Dual task gait test and rehabilitation in the elderly.
Abstract
Objective.– Gait rehabilitation in the elderly is usually focused on motor function. Recently complex motor-cognitive training has been reported more efficient to improve gait rehabilitation [1]. The rational is based on the interrelationship between cognition and motor function, which can be assessed by the dual-task (DT) paradigm [2]. The aim of this study was to investigate the implication of a dual task gait test (DTGT) in gait rehabilitation.Material.– Data were collected from outpatient's gait instability consultations including DTGT. Fifty-six patients were tested (age: 75±7years, F: 27, M: 29).Method.– Patients performed a reference single walking and an attention-demanding task while walking. DT consists in walking and backward counting one by one from fifty. Gait analysis was provided by a three-axis accelerometer (Locometrix™). We computed the evolution of walking speed (WS) and stride regularity index (SR) between the single and the dual walking tasks.Results.– According to the evolution of WS and SR with an interval of±15%, two major different sub-groups were identified (P<0.0001). Subgroup 1: (21 patients) WS and SR remained constant. Subgroup 2: (33 patients), 19 decreased both WS and SR, 14 decreased SR but no change of WS. Two patients were out of these two subgroups, there was an increase of SR (magnet effect) but no change of WS.Discussion.– Gait rehabilitation programs can be tailored according to the results of a DTGT thanks to information about changes in velocity and regularity, which can be linked to the balance between motor and cognitive therapies.