Bergamin Marco, Gobbo Stefano, Zanotto Tobia, Sieverdes John C, Alberton Cristine L, Zaccaria Marco, Ermolao Andrea
Sport and Exercise Medicine Division, Department of Medicine, University of Padova Padova, Italy.
College of Nursing, Medical University of South Carolina Charleston, SC, USA.
Front Aging Neurosci. 2014 Oct 22;6:271. doi: 10.3389/fnagi.2014.00271. eCollection 2014.
Dual-task performance assessments of competing parallel tasks and postural outcomes are growing in importance for geriatricians, as it is associated with predicting fall risk in older adults. This study aims to evaluate the postural stability during different dual-task conditions including visual (SMBT), verbal (CBAT) and cognitive (MAT) tasks in comparison with the standard Romberg's open eyes position (OE). Furthermore, these conditions were investigated in a sample of young adults and a group of older healthy subjects to examine a potential interaction between type of secondary task and age status. To compare these groups across the four conditions, a within-between mixed model ANOVA was applied. Thus, a stabilometric platform has been used to measure center of pressure velocity (CoPV), sway area (SA), antero-posterior (AP) and medio-lateral (ML) oscillations as extents of postural sway. Tests of within-subjects effects indicated that different four conditions influenced the static balance for CoPV (p < 0.001), SA (p < 0.001). Post-hoc analyses indicated that CBAT task induced the worst balance condition on CoPV and resulted in significantly worse scores than OE (-11.4%; p < 0.05), SMBT (-17.8%; p < 0.01) and MAT (-17.8%; p < 0.01) conditions; the largest SA was found in OE, and it was statistically larger than SMBT (-27.0%; p < 0.01) and MAT (-23.1%; p < 0.01). The between-subjects analysis indicated a general lower balance control in the group of elderly subjects (CoPV p < 0.001, SA p < 0.002), while, the mixed model ANOVA did not detect any interaction effect between types of secondary task and groups in any parameters (CoPV p = 0.154, SA p = 0.125). Postural sway during dual-task assessments was also found to decrease with advancing age, however, no interactions between aging and types of secondary tasks were found. Overall, these results indicated that the secondary task which most influenced the length of sway path, as measured by postural stability was a simple verbal assignment.
对于老年病医生而言,竞争性并行任务的双任务表现评估及姿势结果愈发重要,因为这与预测老年人跌倒风险相关。本研究旨在评估在不同双任务条件下的姿势稳定性,这些条件包括视觉任务(SMBT)、语言任务(CBAT)和认知任务(MAT),并与标准的睁眼罗姆伯格姿势(OE)进行比较。此外,在一组年轻成年人和一组健康老年人样本中对这些条件进行了研究,以检验次要任务类型与年龄状态之间的潜在相互作用。为了在这四种条件下比较这些组,应用了组内-组间混合模型方差分析。因此,使用了一个稳定测量平台来测量压力中心速度(CoPV)、摆动面积(SA)、前后(AP)和左右(ML)振荡,作为姿势摆动的程度。受试者内效应检验表明,不同的四种条件影响了CoPV(p < 0.001)、SA(p < 0.001)的静态平衡。事后分析表明,CBAT任务在CoPV上导致了最差的平衡条件,并且其得分显著低于OE(-11.4%;p < 0.05)、SMBT(-17.8%;p < 0.01)和MAT(-17.8%;p < 0.01)条件;在OE中发现了最大的SA,并且在统计学上它大于SMBT(-27.0%;p < 0.01)和MAT(-23.1%;p < 0.01)。受试者间分析表明,老年受试者组的总体平衡控制较低(CoPV p < 0.001,SA p < 0.002),而混合模型方差分析未在任何参数中检测到次要任务类型与组之间的任何交互作用(CoPV p = 0.154,SA p = 0.125)。在双任务评估期间,姿势摆动也被发现随着年龄的增长而减少,然而,未发现衰老与次要任务类型之间的相互作用。总体而言,这些结果表明,通过姿势稳定性测量,对摆动路径长度影响最大的次要任务是一个简单的语言任务。