Tang Pei-Fang, Wilford Emily, Tu Chien-Kuang, Wu Yen-Tzu
School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan; Center for Artificial Intelligence and Robotics, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan; North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, UK.
Gait Posture. 2025 May;118:115-121. doi: 10.1016/j.gaitpost.2025.02.004. Epub 2025 Feb 10.
Dual-task gaits are linked to falls in older individuals, but their underlying structure is unknown compared to single-task gaits. We employed principal component analysis (PCA) to discover independent domains underlying single- and dual-task gaits in cognitively healthy community-dwelling people over 45.
One hundred eighty-nine independent individuals (aged 45-80) completed health surveys, physical and cognitive tests, and walking evaluations under single-task, motor dual-task, and cognitive dual-task conditions. We applied PCA to 17 spatiotemporal gait parameters to identify independent domains for each gait. Logistic regression analyses were conducted to determine demographic, physical, and cognitive characteristics associated with domain scores.
The results revealed six independent domains consistent across all three gait types: rhythm, variability, phase, pace, base of support (BOS), and asymmetry. These domains accounted for 77.2-83.8 % of the overall gait variance. Rhythm, variability, and phase were the top three domains for all three gait types. Pace was the fourth domain for single- and motor dual-task gaits, while asymmetry held this position for the cognitive dual-task gait. In all three gaits, male sex and heavier weight were associated with greater BOS scores. Taller height and shorter five-times-sit-to-stand test (5XSST) time were associated with greater pace scores, while heavier weight was additionally linked to greater phase scores (p < 0.05). Notably, greater variability domain scores in the cognitive dual-task gait were uniquely associated with poorer executive function, balance, and shorter 5XSST time (p < 0.05).
PCA results revealed consistent gait domains across single-, dual-, and cognitive dual-task conditions in older adults. These findings support the feasibility of using standardized, streamlined assessments focusing on these core domains in geriatric gait assessments. Findings of the unique cognitive dual-task gait characteristics highlight the importance of assessing gait variability and asymmetry of this gait for fall risk screening and prevention interventions.
双任务步态与老年人跌倒有关，但与单任务步态相比，其潜在结构尚不清楚。我们采用主成分分析（PCA）来发现45岁以上认知健康的社区居民单任务和双任务步态背后的独立领域。
189名独立个体（年龄45 - 80岁）完成了健康调查、身体和认知测试，以及在单任务、运动双任务和认知双任务条件下的步行评估。我们将PCA应用于17个时空步态参数，以确定每种步态的独立领域。进行逻辑回归分析以确定与领域得分相关的人口统计学、身体和认知特征。
结果显示，在所有三种步态类型中存在六个一致的独立领域：节奏、变异性、相位、步速、支撑面（BOS）和不对称性。这些领域占总体步态方差的77.2 - 83.8%。节奏、变异性和相位是所有三种步态类型的前三个领域。步速是单任务和运动双任务步态的第四个领域，而不对称性在认知双任务步态中占据这一位置。在所有三种步态中，男性和体重较重与更大的支撑面得分相关。身高较高和五次坐立试验（5XSST）时间较短与更大的步速得分相关，而体重较重还与更大的相位得分相关（p < 0.05）。值得注意的是，认知双任务步态中更大的变异性领域得分与较差的执行功能、平衡能力以及较短的5XSST时间独特相关（p < 0.05）。
PCA结果揭示了老年人在单任务、双任务和认知双任务条件下一致的步态领域。这些发现支持了在老年步态评估中使用专注于这些核心领域的标准化、简化评估的可行性。独特的认知双任务步态特征的发现突出了评估这种步态的变异性和不对称性对于跌倒风险筛查和预防干预的重要性。
