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会话内双任务步行练习可改善患有多发性硬化症的老年人的步态变异性。

Within-session dual-task walking practice improves gait variability in older adults with multiple sclerosis.

作者信息

Hernandez Manuel E, Motl Robert W, Foley Frederick W, Izzetoglu Meltem, Wagshul Mark, Holtzer Roee

机构信息

Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, United States; Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States; Neuroscience Program, College of Liberal Arts & Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States; Beckman Institute, University of Illinois Urbana-Champaign, Urbana, IL, United States.

Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States.

出版信息

Gait Posture. 2025 Jun;119:171-177. doi: 10.1016/j.gaitpost.2025.03.011. Epub 2025 Mar 19.

Abstract

BACKGROUND

Greater gait variability is associated with falls in aging and multiple sclerosis. However, whether older adults with MS (OAMS), show higher gait variability relative to healthy older adults (HOA), under single and dual-task walking conditions, has not been reported. Furthermore, it is unclear whether practice may improve gait variability in both groups.

RESEARCH QUESTION

Is gait variability higher in OAMS relative to HOA, particularly in DTW compared to STW? Furthermore, does practice result in decreased gait variability in both groups, notably under DTW compared to STW?

METHODS

We examined the effect of within-session practice on gait variability during single (STW) and dual (DTW) task gait conditions. OAMS (n = 97, mean±SD age: 65 ± 5 years, 66 females) and HOA (n = 113, mean±SD age: 68 ± 7 years, 73 females) were recruited. Practice effects on gait variability were evaluated over three repeated counterbalanced STW and DTW trials. Gait variability measures included Coefficient of Variation (CV) in stride velocity, stride length, and swing time.

RESULTS

OAMS demonstrated higher gait variability, on all measures, relative to HOA during both STW and DTW (P < 0.001). Gait variability on all measures was higher in DTW compared to STW, (P < 0.05). Practice resulted in decreased gait variability (P < 0.01) on all measures in both OAMS and HOA. Furthermore, practice resulted in decreased temporal gait variability, as measured by swing time CV, under DTW in particular (P < 0.05).

SIGNIFICANCE

In conclusion, OAMS exhibited greater gait variability than HOA, yet both groups demonstrated decreases in temporal and spatial gait variability after within-session practice, notably under DTW, which in turn may reduce fall risk.

摘要

背景

更大的步态变异性与衰老和多发性硬化症患者的跌倒有关。然而,患有多发性硬化症的老年人(OAMS)在单任务和双任务步行条件下相对于健康老年人(HOA)是否表现出更高的步态变异性,尚未见报道。此外,尚不清楚练习是否可以改善两组的步态变异性。

研究问题

OAMS的步态变异性是否高于HOA,特别是在双任务步行(DTW)与单任务步行(STW)相比时?此外,练习是否会导致两组的步态变异性降低,特别是在DTW与STW相比时?

方法

我们研究了单任务(STW)和双任务(DTW)步态条件下,单次练习对步态变异性的影响。招募了OAMS(n = 97,平均±标准差年龄:65±5岁,66名女性)和HOA(n = 113,平均±标准差年龄:68±7岁,73名女性)。在三次重复的、平衡的STW和DTW试验中评估练习对步态变异性的影响。步态变异性测量包括步速、步长和摆动时间的变异系数(CV)。

结果

在STW和DTW期间,OAMS在所有测量指标上的步态变异性均高于HOA(P < 0.001)。与STW相比,DTW在所有测量指标上的步态变异性更高(P < 0.05)。练习导致OAMS和HOA在所有测量指标上的步态变异性降低(P < 0.01)。此外,练习导致时间步态变异性降低,特别是通过DTW下的摆动时间CV测量(P < 0.05)。

意义

总之,OAMS的步态变异性比HOA更大,但两组在单次练习后,特别是在DTW下,时间和空间步态变异性均降低,这反过来可能降低跌倒风险。

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