Effect of dual-tasking on walking and cognitive demands in adults with Alzheimer’s dementia experienced in using a 4-wheeled walker

Hunter, Susan; Omaña, Humberto; Madou, Edward; Wittich, Walter; Johnson, Andrew M.; Divine, Alison; Holmes, Jeffrey D.

doi:10.1016/j.gaitpost.2020.01.024

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…When cognitive functions deteriorate and processing two actions becomes difficult, older people are placed at risk, and independence is compromised [ 17 ]. Healthy adults have the ability to develop dual-task activities; however, as a result of the ageing process and/or stages of neurological disorders, the ability to perform multiple tasks can be affected [ 1 , 7 ]. Consequently, preserving and improving a person’s walking ability during other daily life activities is a crucial aim for extending functionality.…”

Section: Discussionmentioning

confidence: 99%

“…Activities such as driving or walking are considered automatic motor sequences, largely operating independently from more cognitively intensive processes such as communication. When combined into a dual-task activity, the interaction of the perceptual-motor and cognitive neurophysiologic processes may have an influence upon the postural control that has a primary support function [ 6 , 7 ]. The turning characteristics during ambulating are a major contributor to motor disability, falls, and reduced quality of life in older people, largely because the necessary (intrinsic) dynamic balance control decreases with age [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

Barros

Melo

Domingos

et al. 2021

JPM

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Numerous of our daily activities are performed within multitask or dual task conditions. These conditions involve the interaction of perceptual and motor processes involved in postural control. Age-related changes may negatively impact cognition and balance control. Studies identifying changes related to dual-task actions in older people are need. This study aimed to determine the effects of different types of dual-tasking on the balance control of healthy older adults. The sample included 36 community-living older adults, performing two tests—a sway test and a timed up-and-go test—in three conditions: (a) single motor task; (b) dual motor task; and (c) dual motor task with cognitive demands. Cognitive processes (dual-task and cognition) affected static balance, increasing amplitude (p < 0.001) and frequency (p < 0.001) of the center of mass displacements. Dynamic balance revealed significant differences between the single motor condition and the other two conditions during gait phases (p < 0.001). The effect of dual-tasking in older adults suggests that cognitive processes are a main cause of increased variability in balance and gait when under an automatic control. During sit-to-stand, turning, and turn-to-sit movements under dual-tasking, the perceptive information becomes the most important focus of attention, while any cognitive task becomes secondary.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

Barros

Melo

Domingos

et al. 2021

JPM

View full text Add to dashboard Cite

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“…Therefore, prescription of mobility aids is still an important clinical tool to compensate for de cits. People with dementia newly learning or experienced in using a 4-wheeled walker demonstrate increased cognitive demands and a deterioration in gait in distracting situations and when manoeuvring around obstacles [19,20].…”

Section: Introductionmentioning

confidence: 99%

Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

Hunter

Divine

Omaña

et al. 2020

Preprint

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Background: Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.Methods: Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n=5) scored participant videos of people with dementia (n=10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results: Three focus groups (n=17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC=0.92, 95%CI (0.81, 0.98), p<0.001) and SUMAC-EQ (ICC=0.82, 95%CI (0.54, 0.95), p<0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC=0.89, 95%CI (0.81, 0.94), p<0.001) and SUMAC-EQ (ICC=0.88, 95%CI (0.79, 0.93), p<0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs=0.84), but not EQ (rs=0.39).Conclusions: The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

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“…Therefore, prescription of mobility aids is still an important clinical tool to compensate for deficits. People with dementia newly learning or experienced in using a 4-wheeled walker demonstrate increased cognitive demands and a deterioration in gait in distracting situations and when manoeuvring around obstacles [15,22]. Additionally, the uptake and safe use of mobility aids may be impacted by cognitive impairment through a lack of self-awareness or incomplete learning to use the equipment safely [8].…”

Section: Introductionmentioning

confidence: 99%

Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change. Methods Healthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations. Results Three focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39). Conclusions The focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

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Effect of dual-tasking on walking and cognitive demands in adults with Alzheimer’s dementia experienced in using a 4-wheeled walker

Cited by 15 publications

References 30 publications

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

Development, reliability and validity of the Safe Use of Mobility Aids Checklist (SUMAC) for 4-wheeled walker use in people living with dementia

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