FEATURE PATIENT CARE Aging and gait Life and longevity part 7 W by dr . don fitz -ritson , dc DR. DON FITZ-RITSON is a chiropractor and a rehab specialist. He was an Assistant Professor at CMCC. He published 17 papers and 3 chapters on chiropractic. He co-invented a laser and it received 7 Health Canada Approvals. He is focused on helping the aging population live better lives. 20 Chiropractic and Naturopathic Doctor July/August 2021 www.Cndoctor.ca Photo: Andrey Bandurenko / Adobe Stock e all take gait for granted, but it is a complex activity which essentially affects our health, our functional abilities and our sense of who or what we are. Can you imagine your life without gait? We need to first become aware of this gift – called gait -understand and nurture it, so that it serves us even when we are 100 years old. What causes our gait to change, when does it begin, what areas of our body are most affected and how do we prevent decline which we have come to accept as part of the aging process? As we understand more factors regarding what it is and how gait is controlled, we’ll gain insight on how to nurture and keep our gait at optimal levels, so we can enjoy life as we age. An in depth assessment with equipment is necessary by a Chiropractor or Physical Therapist. To begin, here is a review of some of the basic components of gait. A human walking cycle has two main phases: Stance phase and Swing phase. During stance time the foot is on the ground and represents about 60% of the gait cycle. The swing period constitutes approximately 40% of the gait cycle and describes the period when the foot is not in con-tact with the ground.(1) Parameters such as foot placement, step length, step width, velocity and limb angles, must be considered along with muscle involvement for everything mentioned above. Once you include muscles, the Nervous System comes into play for muscle contraction, strength, sequencing, co-ordination, balance and posture. No wonder gait is so complex! Physiological changes in the Nervous System and body are altered with aging and these changes affect the gait pattern. Reduced walking speed is the most consistent age-related change, but there are other contributors to an altered gait including impaired balance and stability, lower extremity strength, and the fear of falling.(2) According to the WHO, limited physical activity (gait), is the fourth most common premature death risk factor in the world. Physical activity and gait has a positive effect on the quality of life and cognitive functions of the elderly.(3) LOWER LIMB It would be helpful if there was an identified age of major gait decline, because this would allow for timely preventable interventions to occur, as lower gait velocities are associated with falls, decreased mobility, frailty and death. A study looked at a large sample of women and found that gait de-cline began at 65 and peaked with major declines at 71 years. (4). This article will review factors that affect the entire body, beginning from the feet and moving up to the brain. With advancing age, there is a general tendency for the body and especially the feet to exhibit increased soft tissue stiffness, decreased range of motion, decreased strength and in the feet a more pronated posture. Pronated feet will re-duce joint mobility and function, making them less efficient for propulsion when walking.(5), and a study showed that foot disorders currently affect between 71 and 87% of older
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