An exploration of step time variability on smooth and irregular surfaces in older persons with neuropathy.
BACKGROUND
Increased step time variability, particularly on an irregular surface, has been associated with impaired mobility function and a variety of diseases. However the biomechanical necessity, or advantage, of increasing step time variability has not been identified.


METHODS
We performed a secondary analysis of gait data previously obtained on 42 subjects age 50 or older with neuropathy who walked on smooth and irregular surfaces, the latter with and without three interventions (cane, ankle orthosis and wall touch) that provided frontal plane support.


RESULTS
Step time variability on smooth and irregular surfaces was most strongly associated with reduction in step length on the irregular surface as compared to the smooth. More specifically, the greater the decrease in step length on the irregular surface the greater the step time variability on both surfaces and the greater the increase in step time variability on the irregular surface. The increase in step length on the irregular surface afforded by the interventions coincided with a decrease in step time variability. The subjects did not simultaneously demonstrate increased step time variability and step width range on the irregular surface.


CONCLUSIONS
Among adults age 50 and older with neuropathy, increased step time variability is strongly associated with the need to shorten step length on an irregular surface. Therefore step time variability may be a marker for instability during single limb stance which necessitates rapidly placed, shortened recovery steps. Such steps may also offer the advantage of reducing extremes in lateral foot placement of the swing limb, and so assist in maintaining frontal plane stability.
Richardson
James K
JK
Department of Physical Medicine and Rehabilitation, University of Michigan, 325 East Eisenhower Parkway, Ann Arbor, MI 48108, United States. jkrich@umich.edu
Thies
Sibylle
S
Ashton-Miller
James A
JA
D000368:Aged; D000369:Aged, 80 and over; D003198:Computer Simulation; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis; D013997:Time Factors; D016138:Walking