Guedes Rita C, Dias Rosângela C, Pereira Leani S M, Silva Sílvia L A, Lustosa Lygia P, Dias João M D
Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Departamento de Fisioterapia, Universidade Federal de Alfenas, Alfenas, MG, Brazil.
Braz J Phys Ther. 2014 Sep-Oct;18(5):445-52. doi: 10.1590/bjpt-rbf.2014.0034. Epub 2014 Sep 12.
Gait parameters such as gait speed (GS) are important indicators of functional capacity. Frailty Syndrome is closely related to GS and is also capable of predicting adverse outcomes. The cognitive demand of gait control is usually explored with dual-task (DT) methodology.
To investigate the effect of DT and frailty on the spatio-temporal parameters of gait in older people and identify which variables relate to GS.
The presence of frailty was verified by Fried's Frailty Criteria. Cognitive function was evaluated with the Mini-Mental State Exam (MMSE) and gait parameters were analyzed through the GAITRite(®) system in the single-task and DT conditions. The Kolmogorov-Smirnov, ANOVA, and Pearson's Correlation tests were administered.
The participants were assigned to the groups frail (FG), pre-frail (PFG), and non-frail (NFG). During the DT, the three groups showed a decrease in GS, cadence, and stride length and an increase in stride time (p<0.001). The reduction in the GS of the FG during the DT showed a positive correlation with the MMSE scores (r=730; p=0.001) and with grip strength (r=681; p=0.001).
Gait parameters are more affected by the DT, especially in the frail older subjects. The reduction in GS in the FG is associated with lower grip strength and lower scores in the MMSE. The GS was able to discriminate the older adults in the three levels of frailty, being an important measure of the functional capacity in this population.
步态速度（GS）等步态参数是功能能力的重要指标。衰弱综合征与GS密切相关，也能够预测不良后果。步态控制的认知需求通常采用双任务（DT）方法进行探究。
研究双任务和衰弱对老年人步态时空参数的影响，并确定哪些变量与步态速度相关。
通过弗里德衰弱标准验证衰弱的存在。使用简易精神状态检查表（MMSE）评估认知功能，并通过GAITRite（®）系统在单任务和双任务条件下分析步态参数。进行了柯尔莫哥洛夫-斯米尔诺夫检验、方差分析和皮尔逊相关检验。
参与者被分为衰弱组（FG）、衰弱前期组（PFG）和非衰弱组（NFG）。在双任务期间，三组的步态速度、步频和步幅均下降，步长增加（p<0.001）。双任务期间衰弱组步态速度的降低与MMSE评分呈正相关（r=0.730；p=0.001），与握力呈正相关（r=0.681；p=0.001）。
步态参数受双任务的影响更大，尤其是在衰弱的老年受试者中。衰弱组步态速度的降低与较低的握力和MMSE较低的得分相关。步态速度能够区分三个衰弱水平的老年人，是该人群功能能力的一项重要指标。
