NearLab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Ponzio 34/5, 20133, Milano, MI, Italy.
NearLab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Ponzio 34/5, 20133, Milano, MI, Italy.
Gait Posture. 2021 May;86:27-32. doi: 10.1016/j.gaitpost.2021.02.028. Epub 2021 Feb 25.
Early detection of gait impairments in older adults allows the early uncovering of fall risk and/or cognitive deficits, resulting in timely interventions. Dual-task paradigms have been shown to be more sensitive than single-task conditions for the detection of subtle yet relevant gait impairments.
Can a system - encompassing a pair of instrumented insoles and a customized mobile app - transparently and accurately study ecological walking activities in single- and dual-task conditions, with the aim of detecting early and subtle age-related alterations of gait?
The system was tested on 19 older adults during outdoor walking (two identical single-task trials and two motor-cognitive dual-task trials with the user engaged in a simple phone call and in a cognitive-demanding phone call). A single-task cognitive trial was included. Relative reliability of the gait parameters provided by the insoles during single-task walking was investigated (Intraclass Correlation Coefficient). The effect of dual tasking on both motor (Friedman test) and cognitive (Wilcoxon signed-rank test) domains was studied. To study usability, the system was tested on 5 older adults in real-life environment over 3 months.
Most of the parameters showed excellent reliability. Independently from the cognitive demand, walking while talking resulted in increased gait cycle and step time, with a prolonged stance phase due to an augmented double-support. Variability of gait cycle and stance phase increased only during the most demanding dual-task. Dual tasking resulted in a reduced cognitive score. Usability feedback were excellent, with users reporting to understand the usefulness of the devised system and to feel at ease when using the system and the insoles.
This work paves the way toward fruitful applications of the devised system to achieve accurate and ecological monitoring of daily-life walking activities, with the final aim of detecting early and subtle alterations of gait.
在老年人中早期发现步态障碍可早期发现跌倒风险和/或认知缺陷，从而及时进行干预。双任务范式已被证明比单任务条件更能敏感地检测到细微但相关的步态障碍。
一套系统——包括一对仪器化鞋垫和一个定制的移动应用程序——能否透明且准确地研究单任务和双任务条件下的生态行走活动，旨在检测与年龄相关的早期和细微步态变化？
该系统在 19 名老年人进行户外行走时进行了测试（两次相同的单任务试验和两次运动认知双任务试验，用户进行了简单的电话通话和认知要求较高的电话通话）。还包括一次单任务认知试验。研究了鞋垫在单任务行走时提供的步态参数的相对可靠性（组内相关系数）。研究了双任务对运动（Friedman 检验）和认知（Wilcoxon 符号秩检验）领域的影响。为了研究可用性，该系统在 3 个月的时间里在真实环境中对 5 名老年人进行了测试。
大多数参数显示出极好的可靠性。无论认知需求如何，边走路边说话都会导致步态周期和步长时间增加，由于双支撑时间延长，站立时间延长。只有在最具挑战性的双任务中，步态周期和站立时间的变异性才会增加。双任务会导致认知分数降低。可用性反馈非常好，用户报告理解所设计系统的有用性，并在使用系统和鞋垫时感到自在。
这项工作为该系统的有益应用铺平了道路，以实现对日常生活行走活动的准确和生态监测，最终目标是检测早期和细微的步态变化。
