Health Science Center, Sacred Heart University, USC, Bauru, Brazil; Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, USP, Ribeirão Preto, Brazil.
Department of Physical Therapy and Occupational Therapy, São Paulo State University, UNESP, Marília, Brazil.
Hum Mov Sci. 2021 Feb;75:102747. doi: 10.1016/j.humov.2020.102747. Epub 2020 Dec 19.
To compare the parameters of gait kinematics of older adults with cognitive impairment who live in community dwellings or those living or spending most of the time in non-family environment settings.
The sample was composed of 33 older adults of both sexes with cognitive impairment. Participants were separated into three groups: a community-dwelling older adult group comprised of 11 subjects; a semi-institutionalized older adult group comprised of 10 older adults attended in a geriatric daycare institution; and an institutionalized older adult group comprised of 12 older adults living in long-term institutions. Gait kinematics were recorded by pressure sensors (footswitches). Fifty gait cycles at self-selected pace were analyzed to obtain: gait speed, stride length, stance, swing, and stride time. The variability of these parameters was also analyzed.
MANCOVA identified the main effect of groups (p < 0.001). Gait speed of older adults living in long-term institutions and older adults attended in geriatric daycare institutions was slower than community-living older adults (p < 0.001 and p = 0.04, respectively). Swing and stride time variability was higher in older adults living in long-term institutions (p = 0.003 and p = 0.001) and in older adults attended in geriatric daycare institutions (p = 0.02 and p = 0.001) than in community-dwelling older adults.
The most important finding was that older adults with cognitive impairment who need non-family residential setting care had higher gait kinematics abnormalities, which may increase the risk of falls, compared to those who live in the community.
比较居住在社区中的认知障碍老年人与生活或大部分时间在非家庭环境中的认知障碍老年人的步态运动学参数。
该样本由 33 名患有认知障碍的男女老年人组成。参与者分为三组:一组是居住在社区中的老年组,由 11 名受试者组成;一组是半机构化的老年组,由 10 名在老年日托机构接受治疗的老年人组成;一组是机构化的老年组,由 12 名生活在长期机构中的老年人组成。步态运动学通过压力传感器(脚踏开关)记录。分析 50 个自主选择速度的步态周期,以获得:步行速度、步长、站立、摆动和步长时间。还分析了这些参数的可变性。
MANCOVA 确定了组别的主要影响(p<0.001)。生活在长期机构中的老年人和在老年日托机构接受治疗的老年人的步行速度比生活在社区中的老年人慢(p<0.001 和 p=0.04)。生活在长期机构中的老年人(p=0.003 和 p=0.001)和在老年日托机构接受治疗的老年人(p=0.02 和 p=0.001)的摆动和步长时间变异性更高。
最重要的发现是,需要非家庭居住环境护理的认知障碍老年人的步态运动学异常更高,与生活在社区中的老年人相比,他们跌倒的风险可能更高。