Department of Acute Geriatrics, University Hospital of Basel, Basel, Switzerland. bridenbaughs @ uhbs.ch
Gerontology. 2011;57(3):256-64. doi: 10.1159/000322194. Epub 2010 Oct 27.
Walking is a complex motor task generally performed automatically by healthy adults. Yet, by the elderly, walking is often no longer performed automatically. Older adults require more attention for motor control while walking than younger adults. Falls, often with serious consequences, can be the result. Gait impairments are one of the biggest risk factors for falls. Several studies have identified changes in certain gait parameters as independent predictors of fall risk. Such gait changes are often too discrete to be detected by clinical observation alone. At the Basel Mobility Center, we employ the GAITRite electronic walkway system for spatial-temporal gait analysis. Although we have a large range of indications for gait analyses and several areas of clinical research, our focus is on the association between gait and cognition. Gait analysis with walking as a single-task condition alone is often insufficient to reveal underlying gait disorders present during normal, everyday activities. We use a dual-task paradigm, walking while simultaneously performing a second cognitive task, to assess the effects of divided attention on motor performance and gait control. Objective quantification of such clinically relevant gait changes is necessary to determine fall risk. Early detection of gait disorders and fall risk permits early intervention and, in the best-case scenario, fall prevention. We and others have shown that rhythmic movement training such as Jaques-Dalcroze eurhythmics, tai chi and social dancing can improve gait regularity and automaticity, thus increasing gait safety and reducing fall risk.
行走是一项复杂的运动任务，通常由健康的成年人自动完成。然而，老年人的行走往往不再是自动完成的。老年人在行走时需要更多的注意力来控制运动，而年轻人则不需要。这可能导致跌倒，而且往往会带来严重的后果。步态障碍是跌倒的最大风险因素之一。多项研究已经确定了某些步态参数的变化是跌倒风险的独立预测因素。这些步态变化通常过于离散，仅凭临床观察无法察觉。在巴塞尔移动中心，我们使用 GAITRite 电子步道系统进行时空步态分析。尽管我们有广泛的步态分析适应证和多个临床研究领域，但我们的重点是步态与认知之间的关联。仅在单一任务条件下进行步态分析，例如行走，通常不足以揭示正常日常活动中存在的潜在步态障碍。我们使用双重任务范式，在行走的同时同时执行第二项认知任务，以评估注意力分散对运动表现和步态控制的影响。客观量化这些与临床相关的步态变化对于确定跌倒风险是必要的。早期发现步态障碍和跌倒风险可以进行早期干预，在最好的情况下，可以预防跌倒。我们和其他人已经表明，节奏运动训练，如雅克·达尔克罗兹节奏运动、太极拳和社交舞蹈，可以改善步态的规律性和自动性，从而提高步态安全性，降低跌倒风险。
