Shedding light on walking in the dark: the effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls

Kesler Anat, Leibovich Gregory, Herman Talia, Gruendlinger Leor, Giladi Nir, Hausdorff

Description

Objective To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD) and to compare their response to that of healthy elderly controls. Methods 22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens) and in near darkness (5 lumens). Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. Results Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. Conclusion Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients.

Sujets

• Gait
• Variability
• Vision
• Ageing
• Lighting

Informations

• Publié par: biomed
• Publié le: 01 janvier 2005
• Nombre de lectures: 10
• Langue: English

Extrait

Journal of NeuroEngineering and Rehabilitation

BioMedCentral

Open Access Research Shedding light on walking in the dark: the effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls 2 11,3 1 Anat Kesler, Gregory Leibovich, Talia Herman, Leor Gruendlinger, 1,3,4 1,3,5 Nir Giladiand Jeffrey M Hausdorff*

1 2 Address: MovementDisorders Unit, Department of Neurology, TelAviv Sourasky Medical Center, TelAviv, Israel,Department of 3 Ophthalmology, TelAviv Sourasky Medical Center, TelAviv, Israel,Department of Physical Therapy, Sackler School of Medicine, TelAviv 4 5 University, TelAviv, Israel,Department of Neurology, Sackler School of Medicine, TelAviv University, TelAviv, Israel andDivision on Aging, Harvard Medical School, Boston, MA, USA Email: Anat Kesler  [e-mail]; Gregory Leibovich  [e-mail]; Talia Herman  [e-mail]; Leor Gruendlinger  [e-mail]; Nir Giladi  [e-mail]; Jeffrey M Hausdorff*  [e-mail] * Corresponding author

Published: 28 August 2005Received: 05 April 2005 Accepted: 28 August 2005 Journal of NeuroEngineering and Rehabilitation2005,2:27 doi:10.1186/1743-0003-2-27 This article is available from: http://www.jneuroengrehab.com/content/2/1/27 © 2005 Kesler et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

gaitvariabilityvisionfall riskaginglightingHigherLevel Gait Disorders

Abstract Objective:To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD) and to compare their response to that of healthy elderly controls. Methods:22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens) and in near darkness (5 lumens). Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. Results:Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. Conclusion:Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients.

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