Spatiotemporal and dynamic foot biomechanical parameters in older adults with balance disorders and a history of previous falls.

PURPOSE: Balance disorders increase fall risk in older adults, yet global gait parameters may lack sensitivity to detect subtle impairments. This study evaluates whether detailed spatiotemporal and plantar-pressure measures more effectively identify balance-related gait alterations. METHODS: Fifty-two older adults (55-82 years) were assigned to a balance disorders group (n = 26) or a control group (n = 26) based on fall history and Dizziness Handicap Inventory scores. Barefoot walking trials were recorded using a pedobarographic platform. Scalar spatiotemporal gait parameters and pressure-related signals were normalized to body height and body mass, respectively. Dynamic foot balance parameters were analyzed as time-normalized waveforms over the stance phase. Between-group and within-group comparisons were performed using conventional statistical methods and Statistical Parametric Mapping (SPM). RESULTS: No statistically significant between-group differences were found in global spatiotemporal gait parameters or in group-averaged mean and variability waveforms of dynamic foot balance measures. However, within-group SPM analyses presented stance-phase intervals with significant left-right asymmetries in selected dynamic foot balance parameters, occurring more frequently in participants with balance disorders. These asymmetries were parameter- as well as phase-specific and showed substantial inter-individual variability. CONCLUSIONS: Older adults with balance disorders may preserve overall gait characteristics during steady-state walking while exhibiting subtle, localized asymmetries in dynamic foot balance. Waveform-based plantar pressure analysis may capture balance-related gait alterations not detected by global gait measures, although the clinical relevance of these findings requires further investigation.