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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2013 December;49(6):857-64

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Physical training-related changes in gait variability while single and dual tasking in older adults: magnitude of gait variability at baseline matters

Beauchet O. 1, 2, 3, Launay C. 1, 2, Annweiler C. 1, 2, 3, Fantino B. 1, 2, Allali G. 4, De Decker L. 5

1 Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, France;
2 Angers University Memory Clinic, France;
3 UPRES EA 4638, University of Angers, UNAM, Angers, France;
4 Department of Neurology, Geneva University Hospitals, Geneva, Switzerland;
5 Department of Geriatrics, Nantes University Hospital, Nantes, France


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Objectives: Few studies have examined the effects of physical training programs on gait variability while single and dual tasking, and they reported mixed results. The aim of this study was to compare the stride time variability while single and dual tasking before and after a physical training program developed to improve gait stability in French community-dwelling older adults.
Design: A prospective pre-post interventional cohort study.
Setting: The community-dwelling area of “Pays de la Loire”, France.
Population: Forty-eight older adults (mean age ± standard deviation 72.2±8 years; 75% female).
Methods: Physical training program consisted in 12 sessions scheduled to attend physical exercises 1 time a week with total time duration of 3 months. Coefficient of variation (CoV) of stride time under three walking conditions (i.e., walking alone, walking while backward counting, and while performing a verbal fluency task) was determined while steady-state walking using the SMTEC® footswitches system before and after the physical training program. Participants were separated into two groups based on being or not in the highest tertile (i.e., worst performance with cutpoint >4.4%) of the CoV of stride time while walking alone.
Results: After physical training compared to before period, a significant decrease in CoV of stride time (i.e., better gait performance) while walking alone (2.8±2.8% versus 7±7.1%, P=0.001) but not while dual tasking (P=0.600 for counting backward and P=0.105 for verbal fluency task) was shown in participants who had highest (i.e., worst) gait variability at baseline. In addition, physical training modified the strategy of dual tasking in participants with highest gait variability at baseline compared to the other participants. Before training, a significant decrease in CoV of stride time (7±7.1% versus 4.9±4.6%, P=0.017) while counting backward was shown, but there was a significant increase after training (2.8±2.8% versus 5.4±5.8%, P=0.007).
Conclusions: Physical training reduced gait variability while walking alone in participants with gait instability, and influenced their strategy for dual tasking.
Clinical Rehabilitation Impact: Physical program training developed in the community to improve gait stability should included participants with high gait variability.

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olbeauchet@chu-angers.fr