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Effect of dual-tasking on walking and cognitive demands in adults with Alzheimer's dementia experienced in using a 4-wheeled walker.

Identifieur interne : 000232 ( Main/Exploration ); précédent : 000231; suivant : 000233

Effect of dual-tasking on walking and cognitive demands in adults with Alzheimer's dementia experienced in using a 4-wheeled walker.

Auteurs : Susan W. Hunter [Canada] ; Humberto Omana [Canada] ; Edward Madou [Canada] ; Walter Wittich [Canada] ; Keith D. Hill [Australie] ; Andrew M. Johnson [Canada] ; Alison Divine [Royaume-Uni] ; Jeffrey D. Holmes [Canada]

Source :

RBID : pubmed:32044696

Descripteurs français

English descriptors

Abstract

BACKGROUND

Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.

RESEARCH QUESTION

What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?

METHODS

Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience participated. Three walking configurations: 1) straight path (SP), 2) Groningen Meander Walking Test (GMWT), and 3) Figure of 8 path (F8) were tested under two walking conditions: 1) single-task (walking with aid) and 2) dual-task (walking with aid and completing a cognitive task). Tri-axial accelerometers collected velocity, cadence and stride time variability (STV). Gait and cognitive task cost were the percentage difference between single-task and dual-task conditions. Two-way repeated measures ANOVAs were used to answer the study question.

RESULTS

A significant interaction between walking configuration and condition was found for velocity (p = 0.002, ω

SIGNIFICANCE

Dual-task testing in experienced users results in slower walking, fewer steps and increased STV, which increases falls risk in people with mild to moderate AD and becomes most pronounced in complex environments.


DOI: 10.1016/j.gaitpost.2020.01.024
PubMed: 32044696


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Alzheimer Disease (physiopathology)</term>
<term>Alzheimer Disease (psychology)</term>
<term>Cognition (MeSH)</term>
<term>Female (MeSH)</term>
<term>Gait (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
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<term>Walking (psychology)</term>
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<term>Déambulateurs (MeSH)</term>
<term>Démarche (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Maladie d'Alzheimer (physiopathologie)</term>
<term>Maladie d'Alzheimer (psychologie)</term>
<term>Marche à pied (psychologie)</term>
<term>Mâle (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Test de marche (MeSH)</term>
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<term>Marche à pied</term>
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<term>Alzheimer Disease</term>
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<term>Aged, 80 and over</term>
<term>Cognition</term>
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<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESEARCH QUESTION</b>
</p>
<p>What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience participated. Three walking configurations: 1) straight path (SP), 2) Groningen Meander Walking Test (GMWT), and 3) Figure of 8 path (F8) were tested under two walking conditions: 1) single-task (walking with aid) and 2) dual-task (walking with aid and completing a cognitive task). Tri-axial accelerometers collected velocity, cadence and stride time variability (STV). Gait and cognitive task cost were the percentage difference between single-task and dual-task conditions. Two-way repeated measures ANOVAs were used to answer the study question.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>A significant interaction between walking configuration and condition was found for velocity (p = 0.002, ω</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SIGNIFICANCE</b>
</p>
<p>Dual-task testing in experienced users results in slower walking, fewer steps and increased STV, which increases falls risk in people with mild to moderate AD and becomes most pronounced in complex environments.</p>
</div>
</front>
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<Month>11</Month>
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<Month>11</Month>
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<Abstract>
<AbstractText Label="BACKGROUND">Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.</AbstractText>
<AbstractText Label="RESEARCH QUESTION">What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?</AbstractText>
<AbstractText Label="METHODS">Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience participated. Three walking configurations: 1) straight path (SP), 2) Groningen Meander Walking Test (GMWT), and 3) Figure of 8 path (F8) were tested under two walking conditions: 1) single-task (walking with aid) and 2) dual-task (walking with aid and completing a cognitive task). Tri-axial accelerometers collected velocity, cadence and stride time variability (STV). Gait and cognitive task cost were the percentage difference between single-task and dual-task conditions. Two-way repeated measures ANOVAs were used to answer the study question.</AbstractText>
<AbstractText Label="RESULTS">A significant interaction between walking configuration and condition was found for velocity (p = 0.002, ω
<sup>2</sup>
 = 0.36), cadence (p = 0.04, ω
<sup>2</sup>
 = 0.15) and STV (p < 0.001, ω
<sup>2</sup>
 = 0.53). Velocity and cadence decreased and STV increased with increasing walking configuration complexity and upon dual-tasking. Dual-task gait and cognitive task cost deteriorated in all walking configurations, but gait was prioritized in the GMWT and F8 configurations. Despite familiarity, experienced walker users with AD exhibit impaired gait when walking in complex situations which increases falls risk. Upon dual-task, individuals with AD self-prioritized a posture-first strategy in complex configurations.</AbstractText>
<AbstractText Label="SIGNIFICANCE">Dual-task testing in experienced users results in slower walking, fewer steps and increased STV, which increases falls risk in people with mild to moderate AD and becomes most pronounced in complex environments.</AbstractText>
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<DescriptorName UI="D014853" MajorTopicYN="Y">Walkers</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016138" MajorTopicYN="N">Walking</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">Alzheimer disease</Keyword>
<Keyword MajorTopicYN="Y">Assistive devices</Keyword>
<Keyword MajorTopicYN="Y">Gait</Keyword>
<Keyword MajorTopicYN="Y">Multitasking behavior</Keyword>
<Keyword MajorTopicYN="Y">Walkers</Keyword>
</KeywordList>
<CoiStatement>Declaration of Competing Interest The authors have no conflict of interest to report.</CoiStatement>
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<Year>2019</Year>
<Month>07</Month>
<Day>26</Day>
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<Year>2020</Year>
<Month>01</Month>
<Day>08</Day>
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<PubMedPubDate PubStatus="accepted">
<Year>2020</Year>
<Month>01</Month>
<Day>24</Day>
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<PubMedPubDate PubStatus="pubmed">
<Year>2020</Year>
<Month>2</Month>
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<Year>2020</Year>
<Month>11</Month>
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<PubMedPubDate PubStatus="entrez">
<Year>2020</Year>
<Month>2</Month>
<Day>12</Day>
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<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="pubmed">32044696</ArticleId>
<ArticleId IdType="pii">S0966-6362(20)30053-9</ArticleId>
<ArticleId IdType="doi">10.1016/j.gaitpost.2020.01.024</ArticleId>
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<country>
<li>Australie</li>
<li>Canada</li>
<li>Royaume-Uni</li>
</country>
<region>
<li>Angleterre</li>
<li>Yorkshire-et-Humber</li>
</region>
<settlement>
<li>Leeds</li>
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<orgName>
<li>Université de Leeds</li>
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<name sortKey="Hunter, Susan W" sort="Hunter, Susan W" uniqKey="Hunter S" first="Susan W" last="Hunter">Susan W. Hunter</name>
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<name sortKey="Holmes, Jeffrey D" sort="Holmes, Jeffrey D" uniqKey="Holmes J" first="Jeffrey D" last="Holmes">Jeffrey D. Holmes</name>
<name sortKey="Johnson, Andrew M" sort="Johnson, Andrew M" uniqKey="Johnson A" first="Andrew M" last="Johnson">Andrew M. Johnson</name>
<name sortKey="Madou, Edward" sort="Madou, Edward" uniqKey="Madou E" first="Edward" last="Madou">Edward Madou</name>
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