Maximum Step Length: Relationships to age and knee and hip extensor capacities

Background Maximum Step Length may be used to identify older adults at increased risk for falls. Since leg muscle weakness is a risk factor for falls, we tested the hypotheses that maximum knee and hip extension speed, strength, and power capacities would significantly correlate with Maximum Step Length and also that the “step out and back” Maximum Step Length [Medell, J.L., Alexander, N.B., 2000. A clinical measure of maximal and rapid stepping in older women. J. Gerontol. A Biol. Sci. Med. Sci. 55, M429–M433.] would also correlate with the Maximum Step Length of its two sub-tasks: stepping “out only” and stepping “back only”. These sub-tasks will be referred to as versions of Maximum Step Length. Methods Unimpaired younger (N = 11, age = 24[3] years) and older (N = 10, age = 73[5] years) women performed the above three versions of Maximum Step Length. Knee and hip extension speed, strength, and power capacities were determined on a separate day and regressed on Maximum Step Length and age group. Version and practice effects were quantified and subjective impressions of test difficulty recorded. Hypotheses were tested using linear regressions, analysis of variance, and Fisher’s exact test. Findings Maximum Step Length explained 6–22% additional variance in knee and hip extension speed, strength, and power capacities after controlling for age group. Within- and between-block and test–retest correlation values were high (>0.9) for all test versions. Interpretation Shorter Maximum Step Lengths are associated with reduced knee and hip extension speed, strength, and power capacities after controlling for age. A single out-and-back step of maximal length is a feasible, rapid screening measure that may provide insight into underlying functional impairment, regardless of age.