Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.
Background: Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach.Methods: An observational study includ...
| Publicado en: | Journal of NeuroEngineering & Rehabilitation (JNER) Vol. 14; no. 1; pp. 1 - 15 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
1/31/2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121070783&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121070783 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17430003 1CUC jtl: Journal of NeuroEngineering & Rehabilitation (JNER) issn: 17430003 maglogo: N pubinfo: dt: 1/31/2017 vid: 14 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 121070783 121070783 NLM28143497 121070783 10.1186/s12984-017-0218-1 NLM28143497 121070783 ppf: 1 ppct: 14 formats: tig: atl: Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes. aug: au: Auvinet, Bernard Touzard, Claude Montestruc, François Delafond, Arnaud Goeb, Vincent affil: Rheumalogy Unit, Polyclinique du Maine, 4 Avenue des Français Libres, F 53010 Laval, France sug: subj: Neurologic Examination Methods Gait Disorders, Neurologic Diagnosis Gait Disorders, Neurologic Etiology Aged Gait Physiology Male Walking Physiology Female Phenotype Human Aged: 65+ years Male Female ab: Background: Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach.Methods: An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi2 tests).Results: Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity allowed the identification of 3 motor phenotypes (p < 0.01), without any difference for white matter hyperintensities, but with an increased Scheltens score from the first to the third motor phenotype (p = 0.05).Conclusions: Gait analysis under dual-task conditions in elderly people suffering from gait disorders or memory impairment is of great value in assessing the severity of gait disorders, differentiating between peripheral pathologies and central nervous system pathologies, and identifying motor phenotypes. Correlations between motor phenotypes and brain imaging require further studies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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