Lower extremity muscle performance associated with community ambulation in elderly fallers

Background. Knowing lower extremity muscle groups associated with community ambulation functions is important for developing physical disability prevention/intervention programmes for older adults experiencing falls. We aimed to identify lower extremity muscle groups significantly associated with walking endurance, walking speed, and stepping performance among community-dwelling elderly fallers. Methods. 17 male and 25 female community-dwelling older persons (mean age, 76 years) with at least one fall in the previous year were recruited. Mobility was measured by distance walked in 5 minutes (meters), fast walking speed (m/s), and time to step up and down a curb 5 times (step/s). Isometric muscle strength of bilateral hip flexors and extensors and knee extensors were measured by a handheld dynamometer and standardised by body mass index. The functional strength of bilateral ankle plantar flexors was measured by the heel-rise test. Results. The ankle plantar flexor strength was significantly associated with walking endurance, gait speed, and stepping performance, accounting for 42% to 57% of the variance. Conclusions. The functional strength of plantar flexors is an important determinant of ambulation capacity in community-dwelling elderly fallers. This finding has clinical implications for effective prevention or intervention for older adults experiencing falls.