Hip osteoarthritis (OA) affects the entire joint and significantly alters gait. Assessing gait through a single trunk inertial measurement unit (IMU) in clinical settings offers a more practical alternative to complex laboratory settings, allowing for the capture of natural gait movements with valuable biomechanical insights. We evaluated (1) whether gait quality differs between individuals with hip OA and healthy controls during habitual and fast walking, (2) whether gait changes from habitual to fast walking differ between groups. Forty individuals with hip OA and 40 age-matched healthy controls underwent 25-m habitual walk and 40-m fast walk. Six gait quality parameters—step symmetry, stride symmetry, stability, smoothness, regularity, and complexity—were analyzed from the IMU signals. During habitual walking, individuals with hip OA exhibited reduced symmetry and stability and several vertical impairments. During fast walking, individuals with hip OA continued to show reduced step symmetry and a more constrained gait in the mediolateral direction. Additionally, people with hip OA also showed limited adjustments when transitioning from habitual to fast walking, in contrast to the significant adjustments observed in healthy controls. These findings indicate that gait in individuals with hip OA is impaired during habitual and fast walking, with limited adaptations across the transition between the two conditions.

Age-related changes in walking are often evaluated using performance-based measures, but little is known about how trunk-derived gait quality changes across healthy adulthood during habitual walking. This study examined gait quality using a single inertial measurement unit positioned at the lower back to record acceleration and angular velocity signals during approximately 5 min of continuous self-selected overground habitual walking in healthy adults across multiple age groups spanning adulthood. Step and stride symmetry were derived from trunk acceleration autocorrelation, local dynamic stability was quantified using the maximum Lyapunov exponent, and smoothness was derived from trunk angular velocity. Associations with age were evaluated, and additional analyses examined whether hip muscle strength and physical activity contributed to inter-individual variation in these gait measures. Age was associated with lower step symmetry and reduced local dynamic stability, whereas smoothness showed more limited age-related changes. Hip extensor and internal rotator strength explained additional variance in specific gait quality measures, while physical activity showed limited associations. These findings indicate that a single lower-back IMU can detect subtle age-related differences in interpretable gait quality during habitual walking across adulthood.