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Dotov D, Motsenyat A, Trainor LJ. Concurrent Supra-Postural Auditory-Hand Coordination Task Affects Postural Control: Using Sonification to Explore Environmental Unpredictability in Factors Affecting Fall Risk. SENSORS (BASEL, SWITZERLAND) 2024; 24:1994. [PMID: 38544259 PMCID: PMC10974305 DOI: 10.3390/s24061994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/10/2024] [Accepted: 03/18/2024] [Indexed: 04/01/2024]
Abstract
Clinical screening tests for balance and mobility often fall short of predicting fall risk. Cognitive distractors and unpredictable external stimuli, common in busy natural environments, contribute to this risk, especially in older adults. Less is known about the effects of upper sensory-motor coordination, such as coordinating one's hand with an external stimulus. We combined movement sonification and affordable inertial motion sensors to develop a task for the precise measurement and manipulation of full-body interaction with stimuli in the environment. In a double-task design, we studied how a supra-postural activity affected quiet stance. The supra-postural task consisted of rhythmic synchronization with a repetitive auditory stimulus. The stimulus was attentionally demanding because it was being modulated continuously. The participant's hand movement was sonified in real time, and their goal was to synchronize their hand movement with the stimulus. In the unpredictable condition, the tempo changed at random points in the trial. A separate sensor recorded postural fluctuations. Young healthy adults were compared to older adult (OA) participants without known risk of falling. The results supported the hypothesis that supra-postural coordination would entrain postural control. The effect was stronger in OAs, supporting the idea that diminished reserve capacities reduce the ability to isolate postural control from sensory-motor and cognitive activity.
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Affiliation(s)
- Dobromir Dotov
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE 68182, USA
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Ariel Motsenyat
- Integrated Biomedical Engineering and Health Science, McMaster University, Hamilton, ON L8S 4K1, Canada;
| | - Laurel J. Trainor
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8S 4K1, Canada;
- Rotman Research Institute, Toronto, ON M6A 2E1, Canada
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Weston AR, Antonellis P, Fino PC, Hoppes CW, Lester ME, Weightman MM, Dibble LE, King LA. Quantifying Turning Tasks With Wearable Sensors: A Reliability Assessment. Phys Ther 2024; 104:pzad134. [PMID: 37802908 DOI: 10.1093/ptj/pzad134] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/05/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE The aim of this study was to establish the test-retest reliability of metrics obtained from wearable inertial sensors that reflect turning performance during tasks designed to imitate various turns in daily activity. METHODS Seventy-one adults who were healthy completed 3 turning tasks: a 1-minute walk along a 6-m walkway, a modified Illinois Agility Test (mIAT), and a complex turning course (CTC). Peak axial turning and rotational velocity (yaw angular velocity) were extracted from wearable inertial sensors on the head, trunk, and lumbar spine. Intraclass correlation coefficients (ICCs) were established to assess the test-retest reliability of average peak turning speed for each task. Lap time was collected for reliability analysis as well. RESULTS Turning speed across all tasks demonstrated good to excellent reliability, with the highest reliability noted for the CTC (45-degree turns: ICC = 0.73-0.81; 90-degree turns: ICC = 0.71-0.83; and 135-degree turns: ICC = 0.72-0.80). The reliability of turning speed during 180-degree turns from the 1-minute walk was consistent across all body segments (ICC = 0.74-0.76). mIAT reliability ranged from fair to excellent (end turns: ICC = 0.52-0.72; mid turns: ICC = 0.50-0.56; and slalom turns: ICC = 0.66-0.84). The CTC average lap time demonstrated good test-retest reliability (ICC = 0.69), and the mIAT average lap time test-retest reliability was excellent (ICC = 0.91). CONCLUSION Turning speed measured by inertial sensors is a reliable outcome across a variety of ecologically valid turning tasks that can be easily tested in a clinical environment. IMPACT Turning performance is a reliable and important measure that should be included in clinical assessments and clinical trials.
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Affiliation(s)
- Angela R Weston
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, Utah, USA
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, San Antonio, Texas, USA
| | - Prokopios Antonellis
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Carrie W Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, San Antonio, Texas, USA
| | - Mark E Lester
- Department of Physical Therapy, University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | | | - Leland E Dibble
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Laurie A King
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
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Zukowski LA, Fino PC, Levin I, Hsieh KL, Lockhart SN, Miller ME, Laurienti PJ, Kritchevsky SB, Hugenschmidt CE. Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults. Hum Mov Sci 2024; 93:103175. [PMID: 38198920 PMCID: PMC11195422 DOI: 10.1016/j.humov.2023.103175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/13/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Capturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain. METHODS Participants included 56 OA (>70 years of age) and 29 YA (25-35 years of age). In OA, Aβ deposition in the brain was quantified by PET imaging. All participants completed a series of cognitive assessments, a functional mobility assessment, and self-report questionnaires. Then participants performed two sets of walking trials on a custom-built walkway containing a mixture of even and uneven surface sections, including three trials with a grass uneven surface and three trials with a rocks uneven surface. Gait data were recorded using a wireless inertial measurement unit system. Stride length, gait speed, and gait smoothness (i.e., log dimensionless lumbar jerk) in the anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were calculated for each stride. Outcomes were retained for five stride locations immediately surrounding the surface transition. RESULTS OA exhibited slower gait (Grass: p < 0.001; Rocks: p = 0.006), shorter strides (Grass: p < 0.001; Rocks: p = 0.008), and smoother gait (Grass AP: p < 0.001; Rocks AP: p = 0.002; Rocks ML: p = 0.02) than YA, but they also exhibited greater reductions in gait speed and stride length than YA while transitioning to the uneven grass and rocks surfaces. Within the OA group, those with greater Aβ deposition exhibited decreases in smoothness with age (Grass AP: p = 0.02; Rocks AP: p = 0.03; Grass ML: p = 0.04; Rocks ML: p = 0.03), while those with lower Aβ deposition exhibited increasing smoothness with age (Grass AP: p = 0.01; Rocks AP: p = 0.02; Grass ML: p = 0.08; Rocks ML: p = 0.07). Better functional mobility was associated with less smooth gait (Grass ML: p = 0.02; Rocks ML: p = 0.05) and with less variable gait smoothness (Grass and Rocks AP: both p = 0.04) in the OA group. CONCLUSION These results suggest that, relative to YA, OA may be adopting more cautious, compensatory gait strategies to maintain smoothness when approaching surface transitions. However, OA with greater Aβ deposition may have limited ability to adopt compensatory gait strategies to increase the smoothness of their walking as they get older because of neuropathological changes altering the sensory integration process and causing worse dynamic balance (i.e., jerkier gait). Functional mobility, in addition to age and Aβ deposition, may be an important factor of whether or not an OA chooses to employ compensatory strategies to prioritize smoothness while walking and what type of compensatory strategy an OA chooses.
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Affiliation(s)
- Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, United States of America.
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Ilana Levin
- Department of Physical Therapy, High Point University, High Point, NC, United States of America
| | - Katherine L Hsieh
- Department of Physical Therapy, Georgia State University, Atlanta, GA, United States of America
| | - Samuel N Lockhart
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
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Sato SD, Choi JT. Reduced corticospinal drive and inflexible temporal adaptation during visually guided walking in older adults. J Neurophysiol 2023; 130:1508-1520. [PMID: 37937342 PMCID: PMC10994519 DOI: 10.1152/jn.00078.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/09/2023] Open
Abstract
Corticospinal drive during walking is reduced in older adults compared with young adults, but it is not clear how this decrease might compromise one's ability to adjust stepping, particularly during visuomotor adaptation. We hypothesize that age-related changes in corticospinal drive could predict differences in older adults' step length and step time adjustments in response to visual perturbations compared with younger adults. Healthy young (n = 21; age 18-33 yr) and older adults (n = 20; age 68-80 yr) were tested with a treadmill task, incorporating visual feedback of the foot position and stepping targets in real-time. During adaptation, the visuomotor gain was reduced on one side, causing the foot cursor and step targets to move slower on that side of the screen (i.e., split-visuomotor adaptation). Corticospinal drive was quantified by coherence between electromyographic signals in the beta-gamma frequency band (15-45 Hz). The results showed that 1) older adults adapted to visuomotor perturbations during walking, with a similar reduction in error asymmetry compared with younger adults; 2) however, older adults showed reduced adaptation in step time symmetry, despite demonstrating similar adaptation in step length asymmetry compared with younger adults; and 3) smaller overall changes in step time asymmetry was associated with reduced corticospinal drive to the tibialis anterior in the slow leg during split-visuomotor adaptation. These findings suggest that changes in corticospinal drive may affect older adults' control of step timing in response to visual challenges. This could be important for safe navigation when walking in different environments or dealing with unexpected circumstances.NEW & NOTEWORTHY Corticospinal input is essential for visually guided walking, especially when the walking pattern must be modified to accurately step on safe locations. Age-related changes in corticospinal drive are associated with inflexible step time, which necessitates different locomotor adaptation strategies in older adults.
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Affiliation(s)
- Sumire D Sato
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Julia T Choi
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, Massachusetts, United States
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Le Rossignol S, Fraser E, Grant A, Doma K, Wilkinson M, Morse L, McEwen P, Hazratwala K, Connor J. Patients with knee osteoarthritis have altered gait and gaze patterns compared to age-matched controls: A pilot study. PLoS One 2023; 18:e0283451. [PMID: 38011143 PMCID: PMC10681189 DOI: 10.1371/journal.pone.0283451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/07/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE Although knee Osteoarthritis (KOA) sufferers are at an increased risk of falls, possibly due to impaired gait function, the associated gaze behaviour in patients with KOA are largely unknown. Thus, we compared gait and gaze behaviours characteristics between KOA patients and asymptomatic age-matched controls. RESULTS For Timed Up and Go (TUG) and stair climb tasks, the KOA group demonstrated longer periods of gaze fixations with less frequency of fixations compared to the control group. Conversely, for the Timed up and Go Agility (TUGA) test shorter fixation and frequency patterns were observed. The KOA group presented a shorter final stride length prior to the initiation of the first step in the Stair climb assessment. In addition, for the 30m walk and dual task assessments, the average step length was significantly shorter in the KOA group compared to controls. CONCLUSION Overall, we found altered gait and gaze behaviours are evident in KOA patients which could relate to their increased falls risk.
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Affiliation(s)
- Scott Le Rossignol
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Ewen Fraser
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Andrea Grant
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Kenji Doma
- School of Exercise Science, James Cook University, Townsville, Queensland, Australia
| | - Matthew Wilkinson
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Levi Morse
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Peter McEwen
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Kaushik Hazratwala
- Orthopaedic Research Institute of Queensland, Townsville, Queensland, Australia
| | - Jonathan Connor
- School of Exercise Science, James Cook University, Townsville, Queensland, Australia
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7
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Wan ZY, Liu YX, Zhang X, Wang R. An Integrated Eye-Tracking and Motion Capture System in Synchronized Gaze and Movement Analysis. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941206 DOI: 10.1109/icorr58425.2023.10304692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Integrating mobile eye-tracking and motion capture emerges as a promising approach in studying visual-motor coordination, due to its capability of expressing gaze data within the same laboratory-centered coordinate system as body movement data. In this paper, we proposed an integrated eye-tracking and motion capture system, which can record and analyze temporally and spatially synchronized gaze and motion data during dynamic movement. The accuracy of gaze measurement were evaluated on five participants while they were instructed to view fixed vision targets at different distances while standing still or walking towards the targets. Similar accuracy could be achieved in both static and dynamic conditions. To demonstrate the usability of the integrated system, several walking tasks were performed in three different pathways. Results revealed that participants tended to focus their gaze on the upcoming path, especially on the downward path, possibly for better navigation and planning. In a more complex pathway, coupled with more gaze time on the pathway, participants were also found having the longest step time and shortest step length, which led to the lowest walking speed. It was believed that the integration of eye-tracking and motion capture is a feasible and promising methodology quantifying visual-motor coordination in locomotion.
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Fall history in older adults impacts acceleration profiles after a near collision with a moving pedestrian hazard. Aging Clin Exp Res 2023; 35:621-631. [PMID: 36705894 DOI: 10.1007/s40520-023-02345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Environmental hazards (e.g., pedestrian traffic) cause falls and testing environment impacts gait in older adults. However, most fall risk evaluations do not assess real-world moving hazard avoidance. AIMS This study examined the effect of fall history in older adults on acceleration profiles before, during, and after a near collision with a moving hazard, in laboratory and real-world settings. METHODS Older adults with (n = 14) and without a fall history (n = 15) performed a collision avoidance walking task with a sudden moving hazard in real-world and laboratory settings. Gait acceleration and video data of participants' first-person views were recorded. Four mixed effects multilevel models analyzed the magnitude and variability of mean and peak anteroposterior and mediolateral acceleration while walking before, during, and after the moving hazard in both environments. RESULTS In the real-world environment, older adults without a fall history increased their mean anteroposterior acceleration after the moving hazard (p = 0.046), but those with a fall history did not (p > 0.05). Older adults without a fall history exhibited more intersubject variability than those with a fall history in mean (p < 0.001) and peak anteroposterior (p = 0.015) acceleration across environments and epochs. Older adults without a fall history exhibited a slower peak mediolateral reaction during the moving hazard (p = 0.014) than those with a fall history. CONCLUSIONS These results suggest that compared to older adults with a fall history, older adults without a fall history are more adaptable and able to respond last-minute to unexpected hazards. Older adults with a fall history exhibited more homogenous responses.
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Haggard AV, Tennant JE, Shaikh FD, Hamel R, Kline PW, Zukowski LA. Including cognitive assessments with functional testing predicts capabilities relevant to everyday walking in older adults. Gait Posture 2023; 100:75-81. [PMID: 36493686 DOI: 10.1016/j.gaitpost.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 10/21/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Dual-task (DT) testing reflects real-world walking demands in older adults but is not always feasible to perform in clinic. Whether clinical measures that predict single-task (ST) performance also predict DT performance or dual-task effects (DTEs) has not been fully explored. RESEARCH QUESTION What are the relationships between cognitive performance, functional mobility, and self-reported physical activity and balance confidence and ST and DT Gait Speed and Cognitive Reaction Time, as well as DTEs on Gait Speed (DTEGS) and Cognitive Reaction Time (DTERT), in older adults? METHODS Sixty-two older adults (71.5 ± 7.1 years, 17 males) completed cognitive performance, functional mobility, and self-report physical activity and balance confidence assessments. Three 1-min trials were performed: 1) ST Cognition (clock task), 2) ST Gait and 3) DT Cognition + Gait, with Cognitive Reaction Time (recorded during clock task performance via DirectRT) and Gait Speed (measured during walking trial via APDM system) recorded, and DTEGS and DTERT calculated, as the cognitive and gait outcomes. Six multivariate regressions were conducted to test whether cognitive performance, functional mobility, and self-report assessments predicted Gait Speed and Cognitive Reaction Time in ST and DT conditions and DTEs. RESULTS The Comprehensive Trail Making Test (CTMT) predicted Reaction Time in ST cognitive (β = - 0.525, p = .003) and DT (β = - 0.510, p = .006) trials. The Physical Activity Scale for the Elderly (PASE) predicted DTERT (β = - 0.397, p = .008). The 10-Meter Walk Test (10MWT) predicted Gait Speed in ST gait (β = 0.692, p < .001) and DT (β = 0.715, p < .001) trials. The Four Square Step Test (FSST) predicted ST Gait Speed (β = - 0.233, p = .034). The Montreal Cognitive Assessment (MoCA) (β = 0.293, p = .027), 10MWT (β = 0.322, p = .046), and the FSST (β = 0.378, p = .019) predicted DTEGS. SIGNIFICANCE The 10MWT, CTMT, and MoCA can be easily implemented in the clinic and may be good choices to assess cognitive and functional abilities necessary for ambulation in older adults.
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Affiliation(s)
- Alexa V Haggard
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | | | - Faisal D Shaikh
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Renee Hamel
- Department of Physical Therapy, High Point University, High Point, NC, USA; School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Paul W Kline
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, USA.
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10
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Fiset F, Lamontagne A, McFadyen BJ. Effects of age on the visuo-locomotor control used to circumvent a virtual pedestrian with different limb movements. Hum Mov Sci 2023; 87:103026. [PMID: 36368219 DOI: 10.1016/j.humov.2022.103026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/18/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
It is known that young adults (YA) circumvent pedestrians differently than inanimate obstacles and that limb movements of the pedestrian influence minimum clearance for predictable pedestrian paths. Although older adults (OA) use more cautious strategies for general pedestrian avoidance compared to YA, how pedestrian movements influence circumvention by OAs is unknown. The aim of this study was to understand how limb movements of a pedestrian with an initially unpredictable trajectory affect circumvention control in younger vs older healthy adults. Fourteen YA and 14 OA (> 70 years) were immersed in a virtual shopping mall and instructed to circumvent a virtual pedestrian (VP) approaching with either normal locomotor movements, upper limbs fixed, lower limbs fixed, or both upper and lower limbs fixed. Onset distance for trajectory deviation, minimum clearance, walking speed, body segment yaw angles and gaze behaviour were analysed. When the VP lacked local limb movements, both age groups initiated their trajectory deviations farther away, but significantly more so for OA. Minimal clearance was unchanged across conditions and similar for both age groups. OA walked slower, produced smaller head and trunk yaw, and visually focused on the VP for a greater percentage of time. Thus, lack of limb movements of another pedestrian resulted in more cautious circumvention control and OA needed more time to process visual information with greater visual attention focused on the VP. Age-related changes could translate to a greater risk of falls in OA populations with reduced balance and mobility that could limit community ambulation.
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Affiliation(s)
- Félix Fiset
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, IRDPQ, Québec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Québec, Canada; Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital - CISSS Laval site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Québec, Canada
| | - Bradford J McFadyen
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, IRDPQ, Québec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada.
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S, Richardson TK, Savatteri N, Wang Y, Tkachyk C. Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures. Psychogeriatrics 2022; 22:553-573. [PMID: 35535013 DOI: 10.1111/psyg.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Yimo Wang
- Myodetox Markham, Markham, Ontario, Canada
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Parrington L, King LA, Weightman MM, Hoppes CW, Lester ME, Dibble LE, Fino PC. Between-site equivalence of turning speed assessments using inertial measurement units. Gait Posture 2021; 90:245-251. [PMID: 34530311 DOI: 10.1016/j.gaitpost.2021.09.164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Turning is a component of gait that requires planning for movement of multiple body segments and the sophisticated integration of sensory information from the vestibular, visual, and somatosensory systems. These aspects of turning have led to growing interest to quantify turning in clinical populations to characterize deficits or identify disease progression. However, turning may be affected by environmental differences, and the degree to which turning assessments are comparable across research or clinical sites has not yet been evaluated. RESEARCH QUESTION The aim of this study was to determine the extent to which peak turning speeds are equivalent between two sites for a variety of mobility tasks. METHODS Data were collected at two different sites using separate healthy young adult participants (n = 47 participants total), but recruited using identical inclusion and exclusion criteria. Participants at each site completed three turning tasks: a one-minute walk (1 MW) along a six-meter walkway, a modified Illinois Agility Test (mIAT), and a custom clinical turning course (CCTC). Peak yaw turning speeds were extracted from wearable inertial sensors on the head, trunk, and pelvis. Between-site differences and two one-sided tests (TOST) were used to determine equivalence between sites, based on a minimum effect size reported between individuals with mild traumatic brain injury and healthy control subjects. RESULTS No outcomes were different between sites, and equivalence was determined for 6/21 of the outcomes. These findings suggest that some turning tasks and outcome measures may be better suited for multi-site studies. The equivalence results are also dependent on the minimum effect size of interest; nearly all outcomes were equivalent across sites when larger minimum effect sizes of interest were used. SIGNIFICANCE Together, these results suggest some tasks and outcome measures may be better suited for multi-site studies and literature-based comparisons.
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Affiliation(s)
- Lucy Parrington
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Laurie A King
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | | | - Carrie W Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, TX, United States
| | - Mark E Lester
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, TX, United States; Department of Physical Therapy, Texas State University, Round Rock, TX, United States
| | - Leland E Dibble
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States.
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Rapos V, Cinelli ME, Grunberg R, Bourgaize S, Crétual A, Olivier AH. Collision avoidance behaviours between older adult and young adult walkers. Gait Posture 2021; 88:210-215. [PMID: 34118745 DOI: 10.1016/j.gaitpost.2021.05.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Collision avoidance between two walkers requires a mutual adaptation based on visual information in order to be successful. Age-related changes to visuomotor processing, kinesthetic input, and intersegmental dynamics increases the risk of collision and falls in older adults. However, few studies examine behavioural strategies in older adults during collision avoidance tasks with another pedestrian. RESEARCH QUESTION Is there a difference between older adults' and young adults' collision avoidance behaviours with another pedestrian? METHODS Seventeen older adults (x¯ = 68 ± 3 years) and seventeen young adults (x¯ = 23 ± 2 years) walked at a comfortable walking speed along a 12.6 m pathway while avoiding another walker. Trials were randomized equally to include 20 interactions with the same age group and 21 interactions with the opposite age group. Minimum predicted distance (mpd) was used to characterize collision avoidance behaviours between older adults and young adults. RESULTS Older adults had riskier avoidance behaviours, passing closer to the other pedestrian (0.79 m ± 0.18 m) compared to when two young adults were on a collision course (0.93 m ± 0.17 m) (χ²(3) = 35.94, p < .0001). Whenever an older adult was on a collision course with a young adult, the young adult contributed more to the avoidance regardless of passing order. SIGNIFICANCE The results from the current study highlight age-related effects during a collision avoidance task in older adults resulting in risky behaviour and a potential collision. Future studies should further investigate age-related visuomotor deficits during collision avoidance tasks in cluttered environments using virtual reality in order to tease out factors that contribute most to avoidance behaviours in older adults.
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Affiliation(s)
- Victoria Rapos
- Dept. of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Michael E Cinelli
- Dept. of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
| | - Robyn Grunberg
- Dept. of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sheryl Bourgaize
- Dept. of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
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Sharp KC, Cinelli ME. The effects of different environments on older adults' ability to successfully cross a closing gap in virtual reality. Gait Posture 2021; 87:1-5. [PMID: 33866151 DOI: 10.1016/j.gaitpost.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND To navigate through dynamically changing environments and to avoid collisions with stationary and moving obstacles, older adults tend to over rely on their visual system because it is a more reliable source of information. Aging affects both visuomotor integration and visual perception, often resulting in the inability to produce appropriate adaptive locomotor actions in a timely manner. RESEARCH QUESTION Does peripheral visual information in the environment affected older adults' ability to complete a gap-crossing task with a set of closing doors at different rates (0.6-1.2 m/s)? METHODS Fifteen older adults (65-74 years) completed the study inside a virtual environment with three different levels of peripheral visual information: 1) empty; 2) stationary avatars; and 3) moving avatars. Kinematic data was collected using an Optotrak camera system to track the older adults' body movements during the task. RESULTS The results demonstrated that regardless of the environment or closing door speed, older adults maintained consistent approach speeds. However, older adults collided with the fastest moving doors a significant number of times at the fastest door closing rates for the empty and moving avatar conditions. SIGNIFICANCE Although it appears that older adults are able to attend on a central task (i.e., passing through closing doors) and maintain constant behaviours regardless of the visual information from peripheral environment, richness of the peripheral environment provides accurate feedback about self-motion affects success rates.
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Affiliation(s)
- Kasey C Sharp
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Michael E Cinelli
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
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Zukowski LA, Tennant JE, Iyigun G, Giuliani CA, Plummer P. Dual-tasking impacts gait, cognitive performance, and gaze behavior during walking in a real-world environment in older adult fallers and non-fallers. Exp Gerontol 2021; 150:111342. [PMID: 33838215 DOI: 10.1016/j.exger.2021.111342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/22/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Everyday walking often involves simultaneous performance of a cognitive task in environments with competing auditory and visual stimuli. Previous research has not evaluated task performance in these situations, where older adults are known to fall, limiting our understanding of how older adults adjust their gait, visual scanning (gaze), and cognitive processing to avoid falls (or not). The purpose of this study was to examine the effect of dual-task walking in a high-distraction real-world environment on cognitive performance, gait performance, and gaze behavior in older adult fallers relative to non-fallers. METHODS Fourteen community-dwelling, older adult fallers (76.6 ± 9.1 years, 11 females) and 15 community-dwelling, older adult non-fallers (77.4 ± 7.6 years, 11 females) participated. Participants performed single-task walking, single-task cognitive (seated category naming), and dual-task walking (category naming + walking) trials for 1 min each in a real-world environment (busy hospital lobby). Gait speed, stride length variability, stride duration variability, gaze fixation duration on 6 areas of interest (AOIs), and percentage of time fixating on 6 AOIs were recorded during single- and dual-task walking trials. Number of correct responses, time to first response, and mean subsequent response time (measure of rate of decline of response retrieval throughout trial) were determined for single-task cognitive and dual-task walking trials. Two-way MANCOVAs and MANOVAs were used to compare the effects of fall status and task condition on gait and cognitive variables. Hierarchical linear regression models were used to assess predictors of gaze behavior variables. RESULTS Compared to single-task, during dual-task trials, participants walked 0.21 m/s slower, had 1.5 fewer verbal responses, and a 2823 ms shorter mean subsequent response time, indicating a faster declining rate of retrieval during the cognitive task. Additionally, during dual-task walking, participants fixated their gaze on Far People (AOI) for a significantly smaller percentage of time and on the Near Walking Path (AOI) for a significantly greater percentage of time than during single-task walking. During all trials, being a non-faller predicted a longer average fixation duration on the Far Environment (AOI) than for fallers. Environmental busyness, baseline gait speed, and baseline executive function impacted gaze behavior. CONCLUSION All participants exhibited dual-task decrements in gait and cognitive performance and changes in gaze behavior from single- to dual-task walking. Perhaps of more importance, non-fallers appear to have had more freedom to divert their gaze to less relevant environmental stimuli while walking, and two measures of fall risk impacted patterns of gaze behavior differently. Thus, overt visual attention during walking in real-world environments should be further explored in relation to fall risk.
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Affiliation(s)
- Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, United States of America.
| | - Jaclyn E Tennant
- Guilford County Schools, Guilford County, NC, United States of America
| | - Gozde Iyigun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, via Mersin 10, Turkey
| | - Carol A Giuliani
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Prudence Plummer
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, United States of America
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