm? Front. Physiol. 2018; 9:1419.
  5. van Ancum J, van Schooten KS, Jonkman NH, Huijben B, van Lummel RC, Meskers CGC, Maier AB, Pijnappels M. Gait speed assessed by a 4-meter walk test is not representative of daily-life gait speed in community-dwelling adults. Under revision.