Brach Jennifer S, Vanswearingen Jessie M
Curr Transl Geriatr Exp Gerontol Rep. 2013 Dec;2(4). doi: 10.1007/s13670-013-0059-0.
Interventions to improve walking in older adults have historically been multifactorial (i.e. strengthening, endurance and flexibility programs) focusing on improving the underlying impairments. These impairment-based programs have resulted in only modest improvements in walking. In older adults, walking is slow, less stable, inefficient, and the timing and coordination of stepping with postures and phases of gait is poor. We argue the timing and coordination problems are evidence of the loss of motor skill in walking. Taking a lesson from the sports world and from neurorehabilitation, task-oriented motor learning exercise is an essential component of training to improve motor skill and may be a beneficial approach to improving walking in older adults. In this article we: 1) briefly review the current literature regarding impairment-based interventions for improving mobility, 2) discuss why the results have been only modest, and 3) suggest an alternative approach to intervention (i.e. task oriented motor learning).
历史上，为改善老年人行走能力而采取的干预措施一直都是多方面的（即强化、耐力和灵活性训练项目），重点在于改善潜在的功能障碍。这些基于功能障碍的训练项目仅使行走能力有了适度改善。在老年人中，行走速度慢、稳定性差、效率低，并且步幅与步态姿势及阶段的时间配合和协调性不佳。我们认为，时间配合和协调问题证明了行走运动技能的丧失。借鉴体育界和神经康复领域的经验，以任务为导向的运动学习练习是提高运动技能训练的重要组成部分，可能是改善老年人行走能力的有益方法。在本文中，我们：1）简要回顾当前关于基于功能障碍的改善活动能力干预措施的文献，2）讨论为何结果仅为适度改善，3）提出一种替代干预方法（即以任务为导向的运动学习）。
