Objectives: To evaluate the effects of secondary task (motor/cognitive) on selected spatial and temporal gait parameters in geriatric population? The objective of the study is to describe the effects of motor and cognitive secondary tasks on selected spatial and temporal gait parameters in elderly population. Subjects: Fifty (N=50) older subjects (24 women and 26 men), 6575 years, who meet the inclusion and exclusion criteria were recruited in the study. Design: An experimental design study. All tests of all subjects were conducted in the physiotherapy O.P.D. of CSS Hospital, at JAI PHYSIOTHERAPY AND DENTAL CLINIC, SF06, ANSAL GALLERIA, ANSAL TOWN, MEERUT and in the Physiotherapy OPD of S.B.S. Post Graduate Institute of BioMedical Sciences & Research, Balawala, Dehradun. Prior to testing, all the subjects were interviewed about their medical history and had explained the research procedure to them. This information was used to characterize the demographics and health status of subjects participating in the study. Cognition was evaluated by the score of Mini Mental Scale and the balance was evaluated by the Berg’s Balance Scale. The participants were asked to perform, in randomized order, the following tasks. Walking alone at their usual speed over a distance of 10 meters and performing a cognitive task, such as loud backword counting from fifty (arithmetic task), and performing a motor task of carrying a plate with full glass of water while walking. Under the dual task condition subjects were not given instruction on speed, to avoid biasing either speed of walk or cognitive response. Before testing, standardized verbal instructions regarding the test procedure with visual demonstration of the walking test was given. Since we were not interested in the potential efforts of the cognitive task on changes in gait dynamics and gait instability and were not necessarily concerned with subjects performance on the cognitive task itself, we did not evaluate performance on the cognitive task. Each subject completed one trial for all of the testing conditions. The walking trials were realized on a 10 meter walkway in a well lit environment at a self selected speed and wearing their own foot wear. The walkway 9 x 0.5 meter was marked on the floor with two sidelines and the subject was told not to step outside these lines while walking. The subject was followed by a spotter in case of falling. Each walking trial was recorded with a video camera placed on a tripod in front of the walkway; number of steps, number of lateral stepping over and stops were counted and noted from the recording. Time required to complete the 9 meter course was recorded in seconds using a digital stop watch. Participants were given standard instruction to start walking after hearing “Start” and to keep walking until asked to stop. Both the acceleration and deceleration phase of gait were included for analysis. Average gait speed [velocity] was calculated and expressed in centimeter/seconds, the average cadence in number of steps/ minute. The lateral stepping out and stops were counted and expressed in percentage. Data Analysis: All analysis were obtained using SPSS windows. Demographic data of subjects including age, Berg’s Balance Scale and Mini Mental Scale were descriptively summarized. The dependent variables for statistical analysis were gait cadence, gait velocity, lateral stepping out and stops. One way Multivariate analysis of Variance with repeated measures was performed, to analyze the differences in the gait performances among the three conditions: walking with no task, walking with motor task and walking with cognitive task readings. An ï¡ level of 0.05 was used to determine statistical significance Follow up analysis of variance were conducted if the test demonstrated statistical significance. All possible pair wise post hoc analysis was conducted on the significant dependent variable in order to compare difference between conditions. To prevent an inflation of type one error or to maintain á at p=0.05 for this follow up test; a Bonferroni corrected post hoc test was used. Results: The results of my study showed that there is a reduction in walking speed for the cognitive performance in Geriatric subjects. Conclusion: The results of the study show that elderly subjects attend to do a complex secondary task at the same time as walking, there is a significant dual task interference that compromises the cadence, speed of walking, lateral stepping out and stops. Cognitively demanding activity during walking appears to increase the gait interference more and therefore the type of secondary task was a major determinant of the severity of dual task interference. Performance changes in gait and secondary task when performed simultaneously, confirms that walking is an attention demanding task in elderly population. The results of my study supports the hypothesis, within the limitation of this study. The result of this study provides a base for further research as they presents valuable outcomes for practitioners treating the geriatric population for cognitively demanding activity during gait training.
Keywords: CAD(Cadence); VEL(Velocity); LSO(Lateral Stepping Out) and STP(Stops).
Original Article
P. 47-55
