# GAIT DISTURBANCES IN THE ELDERLY--INITIATION OF GAIT

> **NIH NIH R01** · SOUTHERN ILLINOIS UNIVERSITY SCH OF MED · 1992 · $107,690

## Abstract

Numerous neurological illnesses produce symmetrical disturbances of gait
that are characterized by stooped posture, increased time with both feet
on the floor, and decreased velocity, cadence, stride, foot-floor
clearance, and arm swing.  Locomotion becomes hesitant and defensive.
Many patients exhibit particular difficulty with initiation of gait, such
that their feet appear to stick to the floor when they stand and attempt
to walk (start hesitation).  Only a few studies of gait initiation have
been performed in normal people, and the neurophysiological mechanisms of
start hesitation have been the subject of only a few reports.  Start
hesitation is particularly common in patients with Parkinson disease and
diseases that affect the frontal lobes (e.g., Binswanger disease and
normal pressure hydrocephalus), but may be seen in other conditions
(e.g., Alzheimer disease).  Multiple mechanisms of start hesitation are
therefore assured, but there are few clinical tools for deciphering these
mechanisms in a particular patient.  Rapid gait initiation consists of a
sterotyped sequence of postural shifts that propel the body into forward
motion.  These postural shifts are produced by patterns of muscle
activity in the lower extremities that resemble the patterns associated
with voluntary and involuntary postural sway about the ankles.  Impaired
cognition, insufficient postural control, inability to perform skilled
sequential movements, and impaired integration of postural control and
movement are all possible mechanisms of start hesitation that we propose
to explore in a series of neurophysiological experiments in
neurologically healthy young and older people, patients with
Alzheimer,disease, and patients with Parkinson disease.  These
experiments will use choice reaction time paradigms, computer-controlled
infra-red stroboscopic cameras, floor-mounted force plates, and
electromyography to examine the kinematics and electromyographic patterns
of 1) gait initiation, 2) involuntary and voluntary postural sway, 3)
anticipatory postural activity associated with voluntary movement of the
upper extremities, and 4) the execution of stepping movements while
sitting in a chair.  Since many patients with start hesitation exhibit a
combination of dementia and parkinsonian features, the data from our
Alzheimer and Parkinson patients will be used as standards for comparison
with data from elderly patients with other neurological conditions.  This
work will be useful in the design of rehabilitative programs and in
deciphering the pathophysiology of impaired locomotion in older people.

## Key facts

- **NIH application ID:** 3122799
- **Project number:** 1R01AG010837-01
- **Recipient organization:** SOUTHERN ILLINOIS UNIVERSITY SCH OF MED
- **SAM.gov UEI:** NKVZTLYHXJJ7
- **Principal Investigator:** Rodger Elble
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1992
- **Award amount:** $107,690
- **Award type:** 1
- **Project period:** 1992-09-01 → 1997-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3122799

## Citation

> US National Institutes of Health, RePORTER application 3122799, GAIT DISTURBANCES IN THE ELDERLY--INITIATION OF GAIT (1R01AG010837-01). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3122799. Licensed CC0.

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