Université Côte d'Azur, LAMHESS, Nice, France.
Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France.
Aging Clin Exp Res. 2023 Oct;35(10):2109-2118. doi: 10.1007/s40520-023-02506-8. Epub 2023 Aug 3.
Dual-task (DT) walking is of great interest in clinical evaluation to evaluate frailty or cognitive declines in older adults. Frail older adults are known to adopt different walking strategy to overcome fatigue. However, no studies evaluated the effect of muscular or mental fatigue on dual-task walking strategy and the difference between frail and non-frail older adults.
Evaluate the effect of mental and muscular fatigue on spatio-temporal parameters in dual-task walking in young, non-frail and frail older adults.
59 participants divided into 20 young (Y) (24.9 ± 3 years old), 20 non-frail (NF) (75.8 ± 4.9 years old) and 19 frail older adults (F) (81 ± 4.7 years old) performed single-task (ST) walking, single-task cognitive (serial subtraction of 3), and dual-task (subtraction + walking) for 1 min at their fast pace. Gait speed, step length, step length variability, stance and swing phase time, single and double support time, cadence, gait speed variability were recorded in single- and dual-task walking. The dual-task effect (DTE) was calculated as ((DT - ST)/ST) × 100). Generalized linear mixed models (GLMM) were used to compare the effects of mental and muscular fatigue on gait and cognitive variables between the groups.
The DTE walking parameters were worse in F compared to NF or Y but no significant effect of fatigue were highlighted except for swing time and single support time DTEs.
The results were mitigated but a clear difference in dual-task spatio-temporal parameters was found between F and NF which brings hope into the capacity of DT to better reveal frailty.
在临床评估中,双重任务(DT)行走对于评估老年人的虚弱或认知能力下降非常感兴趣。众所周知,虚弱的老年人会采用不同的行走策略来克服疲劳。然而,目前还没有研究评估肌肉或精神疲劳对双重任务行走策略的影响,以及虚弱和非虚弱老年人之间的差异。
评估精神和肌肉疲劳对年轻、非虚弱和虚弱老年人双重任务行走时空参数的影响。
59 名参与者分为 20 名年轻(Y)(24.9±3 岁)、20 名非虚弱(NF)(75.8±4.9 岁)和 19 名虚弱老年人(F)(81±4.7 岁),以最快速度分别进行单任务(ST)行走、单任务认知(连续减去 3)和双重任务(减法+行走)1 分钟。在单任务和双重任务行走中记录步速、步长、步长变异性、站立和摆动阶段时间、单支撑和双支撑时间、步频、步速变异性。双重任务效应(DTE)计算为((DT-ST)/ST)×100)。使用广义线性混合模型(GLMM)比较了精神和肌肉疲劳对各组步态和认知变量的影响。
F 组的 DTE 行走参数比 NF 或 Y 组差,但除了摆动时间和单支撑时间的 DTE 外,没有发现疲劳的显著影响。
结果有所缓解,但 F 组和 NF 组之间的双重任务时空参数存在明显差异,这为 DT 更好地揭示虚弱提供了希望。