title: Identification of gait domains and key gait variables following hip fracture.
abstract: BACKGROUND
  Restoration of gait is an important goal of rehabilitation after hip fracture. Numerous spatial and temporal gait variables have been reported in the literature, but beyond gait speed, there is little agreement on which gait variables should be reported and which are redundant in describing gait recovery following hip fracture. The aims of this study were to identify distinct domains of gait and key variables representing these domains, and to explore how known predictors of poor outcome after hip fracture were associated with these key variables.
  
  
  METHODS
  Spatial and temporal gait variables were collected four months following hip fracture in 249 participants using an electronic walkway (GAITRite®). From the initial set of 31 gait variables, 16 were selected following a systematic procedure. An explorative factor analysis with oblique (oblimin) rotation was performed, using principal component analysis for extraction of factors. Unique domains of gait and the variable best representing these domains were identified. Multiple regression analyses including six predictors; age, gender, fracture type, pain, global cognitive function and grip strength were performed for each of the identified key gait variables.
  
  
  RESULTS
  Mean age of participants was 82.6 (SD = 6.0) years, 75 % were women, and mean gait speed was 0.6 (SD = 0.2) m/sec. The factor analysis revealed four distinct gait domains, and the key variables that best represented these domains were double support time, walk ratio, variability of step velocity, and single support asymmetry. Cognitive decline, low grip strength, extra capsular fracture and male gender, but not pain or age, were significant predictors of impaired gait.
  
  
  CONCLUSIONS
  This work proposes four key variables to represent gait of older people after hip fracture. These core variables were associated with known predictors of poor outcome after hip fracture and should warrant further assessment to confirm their importance as outcome variables in addition to gait speed.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, PO Box 8905, 7491, Trondheim, Norway. pernille.thingstad@ntnu.no.
authors.forename: Pernille
authors.initials: P
authors.lastname: Thingstad
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, PO Box 8905, 7491, Trondheim, Norway. thor@sutmap.com.
authors.forename: Thorlene
authors.initials: T
authors.lastname: Egerton
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, PO Box 8905, 7491, Trondheim, Norway. espen.ihlen@ntnu.no.
authors.forename: Espen F
authors.initials: EF
authors.lastname: Ihlen
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, PO Box 8905, 7491, Trondheim, Norway. kristin.taraldsen@ntnu.no.
authors.forename: Kristin
authors.initials: K
authors.lastname: Taraldsen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Rolf.Moe-Nilssen@uib.no.
authors.forename: Rolf
authors.initials: R
authors.lastname: Moe-Nilssen
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, PO Box 8905, 7491, Trondheim, Norway. jorunn.helbostad@ntnu.no.|Department of Clinical Services, St. Olav University Hospital, Trondheim, Norway. jorunn.helbostad@ntnu.no.
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D006801:Humans; D008297:Male; D053580:Muscle Strength; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D004856:Postural Balance; D011379:Prognosis; D000066768:Rehabilitation Research; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology / Q000523:psychology