scholarly journals WEARABLES REVEAL A GAP BETWEEN GAIT PERFORMANCE IN THE LAB AND DURING 24/7 MONITORING IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S335-S335
Author(s):  
Inbar Hillel ◽  
Laura Avanzino ◽  
Andrea Cereatti ◽  
Marcel Olde Rikkert ◽  
Silvia Del Din ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Daily Living ◽  
Laboratory Setting ◽  
Gait Performance ◽  
Lower Back ◽  
Gait Features

Abstract We compared in-lab usual-walking (UW) and dual-task walking (DTW) to daily-living measures of gait obtained during 24/7 monitoring. In-lab gait features (e.g., gait speed, step and stride regularity) derived from UW and DTW were compared to the same gait features during daily-living in 150 elderly fallers (age: 76.5±6.3 years, 37.6% men). Features were extracted from a lower-back accelerometer. In daily-living setting, subjects wore the device for one week and pre-processing detected 30-second walking bouts. A histogram of all walking bouts was determined for each walking feature for each subject, then each subject’s typical, worst and best values were determined. Statistics of reliability were assessed using ICC and Bland-Altman. As expected, in-lab gait speed, step regularity, and stride regularity were worse during DTW, compared to UW. Gait speed, step regularity, and stride regularity during UW were significantly higher (i.e., better) from the typical daily-living values (p<0.0001) and different (p<0.000) from the worst and best values. DTW values tended to be similar to typical daily-living values (p=0.205, p=0.053, p=0.013 respectively). ICC assessment and Bland-Altman plots indicated that in-lab values do not reliably reflect the daily-walking values. Gait values during relatively long daily-living walking bouts are more similar to the corresponding values obtained in the lab during DTW, as compared to UW. Still, gait performance during most daily-living walking bouts are worse than that measured in-lab and do not reliably reflect each other. That is, an older adult’s typical daily-living gait cannot be estimated by simply measuring walking in a structured, laboratory setting.

scholarly journals Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 287-288
Author(s):  
Jeffrey Hausdorff ◽  
Nofar Schneider ◽  
Marina Brozgol ◽  
Pablo Cornejo Thumm ◽  
Nir Giladi ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Executive Function ◽  
Dual Task ◽  
Gait Speed ◽  
Negative Impact ◽  
Virtual Reality Environment ◽  
Dual Tasking ◽  
Concurrent Performance ◽  
Dual Task Cost

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p<0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p>0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

scholarly journals The Benefits of Physical Activity in Individuals with Cardiovascular Risk Factors: A Longitudinal Investigation Using fNIRS and Dual-Task Walking

2021 ◽  
Vol 10 (4) ◽  
pp. 579
Author(s):  
Deborah Talamonti ◽  
Thomas Vincent ◽  
Sarah Fraser ◽  
Anil Nigam ◽  
Frédéric Lesage ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cognitive Performance ◽  
Dual Task ◽  
Gait Speed ◽  
Regular Physical Activity ◽  
Cortical Response

Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

Gerontology ◽  
2018 ◽  
Vol 65 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Frederico Pieruccini-Faria ◽  
Yanina Sarquis-Adamson ◽  
Manuel Montero-Odasso
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Gait Speed ◽  
Step Length ◽  
Gait Control ◽  
Dual Tasking ◽  
Brain Study

Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

Dual-task gait speed assessments with an electronic walkway and a stopwatch in older adults. A reliability study

2020 ◽  
Vol 142 ◽  
pp. 111102
Author(s):  
M. Montero-Odasso ◽  
Y. Sarquis-Adamson ◽  
N. Kamkar ◽  
F. Pieruccini-Faria ◽  
N. Bray ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Reliability Study

Bingocize®: Utilizing a mobile application to improve gait in community-dwelling older adults

2018 ◽  
Vol 17 (2) ◽  
pp. 9
Author(s):  
Dustin Falls, MS ◽  
Matthew Shake, PhD ◽  
Elizabeth Norris, PhD, PT, OCS ◽  
Scott Arnett, PhD, CSCS,*D ◽  
Jenn Taylor, MS, CTRS ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Gait Speed ◽  
Independent Living ◽  
Mixed Model ◽  
Community Dwelling ◽  
Health Promotion Program ◽  
Post Intervention ◽  
Gait Performance ◽  
Community Dwelling Older Adults

Physical activity (PA) can improve older adults’ gait performance and decrease fall risks, yet adherence to PA programs is low. The purpose of this study was to evaluate the efficacy of a game-centered mobile health promotion application (app) to improve gait performance in community-dwelling older adults. Participants (N = 38; age 72.42 ± 12.58) from four independent living facilities were randomly assigned to experimental (n = 20; app with exercise) or control (n = 18; app without exercise) conditions. Each condition completed a 10-week intervention using an inclusive evidence-based health promotion program that combines bingo and exercise, Bingocize®. The investigators collected baseline/post gait assessments 1 week prior and 1-week post intervention. Data were analyzed using a mixed-model ANOVA (p < 0.05). There were no main effects; however, significant interactions (group × time) were observed, and interactions for gait speed (>5 cm/s) were observed in the experimental condition. Research supports this increase as a meaningful clinical change in gait speed, which may potentially reduce the risk of falls.

Cognitive Reserve Moderates Associations Between Walking Performance Under Single and Dual-Task Conditions and Incident Mobility Impairment in Older Adults

2021 ◽  
Author(s):  
Catherine O’Brien ◽  
Roee Holtzer
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Cognitive Reserve ◽  
Mobility Impairment ◽  
Gait Performance ◽  
Increased Risk ◽  
Wide Range ◽  
Walking Performance ◽  
Incident Cases

Abstract Background Among older adults, walking performance is a reliable indicator of adverse health outcomes including incident mobility impairment. Whereas, attention and executive functions have been implicated in cognitive control of locomotion, much less is known about the role of Cognitive Reserve (CR) in predicting mobility impairments among older adults. Specifically, whether CR moderates the relationship between gait performance and incident mobility impairment, has not been reported. To address this gap in the literature, we examined whether gait performance under Single-Task-Walk (STW) and Dual-Task-Walk (DTW) conditions predicted incident mobility impairment and whether CR moderated this relationship. Methods Participants were 176 (mean age=75.57; %female=53) older adults with baseline SPPB scores of 10-12. Participants completed neuropsychological testing, the SPPB, and a dual-task walking protocol. CR was evaluated using the Wide Range Achievement Test 3 rd edition (WRAT-3). Participants were followed for three years; individuals whose SPPB scores declined below 10 were defined as incident cases of mobility impairment (n=42). Results Moderation analyses revealed significant interaction effects of CR with walking velocity under STW (b = 0.09, 95% CI [0.01, 0.17], z = 2.30, p = 0.02), and DTW (b = 0.10, 95% CI [0.02, 0.17], z = 2.55, p = 0.01) conditions wherein slower gait predicted increased risk of incident mobility impairment among individuals with lower CR. Conclusion These findings extend knowledge about the interrelation of cognitive and mobility functions, revealing the critical role of CR in identifying older adults at risk of developing incident mobility impairment.

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