Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
BMC Geriatr. 2023 Sep 6;23(1):542. doi: 10.1186/s12877-023-04255-9.
Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls.
Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls.
The aim is to assess the efficacy of an arm-in-arm gait-training program in older people.
The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial.
We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry.
Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks.
The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training.
Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors.
ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
跌倒在老年人中是一个严重的问题。虽然平衡和功能锻炼已被证明是有效的，但目前尚不清楚定期散步是否对降低跌倒风险有特定影响。
经常跌倒的老年人步态模式受损。最近的研究表明，使用人际同步：当老年人与年轻人牵手行走时，老年人会与年轻人同步步伐，以恢复更好的步态模式。这种步态训练方法可能会降低跌倒风险。
评估手臂牵手步态训练计划对老年人的疗效。
手臂牵手步态训练试验（AAGaTT）是一项单站点、开放标签、双臂、随机对照试验。
我们将招募 66 对老年人及其年轻的“步态指导员”。老年参与者必须年龄大于 70 岁，有足够的行走能力。他们必须在研究入组前一年内经历过跌倒。
两人组将在室内课程中行走 30 分钟，要么并排而无接触（对照组），要么手臂牵手同步步态（干预组）。步态训练将每周重复三次，为期四周。
主要结果将是在基线和每个干预周（第 1 周-第 4 周）以及第 7 周进行的五分钟步行试验中测量的行走速度。步态质量将使用加速度计进行评估。我们还将使用问卷评估感知到的身体活动和健康状况。最后，我们将监测 18 个月内的跌倒发生率。我们将评估干预组的结果是否比对照组有更大的改善。此外，将进行访谈以评估对步态训练的看法。
运动控制神经生理学的最新进展表明，同步步态与外部线索或人类伙伴可以提高步态训练的效率。手臂牵手步态训练的预期益处包括：降低跌倒风险、无不良反应的安全治疗以及高依从性。这种步态训练计划可能是一种低成本干预措施，对老年人的健康和幸福感有积极影响。
ClinicalTrials.gov NCT05627453。注册日期：2022 年 11 月 25 日。
