To map the literature on gait efficacy in community-dwelling older adults concerning its definitions, measurement methods, and associated factors.
This scoping review used Arksey and O’Malley’s five-stage methodological framework. The eligible studies include the population of older adults, concepts of gait efficacy as the focal point of the investigation, and context studies in community settings. PubMed, EMBASE, CINAHL, and APA PsycArticles databases were searched with a time limit until July 2024. Two review authors independently applied the selection criteria and extracted information systematically. Data were extracted and synthesized in a narrative format.
14 articles met the inclusion criteria, which gathered 8 cross-sectional studies, 3 randomized control trials, 2 longitudinal studies, and 1 Pre-test post-test design. Studies originated from diverse locations including the United States (n=8), Japan (n=3), England (n=2), and Germany (n=1). No paper explained the definition of gait efficacy. Measurements used were the Gait Efficacy Scale (n=5) and the Modified Gait Efficacy Scale (n=9). Key factors influencing gait efficacy included physical conditions (musculoskeletal issues such as osteoarthritis, leg, and back-related pain, walking ability, balance, steps, and exercise), and psychological aspects (self-efficacy and fear of falling). Furthermore, gait efficacy was found as predictor of various outcomes including physical activity, life-space mobility, gait quality, and functional limitations. One study highlighted that poor agility and walking endurance could predict future declines in gait efficacy.
This is the first review that identifies key factors associated with gait efficacy in older adults, suggesting its potential as a predictor of falls. The overlap between gait efficacy factors and known fall-related factors underscores its importance. The findings suggest comprehensive studies to dissect the interactions among these factors are necessary, aiming to bolster gait efficacy and thereby potentially mitigate fall risks.
This review supports the integrated approach to fall prediction that considers both physical and psychological dimensions, particularly highlighting the role of gait efficacy. These findings could be helpful for future researchers to develop fall prediction models that not only improve predictive accuracy but also substantially enhance the mobility and independence of older adults.
Older adults
Scoping review
