Usual and dual-task gait adaptations under visual stimulation in older adults at different ages

Pilates and Cognitive Stimulation in Dual Task an Intervention Protocol to Improve Functional Abilities and Minimize the Rate of Age-Related Cognitive Decline in Postmenopausal Women

It is already known the effectiveness of Pilates training on cognitive and functional abilities. It is also known that dual-task exercise and cognitive stimuli improve cognition and functional capacity. However, no previous report combined cognitive stimuli and Pilates in dual task and measured its effects on the cognitive and physical performances of postmenopausal women.

OBJECTIVE

To apply an interventional dual-task (PILATES-COG) protocol and to evaluate its influence on memory, language, and functional physical performances on healthy, community-dwelling postmenopausal older women.

METHODS

47 women with amenorrhea for at least 12 months participated in this study. Those allocated on the PILATES-COG group underwent a 12-week, twice a week regimen of 50 min sessions of simultaneous mat Pilates exercise program and cognitive tasks. Cognitive and physical functional performance were assessed. Two-way mixed ANOVA was used for data analysis, and Bonferroni post hoc tests were used for within- and between-group comparisons.

RESULTS

The PILATES-COG group showed significant improvement after the intervention in semantic verbal fluency (p < 0.001; ηρ² = 0.268), phonological verbal fluency (p < 0.019; ηρ² = 0.143), immediate memory (p < 0.001; ηρ² = 0.258), evocation memory (p < 0.001 ηρ² = 0.282), lower-limb muscle strength (p < 0.001; ηρ² = 0.447), balance (p < 0.001; ηρ² = 0.398), and dual-ask cost (p < 0.05; ηρ² = 0.111) assessments on healthy, community-dwelling postmenopausal older women.

CONCLUSION

This is the first report of a feasible and effective approach using Pilates and cognitive stimulation in dual task for the reduction of age-related cognitive decline and the improvement of physical functional performance in healthy postmenopausal women.

Impact of walking states, self-reported daily walking amount and age on the gait of older adults measured with a smart-phone app: a pilot study

BACKGROUND

Smartphones provide a cost-effective avenue for gait assessment among older adults in the community. The purpose of this study is to explore the impact of walking state, self-reported daily walking amount, and age on gait quality, using a smartphone application.

METHODS

One hundred older adult individuals from North China, aged 73.0 ± 7.7 years, voluntarily participated in this study. They performed three walking tests: normal walking, fast walking, and visually impaired walking. Three-dimensional acceleration data for gait were obtained using the smartphone app Pocket Gait. This study used multivariate analysis of variance (MANOVA) to explore the effects of the walking state, self-reported daily walking amount, and age on the step frequency, root mean square (RMS) acceleration, step time variability, regularity, and symmetry.

RESULTS

The walking state, self-reported daily walking amount, and age had statistically significant effects on gait quality. Compared with normal walking, the step frequency, RMS acceleration, variability, and regularity were greater in the fast-walking state, and simulated visually impaired walking did not significantly affect gait quality. Relatively older individuals had a significant decline in gait quality compared to (relatively) younger older adult individuals. Compared with older adults who walked less than 1 km a day, older adults who walked more had better gait quality.

CONCLUSIONS

The walking state, self-reported daily walking amount, and age have a significant effect on the gait quality of older adults. Walking with pigmented sunglasses can be used as a training intervention to improve gait performance. Older adult people who walk less than 1 km/day have worse gait quality compared with their counterparts.

A Dual-Task Paradigm Using the Oral Trail Making Test While Walking to Study Cognitive-Motor Interactions in Older Adults

Objective: With aging, gait becomes more dependent on executive functions, especially on switching abilities. Therefore, cognitive-motor dual-task (DT) paradigms should study the interferences between gait and switching tasks. This study aimed to test a DT paradigm based on a validated cognitive switching task to determine whether it could distinguish older-old adults (OO) from younger-old adults (YO).

Methods: Sixty-five healthy older participants divided into 29 younger-old (<70 years) and 36 older-old (≥70 years) age groups were evaluated in three single-task (ST) conditions as follows: a cognitive task including a processing speed component [Oral Trail Making Test part A (OTMT-A)], a cognitive task including a switching component [Oral Trail Making Test part B (OTMT-B)], and a gait evaluation at normal speed. They were also evaluated under two DT conditions, i.e., one associating gait with OTMT-A and the other associating gait with OTMT-B. Cognitive and gait performances were measured. The comparison of cognitive and gait performances between condition, logistic regression, and receiver operating characteristic (ROC) analyses were performed.

Results: The cognitive and gait performances were differently affected by the different conditions (i.e., ST, DT, OTMT-A, and OTMT-B). The OTMT-B produced higher interference on gait and cognitive performances. Moreover, a higher number of errors on the OTMT-B performed while walking was associated with the older-old age group.

Conclusion: Using validated cognitive flexibility tasks, this DT paradigm confirms the high interference between switching tasks and gait in older age. It is easily implemented, and its sensitivity to age may highlight its possible usefulness to detect cognitive or motor declines.