REVIEWS   

Minerva Medica 2015 October;106(5):287-307

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Rehabilitation procedures in the management of gait disorders in the elderly

Gandolfi M. ^{1, 2}, Dimitrova E. ^{1, 2}, Nicolli F. ³, Modenese A. ³, Serina A. ³, Waldner A. ^{4, 5}, Tinazzi M. ⁶, Squintani G. ⁷, Smania N. ^{1, 2}, Geroin C. ^{1, 2} ✉

¹ Department of Neurological, Biomedical and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy; ² Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; ³ School of Specialization in Physical Medicine and Rehabilitation, University of Verona, Verona, Italy; ⁴ Department of Neurological Rehabilitation, Villa Melitta Private Clinic, Bolzano, Italy; ⁵ Research Department for Neurorehabilitation South Tyrol, Bolzano, Italy 6 Movement Disorders Division, Neurology Unit, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy; ⁷ Neurology Unit, Neuroscience Department, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

Gait disorders are common and very disabling in elderly people, leading to an increase of risk of falling and reductions in quality of life. So far, many clinical classifications of gait disorders in the elderly population have been proposed. Here we suggest a novel categorization of gait disorders in elderly people, which takes into account the several resources required during gait. The biomechanical constraints, movement and sensory strategies, orientation in space, control of dynamics and cognitive processing are essential to perform safely gait. Moreover, the strictly connection between gait and balance has been discussed. According to this perspective, a literature search was performed including studies investigating the rehabilitation procedures in the management of balance and gait disorders in elderly people. Training aimed at improving muscle strength and flexibility, movement strategies, sensorimotor integration and sensory reweighting processes, balance in static and dynamic conditions and cognitive strategies have been proposed as possible therapeutic approaches in elderly people affected by gait disorders. Moreover, the role of new technological devices in improving balance and gait control has been also described. A multidisciplinary and interdisciplinary approach is fundamental for the management of gait disorders in elderly people. Rehabilitation procedures should take into consideration all the potential constraints involved in gait disorders in order to select the most appropriate intervention.