Validation of a Measure of Smoothness of Walking

Background. Altered biomechanics and/or neural control disrupt the timing of postures and muscle patterns necessary for smooth and regular stepping. Harmonic ratio of trunk accelerations has been proposed as a measure of smoothness of walking. We sought to validate this measure of smoothness by examining the measure in groups expected to differ in smoothness (ie, young and old) and across walking conditions expected to affect smoothness (ie, straight path, curved path, and dual task). Methods. Thirty young (mean age = 24.4 +/- 4.3 years) and 30 older adults (mean age = 77.5 +/- 5.1 years) who could ambulate independently participated. We measured linear acceleration of the body along vertical, anterior-posterior, and medial-lateral axes using a triaxial accelerometer firmly attached to the skin over the L3 segment of the lumbar spine during straight path, curved path, and dual task (reciting every other letter of the alphabet) walking. Results. Older adults had lower harmonic ratio anterior-posterior (HR(AP)), that is, were less smooth in the direction of motion and walked more slowly than young adults for all walking conditions. Once the analyses were adjusted for walking speed, only HR(AP) differed between young and old participants for all walking conditions. For the most part, both young and old participants were less smooth for slow pace walking, curved path walking, and dual task walking compared with usual pace straight path walking. Conclusions. The harmonic ratio, calculated from trunk acceleration, is a valid measure of smoothness of walking, which may be thought of as a measure of the motor control of walking.