scholarly journals Dual-Task Does Not Increase Slip and Fall Risk in Healthy Young and Older Adults during Walking

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Rahul Soangra ◽  
Thurmon E. Lockhart
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Fall Risk ◽  
Step Length ◽  
Healthy Individuals ◽  
Healthy Older Adults ◽  
Gait Characteristics ◽  
Heel Contact ◽  
Fall Risks ◽  
The Relationship

Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants’ fall risks are modified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task walking have no destabilizing effect on gait and slip responses in healthy individuals. We also found that, during dual-tasking, healthy individuals adopted cautious gait mode (CGM) strategy that is characterized by reduced walking speed, shorter step length, increased step width, and reduced heel contact velocity and is likely to be an adaptation to minimize attentional demand and decrease slip and fall risk during limited available attentional resources. Exploring interactions between gait variability and cognitive functions while walking may lead to designing appropriate fall interventions among healthy and patient population with fall risk.

scholarly journals Normative Data for a Tablet-Based Dual-Task Assessment in Healthy Older Adults

2020 ◽  
Author(s):  
Maxime Lussier ◽  
Kathia Saillant ◽  
Tudor Vrinceanu ◽  
Carol Hudon ◽  
Louis Bherer
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Normative Data ◽  
Healthy Older Adults ◽  
Highly Educated ◽  
Coefficient Of Variability ◽  
French And English ◽  
Task Assessment ◽  
English Speaking ◽  
The Relationship

Abstract Objective The objective of this study is to provide normative data for a tablet-based dual-task assessment in older adults without cognitive deficits. Method In total, 264 participants aged between 60 and 90 years, French and English-speaking, were asked to perform two discrimination tasks, alone and concurrently. The participants had to answer as fast as possible to one or two images appearing in the center of the tablet by pressing to the corresponding buttons. Normative data are provided for reaction time (RT), coefficient of variation, and accuracy. Analyses of variance were performed by trial types (single-pure, single-mixed, dual-mixed), and linear regressions assessed the relationship between performance and sociodemographic characteristics. Results The participants were highly educated and a large proportion of them were women (73.9%). The accuracy on the task was very high across all blocks. RT data revealed both a task-set cost and a dual-task cost between the blocks. Age was associated with slower RT and with higher coefficient of variability. Men were significantly slower on dual-mixed trials, but their coefficient of variability was lower on single-pure trials. Education was not associated with performance. Conclusions This study provides normative data for a tablet-based dual-task assessment in older adults without cognitive impairment, which was lacking. All participants completed the task with good accuracy in less than 15 minutes and thus, the task is transferable to clinical and research settings.

scholarly journals Fall Risk in Older Adults Transitioning between Different Flooring Materials

Sci ◽  
2019 ◽  
Vol 1 (3) ◽  
pp. 63
Author(s):  
Hyung Kim ◽  
Thurmon Lockhart
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Whole Body ◽  
Contact Phase ◽  
Old Adults ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Heel Contact ◽  
Flooring Materials

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

scholarly journals Visual-Somatosensory Integration and Balance: Evidence for Psychophysical Integrative Differences in Aging

2014 ◽  
Vol 27 (1) ◽  
pp. 17-42 ◽  
Author(s):  
Jeannette R. Mahoney ◽  
Roee Holtzer ◽  
Joe Verghese
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Multisensory Processing ◽  
Reaction Times ◽  
The Elderly ◽  
Static Balance ◽  
Healthy Older Adults ◽  
Stance Time ◽  
Study Participants ◽  
The Relationship

Research detailing multisensory integration (MSI) processes in aging and their association with clinically relevant outcomes is virtually non-existent. To our knowledge, the relationship between MSI and balance has not been well-established in aging. Given known alterations in unisensory processing with increasing age, the aims of the current study were to determine differential behavioral patterns of MSI in aging and investigate whether MSI was significantly associated with balance and fall-risk. Seventy healthy older adults ( years; 58% female) participated in the current study. Participants were instructed to make speeded responses to visual, somatosensory, and visual-somatosensory (VS) stimuli. Based on reaction times (RTs) to all stimuli, participants were classified into one of two groups (MSI or NO MSI), depending on their MSI RT benefit. Static balance was assessed using mean unipedal stance time. Overall, results revealed that RTs to VS stimuli were significantly shorter than those elicited to constituent unisensory conditions. Further, the current experimental design afforded differential patterns of multisensory processing, with 75% of the elderly sample demonstrating multisensory enhancements. Interestingly, 25% of older adults did not demonstrate multisensory RT facilitation; a finding that was attributed to extremely fast RTs overall and specifically in response to somatosensory inputs. Individuals in the NO MSI group maintained significantly better unipedal stance times and reported less falls, compared to elders in the MSI group. This study reveals the existence of differential patterns of multisensory processing in aging, while describing the clinical translational value of MSI enhancements in predicting balance and falls risk.

scholarly journals Perturbation Training for Fall-Risk Reduction in Healthy Older Adults: Interference and Generalization to Opposing Novel Perturbations Post Intervention

2021 ◽  
Vol 3 ◽  
Author(s):  
Tanvi Bhatt ◽  
Yiru Wang ◽  
Shuaijie Wang ◽  
Lakshmi Kannan
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Step Length ◽  
Community Dwelling ◽  
Control Group ◽  
Reactive Control ◽  
Ctrl Group ◽  
Healthy Older Adults ◽  
Perturbation Training ◽  
Perturbed Walking

This study examined the effects of perturbation training on the contextual interference and generalization of encountering a novel opposing perturbation. One hundred and sixty-nine community-dwelling healthy older adults (69.6 ± 6.4 years) were randomly assigned to one of the three groups: slip-perturbation training (St, n = 67) group received 24 slips, trip-perturbation training (Tt, n = 67) group received 24 trips, and control (Ctrl: n = 31) group received only non-perturbed walking trials (ClinicalTrials.gov NCT03199729; https://clinicaltrials.gov/ct2/show/NCT03199729). After training, all groups had 30 min of rest and three post-training non-perturbed walking trials, followed by a reslip and a novel trip trial for St, a retrip and a novel slip trial for Tt, and randomized novel slip and trip trials for Ctrl. The margin of stability (MOS), step length, and toe clearance of post-training walking trials were compared among three groups to examine interferences in proactive adjustment. Falls, MOS at the instant of recovery foot touchdown, and hip height of post-training perturbation trials were investigated to detect interferences and generalization in reactive responses. Results indicated that prior adaptation to slip perturbation training, resulting in walking with a greater MOS (more anterior) and a shorter step length (p < 0.01) than that of the Ctrl group, would be associated with a greater likelihood to forward balance loss if encountered with a trip. The trip adaptation training mainly induced a higher toe clearance during walking (p < 0.01) than the Ctrl group, which could lead to reduced effectiveness of the reactive response when encountered with a novel slip. However, there was no difference in the reactive MOS, limb support, and falls between the control group and the slip and trip training groups on their respective opposing novel perturbation post-training (MOS, limb support, and falls for novel slip: Tt = Ctrl; for the novel trip: St = Ctrl, both p > 0.05). Current findings suggested that, although perturbation training results in proactive adjustments that could worsen the reactive response (interference) when exposed to an unexpected opposing perturbation, older adults demonstrated the ability to immediately generalize the training-induced adaptive reactive control to maintain MOS, to preserve limb support control, and to reduce fall risk.

scholarly journals Decrease in walking speed increases hip moment impulse in the frontal plane during the stance phase

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8110
Author(s):  
Takuma Inai ◽  
Tomoya Takabayashi ◽  
Mutsuaki Edama ◽  
Masayoshi Kubo
Keyword(s):  
Older Adults ◽  
Stance Phase ◽  
Walking Speed ◽  
Hip Osteoarthritis ◽  
Frontal Plane ◽  
Step Length ◽  
Healthy Older Adults ◽  
Steps Per Day ◽  
Public Dataset ◽  
The Relationship

Background Increased daily cumulative hip moment in the frontal plane (i.e., the product of hip moment impulse in the frontal plane during the stance phase and mean steps per day) is a risk factor for progression of hip osteoarthritis. Although hip osteoarthritis generally causes a decrease in the walking speed, its effect on hip moment impulse in the frontal plane is unclear. The purpose of this study was to examine the relationship between decrease in walking speed and hip moment impulse in the frontal plane. Methods We used a public dataset of treadmill walking in 17 older adults (mean (SD) age: 63.2 (8.0) years). The subjects walked on the treadmill for 30 s under five conditions: (1) 40% of comfortable non-dimensional speed (CNDS), (2) 55% CNDS, (3) 70% CNDS, (4) 85% CNDS, and (5) 100% CNDS. The hip moment impulse in the frontal plane non-normalized (or normalized) to step length (Nm s/kg [or Nm s/(kg m)]) for each condition was calculated. Furthermore, the relationship between walking speed and hip moment impulse in the frontal plane non-normalized (or normalized) to step length was examined using regression analysis based on a previous study. Results A decrease in non-dimensional speed (i.e., walking speed) significantly increased the non-normalized (or normalized) hip moment impulse in the frontal plane during the stance phase. The relationship between walking speed and non-normalized (or normalized) hip moment impulse in the frontal plane was fitted by a second-order polynomial. Discussion This study revealed that a decrease in walking speed increased the non-normalized (or normalized) hip moment impulse in the frontal plane in healthy older adults. This finding is useful for understanding the relationship between walking speed and hip moment impulse in the frontal plane and suggests that a decrease in walking speed may actually increase the daily cumulative hip moment in the frontal plane of patients with hip osteoarthritis.

scholarly journals Fall Risk in Older Adults Transitioning between Different Flooring Materials

Sci ◽  
2019 ◽  
Vol 1 (3) ◽  
pp. 66
Author(s):  
Hyung Kim ◽  
Thurmon Lockhart
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Whole Body ◽  
Contact Phase ◽  
Old Adults ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Heel Contact ◽  
Flooring Materials

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

Dynamic Stability of Older Adults Under Dual Task Paradigm During Stair Descent

Motor Control ◽  
2020 ◽  
Vol 24 (1) ◽  
pp. 113-126 ◽  
Author(s):  
Cui Zhang ◽  
Qipeng Song ◽  
Wei Sun ◽  
Yu Liu
Keyword(s):  
Older Adults ◽  
Dynamic Stability ◽  
Dual Task ◽  
Positive Impact ◽  
Center Of Mass ◽  
Step Length ◽  
Task Condition ◽  
Dual Task Condition ◽  
Healthy Older Adults ◽  
Stair Descent

Daily stair activities have become increasingly challenging for older adults with deterioration in physical and cognitive capabilities. However, the dynamic stability of older adults during stair descent under a concurrent dual-task condition remains undetermined. The gait and dynamic stability variables of 40 healthy older adults were measured under single- and dual-task conditions during stair descent. The step length, step width, and single support time did not significantly increase (p > .05) under the dual-task condition during stair descent. The medial–lateral center of mass velocity significantly increased (p < .003), whereas the medial–lateral margin of dynamic stability value significantly decreased (p < .006) at the landing and initial single support under the dual-task condition during stair descent. The self-regulatory ability of healthy older adults under the dual-task condition during stair descent was underestimated. Dual tasking displayed a positive impact on the anterior–posterior dynamic stability of healthy older adults.

scholarly journals Fall Risk in Older Adults Transitioning between Different Flooring Materials

Sci ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 9
Author(s):  
Hyung Nam Kim ◽  
Thurmon E. Lockhart
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Whole Body ◽  
Contact Phase ◽  
Old Adults ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Heel Contact ◽  
Flooring Materials

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

scholarly journals Dual task walking in healthy aging: Effects of narrow and wide walking paths

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261647
Author(s):  
Charlotte Hennah ◽  
Geraint Ellis ◽  
Michail Doumas
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Fall Risk ◽  
Stride Length ◽  
Cognitive Task ◽  
Urban Setting ◽  
Step Width ◽  
Aging Effects ◽  
Gait Characteristics

Dual-task walking may lead to gait instability and a higher fall risk in older adults, particularly when walking in a busy city street. Challenging street features such as narrow sidewalks not only discourage walking, but are also likely to be taxing for older adults’ cognitive resources and gait characteristics. The aim of this study was to assess the way older adults’ gait characteristics are affected by walking on a narrow path while performing a challenging cognitive task in lab conditions imitating common urban environments. Nineteen young and eighteen older adults walked on a narrow (40cm) and a wide (80cm) path and performed a cognitive (n-back) task individually adjusted to 80% accuracy. The two tasks were performed separately (Single-Task) and concurrently (Dual-Task). Both groups walked faster, and their step width was narrower on the narrow path. During dual-task walking on the narrow path, older adults showed significant dual-task costs in the cognitive task, gait speed, step width, and stride length. Dual-task walking was associated with decreased gait speed and stride length in both age groups, suggesting that dual-task walking may adversely affect gait, particularly when walking on narrow paths. These conditions may lead to gait instability and an increased fall risk for older adults, particularly when walking along the narrow sidewalks commonly found within the built environment. However, more research is needed in an urban setting to determine the extent of the fall risk narrow sidewalks present for older adults.

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