Montero-Odasso M, Sarquis-Adamson Y, Kamkar N, Pieruccini-Faria F, Bray N, Cullen S, Mahon J, Titus J, Camicioli R, Borrie M J, Bherer L, Speechley M
Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.
Exp Gerontol. 2020 Dec;142:111102. doi: 10.1016/j.exger.2020.111102. Epub 2020 Oct 2.
BACKGROUND/OBJECTIVES: Slow gait speed prospectively predicts elevated risk of adverse events such as falls, morbidity, and mortality. Additionally, gait speed under a cognitively demanding challenge (dual-task gait) predicts further cognitive decline and dementia incidence. This evidence has been mostly collected using electronic walkways; however, not all clinical set ups have an electronic walkway and comparability with simple manual dual-gait speed testing, like a stopwatch, has not yet been examined. Our main objective was to assess concurrent-validity and reliability of gait speed assessments during dual-tasking using a stopwatch and electronic walkway in older adults with mild and subjective cognitive impairment (MCI and SCI).
Cross-sectional, reliability study.
Clinic based laboratory at an academic hospital in London, ON, Canada.
237 walk tests from 34 community-dwelling participants (mean age 71.84 SD 5.38; 21 female - 62%, 13 male - 38%) with SCI and MCI. were included from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study.
Each participant performed seven walk tests: three single gait walks at their normal pace, three dual-task walks (walking and counting backwards by one, by sevens, and naming animals), and one fast walk.
Gait speed (cm/s) for each walk was measured simultaneously with an electronic walkway (Zeno Mat®) and a handheld stopwatch (Ultrak chronometer®). Dual-task cost (DTC) was calculated for the three individual dual-task walks as [((single gait speed - dual-task gait speed) / single gait speed) ∗ 100]. Level of agreement between the two measurement methods was analyzed using Pearson correlations, paired t-tests, and Bland-Altman plots.
Gait speed was consistently lower when measured with the stopwatch than with the electronic walkway (mean speed difference: 10.6 cm/s ± 5.1, p < 0.001). Calculating DTC, however, yielded very similar results with both methods (mean DTC difference: 0.19 ± 1.18, p = 0.872). The higher the DTC, the closer the measurement between methods.
Assessing and calculating DTC with a stopwatch is simple, accessible and reliable. Its validity and reliability were high in this clinical sample of community older adults with SCI and MCI.
背景/目的：步速缓慢可前瞻性预测跌倒、发病和死亡等不良事件风险升高。此外，在认知要求较高的挑战（双任务步态）下的步速可预测进一步的认知衰退和痴呆症发病率。这些证据大多是使用电子步道收集的；然而，并非所有临床机构都有电子步道，且与简单的手动双步态速度测试（如秒表）的可比性尚未得到检验。我们的主要目的是评估在轻度和主观认知障碍（MCI和SCI）的老年人中，使用秒表和电子步道进行双任务时步态速度评估的同时效度和可靠性。
横断面可靠性研究。
加拿大安大略省伦敦市一家学术医院的基于诊所的实验室。
从神经退行性变和痴呆症综合评估（COMPASS-ND）研究中纳入了34名社区居住参与者（平均年龄71.84，标准差5.38；21名女性 - 62%，13名男性 - 38%）的237次步行测试，这些参与者患有SCI和MCI。
每位参与者进行七次步行测试：三次以正常步速的单步态步行、三次双任务步行（步行并倒着数1、数7以及说出动物名称）和一次快速步行。
每次步行的步态速度（厘米/秒）同时使用电子步道（Zeno Mat®）和手持秒表（Ultrak chronometer®）进行测量。计算三次单独双任务步行的双任务成本（DTC）为[((单步态速度 - 双任务步态速度) / 单步态速度) * 100]。使用Pearson相关性、配对t检验和Bland-Altman图分析两种测量方法之间的一致性水平。
用秒表测量的步态速度始终低于用电子步道测量的速度（平均速度差：10.6厘米/秒±5.1，p < 0.001）。然而，两种方法计算DTC得出的结果非常相似（平均DTC差：0.19±1.18，p = 0.872）。DTC越高，两种方法之间的测量结果越接近。
用秒表评估和计算DTC简单、可行且可靠。在这个患有SCI和MCI的社区老年人临床样本中，其效度和可靠性较高。
