scholarly journals Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters

2016 ◽  
Vol 19 (1) ◽  
pp. 165-182 ◽  
Author(s):  
Gisele de Cássia Gomes ◽  
Luci Fuscaldi Teixeira-Salmela ◽  
Flávia Alexandra Silveira de Freitas ◽  
Maria Luísa Morais Fonseca ◽  
Marina de Barros Pinheiro ◽  
...  
Keyword(s):  
The Elderly ◽  
Elderly Persons ◽  
Step Width ◽  
Kinematic Parameters ◽  
Time Step ◽  
Double Support ◽  
Gait Parameters ◽  
Task Conditions ◽  
Double Support Time ◽  
Support Time

Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.

scholarly journals OPTIC FLOW IMPROVES SPATIAL GAIT FUNCTIONING ESPECIALLY IN MEDIOLATERAL DIRECTION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S658-S658
Author(s):  
Farahnaz Fallahtafti ◽  
Hyeon Jung Kim ◽  
Jennifer M Yentes ◽  
Dawn Venema ◽  
Julie Blaskewicz Boron
Keyword(s):  
Older Adults ◽  
Optic Flow ◽  
Repeated Measures ◽  
Visual Information ◽  
Step Length ◽  
Step Width ◽  
Gait Performance ◽  
Double Support ◽  
Double Support Time ◽  
Support Time

Abstract Instances where multiple tasks are completed simultaneously are considered high cognitive load situations (HCLS, also called dual-task), potentially affecting gait performance in older adults. Walking while talking is a common HCLS that requires additional cognitive resources. Optic flow (OF) provides visual information about speed and direction of self-motion, and thus, may ameliorate gait deficits under HCLS. This study aimed to identify the effect of HCLS, as well as OF, on gait performance in older adults. The HCLS included walking while talking on the phone, compared to walking alone. Fifteen older adults (70.86±4.7yrs) underwent four experimental conditions: walking alone with(1) and without OF(2), as well as walking while talking with(3) and without OF(4). Step width, step length, and double support time were measured and examined with 2(HCLS) x 2(OF) repeated-measures ANOVAs. There was a main effect of OF; step width was narrower with OF compared to without OF (p=0.048). For step length, there was a significant interaction between HCLS and OF (p=0.045). Without OF, there were no differences in step length; however, with OF step length was significantly longer when walking alone compared to when walking while talking (p=0.002). Double support time was not affected by HCLS or OF. Considering younger adults have longer and narrower steps compared to older adults, OF may have enhanced step width regardless of HCLS and step length when walking only. Using OF in training programs designed for older adults, could be a potential factor to improve spatial gait function, more so in the mediolateral direction.

scholarly journals Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

2018 ◽  
Vol 31 (9) ◽  
pp. 1287-1303 ◽  
Author(s):  
Shirin Modarresi ◽  
Alison Divine ◽  
Jessica A. Grahn ◽  
Tom J. Overend ◽  
Susan W. Hunter
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Future Research ◽  
Time Variability ◽  
Double Support ◽  
People With Dementia ◽  
Gait Parameters ◽  
Increased Risk ◽  
Double Support Time ◽  
Support Time

ABSTRACTBackground:People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective:To review gait parameters and characteristics associated with falls in people with dementia.Methods:Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results:Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion:This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

Physiological and Cognitive Determinants of Dual-Task Costs for Gait Parameters: The Yishun Study

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Lay Khoon Lau ◽  
Jagadish Ullal Mallya ◽  
Wei Jun Benedict Pang ◽  
Kexun Kenneth Chen ◽  
Khalid bin Abdul Jabbar ◽  
...  
Keyword(s):  
Dual Task ◽  
Gait Speed ◽  
Postural Sway ◽  
Step Length ◽  
Double Support ◽  
Immediate Memory ◽  
Gait Parameters ◽  
Primary Determinant ◽  
Double Support Time ◽  
Support Time

Background: Studies indicate that physiological and cognitive aging are causally related and functionally interdependent. However, the relative contribution of physiological factors and cognition to dual-task costs (DTC) of gait parameters has not been well studied. In this cross-sectional study, we examined the trajectory of DTC of gait parameters across the adult age spectrum for both sexes and identified the contributions of physical and cognitive performance to DTC of gait. Methods: A total of 492 community-dwelling adults, aged 21–90 years, were randomly recruited into the study. Participants were divided into 7 age groups, with 10-year age range for each group. Demographic data, height, body mass, education level, and information on comorbidities were recorded. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physical performance included visual contrast sensitivity, postural sway, hand reaction time, handgrip strength, knee extensor strength, and single-task and dual-task gait assessments. Stepwise multivariable regression was used to examine the association between physical and cognitive performance with DTC of gait parameters. Results: Women were found to have significantly higher DTC of gait speed (p = 0.01), cadence (p < 0.01), and double support time (p < 0.01) than men. However, significant aging effect on DTC of gait speed (p = 0.01), step length (p = 0.01), and double support time (p = 0.01) was observed in men but not in women. Immediate memory was the primary determinant for the DTC of gait speed (β = −0.25, p < 0.01), step length (β = −0.22, p < 0.01), and cadence (β = −0.15, p = 0.03) in men. Besides immediate memory, postural sway (β = −0.13, p = 0.03) and hand reaction (β = 0.14, p = 0.02) were also significantly associated with DTC of step length and cadence, respectively, in women. Conclusion: There were sex differences in the amplitude and trajectories of DTC of gait parameters. The DTC increased with age in men but not in women. Immediate memory was the primary determinant of DTC of gait parameters in men while immediate memory, postural sway, and reaction time were associated with DTC of gait in women. Future studies should investigate the clinical implications of the sex differences in the DTC with fall risks.

scholarly journals Differential Gait Patterns by History of Falls and Knee Pain Status in Healthy Older Adults: Results From the Baltimore Longitudinal Study of Aging

2018 ◽  
Vol 26 (4) ◽  
pp. 577-582 ◽  
Author(s):  
Seung-uk Ko ◽  
Gerald J. Jerome ◽  
Eleanor M. Simonsick ◽  
Stephanie Studenski ◽  
Luigi Ferrucci
Keyword(s):  
Knee Pain ◽  
Gait Patterns ◽  
Healthy Older Adults ◽  
Double Support ◽  
Walking Gait ◽  
Pain Status ◽  
Gait Parameters ◽  
History Of ◽  
Double Support Time ◽  
Support Time

Consideration of knee pain can be crucial for identifying fall-related gait patterns. While walking, gait parameters at usual speed were examined in persons with different falls and knee pain status. A total of 439 adults aged 60–92 years participated in this study. Persons with a history of falls had a wider stride width (p = .036) and longer double support time (p = .034) than nonfallers. In the absence of knee pain, fallers had longer double support time than nonfallers (p = .012), but no differences in double support time by history of falls were observed in participants with knee pain. With slower gait speed, fallers with knee pain have narrower stride width and larger hip range of motion (p = .027 and p = .001, respectively). Results suggest the importance of considering knee pain in fall studies for better understanding the fall-related differential gait mechanisms and for designing fall prevention intervention strategies.

scholarly journals Diminished Locomotor Control Is Associated With Reduced Neurovascular Coupling in Older Adults

2019 ◽  
Vol 75 (8) ◽  
pp. 1516-1522 ◽  
Author(s):  
Azizah J Jor’dan ◽  
Brad Manor ◽  
Ikechukwu Iloputaife ◽  
Daniel A Habtemariam ◽  
Jonathan F Bean ◽  
...  
Keyword(s):  
Older Adults ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Dual Task ◽  
Step Width ◽  
Dual Tasking ◽  
Double Support ◽  
Walking Performance ◽  
Double Support Time ◽  
Support Time

Abstract Background Walking, especially while dual-tasking, requires functional activation of cognitive brain regions and their connected neural networks. This study examined the relationship between neurovascular coupling (NVC), as measured by the change in cerebral blood flow in response to performing a cognitive executive task, and dual-task walking performance. Methods Seventy community-dwelling older adults aged 84 ± 5 years within the Maintenance of Balance, Independent Living, Intellect and Zest in the Elderly (MOBILIZE) Boston Study were divided into LOW (n = 35) and HIGH (n = 35) NVC. NVC was quantified by transcranial Doppler ultrasound and stratified by the median change in cerebral blood flow velocity of the middle cerebral artery induced by the performance of the n-back task of executive function. Walking metrics included walking speed, step width, stride length, stride time, stride time variability, and double-support time from single- and dual-task walking conditions, as well as the “cost” of dual-tasking. Results During both single- and dual-task walking, older adults with LOW NVC displayed narrower step width (p = .02 and p = .02), shorter stride length (p = .01 and p = .02), and longer double-support time (p = .03 and p = .002) when compared with the HIGH group. During single-task walking only, LOW NVC was also linked to slower walking speed (p = .02). These associations were independent of age, height, hypertension, atrial fibrillation, and assistive device. The LOW and HIGH NVC groups did not differ in dual-task costs to walking performance. Conclusion In older adults, diminished capacity to regulate cerebral blood flow in response to an executive function task is linked to worse walking performance under both single- and dual-task conditions, but not necessarily dual-task costs.

scholarly journals Instrumented Wireless SmartInsole System for Mobile Gait Analysis: A Validation Pilot Study with Tekscan Strideway

2018 ◽  
Vol 7 (3) ◽  
pp. 36 ◽  
Author(s):  
Faisal Arafsha ◽  
Christina Hanna ◽  
Ahmed Aboualmagd ◽  
Sarah Fraser ◽  
Abdulmotaleb El Saddik
Keyword(s):  
Pilot Study ◽  
Sensory System ◽  
Measurement Unit ◽  
Time Step ◽  
Double Support ◽  
Gait Parameters ◽  
Two Systems ◽  
Free Environment ◽  
The University ◽  
Double Support Time

A SmartInsoles Cyber-Physical System (CPS) is designed and implemented for the purpose of measuring gait parameters of multiple users in a restriction-free environment. This CPS comprises a master software installed on a computer and numerous multi-sensory health devices in the form of smart insoles. Each of these insoles contains 12 Force-Sensitive Resistor (FSR) sensors, an Inertial Measurement Unit (IMU), a WiFi-enabled microcontroller and a battery to power all components. A validation pilot study was completed in collaboration with the Interdisciplinary School of Health Sciences at the University of Ottawa by performing 150 trials on 15 healthy subjects. Each subject performed 10 walks on the Tekscan Strideway gait mat system, while simultaneously wearing the designed SmartInsoles CPS. Spatiotemporal data for over 450 unique steps were collected by both systems. These data were analyzed carefully, and a thorough comparison was performed between the results from the two systems. Seven parameters were analyzed in this study: stride time, stance time, swing time, double support time, step time, cadence and gait time. Detailed results in the form of tables, scatterplots, histograms and Bland–Altman graphs were generated. Analysis of the results shows high agreement between the values of the two systems and suggests high accuracy of the implemented CPS as a multi-device, multi-sensory system for gait measurement and analysis.

scholarly journals Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Goran Radunović ◽  
Zoran Veličković ◽  
Melanija Rašić ◽  
Saša Janjić ◽  
Vladana Marković ◽  
...  
Keyword(s):  
Functional Status ◽  
Dual Task ◽  
Stride Length ◽  
Clinical Symptoms ◽  
Gait Pattern ◽  
Dual Tasks ◽  
Double Support ◽  
Gait Parameters ◽  
Double Support Time ◽  
Support Time

Abstract Background The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients’ functional status and presence or absence of clinical symptoms associated with FM. Methods Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. Results The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. Conclusions Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups.

scholarly journals Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors

10.2196/27087 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e27087
Author(s):  
Julie Soulard ◽  
Jacques Vaillant ◽  
Athan Baillet ◽  
Philippe Gaudin ◽  
Nicolas Vuillerme
Keyword(s):  
Pain Intensity ◽  
Gait Speed ◽  
Stride Length ◽  
Healthy Controls ◽  
Double Support ◽  
Swing Time ◽  
Gait Parameters ◽  
Stance Time ◽  
Double Support Time ◽  
Support Time

Background Axial spondyloarthritis (axSpA) can lead to spinal mobility restrictions associated with restricted lower limb ranges of motion, thoracic kyphosis, spinopelvic ankylosis, or decrease in muscle strength. It is well known that these factors can have consequences on spatiotemporal gait parameters during walking. However, no study has assessed spatiotemporal gait parameters in patients with axSpA. Divergent results have been obtained in the studies assessing spatiotemporal gait parameters in ankylosing spondylitis, a subgroup of axSpA, which could be partly explained by self-reported pain intensity scores at time of assessment. Inertial measurement units (IMUs) are increasingly popular and may facilitate gait assessment in clinical practice. Objective This study compared spatiotemporal gait parameters assessed with foot-worn IMUs in patients with axSpA and matched healthy individuals without and with pain intensity score as a covariate. Methods A total of 30 patients with axSpA and 30 age- and sex-matched healthy controls performed a 10-m walk test at comfortable speed. Various spatiotemporal gait parameters were computed from foot-worn inertial sensors including gait speed in ms–1 (mean walking velocity), cadence in steps/minute (number of steps in a minute), stride length in m (distance between 2 consecutive footprints of the same foot on the ground), swing time in percentage (portion of the cycle during which the foot is in the air), stance time in percentage (portion of the cycle during which part of the foot touches the ground), and double support time in percentage (portion of the cycle where both feet touch the ground). Results Age, height, and weight were not significantly different between groups. Self-reported pain intensity was significantly higher in patients with axSpA than healthy controls (P<.001). Independent sample t tests indicated that patients with axSpA presented lower gait speed (P<.001) and cadence (P=.004), shorter stride length (P<.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than healthy controls. When using pain intensity as a covariate, spatiotemporal gait parameters were still significant with patients with axSpA exhibiting lower gait speed (P<.001), shorter stride length (P=.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than matched healthy controls. Interestingly, there were no longer statistically significant between-group differences observed for the cadence (P=.17). Conclusions Gait was significantly altered in patients with axSpA with reduced speed, cadence, stride length, and swing time and increased double support and stance time. Taken together, these changes in spatiotemporal gait parameters could be interpreted as the adoption of a so-called cautious gait pattern in patients with axSpA. Among factors that may influence gait in patients with axSpA, patient self-reported pain intensity could play a role. Finally, IMUs allowed computation of spatiotemporal gait parameters and are usable to assess gait in patients with axSpA in clinical routine. Trial Registration ClinicalTrials.gov NCT03761212; https://clinicaltrials.gov/ct2/show/NCT03761212 International Registered Report Identifier (IRRID) RR2-10.1007/s00296-019-04396-4

scholarly journals Split-Belt Treadmill Adaptation Transfers to Overground Walking in Persons Poststroke

2009 ◽  
Vol 23 (7) ◽  
pp. 735-744 ◽  
Author(s):  
Darcy S. Reisman ◽  
Robert Wityk ◽  
Kenneth Silver ◽  
Amy J. Bastian
Keyword(s):  
Step Length ◽  
Overground Walking ◽  
Double Support ◽  
Context Switching ◽  
Before And After ◽  
Partial Transfer ◽  
And Gender ◽  
Double Support Time ◽  
Support Time ◽  
Control Locomotion

Background and Objective. Following stroke, subjects retain the ability to adapt interlimb symmetry on the split-belt treadmill. Critical to advancing our understanding of locomotor adaptation and its usefulness in rehabilitation is discerning whether adaptive effects observed on a treadmill transfer to walking over ground. We examined whether aftereffects following split-belt treadmill adaptation transfer to overground walking in healthy persons and those poststroke. Methods. Eleven poststroke and 11 age-matched and gender-matched healthy subjects walked over ground before and after walking on a split-belt treadmill. Adaptation and aftereffects in step length and double support time were calculated. Results. Both groups demonstrated partial transfer of the aftereffects observed on the treadmill ( P < .001) to overground walking ( P < .05), but the transfer was more robust in the subjects poststroke ( P < .05). The subjects with baseline asymmetry after stroke improved in asymmetry of step length and double limb support ( P = .06). Conclusions. The partial transfer of aftereffects to overground walking suggests that some shared neural circuits that control locomotion for different environmental contexts are adapted during split-belt treadmill walking. The larger adaptation transfer from the treadmill to overground walking in the stroke survivors may be due to difficulty adjusting their walking pattern to changing environmental demands. Such difficulties with context switching have been considered detrimental to function poststroke. However, we propose that the persistence of improved symmetry when changing context to overground walking could be used to advantage in poststroke rehabilitation.

scholarly journals Kinematic and Kinetic Patterns Related to Free-Walking in Parkinson’s Disease

Sensors ◽  
2018 ◽  
Vol 18 (12) ◽  
pp. 4224 ◽  
Author(s):  
Martín Martínez ◽  
Federico Villagra ◽  
Juan Castellote ◽  
María Pastor
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Feature Selection ◽  
Clinical Status ◽  
Automatic Classification ◽  
Healthy Controls ◽  
Double Support ◽  
Gait Asymmetry ◽  
Double Support Time ◽  
Support Time

The aim of this study is to compare the properties of free-walking at a natural pace between mild Parkinson’s disease (PD) patients during the ON-clinical status and two control groups. In-shoe pressure-sensitive insoles were used to quantify the temporal and force characteristics of a 5-min free-walking in 11 PD patients, in 16 young healthy controls, and in 12 age-matched healthy controls. Inferential statistics analyses were performed on the kinematic and kinetic parameters to compare groups’ performances, whereas feature selection analyses and automatic classification were used to identify the signature of parkinsonian gait and to assess the performance of group classification, respectively. Compared to healthy subjects, the PD patients’ gait pattern presented significant differences in kinematic parameters associated with bilateral coordination but not in kinetics. Specifically, patients showed an increased variability in double support time, greater gait asymmetry and phase deviation, and also poorer phase coordination. Feature selection analyses based on the ReliefF algorithm on the differential parameters in PD patients revealed an effect of the clinical status, especially true in double support time variability and gait asymmetry. Automatic classification of PD patients, young and senior subjects confirmed that kinematic predictors produced a slightly better classification performance than kinetic predictors. Overall, classification accuracy of groups with a linear discriminant model which included the whole set of features (i.e., demographics and parameters extracted from the sensors) was 64.1%.

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