Principal Component Analysis of Gait Continuous Relative Phase (CRP): Uncovering Lower Limb Coordination Biomarkers for Functional Disability in Older Adults

Symmetry in gait coordination reflects the balanced timing and movement between lower limb joints, which are essential for efficient locomotion and functional independence in older adults. Although gait coordination is recognized as a key indicator of aging-related adaptations and functional decline, most studies rely on isolated measures without fully addressing symmetry in intra- and interlimb coordination. This study aimed to identify principal components of gait coordination symmetry and their association with functional disability in older adults. A cross-sectional study assessed 60 community-dwelling older adults (60+), stratified by functional disability (35 non-disabled; 25 disabled). The three-dimensional range of motion of lower limb joints was assessed during the gait cycle using an optoelectronic system. Intra- and intersegmental coordination was assessed by the continuous relative phase (CRP), a nonlinear measure that captures both timing and movement relationships between joint angles. Principal component analysis was applied to CRP means and coefficients-of-variation (CV) to identify key coordination principal components (PC). Of eight PC explaining 78.86% of variance, only the PC1 distinguished disability status (p = 0.007, d = 0.66). This component included sagittal-plane intrasegmental CRP mean and CV for the knee–ankle and hip–ankle. This study is novel in combining CRP-derived measures of intra- and interlimb symmetry with principal component analysis to distinguish functional disability in older adults. The findings indicate that sagittal-plane intrasegmental CRP symmetry may serve a relevant biomarker of gait impairment. By linking kinematic coordination features to functional disability, this approach complements clinical assessments and supports early identification of mobility decline in older adults.