Examining the Role of Fear of Falling on Gait Parameters and Short-Term Gait Adaptation in Older Adults

<b>Background</b>: Motor adaptation is a process where movements need to be modified in response to changes in the task, environment, or organism itself. Even a very short-term process of adaptation to different movement execution conditions leads to improvements in task performance. There is no information in the literature on whether such a gain would be present in older adults with different fear of falling levels (FoF). <b>Methods</b>: Thirty older adults with various FoF underwent short-term adaptive gait training on a treadmill. Participants' spatiotemporal and foot loading characteristics were assessed directly before and after stimulation in two walking conditions: with preferred speed, and in challenging conditions (maximum speed). <b>Results</b>: Correlation analysis revealed moderate-to-strong associations with fear (0.66-0.74) in a majority of spatiotemporal parameters, as well as in rear and forefoot loading (0.48-0.82). In more challenging conditions, observed associations were more pronounced; however, comparative analysis revealed that the correlation was significantly stronger only in stride length (<i>p</i> = 0.03), walking speed (<i>p</i> = 0.03), forefoot (<i>p</i> = 0.01), and rearfoot loading (<i>p</i> = 0.02). There was a marginal effect of adaptive training during walking with preferred speed, but in demanding conditions, results showed significant improvements in each fear level group. <b>Conclusions</b>: The correlation between fear and plantar loading during walking in older adults implies a more cautious foot roll-over pattern with increasing FoF. Results also suggest that the relationship between fear and detrimental gait changes scales to some extent with motor task difficulty. The data suggest preserved but possibly attenuated gait adaptability in highly fearful older adults.