The role of gender in gait analysis in the elderly

The purpose of this study was to identify gender-related differences in the gait of functionally independent elderly men and women when walking at self selected walking velocity (SSWV). A quantitative gait analysis was conducted on 59 men (mean age 75.7, SD 5.8, range 69-91 years) and 127 women (mean age 75.2, SD 4.9, range 68-91 years) who could walk independently, regarded themselves to be in good health, and were independent in terms of activities of daily living. The analysis was based on foot placements in the sagittal plane recorded using a video camera. ANO VA gender comparisons revealed significant differences (p -0.0013) in all phases of walking, step length, standing height and knee length, but no significant differences in walking speed. Women were found to take shorter steps at greater frequency than men to attain the same walking velocity. When phase and step length variables were normalized to a percent of each individuals stride time (phase variables) and knee height as a measure of stature (step lengths), there were no significant gender differences. These findings suggest that at SSWV gait differences in older persons are due to stature and not to gender, and that the use of norms which are gender based may be inappropriate. Thus, the gait of elderly men and women walking at SSWV may be analysed together, provided that the step length data are normalized to stature and phase data to stride time

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this