Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France.
Neurophysiol Clin. 2020 Nov;50(6):401-440. doi: 10.1016/j.neucli.2020.10.008. Epub 2020 Nov 8.
With about one third of adults aged 65 years and older being reported worldwide to fall each year, and an even higher prevalence with advancing age, aged-related falls and the associated disabilities and mortality are a major public health concern. In this context, identification of fall risk in healthy older adults is a key component of fall prevention. Since dual-task outcomes rely on the interaction between cognition and motor control, some studies have demonstrated the role of dual-task walking performance or costs in predicting future fallers. However, based on previous reviews on the topic, (1) discriminative and (2) predictive powers of dual tasks involving gait and a concurrent task are still a matter of debate, as is (3) their superiority over single tasks in terms of fall-risk prediction. Moreover, less attention has been paid to dual tasks involving postural control and transfers (such as gait initiation and turns) as motor tasks. In the present paper, we therefore systematically reviewed recent literature over the last 7 years in order to answer the three above mentioned questions regarding the future of lab-based dual tasks (involving posture, gait initiation, gait and turning) as easily applicable tests for identifying healthy older adult fallers. Despite great heterogeneity among included studies, we emphasized, among other things, the promising added value of dual tasks including turns and other transfers, such as in the Timed Up and Go test, for prediction of falls. Further investigation of these is thus warranted.
据报道,全世界约有三分之一的 65 岁及以上成年人每年都会跌倒,而且随着年龄的增长,跌倒的发生率更高,与年龄相关的跌倒及其相关的残疾和死亡率是一个主要的公共卫生问题。在这种情况下,识别健康老年人的跌倒风险是预防跌倒的关键组成部分。由于双重任务的结果依赖于认知和运动控制的相互作用,一些研究已经证明了双重任务行走表现或成本在预测未来跌倒者中的作用。然而,基于之前对该主题的综述,(1)涉及步态和并发任务的双重任务的区分和预测能力,(2)仍然存在争议,(3)在跌倒风险预测方面,它们是否优于单一任务,这仍然存在争议。此外,对涉及姿势控制和转移(如步态起始和转弯)的双重任务的关注较少,这些转移是运动任务。在本文中,我们因此系统地回顾了过去 7 年的最新文献,以回答关于未来基于实验室的双重任务(涉及姿势、步态起始、步态和转弯)作为识别健康老年人跌倒者的简便适用测试的三个上述问题。尽管纳入的研究存在很大的异质性,但我们强调了包括转弯和其他转移在内的双重任务的有希望的附加价值,例如在计时起立和行走测试中,对跌倒的预测。因此,有必要进一步研究这些问题。
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