Characteristics of stepping over an obstacle in community dwelling older adults under dual-task conditions

Schrodt, Lori A.; Mercer, Vicki S.; Giuliani, Carol; Hartman, Marilyn

doi:10.1016/s0966-6362(03)00067-5

Cited by 95 publications

(62 citation statements)

References 32 publications

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“…The results from dual-task walking studies suggest that concurrent cognitive performance should have a detrimental effect on the control of foot placement during obstacle crossing. There has been some indication of this in the literature [12][13][14] but these results are not conclusive. For example, Chen et al [13] observed participants walking and avoiding a suddenly appearing band of light projected on the walkway.…”

Section: Introductionmentioning

confidence: 93%

“…In upright standing it can be difficult to interpret dual-task effects because concurrent cognitive activity has been shown to both increase and decrease postural sway [10,11]. Few studies have examined the effect of concurrent cognitive activity or ageing on foot placement when negotiating obstacles [12][13][14]. The results from dual-task walking studies suggest that concurrent cognitive performance should have a detrimental effect on the control of foot placement during obstacle crossing.…”

Section: Introductionmentioning

confidence: 99%

“…Since the reaction task in this study directed visual attention from the immediate walkway, it is not possible to infer that increased attention demands led to impaired stepping control. Schrodt et al [12] demonstrated that a concurrent memory task altered stride positioning when crossing obstacles but reported no other changes to gait. Brown et al [14] examined changes to a verbal reaction time task during obstacle crossing.…”

Section: Introductionmentioning

confidence: 99%

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Stepping over obstacles: Attention demands and aging

2009

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Older adults have been shown to trip on obstacles despite taking precautions to step carefully. It has been demonstrated in dual-task walking that age-related decline in cognitive and attentional mechanisms can compromise postural management. This is yet to be substantiated during obstacle negotiation when walking. Forty-six healthy volunteers (aged 20-79 years) stepped over obstacles in their path whilst walking and performing a verbal fluency task. Using 3D kinematic analysis we compared obstacle crossing during single (obstacle crossing only) and dual-task (obstacle crossing with verbal task) conditions. We grouped the participants into three age groups and examined age-related changes to cognitive interference on obstacle crossing. During dual-task trials, the 20-29 and 60-69 groups stepped closer to the obstacles prior to crossing, increased vertical toe-obstacle clearance, and had reduced gait variability. In these two groups there was a small dual-task decrease in verbal output. The 70-79 group applied similar dual-task stepping strategies during precrossing. However, during crossing they showed reduced vertical toe-to-obstacle clearance and increased variability of obstacle-to-heel distance. Additionally, this group did not show any significant change to verbal output across trials. These results suggest that with advanced age, increased cognitive demands are more likely to have a detrimental impact on motor performance, leading to compromised safety margins and increased variability in foot placement. We conclude that younger adults utilise a posture-preserving strategy during complex tasks but the likelihood of this strategy being used decreases with advanced age.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stepping over obstacles: Attention demands and aging

2009

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“…One way to measure functional abilities is to use an obstacle course (Schrodt et al 2004). The Standard Walking Obstacle Course (SWOC) is a 12.2 m carpeted path with turns and obstacles at standardized locations.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between the C-leg® Microprocessor-Controlled Prosthetic Knee and Non-Microprocessor Control Prosthetic Knees

Seymour

Engbretson

Kott

et al. 2007

Prosthetics &Amp; Orthotics International

107

119

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This study investigated energy expenditure and obstacle course negotiation between the C-leg 1 and various non-microprocessor control (NMC) prosthetic knees and compared a quality of life survey (SF-36v2 TM ) of use of the C-leg 1 to national norms. Thirteen subjects with unilateral limb loss (12 with trans-femoral and one with a knee disarticulation amputation) participated in the study. The mean age was 46 years, range 30 -75. Energy expenditure using both the NMC and C-leg 1 prostheses was measured at self-selected typical and fast walking paces on a motorized treadmill. Subjects were also asked to walk through a standardized walking obstacle course carrying a 4.5 kg (10 lb) basket and with hands free. Finally, the SF-36v2 TM was completed for subjects while using the C-leg 1 . Statistically significant differences were found in oxygen consumption between prostheses at both typical and fast paces with the C-leg 1 showing decreased values. Use of the C-leg 1 resulted in a statistically significant decrease in the number of steps and time to complete the obstacle course. Scores on a quality of life index for subjects using the C-leg 1 were above the mean for norms for limitation in the use of an arm or leg, equal to the mean for the general United States population for the physical component score and were above this mean for the mental component score. Based on oxygen consumption and obstacle course findings, the C-leg 1 when compared to the NMC prostheses may provide increased functional mobility and ease of performance in the home and community environment. Questionnaire results suggest a minimal quality of life impairment when using a C-leg 1 for this cohort of individuals with amputation.

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“…Uma possível explicação para a interferência da tarefa dupla no controle postural é a competição da tarefa secundária com a efetividade da resposta motora e da aferência sensorial para manter o equilíbrio. Tanto tarefas primárias quanto secundárias ocorrem por processos neuronais similares, podendo ocorrer prejuízo de uma ou ambas quando a capacidade do indivíduo vai além de sua reserva 34,35 .…”

Section: Discussionunclassified

Efeito da realização simultânea de tarefas cognitivas e motoras no desempenho funcional de idosos da comunidade

et al. 2008

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RESUMO: O objetivo deste estudo foi avaliar o efeito de seis diferentes tarefas duplas no desempenho funcional de idosos da comunidade. Em 35 idosos com idade média de 69,6±7,1 anos foi aplicado o teste de levantar e caminhar cronometrado (TLCC, Timed up and go ou TUG) simples (TLCCS) e associado a duas tarefas motoras -carregar um copo com água (TLCCM1) e transferir moedas de um bolso para o outro (TLCCM2) -e duas cognitivas, repetir uma frase (TLCCC1) e falar os dias da semana em ordem inversa (TLCCC2), sendo aferidos os acertos e erros nessas tarefas. Houve piora significativa da média do tempo em segundos no TLCC nas tarefas duplas, independente da tarefa, e correlação significativa, de moderada (r=0,676) a quase perfeita (r=0,953), entre os tempos de cada tipo de TLCC. O número de moedas transferidas no TLCCM2 e o número de dias na semana dito em ordem inversa no TLCCC2 apresentaram correlação com o tempo gasto para realizar todas as outras tarefas. Essas duas tarefas foram as que mais afetaram o tempo do TLCC (p<0,001). Os idosos estudados apresentaram pois pior desempenho no TLCC associado à realização de tarefas duplas. As tarefas com pior desempenho funcional verificados foram os de passar moedas de um bolso para outro e falar os dias da semana em ordem inversa. A complexidade da tarefa foi mais importante que sua natureza motora ou cognitiva. DESCRITORES: Análise e desempenho de tarefas; Atividade motora; Idoso; Manifestações neurocomportamentais ABSTRACT:The purpose was to assess the effect of six different dual tasks in community dwelling elderly. Thirty-five volunteers (aged 69.6±7.1 years) were submitted to the Timed Up and Go test (TUG) and to further five tasks wherein TUG was associated to two motor tasks -carrying a glass of water (TUGM1) and transferring coins from one pocket to another (TUGM2); to two cognitive tasks -repeating a sentence (TUGC1) and saying weekdays backwards (TUGC2); and to a motor-cognitive task, of carrying a glass of water while repeating a sentence (TUGMC). Time spent, failure and success in each task were counted. Results showed a significant decrease in average time (in seconds) spent in TUG when associated with all tasks; and a significant correlation from moderate (r=0.676) to almost perfect (r=0.953) between the times of each association with TUG. The number of transferred coins in TUGM2 and the number of days of the week correctly said in TUGC2 showed a correlation with the time spent in all the other tasks. These two tasks most affected the time spent to accomplish TUG (p<0.001). Hence, dwelling community elderly showed a decrease in performance at all dual tasks associated to TUG. The worst functional performances were transferring coins from one pocket to another and saying weekdays backwards, showing that task complexity, rather than task nature, had greater impact on the time spent to perform TUG.

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Characteristics of stepping over an obstacle in community dwelling older adults under dual-task conditions

Cited by 95 publications

References 32 publications

Stepping over obstacles: Attention demands and aging

Stepping over obstacles: Attention demands and aging

Comparison Between the C-leg® Microprocessor-Controlled Prosthetic Knee and Non-Microprocessor Control Prosthetic Knees

Efeito da realização simultânea de tarefas cognitivas e motoras no desempenho funcional de idosos da comunidade

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