行走中双重任务表现的临床测量方法的开发：行走与记忆测试的信度和初步效度

Development of a clinical measure of dual-task performance in walking: reliability and preliminary validity of the Walking and Remembering Test.

作者信息

McCulloch Karen L, Mercer Vicki, Giuliani Carol, Marshall Steve

机构信息

Center for Human Movement Science, Division of Physical Therapy, Bondurant Hall Suite 3024, 321 S. Columbia Street, University of North-Carolina at Chapel Hill, Chapel Hill, NC 27599-7135, USA.

出版信息

J Geriatr Phys Ther. 2009;32(1):2-9. doi: 10.1519/00139143-200932010-00002.

DOI:10.1519/00139143-200932010-00002

PMID:19856629

Abstract

OBJECTIVES

(1) To examine the reliability of a new clinical measure of simultaneous walking with performance of a working memory task, the Walking and Remembering Test (WART). (2) To compare older adult to younger adult WART performance to illustrate preliminary validity.

SUBJECTS

Convenience sample of 25 young adults (ages 22-35) and 25 older adults (ages 65-86) performed the WART twice.

METHODS

Subjects walked 6.1 meters at their fastest safe speed along a path requiring a narrowed base of support in both single and dual-task (with simultaneous digit span task) conditions. Reductions in walking and cognitive performance were examined in the dual-task condition for older adults as compared to younger adults.

MAIN OUTCOME MEASURES

Walking time, step accuracy, digit span memory accuracy, and dual-task costs for walking and cognitive tasks.

RESULTS

Inter-rater reliability ICC (2,1) values were > or = .97 for walking time and digit span accuracy. Rater agreement of steps off the path was excellent (93%) for young adults and good (76%) for older adults. Test-retest reliability ICC (2,1) values for walking time were > or = .79. Older adults were slower and remembered shorter digit spans, and demonstrated greater dual-task costs for digit span accuracy and steps off the path than younger adults, but relative dual-task costs for walking time were not significantly different between groups.

CONCLUSIONS

The WART is a reliable clinical measure of dual-task memory and walking that can be administered safely with community-dwelling older adults. Expected greater dual-task costs for older adults were observed, but not as strongly as anticipated in this group of very active subjects. The WART provides information that may be useful in targeting patients for intervention to reduce risk of falls in dual-task conditions, but needs validation with older adults across a greater range of walking ability.

摘要

目的

（1）检验一种新的临床测量方法——行走与记忆测试（WART）的可靠性，该方法用于同时测量行走能力和执行工作记忆任务的表现。（2）比较老年人与年轻人的WART表现，以说明其初步有效性。

受试者

25名年轻人（年龄22 - 35岁）和25名老年人（年龄65 - 86岁）的便利样本，每人进行两次WART测试。

方法

受试者以最快安全速度沿一条需要缩小支撑面的路径行走6.1米，分为单任务和双任务（同时进行数字广度任务）两种条件。比较老年人与年轻人在双任务条件下行走和认知表现的下降情况。

主要观察指标

行走时间、步幅准确性、数字广度记忆准确性以及行走和认知任务的双任务成本。

结果

行走时间和数字广度准确性的组间相关系数ICC（2,1）值≥0.97。年轻人偏离路径步数的评分者一致性极佳（93%），老年人为良好（76%）。行走时间的重测信度ICC（2,1）值≥0.79。老年人行走速度较慢，记住的数字广度较短，在数字广度准确性和偏离路径步数方面的双任务成本比年轻人更高，但两组在行走时间的相对双任务成本上无显著差异。