Article

OBJECTIVES: To evaluate the effect of a novel divided attention task-walking
under auditory constraints-on gait performance in older adults and to determine
whether this effect was moderated by cognitive status. DESIGN: Validation cohort.
SETTING: General community. PARTICIPANTS: Ambulatory older adults without
dementia (N=104). INTERVENTIONS: Not applicable.
In this pilot study, we evaluated walking under auditory constraints in 104 older adults
who completed 3 pairs of walking trials on a gait mat under 1 of 3 randomly
assigned conditions: 1 pair without auditory stimulation and 2 pairs with
emotionally charged auditory stimulation with happy or sad sounds. RESULTS: The
mean age of subjects was 80.6+/-4.9 years, and 63% (n=66) were women. The mean
velocity during normal walking was 97.9+/-20.6cm/s, and the mean cadence was
105.1+/-9.9 steps/min. The effect of walking under auditory constraints on gait
characteristics was analyzed using a 2-factorial analysis of variance with a
1-between factor (cognitively intact and minimal cognitive impairment groups) and
a 1-within factor (type of auditory stimuli). In both happy and sad auditory
stimulation trials, cognitively intact older adults (n=96) showed an average
increase of 2.68cm/s in gait velocity (F1.86,191.71=3.99; P=.02) and an average
increase of 2.41 steps/min in cadence (F1.75,180.42=10.12;
P<.001) as compared
with trials without auditory stimulation. In contrast, older adults with minimal
cognitive impairment (Blessed test score, 5-10; n=8) showed an average reduction
of 5.45cm/s in gait velocity (F1.87,190.83=5.62; P=.005) and an average reduction
of 3.88 steps/min in cadence (F1.79,183.10=8.21; P=.001) under both auditory
stimulation conditions. Neither baseline fall history nor performance of
activities of daily living accounted for these differences. CONCLUSIONS: Our
results provide preliminary evidence of the differentiating effect of emotionally
charged auditory stimuli on gait performance in older individuals with minimal
cognitive impairment compared with those without minimal cognitive impairment. A
divided attention task using emotionally charged auditory stimuli might be able
to elicit compensatory improvement in gait performance in cognitively intact
older individuals, but lead to decompensation in those with minimal cognitive
impairment. Further investigation is needed to compare gait performance under
this task to gait on other dual-task paradigms and to separately examine the
effect of physiological aging versus cognitive impairment on gait during walking
under auditory constraints.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS