Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people

C.J. Lamoth, F.J. van Deudekom, J.P. van Campen, B.A. Appels, O.J. de Vries, M.A.G.M. Pijnappels

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Background: Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to identify persons with a high tendency to fall. Recent studies have shown that stride variability is increased in elderly and under dual task condition and might be more sensitive to detect fall risk than walking speed. In the present study we complemented stride related measures with measures that quantify trunk movement patterns as indicators of dynamic balance ability during walking. The aim of the study was to quantify the effect of impaired cognition and dual tasking on gait variability and stability in geriatric patients. Methods. Thirteen elderly with dementia (mean age: 82.6 ± 4.3 years) and thirteen without dementia (79.4± 5.55) recruited from a geriatric day clinic, walked at self-selected speed with and without performing a verbal dual task. The Mini Mental State Examination and the Seven Minute Screen were administered. Trunk accelerations were measured with an accelerometer. In addition to walking speed, mean, and variability of stride times, gait stability was quantified using stochastic dynamical measures, namely regularity (sample entropy, long range correlations) and local stability exponents of trunk accelerations. Results: Dual tasking significantly (p < 0.05) decreased walking speed, while stride time variability increased, and stability and regularity of lateral trunk accelerations decreased. Cognitively impaired elderly showed significantly (p < 0.05) more changes in gait variability than cognitive intact elderly. Differences in dynamic parameters between groups were more discerned under dual task conditions. Conclusions: The observed trunk adaptations were a consistent instability factor. These results support the concept that changes in cognitive functions contribute to changes in the variability and stability of the gait pattern. Walking under dual task conditions and quantifying gait using dynamical parameters can improve detecting walking disorders and might help to identify those elderly who are able to adapt walking ability and those who are not and thus are at greater risk for falling. © 2011 Lamoth et al; licensee BioMed Central Ltd.
    Original languageEnglish
    JournalJournal of NeuroEngineering and Rehabilitation
    Volume8
    Issue number2
    DOIs
    Publication statusPublished - 2011

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    Gait
    Cognition
    Walking
    Aptitude
    Accidental Falls
    Geriatrics
    Dementia
    Frail Elderly
    Entropy
    Incidence
    Walking Speed

    Cite this

    @article{7c0a4d980cca46b9ab191a5c50048756,
    title = "Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people",
    abstract = "Background: Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to identify persons with a high tendency to fall. Recent studies have shown that stride variability is increased in elderly and under dual task condition and might be more sensitive to detect fall risk than walking speed. In the present study we complemented stride related measures with measures that quantify trunk movement patterns as indicators of dynamic balance ability during walking. The aim of the study was to quantify the effect of impaired cognition and dual tasking on gait variability and stability in geriatric patients. Methods. Thirteen elderly with dementia (mean age: 82.6 ± 4.3 years) and thirteen without dementia (79.4± 5.55) recruited from a geriatric day clinic, walked at self-selected speed with and without performing a verbal dual task. The Mini Mental State Examination and the Seven Minute Screen were administered. Trunk accelerations were measured with an accelerometer. In addition to walking speed, mean, and variability of stride times, gait stability was quantified using stochastic dynamical measures, namely regularity (sample entropy, long range correlations) and local stability exponents of trunk accelerations. Results: Dual tasking significantly (p < 0.05) decreased walking speed, while stride time variability increased, and stability and regularity of lateral trunk accelerations decreased. Cognitively impaired elderly showed significantly (p < 0.05) more changes in gait variability than cognitive intact elderly. Differences in dynamic parameters between groups were more discerned under dual task conditions. Conclusions: The observed trunk adaptations were a consistent instability factor. These results support the concept that changes in cognitive functions contribute to changes in the variability and stability of the gait pattern. Walking under dual task conditions and quantifying gait using dynamical parameters can improve detecting walking disorders and might help to identify those elderly who are able to adapt walking ability and those who are not and thus are at greater risk for falling. {\circledC} 2011 Lamoth et al; licensee BioMed Central Ltd.",
    author = "C.J. Lamoth and {van Deudekom}, F.J. and {van Campen}, J.P. and B.A. Appels and {de Vries}, O.J. and M.A.G.M. Pijnappels",
    year = "2011",
    doi = "10.1186/1743-0003-8-2",
    language = "English",
    volume = "8",
    journal = "Journal of NeuroEngineering and Rehabilitation",
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    Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people. / Lamoth, C.J.; van Deudekom, F.J.; van Campen, J.P.; Appels, B.A.; de Vries, O.J.; Pijnappels, M.A.G.M.

    In: Journal of NeuroEngineering and Rehabilitation, Vol. 8, No. 2, 2011.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people

    AU - Lamoth, C.J.

    AU - van Deudekom, F.J.

    AU - van Campen, J.P.

    AU - Appels, B.A.

    AU - de Vries, O.J.

    AU - Pijnappels, M.A.G.M.

    PY - 2011

    Y1 - 2011

    N2 - Background: Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to identify persons with a high tendency to fall. Recent studies have shown that stride variability is increased in elderly and under dual task condition and might be more sensitive to detect fall risk than walking speed. In the present study we complemented stride related measures with measures that quantify trunk movement patterns as indicators of dynamic balance ability during walking. The aim of the study was to quantify the effect of impaired cognition and dual tasking on gait variability and stability in geriatric patients. Methods. Thirteen elderly with dementia (mean age: 82.6 ± 4.3 years) and thirteen without dementia (79.4± 5.55) recruited from a geriatric day clinic, walked at self-selected speed with and without performing a verbal dual task. The Mini Mental State Examination and the Seven Minute Screen were administered. Trunk accelerations were measured with an accelerometer. In addition to walking speed, mean, and variability of stride times, gait stability was quantified using stochastic dynamical measures, namely regularity (sample entropy, long range correlations) and local stability exponents of trunk accelerations. Results: Dual tasking significantly (p < 0.05) decreased walking speed, while stride time variability increased, and stability and regularity of lateral trunk accelerations decreased. Cognitively impaired elderly showed significantly (p < 0.05) more changes in gait variability than cognitive intact elderly. Differences in dynamic parameters between groups were more discerned under dual task conditions. Conclusions: The observed trunk adaptations were a consistent instability factor. These results support the concept that changes in cognitive functions contribute to changes in the variability and stability of the gait pattern. Walking under dual task conditions and quantifying gait using dynamical parameters can improve detecting walking disorders and might help to identify those elderly who are able to adapt walking ability and those who are not and thus are at greater risk for falling. © 2011 Lamoth et al; licensee BioMed Central Ltd.

    AB - Background: Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to identify persons with a high tendency to fall. Recent studies have shown that stride variability is increased in elderly and under dual task condition and might be more sensitive to detect fall risk than walking speed. In the present study we complemented stride related measures with measures that quantify trunk movement patterns as indicators of dynamic balance ability during walking. The aim of the study was to quantify the effect of impaired cognition and dual tasking on gait variability and stability in geriatric patients. Methods. Thirteen elderly with dementia (mean age: 82.6 ± 4.3 years) and thirteen without dementia (79.4± 5.55) recruited from a geriatric day clinic, walked at self-selected speed with and without performing a verbal dual task. The Mini Mental State Examination and the Seven Minute Screen were administered. Trunk accelerations were measured with an accelerometer. In addition to walking speed, mean, and variability of stride times, gait stability was quantified using stochastic dynamical measures, namely regularity (sample entropy, long range correlations) and local stability exponents of trunk accelerations. Results: Dual tasking significantly (p < 0.05) decreased walking speed, while stride time variability increased, and stability and regularity of lateral trunk accelerations decreased. Cognitively impaired elderly showed significantly (p < 0.05) more changes in gait variability than cognitive intact elderly. Differences in dynamic parameters between groups were more discerned under dual task conditions. Conclusions: The observed trunk adaptations were a consistent instability factor. These results support the concept that changes in cognitive functions contribute to changes in the variability and stability of the gait pattern. Walking under dual task conditions and quantifying gait using dynamical parameters can improve detecting walking disorders and might help to identify those elderly who are able to adapt walking ability and those who are not and thus are at greater risk for falling. © 2011 Lamoth et al; licensee BioMed Central Ltd.

    U2 - 10.1186/1743-0003-8-2

    DO - 10.1186/1743-0003-8-2

    M3 - Article

    VL - 8

    JO - Journal of NeuroEngineering and Rehabilitation

    JF - Journal of NeuroEngineering and Rehabilitation

    SN - 1743-0003

    IS - 2

    ER -