老年人与年轻人双重任务下阶梯行走步态特征比较

doi:10.3969/j.issn.1006-9771.2020.03.004

Abstract

Abstract:

Objective To compare the biomechanical characteristics and cognitive task performance of the young and the old adults as ascending and descending staircase. Methods From March to April, 2018, 25 volunteers, including twelve old persons aged (71.54±3.25) and 13 young persons aged (22.24±1.56), were tested with continuous minus seven as sitting (pre-test), walking up and down stairs, walking up and down stairs with continuous minus seven and continuous minus seven as sitting again (post-test). Results The performance of continuous minus seven was better as walking up stairs and post-test than pre-test in the old persons, and it was better as both up and down stairs, as well as post-test than pre-test in the young persons. As walking up stairs, the main effects of both age (F > 5.037, P < 0.05) and task ( F > 6.122, P < 0.05) were significant in walking time, step length, frequency and speed; while walking down stairs, the main effects of both age ( F > 17.252, P < 0.01) and task ( F > 6.274, P < 0.05) were significant in walking time, step frequency and speed. Conclusion People would alter the focus on cognitive tasks according to the difficulty of the action. The old adults would be more conservative in the action as upstair during the dual task, and would pay less attention to cognitive task additionally as downstair.

Key words: fall, posture control, gait, staircase walking, young, aged

CLC Number:

R493

LIU Li,ZHANG Ting-ran,LUO Jiong,ZHOU Bai-fu,OUYANG Yi-yi,LUO Zhi-zhu. Gait Characteristics of Staircase Walking of Old and Young Adults under Dual Task Situation[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(3): 285-290.

Figures/Tables 6

References 30

[1]	Ulus Y, Durmus D, Akyol Y, et al. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons[J]. Arch Gerontol Geriatr, 2012, 54(3):429-433. doi: 10.1016/j.archger.2011.06.010
[2]	Chen S S, Lin K L, Lu C H, et al. Psychotropic medications and fall risk in community-dwelling older persons using walking-aids[J]. J Physiother, 2015, 101(1):227-228.
[3]	张祥荣, 陈长香. 社区高龄老人综合支持体系与跌倒风险的相关性[J]. 护理研究, 2017, 31(34):65-69.
[4]	刘蒲, 曹莉莉, 方红, 等. 上海市闵行区养老机构内60岁及以上老年人跌倒现状[J]. 环境与职业医学, 2017, 34(6):527-530.
[5]	Hung C H, Wang C J, Tang T C, et al. Recurrent falls and its risk factors among older men living in the veterans retirement communities: a cross-sectional study[J]. Arch Gerontol Geriatr, 2017, 70:214-218. doi: 10.1016/j.archger.2017.02.001
[6]	Winter D A. Anatomy, Biomechanics and Control of Balance during Standing and Walking [R]. Canada: Canadian Cataloguing in Publication Data, 1995.
[7]	Kurz I, Gimmon Y, Shapiro A, et al. Unexpected perturbations training improves balance control and voluntary stepping times in older adults: a double blind randomized control trial[J]. BMC Geriatrics, 2016, 16:58-65. doi: 10.1186/s12877-016-0223-4
[8]	Sparto P J, Newman A B, Simonsick E M. Contributions to lateral balance control in ambulatory older adults[J]. Aging Clin Exp Res First Online, 2017, 23(8):1-9.
[9]	Sun R, Sosnoff J J. Novel sensing technology in fall risk assessment in older adults: a systematic review[J]. BMC Geriatrics, 2018, 18:14-17. doi: 10.1186/s12877-018-0706-6
[10]	Hallgren J, Fransson E I, Kåreholt I, et al. Factors associated with hospitalization risk among community living middle aged and older persons: results from the Swedish Adoption/Twin Study of Aging (SATSA)[J]. Arch Gerontol Geriatr, 2016, 66:102-108. doi: 10.1016/j.archger.2016.05.005
[11]	Pi H Y, Hu M M, Zhang J, et al. Circumstances of falls and fall-related injuries among frail elderly under home care in China[J]. Int J Nurs Stud, 2015, 2(3):237-242.
[12]	Startzell J, Owens D, Mulfinger L, et al. Stair negotiation in older people: a review[J]. J Am Geriatr Soc, 2000, 48(5):567-580. pmid: 10811553
[13]	Frykberg G E, Johansson G M, Schelin L, et al. The Arm Posture Score for assessing arm swing during gait: an evaluation of adding rotational components and the effect of different gait speeds[J]. Gait Posture, 2014, 40(1):64-69. doi: 10.1016/j.gaitpost.2014.02.006 pmid: 24647039
[14]	Huang M H, Brown S H. Age differences in the control of postural stability during reaching tasks[J]. Gait Posture, 2013, 38(4):837-842. doi: 10.1016/j.gaitpost.2013.04.004
[15]	Faraldo-García A, Santos-Pérez S, Crujeiras R, et al. Postural changes associated with ageing on the sensory organization test and the limits of stability in healthy subjects[J]. Auris Nasus Larynx, 2016, 43(2):149-154. doi: 10.1016/j.anl.2015.07.001 pmid: 26254957
[16]	Huntley A H, Zettel J L, Vallis L A. Effect of aging on dynamic postural stability and variability during a multi-directional lean and reach object transportation task[J]. Arch Gerontol Geriatr, 2016, 66:154-160. doi: 10.1016/j.archger.2016.06.003
[17]	Subramaniam S, Bhatt T. Effect of Yoga practice on reducing cognitive-motor interference for improving dynamic balance control in healthy adults[J]. Complement Ther Med, 2017, 30:30-35. doi: S0965-2299(16)30266-7 pmid: 28137524
[18]	Dubost V, Kressig R W, Gonthier R, et al. Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults[J]. Hum Mov Sci, 2006, 25(3):372-382. doi: 10.1016/j.humov.2006.03.004
[19]	Harley C, Wilkie R M, Wann J P. Stepping over obstacles: attention demands and aging[J]. Gait Posture, 2009, 29(3):428-432. doi: 10.1016/j.gaitpost.2008.10.063 pmid: 19084412
[20]	Berg K, Maki B, Williams J, et al. Clinical and laboratory measures of postural balance in an elderly population[J]. Arch Phys Med Rehab, 1992, 73(11):1073. pmid: 1444775
[21]	Folstein M F, Folstein S E, McHugh P R. Minimental State: a practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3):189-198. pmid: 1202204
[22]	Springer S, Giladi N, Peretz C, et al. Dual-tasking effects on gait variability: the role of aging, falls, and executive function[J]. Movement Disord, 2006, 21(7):950-957. pmid: 16541455
[23]	Fok P, Farrell M, McMeeken J. Prioritizing gait in dual-task conditions in people with Parkinson's[J]. Hum Mov Sci, 2010, 29(5):831-842. doi: 10.1016/j.humov.2010.06.005
[24]	Hollman J H, Kovash F M, Kubik J J, et al. Age-related differences in spatiotemporal markers of gait stability during dual task walking[J]. Gait Posture, 2007, 26(1):113-119. pmid: 16959488
[25]	Mofateh R, Salehi R, Negahban H, et al. Effects of cognitive versus motor dual-task on spatiotemporal gait parameters in healthy controls and multiple sclerosis patients with and without fall history[J]. Mult Scler Relatdis, 2017, 18:8-14.
[26]	Yogev G, Giladi N, Peretz C, et al. Dual tasking, gait rhythmicity, and Parkinson's disease: which aspects of gait are attention demanding?[J]. Eur J Neurosci, 2005, 22(5):1248-1256. doi: 10.1111/ejn.2005.22.issue-5
[27]	Nutt J G, Marsden C D, Tompson P D. Human walking and higher-level gait disorders, particularly in the elderly[J]. Neurology, 1993, 43(2):268-279. pmid: 8437689
[28]	Nakamoto M, Otsuka R, Yuki A, et al. Higher gait speed and smaller sway area decrease the risk for decline in higher-level functional capacity among middle-aged and elderly women[J]. Arch Gerontol Geriatr, 2015, 61(3):429-436. doi: 10.1016/j.archger.2015.08.001
[29]	Lee H, Chou L. Balance control during stair negotiation in older adults[J]. J Biomech, 2007, 40(11):2530-2536. doi: 10.1016/j.jbiomech.2006.11.001
[30]	Hamel K, Cavanagh P. Stair performance in people aged 75 and older[J]. J Am Geriatr Soc, 2004, 52(4):563-567. doi: 10.1111/(ISSN)1532-5415

组别	n	男/女(n)	年龄(岁)	身高(m)	体质量(kg)
老年人	12	6/6	64.55±3.65	1.65±0.11	64.34±6.78
年轻人	13	6/7	24.35±4.53	1.67±0.09	62.05±5.56
F值			7.51	0.73	1.05
P值			< 0.001	0.29	0.12

组别	n	前测(a)	上楼梯(b)	下楼梯(c)	后测(d)	F值	P值	多重比较
老年人	12	18.55±23.69	23.14±54.17	20.59±0.36	23.77±65.32	3.692	0.038	a = c < b = d
年轻人	13	32.57±36.14	35.09±1.40	38.63±0.31	39.15±11.26	6.583	0.017	a < b < c = d
F值		5.61	4.71	5.07	5.94
P值		< 0.001	< 0.001	< 0.001	< 0.001

任务	组别	步行时间(s)	步长(m)	步宽(m)	步频(/s)	步速(m/s)	时间CV (%)	速度CV (%)
单一任务	老年人	1.24±0.08	0.84±0.07	0.11±0.03	1.65±0.24	0.65±0.05	6.45±2.64	7.70±5.01
单一任务	年轻人	1.05±0.06	0.91±0.11	0.12±0.03	1.87±0.15	0.81±0.07	5.72±1.44	8.65±4.52
双重任务	老年人	1.46±0.08	0.86±0.13	0.12±0.01	1.48±0.29	0.65±0.05	5.48±1.54	7.78±3.22
双重任务	年轻人	1.17±0.08	0.852±0.08	0.11±0.04	1.79±0.16	0.77±0.06	6.84±3.01	7.80±3.98
年龄主效应	F值	9.021	0.542	0.992	12.473	8.772	0.261	0.542
	P值	0.003	0.311	0.372	0.009	0.007	0.552	0.319
任务主效应	F值	11.050	0.743	0.330	17.032	9.235	0.392	0.783
	P值	0.002	0.163	0.098	0.006	0.04	0.397	0.195
交互效应	F值	1.775	0.892	0.745	0.897	0.562	0.842	0.593
	P值	0.071	0.241	0.173	0.109	0.081	0.406	0.410

任务	组别	步行时间(s)	步长(m)	步宽(m)	步频(/s)	步速(m/s)	时间CV (%)	速度CV (%)
单一任务	老年人	1.34±0.07	0.68±0.08	0.09±0.053	1.55±0.21	0.53±0.04	5.23±2.88	7.55±4.15
单一任务	年轻人	1.16±0.06	0.73±0.04	0.10±0.04	1.75±0.14	0.64±0.05	4.31±1.63	5.18±2.26
双重任务	老年人	1.45±0.06	0.65±0.06	0.10±0.03	1.41±0.24	0.47±0.03	4.14±2.27	6.39±2.08
双重任务	年轻人	1.20±0.08	0.70±0.10	0.09±0.05	1.67±0.13	0.59±0.05	6.67±2.53	8.48±3.29
年龄主效应	F值	10.121	5.073	0.612	12.772	9.980	0.812	0.373
	P值	0.002	0.037	0.451	0.035	0.018	0.557	0.459
任务主效应	F值	13.212	6.122	0.171	14.653	15.410	0.513	0.662
	P值	0.006	0.017	0.353	0.028	0.035	0.581	0.359
交互效应	F值	1.575	0.899	0.851	1.275	0.776	1.057	5.014
	P值	0.063	0.306	0.364	0.089	0.427	0.134	0.034

任务	组别	步行时间(s)	步长(m)	步宽(m)	步频(/s)	步速(m/s)	时间CV (%)	速度CV (%)
单一任务	老年人	1.25±0.21	0.51±0.03	0.12±0.04	1.67±0.33	0.46±0.08	6.40±3.65	8.70±3.69
单一任务	年轻人	0.98±0.09	0.58±0.06	0.10±0.06	2.08±0.16	0.61±0.10	6.13±3.52	9.84±4.07
双重任务	老年人	1.43±0.29	0.56±0.04	0.15±0.05	1.47±0.28	0.41±0.09	7.70±3.53	7.32±2.67
双重任务	年轻人	1.04±0.11	0.64±0.05	0.11±0.01	1.95±0.13	0.58±0.09	6.73±3.06	8.62±3.17
年龄主效应	F值	17.252	6.771	4.173	22.554	20.260	0.362	0.480
	P值	0.004	0.023	0.034	0.002	0.003	0.477	0.353
任务主效应	F值	13.323	9.053	6.113	6.274	13.895	0.192	0.552
	P值	0.005	0.007	0.008	0.035	0.004	0.512	0.452
交互效应	F值	1.206	0.849	1.062	1.657	1.574	0.824	0.773
	P值	0.085	0.525	0.069	0.063	0.077	0.568	0.451

Gait Characteristics of Staircase Walking of Old and Young Adults under Dual Task Situation

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 6

References 30

Related Articles 15

Metrics

Comments

Recommended 0

任务	组别	步行时间(s)	步长(m)	步宽(m)	步频(/s)	步速(m/s)	时间CV (%)	速度CV (%)
单一任务	老年人	1.06±0.10	0.78±0.15	0.13±0.06	1.91±0.25	0.77±0.16	6.61±2.54	8.37±3.25
单一任务	年轻人	0.93±0.08	0.93±0.07	0.10±0.04	2.16±0.14	1.02±0.12	8.61±1.87	6.28±2.15
双重任务	老年人	1.20±0.17	0.72±0.06	0.12±0.07	1.72±0.20	0.62±0.13	8.34±3.52	10.49±4.07
双重任务	年轻人	0.99±0.08	0.91±0.14	0.11±0.07	2.04±0.17	0.93±0.09	8.08±3.96	8.31±4.58
年龄主效应	F值	17.362	17.632	0.293	18.213	20.859	0.210	5.778
	P值	0.004	0.005	0.295	0.035	0.035	0.511	0.045
任务主效应	F值	22.013	9.763	0.182	33.177	29.134	29.135	1.226
	P值	0.003	0.007	0.351	0.002	0.014	0.031	0.352
交互效应	F值	1.023	1.362	0.501	1.524	1.551	0.901	0.802
	P值	0.092	0.067	0.527	0.083	0.064	0.558	0.237

[1]	WEI Mengli, ZHONG Yaping, ZHOU Yiwen, GUI Huixian, GUAN Yeming, YU Tingting. Difference in bilateral lower limb muscle synergy mode for gait in patients after unilateral anterior cruciate ligament reconstruction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2024, 30(1): 95-104.
[2]	ZHAO Panchao, JI Zhongqiu, JIANG Guiping, WEN Ruixiang. Influence of different tasks on gait characteristics and task cost in early childhood [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1072-1082.
[3]	HU Xiaoshi, ZHANG Qi, YUE Qing, LIANG Yanhua, LI Xiaosong, FENG Amei, ZHANG Yanqing. Effect of orthopedic elastic bandages on gait symmetry and walking ability in children with spastic hemiplegic cerebral palsy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1083-1089.
[4]	ZHANG Yibin, LÜ Jie, YU Hongliu. Gait phase recognition in intelligent above-knee prosthesis based on fuzzy logic algorithm [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 896-902.
[5]	SUN Zhijie, GUO Xin, LAN Zhi, WANG Qiang. Turn intention perception and fall detection for smart walkers [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(7): 849-855.
[6]	WANG Yiji, ZHOU Hongjun, HE Zejia, LIU Genlin, ZHENG Ying, HAO Chunxia, WEI Bo, KANG Haiqiong, ZHANG Ying, LU Xiaolei, YUAN Yuan, MENG Qianru. Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 639-645.
[7]	ZHU Xiaomin, LIU Huilin, LIU Yuanmin, YAN Zhiyu, DU Xuejing, WANG Ya'nan, ZHANG Tong. Relationship among spontaneous turning direction, balance and fall risk in stroke patients during walking [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 510-515.
[8]	ZHANG Yibin, LI Jianfeng, YU Hongliu. A microprocessor-controlled prosthetic knee and its gait symmetry assessment [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 402-407.
[9]	WANG Fang, YANG Tao, HE Yaoguang, CAO Zijun, LIU Guoqing, HU Jun, ZHANG Jianguo, FAN Yubo. Design of variable stiffness insole based on diabetics plantar pressure during gait period [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 408-415.
[10]	MA Hongying, LIU Jianjun, HE Xuejin, WANG Yuxiang. Effect of rhythmic auditory stimulation on gait of patients with cerebral palsy: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(12): 1386-1394.
[11]	WANG Xiaojun, WANG Lichun, SHI Meichao, LIU Jun, YING Xiaoce, BAI Dehao. Effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(11): 1353-1358.
[12]	ZHANG Hengrui, MENG Zhaoli, CUI Pei, WANG Ruiyi. Impact of different kinds of helmet-mounted display on human balance and posture control [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(11): 1359-1364.
[13]	WU Jiayu, MENG Detao, LIANG Xiaoxiao. Effect of physical activity levels on risk of Parkinson's disease: a cross-sectional analysis based on China Health and Retirement Longitudinal Study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1135-1139.
[14]	LI Siqi,ZHANG Yuling,YANG Jiantao. Estimation of joint torques in human gait based on Gaussian process [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(8): 989-992.
[15]	CHAI Li,WANG Mei. Effect of track body weight support walking training on lower limb motor function in stroke patients: based on ICF Core Set for Stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 653-658.