Conradsson David, Halvarsson Alexandra
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden.
Gait Posture. 2019 Feb;68:562-568. doi: 10.1016/j.gaitpost.2019.01.005. Epub 2019 Jan 4.
Although there is a growing body of literature showing promising effects of balance training on gait in older adults, little is known about the effects of dual-task training on varying domains of spatial and temporal gait parameters.
Does the short-term effects of dual-task balance training differ between single and dual-task gait in older women with osteoporosis with regards to different gait domains (pace, rhythm, variability, asymmetry and postural control)?
Elderly women with osteoporosis who experienced fear of falling and/or ≥1 fall the last 12 months were recruited. Ninety-five participants were randomized to 12 weeks of balance training or to a control group. The participants in the training group (n = 65) received 12 weeks (3 times/week) of balance and gait exercises including dual-tasks, and the control group (n = 30) received care as usual. Single- and dual-task gait were assessed before and after the intervention with an electronic walkway system and analyzed using non-parametric statistics and effect sizes.
68 participants completed the study. The training group walked faster for single- and dual-task gait following training (P ≤ .044) by increasing their cadence (P ≤ .012) and reducing step and swing time (P ≤ .045) compared with the control group. Significant between-group differences in favor of the training group were found for gait variability during dual-task gait (P ≤ .041). The improvement in speed were greater for dual- than single-task gait (0.10 vs. 0.05 m/s) and the effect sizes revealed small to medium effects for dual-task gait, and either non-existent or small for single-task gait.
Greater training effects found on a variety of domains of dual-task gait compared to single-task gait support the role of cognitively demanding exercises for the maintenance of safe ambulation in older women with osteoporosis.
尽管越来越多的文献表明平衡训练对老年人步态有显著效果，但关于双任务训练对空间和时间步态参数不同领域的影响知之甚少。
对于患有骨质疏松症的老年女性，在不同步态领域（步速、节奏、变异性、不对称性和姿势控制）方面，双任务平衡训练的短期效果在单任务和双任务步态之间是否存在差异？
招募过去12个月内有跌倒恐惧和/或至少发生过1次跌倒的骨质疏松老年女性。95名参与者被随机分为接受12周平衡训练的组或对照组。训练组（n = 65）接受为期12周（每周3次）的平衡和步态训练，包括双任务训练，对照组（n = 30）接受常规护理。干预前后使用电子步道系统评估单任务和双任务步态，并使用非参数统计和效应量进行分析。
68名参与者完成了研究。与对照组相比，训练组在训练后单任务和双任务步态的行走速度更快（P≤0.044），通过增加步频（P≤0.012）以及减少步长和摆动时间（P≤0.045）。在双任务步态期间的步态变异性方面，发现训练组有显著的组间差异（P≤0.041）。双任务步态的速度改善大于单任务步态（0.10对0.05米/秒），效应量显示双任务步态有小到中等的效果，而单任务步态不存在或效果较小。
与单任务步态相比，在双任务步态的各个领域发现了更大的训练效果，这支持了认知要求较高的运动对患有骨质疏松症的老年女性维持安全行走的作用。
