Although attention-dividing dual tasks hinder gait performance in older persons, gender differences in gait have not been examined. The purpose of this study was to examine whether gait performance differs between older men and women during dual task walking. A total of 44 healthy adults (20 men and 24 women) aged 65 years or older participated in the study. Participants walked under normal and dual task (backward spelling) conditions at self-selected speeds. Mean gait speed and stride-to-stride variability in gait speed were quantified with GAITRite( ®) instrumentation. Whereas gait speed decreased and variability in gait speed increased in both groups during dual task walking, men walked with greater variability during dual task walking than did women. The magnitude of the increase in variability in gait speed observed in men indicates that stride-to-stride variability in gait speed during dual task walking requires more investigation as a potential risk factor for falls in older men.
Physical therapists working in neurological practice must make choices about which standardized outcome measures are most appropriate for each patient. Significant time constraints in the clinic limit the number of measures that one can reasonably administer. Therapists must choose measures that will provide results that guide the selection of appropriate interventions and are likely to show clinically meaningful change. Therefore, therapists must be able to compare the merits of available measures to identify those that are most relevant for each patient and setting. This article describes a process for selecting outcome measures and illustrates the use of that process with a patient who has had a stroke. The link between selecting objective outcome measures and tracking patient progress is emphasized. Comparisons are made between 2 motor function measures (the Fugl-Meyer Assessment [FMA] of Physical Performance vs the Stroke Rehabilitation Assessment of Movement), and 2 balance measures (Berg Balance Scale vs the Activities-specific Balance Confidence Scale). The use of objective outcome measures allows therapists to quantify information that previously had been described in subjective terms. This allows the tracking of progress, and the comparison of effectiveness and costs across interventions, settings, providers, and patient characteristics.
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