Age and sex differences in normative gait patterns

BACKGROUND: A comprehensive understanding of healthy gait patterns is a critical first step towards understanding age-related pathologies and disorders that are commonly associated with mobility limitations throughout aging. Further, consideration of sex-specific gait patterns throughout the lifespan is important, considering biological differences between males and females that can manifest biomechanically, and epidemiological evidence of female sex being a risk factor for some age-related pathologies such as osteoarthritis. RESEARCH QUESTION: The aim of this study was to characterize the differences in lower extremity joint kinematics and kinetics during gait between asymptomatic adult women and men in different age groups (20-40 years, 41-50 years, 51-59 years, 60+ years). METHODS: This was a secondary analysis conducted on instrumented gait data from 154 asymptomatic adult participants (94 females, 60 males). Three-dimensional hip, knee and ankle joint angles and net external moments were calculated and waveform principal component analysis (PCA) was applied to extract major patterns of variability from each. PC scores were examined for significant sex, age and interaction effects using a two-factor ANOVA analysis (p = 0.001). RESULTS: 13 PC features differed between asymptomatic male and female gait patterns, and were independent of age category. No PC features significantly differed between the age groups, and there were no significant sex by age interactions. SIGNIFICANCE: There are significant magnitude and pattern differences in hip, knee and ankle kinematics and kinetics between asymptomatic women and men. As study participants were asymptomatic, these differences do not necessarily correlate with any injury or disease mechanisms. However, these results do suggest the importance of considering sex-specific analyses in gait study design, and the use of sex-specific normative data in clinical gait studies. These results further suggest that consideration of strict age-matching for gait analysis studies using adult controls is not as critical as sex considerations.