School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Australia.
Department of Health Sciences, Lund University, Lund, Sweden.
Aging Clin Exp Res. 2022 Jun;34(6):1349-1356. doi: 10.1007/s40520-021-02066-9. Epub 2022 Jan 12.
Metronome cueing has been shown to reduce gait variability and thereby potentially reduce falls risk in individuals with Parkinson's disease. It is unclear however, if metronome cueing has a similar effect in healthy older adults with a history of falls.
To investigate whether a traditional and/or an adaptive metronome, based on an individual's gait pattern, were effective in reducing gait variability in older adults with a history of falls.
Twenty older adults (15 women, 71 ± 4.9 years) with a history of falls were included in this cross-over study. Participants received two types of cueing (adaptive and traditional metronome) 1 week apart. The variability of the participants' stride time, stride length, walking speed and duration of double leg support were recorded during three walking conditions (baseline, during feedback and post-feedback gait). Repeated-measures ANOVA was used to assess the possible effects of the two cueing strategies on gait variables.
Compared with the baseline condition, participants had significantly increased stride time variability during feedback (F (2) = 9.83, p < 0.001) and decreased double leg support time variability post-feedback (F (2) 3.69, p = 0.034). Increased stride time variability was observed with the adaptive metronome in comparison to the traditional metronome.
Metronome cueing strategies may reduce double leg support variability in older adults with a history of falls but seem to increase stride time variability. Further studies are needed to investigate if metronome cueing is more beneficial for individuals with greater baseline gait variability than those included in the current study.
节拍器提示已被证明可降低帕金森病患者的步态变异性，从而潜在降低跌倒风险。然而，节拍器提示对于有跌倒史的健康老年人是否具有相似的效果尚不清楚。
研究基于个体步态模式的传统节拍器和/或自适应节拍器是否可有效降低有跌倒史的老年人的步态变异性。
本交叉研究纳入了 20 名有跌倒史的老年人（女性 15 名，71±4.9 岁）。参与者在相隔 1 周的时间内接受两种提示（自适应和传统节拍器）。在三种步行条件（基线、反馈时和反馈后步态）下记录参与者的步时变异性、步长、行走速度和双腿支撑时间。采用重复测量方差分析评估两种提示策略对步态变量的可能影响。
与基线条件相比，参与者在反馈时的步时变异性显著增加（F（2）=9.83，p<0.001），反馈后双腿支撑时间变异性降低（F（2）=3.69，p=0.034）。与传统节拍器相比，自适应节拍器可观察到步时变异性增加。
节拍器提示策略可能会降低有跌倒史的老年人的双腿支撑变异性，但似乎会增加步时变异性。需要进一步的研究来调查节拍器提示是否对基线步态变异性较大的个体比当前研究中纳入的个体更有益。
