Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Japan.
Arch Gerontol Geriatr. 2012 Mar-Apr;54(2):e167-71. doi: 10.1016/j.archger.2012.01.002. Epub 2012 Jan 28.
Few studies have reported the effect of exercise intervention for improving postural control deficit in older adults at high risk of falling. We have developed a "Dual-task Switch Exercise (DSE)" program that focuses on gait initiation performance under the dual-task condition. The purpose of this study was to evaluate whether gait initiation performance could be improved by a specific exercise intervention. Eighteen participants were randomly assigned to either DSE or control groups. The DSE group received focused training to improve the ability to initiate movements quickly under the dual-task condition. The control group received steady-state walking training. After 30-min of seated training sessions, participants received 5-min individualized training sessions once a week for 24 weeks. In the pre- and post-training period, performance of the steady-state gait (10-m walking time) and gait initiation (reaction time, backward center of pressure (COP) displacement) were measured under the single- and dual-task conditions. The results of a randomized clinical trial showed that both groups showed improvement of steady-state walking time under the dual-task condition (main effect of time; p=0.018). However, DSE was more effective in improving both the reaction time and backward COP displacement during gait initiation under the dual-task condition than control (interaction effect of time×group; reaction time, p=0.015; COP displacement, p=0.011). There were no significant differences in steady-state gait and gait initiation performance under the single-task condition between pre- and post-training in both groups. Only the specific exercise intervention improved gait initiation performance under the dual-task condition.
很少有研究报道运动干预对改善高跌倒风险老年人的姿势控制缺陷的效果。我们开发了一种“双重任务转换练习（DSE）”方案，该方案侧重于双重任务条件下的步态起始性能。本研究的目的是评估特定的运动干预是否可以改善步态起始性能。18 名参与者被随机分配到 DSE 或对照组。DSE 组接受有针对性的训练，以提高在双重任务条件下快速启动运动的能力。对照组接受稳态步行训练。在 30 分钟的坐姿训练后，参与者每周接受一次 5 分钟的个性化训练，共 24 周。在训练前和训练后，在单任务和双重任务条件下测量稳态步态（10 米步行时间）和步态起始（反应时间、向后中心压力（COP）位移）的表现。一项随机临床试验的结果表明，两组在双重任务条件下的稳态行走时间都有所改善（时间的主要效果；p=0.018）。然而，与对照组相比，DSE 更有效地改善了双重任务条件下步态起始时的反应时间和向后 COP 位移（时间×组的交互效应；反应时间，p=0.015；COP 位移，p=0.011）。在两组中，在单任务条件下，训练前后的稳态步态和步态起始性能均无显著差异。只有特定的运动干预改善了双重任务条件下的步态起始性能。
