Falls and gait characteristics among older persons with peripheral neuropathy

Objective: To prospectively determine the frequency and circumstances of falls In older persons with peripheral neuropathy and to identify gait characteristics on smooth and irregular surfaces associated with falls in this same population. Design: This was a descriptive and observational study of a prospective group cohort. Spatial and temporal gait measures on smooth and irregular surfaces, as well as basic demographic and clinical data, were obtained in 20 older persons with peripheral neuropathy. Falls and fall-related injuries were then prospectively determined for 1 yr. Results: Thirteen of 20 (65%) subjects fell, and 6 of 20 (30%) subjects sustained a fall-related injury during the year of observation. Of the 76 reported falls, 69 (90.8%) were associated with a surface abnormality (irregular or slick). Gait measures on the smooth surface did not distinguish between fall groups. On the irregular surface, however, step-time variability tended to be higher for those subjects who fell than for those who did not (89 +/- 29 vs. 64 +/- 26 msecs, respectively; P = 0.077) and for those who were injured from a fall compared with those who were not injured (101 +/- 21 vs. 71 +/- 29 msecs, respectively; P = 0.038). Conclusions: Older patients with peripheral neuropathy have a high rate of falls, and these falls are often associated with walking on irregular surfaces. Gait analysis on an irregular surface may be superior to that on a smooth surface for detecting fall risk in this patient population.