McCulloch Karen L, Mercer Vicki, Giuliani Carol, Marshall Steve
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.
J Geriatr Phys Ther. 2009;32(1):2-9. doi: 10.1519/00139143-200932010-00002.
(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.
Convenience sample of 25 young adults (ages 22-35) and 25 older adults (ages 65-86) performed the WART twice.
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.
Walking time, step accuracy, digit span memory accuracy, and dual-task costs for walking and cognitive tasks.
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.
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.
（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。
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。
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。
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。
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。
WART是一种可靠的双任务记忆和行走的临床测量方法，可安全地应用于社区居住的老年人。观察到老年人预期的双任务成本更高，但在这组非常活跃的受试者中不如预期强烈。WART提供的信息可能有助于针对患者进行干预，以降低双任务条件下的跌倒风险，但需要在更大范围行走能力的老年人中进行验证。
