Hunter, SW, Divine, A, Omana, H et al. (4 more authors) (2019) Effect of learning to use a mobility aid on gait and cognitive demands in people with mild to moderate Alzheimer’s dementia: Part II – 4-Wheeled walker. Journal of Alzhiemer's Disease, 71 (1). S115-S124. ISSN 1387-2877
Abstract
Background:
Cognitive deficits and gait problems are common and progressive in Alzheimer’s disease (AD). Prescription of a 4-wheeled walker is a common intervention to improve stability and independence, yet can be associated with an increased falls risk.
Objectives:
1) To examine changes in spatial-temporal gait parameters while using a 4-wheeled walker under different walking conditions, and 2) to determine the cognitive and gait task costs of walking with the aid in adults with AD and healthy older adults.
Methods:
Twenty participants with AD (age 79.1±7.1 years) and 22 controls (age 68.5±10.7 years) walked using a 4-wheeled walker in a straight (6 m) and Figure of 8 path under three task conditions: single-task (no aid), dual-task (walking with aid), and multi-task (walking with aid while counting backwards by ones).
Results:
Gait velocity was statistically slower in adults with AD than the controls across all conditions (all p values <0.025). Stride time variability was significantly different between groups for straight path single task (p = 0.045), straight path multi-task (p = 0.031), and Figure of 8 multi-task (0.036). Gait and cognitive task costs increased while multi-tasking, with performance decrement greater for people with AD. None of the people with AD self-prioritized gait over the cognitive task while walking in a straight path, yet 75% were able to shift prioritization to gait in the complex walking path.
Conclusion:
Learning to use a 4-wheeled walker is cognitively demanding and any additional tasks increases the demands, further adversely affecting gait. The increased cognitive demands result in a decrease in gait velocity that is greatest in adults with AD. Future research needs to investigate the effects of mobility aid training on gait performance.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 – IOS Press and the authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (https://creativecommons.org/licenses/by-nc/4.0/legalcode) |
Keywords: | Aged, gait, assistive devices, cane, dementia |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 17 Apr 2019 15:49 |
Last Modified: | 22 Oct 2019 13:43 |
Status: | Published |
Publisher: | IOS Press |
Identification Number: | 10.3233/JAD-181170 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145062 |
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