Yogev-Seligmann Galit, Hausdorff Jeffrey M, Giladi Nir
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Mov Disord. 2008 Feb 15;23(3):329-42; quiz 472. doi: 10.1002/mds.21720.
Until recently, gait was generally viewed as a largely automated motor task, requiring minimal higher-level cognitive input. Increasing evidence, however, links alterations in executive function and attention to gait disturbances. This review discusses the role of executive function and attention in healthy walking and gait disorders while summarizing the relevant, recent literature. We describe the variety of gait disorders that may be associated with different aspects of executive function, and discuss the changes occurring in executive function as a result of aging and disease as well the potential impact of these changes on gait. The attentional demands of gait are often tested using dual tasking methodologies. Relevant studies in healthy adults and patients are presented, as are the possible mechanisms responsible for the deterioration of gait during dual tasking. Lastly, we suggest how assessments of executive function and attention could be applied in the clinical setting as part of the process of identifying and understanding gait disorders and fall risk.
直到最近,步态通常被视为一项基本自动化的运动任务,只需极少的高级认知输入。然而,越来越多的证据表明,执行功能和注意力的改变与步态障碍有关。本综述讨论了执行功能和注意力在健康行走及步态障碍中的作用,同时总结了近期的相关文献。我们描述了可能与执行功能不同方面相关的各种步态障碍,并讨论了衰老和疾病导致的执行功能变化以及这些变化对步态的潜在影响。步态的注意力需求通常使用双任务方法进行测试。文中呈现了健康成年人和患者的相关研究,以及双任务过程中导致步态恶化的可能机制。最后,我们建议如何将执行功能和注意力评估应用于临床环境,作为识别和理解步态障碍及跌倒风险过程的一部分。