Lee Den-Ching A, Burton Elissa, Meyer Claudia, Haines Terry P, Hunter Susan, Dawes Helen, Suttanon Plaiwan, Fullarton Stephanie, Connelly Fiona, Stout Julie C, Hill Keith D
Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University (Peninsula Campus), Frankston, VIC 3199, Australia.
National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC 3199, Australia.
J Clin Med. 2023 Feb 16;12(4):1574. doi: 10.3390/jcm12041574.
This study examined the potential for effect of a six-week gait aid training program for people with dementia on spatiotemporal gait outcomes, perception of use, and falls with gait aid use. The program utilised four 30-min physiotherapy home visits, scheduled at weeks 1/2/3/6, and was enhanced by carer-supervised practice. Falls and the physiotherapist's clinical judgement of participants achieving safe gait aid use during and after the program were described. Perception ratings at each visit were measured using Likert scales which, along with the spatiotemporal outcomes using the gait aid (Time-Up-and-Go-Test, 4-m-walk-test, Figure-of-8-Walk-Test with/without a cognitive task) at weeks 1 and 6, and at weeks 6 and 12 (6-week post-program), were examined with ordinal logistic regression analyses. Twenty-four community-dwelling older people with dementia and their carers participated. Twenty-one (87.5%) older people achieved safe gait aid use. Twenty falls occurred, and only one faller was using their gait aid when they fell. Walking speed, step length, and cadence significantly improved when walking with the gait aid at week 6 compared with week 1. No significant improvements in spatiotemporal outcomes were retained at week 12. Physiotherapists were more likely to agree that gait aid use had improved walking safety among older people with dementia with subsequent training visits. Larger studies of the gait aid training program are needed for this clinical group.
本研究探讨了一项为期六周的痴呆症患者步态辅助训练计划对时空步态结果、使用认知、以及使用步态辅助器时跌倒情况的潜在影响。该计划包括在第1/2/3/6周安排四次每次30分钟的物理治疗家访,并通过护理人员监督练习加以强化。描述了该计划期间及之后的跌倒情况以及物理治疗师对参与者实现安全使用步态辅助器的临床判断。每次家访时使用李克特量表测量认知评分,并在第1周和第6周以及第6周和第12周(计划结束后6周),使用步态辅助器时的时空结果(起立行走测试、4米步行测试、有/无认知任务的8字步行测试),通过有序逻辑回归分析进行检验。24名社区居住的老年痴呆症患者及其护理人员参与了研究。21名(87.5%)老年人实现了安全使用步态辅助器。共发生了20次跌倒,跌倒时只有一名跌倒者正在使用步态辅助器。与第1周相比,第6周使用步态辅助器行走时,步行速度、步长和步频显著提高。第12周时,时空结果没有显著改善。经过后续训练家访后,物理治疗师更有可能认同使用步态辅助器提高了老年痴呆症患者的行走安全性。对于这个临床群体,需要对步态辅助器训练计划进行更大规模的研究。