College of Health, Medicine and Life Sciences, Brunel University London, UK.
Centre for Cognitive Neuroscience, Brunel University London, UK.
Age Ageing. 2021 May 5;50(3):830-837. doi: 10.1093/ageing/afaa230.
Overly cautious gait is common in older adults. This is characterised by excessively slow gait, shortened steps, broadened base of support and increased double limb support. The current study sought to (1) evaluate if overly cautious gait is associated with attempts to consciously process walking movements, and (2) explore whether an individual's ability to rapidly inhibit a dominant motor response serves to mitigate this relationship.
A total of 50 older adults walked at a self-selected pace on an instrumented walkway containing two raised wooden obstacles (height = 23 cm). Trait conscious movement processing was measured with the Movement-Specific Reinvestment Scale. Short-latency inhibitory function was assessed using a validated electronic go/no-go ruler catch protocol. We used linear regressions to explore the relationship between these variables and gait parameters indicative of overly cautious gait.
When controlling for general cognitive function (MoCA), and functional balance (Berg Balance Scale), the interaction between trait conscious movement processing and short-latency inhibition capacity significantly predicted gait velocity, step length and double limb support. Specifically, older adults with higher trait conscious movement processing and poorer inhibition were more likely to exhibit gait characteristics indicative of cautious gait (i.e. reduced velocity, shorter step lengths and increased double limb support). Neither conscious movement processing nor inhibition independently predicted gait performance.
The combination of excessive movement processing tendencies and poor short-latency inhibitory capacity was associated with dysfunctional or 'overly cautious' gait. It is therefore plausible that improvement in either factor may lead to improved gait and reduced fall risk.
老年人步态过度谨慎较为常见。其特点是步态过于缓慢、步幅缩短、支撑基底变宽以及双下肢支撑时间增加。本研究旨在:(1)评估过度谨慎步态是否与试图有意识地处理行走运动有关;(2)探讨个体快速抑制优势运动反应的能力是否可以减轻这种关系。
共有 50 名老年人在带有两个升高的木制障碍物(高度=23 厘米)的仪器步行道上以自我选择的速度行走。运动特异性再投资量表(Movement-Specific Reinvestment Scale)用于测量特质意识运动处理能力。使用经验证的电子 Go/No-Go 标尺捕捉协议评估短潜伏期抑制功能。我们使用线性回归来探索这些变量与过度谨慎步态相关的步态参数之间的关系。
当控制一般认知功能(MoCA)和功能平衡(Berg 平衡量表)时,特质意识运动处理和短潜伏期抑制能力的交互作用显著预测了步态速度、步长和双下肢支撑。具体而言,具有较高特质意识运动处理能力和较差抑制能力的老年人更有可能表现出谨慎步态的特征(即速度降低、步幅缩短和双下肢支撑增加)。特质意识运动处理和抑制均不能独立预测步态表现。
过度运动处理倾向和较差短潜伏期抑制能力的结合与功能失调或“过度谨慎”步态有关。因此,改善这两个因素中的任何一个都可能导致步态改善和跌倒风险降低。