轻度认知障碍老年人的最小脚趾间隙变异性：与健康对照的差异及舞蹈干预的效果
Minimum toe clearance variability in older adults with mild cognitive impairment: Differences to healthy controls and effects of a dance intervention.
作者信息
Labott Berit K, Herold Fabian, Langhans Corinna, Halfpaap Nicole, Grässler Bernhard, Hökelmann Anita, Müller Notger G, Hamacher Daniel
机构信息
Department of Sport Science, Faculty of Humanities, Otto-von-Guericke University, Magdeburg, Germany; Department of Intervention Research in Exercise Training, Institute of Exercise Training and Sport Informatics, German Sport University, Cologne, Germany; Department of Neurology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany; University of Münster, Department of Neuromotor Behaviour and Exercise, Münster, Germany.
Department of Neurology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany; Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Germany; Department of Physiology, Faculty of Medicine, HMU Health and Medical University Erfurt, Erfurt, Germany.
出版信息
Gait Posture. 2025 May 1;121:101-107. doi: 10.1016/j.gaitpost.2025.04.033.
BACKGROUND
Falls in older adults with mild cognitive impairment (MCI) are a major health issue. For healthy individuals, higher variability in minimum toe clearance (MTC) during gait is associated with the risk of tripping-related falls and dance intervention reduces MTC variability. Such empirical evidence is lacking for individuals with MCI.
RESEARCH QUESTION
We aimed to assess differences in MTC variability between healthy older adults and older adults with MCI. Furthermore, we analysed the effects of a six-month dance intervention on MTC variability in older adults with MCI.
METHODS
We recruited community-dwelling cognitively healthy control participants (n = 34) and participants with MCI (n = 55). All participants underwent gait assessment using inertial sensors. In a cohort study, MTC variability of healthy vs. MCI participants was compared using Welch's t-test. There were no significant differences in the participant's characteristics except for cognitive performance. In a randomised controlled trial, participants with MCI were randomly allocated to either an intervention (IG, n = 27) or a passive control group (CG, n = 28). IG was required to attend a twice-weekly 90-minute dance program for six months. After six months, the gait assessment was repeated in both groups of MCI participants, and the effect of the dance intervention on MTC variability was assessed using 2-level random intercept models. Additionally, the mean MTC was analysed in a secondary analysis.
RESULTS
Adults with MCI exhibited a significantly higher MTC variability compared to healthy adults (p = .016, d = 0.53), but no difference was found in the mean MTC (p = .980, d < 0.01). The dance intervention did not improve either MTC variability (p = .182) or mean MTC (p = .742).
SIGNIFICANCE
The higher MTC variability in older adults with MCI compared to healthy controls may contribute to their higher fall risk. Future studies should investigate the effects of an individually tailored dance intervention, and other intervention approaches on MTC variability and fall risk.
背景
轻度认知障碍（MCI）的老年人跌倒问题是一个主要的健康问题。对于健康个体，步态期间最小脚趾间隙（MTC）的较高变异性与绊倒相关跌倒风险相关，而舞蹈干预可降低MTC变异性。MCI个体缺乏此类实证证据。
研究问题
我们旨在评估健康老年人与MCI老年人之间MTC变异性的差异。此外，我们分析了为期六个月的舞蹈干预对MCI老年人MTC变异性的影响。
方法
我们招募了居住在社区的认知健康对照参与者（n = 34）和MCI参与者（n = 55）。所有参与者使用惯性传感器进行步态评估。在一项队列研究中，使用韦尔奇t检验比较健康参与者与MCI参与者的MTC变异性。除认知表现外，参与者特征无显著差异。在一项随机对照试验中，MCI参与者被随机分配到干预组（IG，n = 27）或被动对照组（CG，n = 28）。IG被要求参加为期六个月、每周两次、每次90分钟的舞蹈课程。六个月后，对两组MCI参与者重复进行步态评估，并使用二级随机截距模型评估舞蹈干预对MTC变异性的影响。此外，在二次分析中分析了平均MTC。
结果
与健康成年人相比，MCI成年人的MTC变异性显著更高（p = .016，d = 0.53），但平均MTC无差异（p = .980，d < 0.01）。舞蹈干预既未改善MTC变异性（p = .182），也未改善平均MTC（p = .742）。
意义
与健康对照组相比，MCI老年人较高的MTC变异性可能导致其较高的跌倒风险。未来研究应调查个体化舞蹈干预及其他干预方法对MTC变异性和跌倒风险 的影响。
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