Assessing Dual Task Gait Asymmetries in Older Adults Using Wireless Instrumented Shoe Insoles

Gait asymmetries have been suggested to be indicators of pathology. Walking while simultaneously completing a secondary cognitive task, or dual task, has been found to alter gait parameters such as stride time and stride length in aging populations. Gait asymmetries are commonly exacerbated in older adults under dual task conditions as attention is diverted away from walking. Although clinically relevant, assessing gait biomechanics outside of traditional laboratory settings can be challenging, but is possible using lightweight wireless sensors. Purpose: Our aim was to assess the influence of a cognitive load on gait asymmetries in older adults using wireless instrumented shoe insoles. Methods: Thirteen participants, six females and seven males (age: 78.3 ± 7.1 years, BMI: 27.1 ± 6.6 kg/m2) participated in the study. Participants were fitted with OpenGo 16-pressure sensor insoles with embedded inertial measurement units in each shoe (Moticon GmbH, Munich, Germany). Participants completed five overground walking conditions, spanning 7 meters in distance: (1) self-paced walking, (2) walking while verbally stating as many animals as possible, (3) walking while spelling the word “world” backwards, (4) walking while counting backwards from 100 by 7s, and (5) walking while balancing a cup full of water on an opaque tray in their dominant hand. We calculated stride time and stride length asymmetry while excluding the initial and final steps of each condition. Gait asymmetries relative to the self-paced walking condition were evaluated among dual task gait conditions using a one-way ANOVA. Results: We did not observe statistically differences among dual task walking conditions based on stride time asymmetry (F(3) = 1.3, p = 0.30), and length asymmetries (F(3) = 0.5, p = 0.65). CONCLUSION: Our approach to measure dual task walking conditions using instrumented in-shoe insoles with minimal participant preparation or recording equipment is a promising approach that can be used in larger trials. Future assessments of step width asymmetry and variability should be considered given the importance of mediolateral balance during overground walking.