How Does Explicit Prioritization Alter Walking During Dual-Task Performance? Effects of Age and Sex on Gait Speed and Variability

被引:239
作者
Yogev-Seligmann, Galit [4 ]
Rotem-Galili, Yael [5 ]
Mirelman, Anat
Dickstein, Ruth [6 ]
Giladi, Nir [7 ]
Hausdorff, Jeffrey M. [1 ,2 ,3 ]
机构
[1] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Lab Gait Anal & Neurodynam, Movement Disorders Unit,Dept Neurol, IL-69978 Tel Aviv, Israel
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Tel Aviv Univ, Sackler Fac Med, Dept Phys Therapy, IL-69978 Tel Aviv, Israel
[4] Tel Aviv Univ, Dr Miriam & Sheldon G Adelson Grad Sch Med, Sackler Fac Med, IL-69978 Tel Aviv, Israel
[5] Univ Haifa, Dept Gerontol, Fac Social Welf & Hlth Sci, IL-31999 Haifa, Israel
[6] Univ Haifa, Dept Phys Therapy, Fac Social Welf & Hlth Sci, IL-31999 Haifa, Israel
[7] Tel Aviv Univ, Dept Neurol, Sackler Fac Med, IL-69978 Tel Aviv, Israel
来源
PHYSICAL THERAPY | 2010年 / 90卷 / 02期
关键词
EXECUTIVE FUNCTION; BALANCE CONSTRAINTS; PARKINSONS-DISEASE; OLDER-ADULTS; ATTENTION; STABILITY; MOTOR; INTERFERENCE; LOCOMOTION; VELOCITY;
D O I
10.2522/ptj.20090043
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background. Previous studies have demonstrated that the performance of a secondary task during walking alters gait. Objective. This study investigated the effects of task prioritization on walking in young and older adults to evaluate the "default" prioritization scheme used, the flexibility to alter prioritization and cortical resources allocated to gait and a secondary cognitive task, and an age-associated changes in these abilities. Design. A cross-sectional study that explicitly altered the focus of attention was used to investigate the effects of prioritization in young and older adults who were healthy. Methods. Gait speed and gait variability were evaluated in young adults (n=40) and older adults (n=17) who were healthy, both during usual walking and under 3 dual-task conditions: (1) no specific prioritization instructions, (2) prioritization of gait, and (3) prioritization of the cognitive task. Results. Young adults significantly increased gait speed in the gait prioritization condition compared with gait speed in the no-instruction condition; a similar tendency was seen in the older adults. Gait speed was reduced when priority was given to the cognitive task in both age groups; however, this effect was less dramatic in the older adults. In the young adults, prioritization of gait tended to have different effects on gait speed among both men and women. In the older adults, but not in the young adults, all dual-task conditions produced increased gait variability, whereas prioritization did not titer this gait feature. Limitations. The sample size and the relative homogeneity of the older adults could be considered as possible limitations of the study. Conclusions. Even among young adults, the effects of secondary, cognitive tasks on gait speed are strongly influenced by prioritization. This finding was less significant in the older adults, suggesting that there is an age-associated decline in the ability to flexibly allocate attention to gait. Somewhat surprisingly, when prioritization was not explicitly instructed, gait speed in both young and older adults most closely resembled that of the condition when they were instructed to focus attention on the cognitive task.
引用
收藏
页码:177 / 186
页数:10
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