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Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker

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...

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Autores principales: Hunter, Susan W., Divine, Alison, Omana, Humberto, Wittich, Walter, Hill, Keith D., Johnson, Andrew M., Holmes, Jeffrey D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839464/
https://www.ncbi.nlm.nih.gov/pubmed/31127767
http://dx.doi.org/10.3233/JAD-181170
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author Hunter, Susan W.
Divine, Alison
Omana, Humberto
Wittich, Walter
Hill, Keith D.
Johnson, Andrew M.
Holmes, Jeffrey D.
author_facet Hunter, Susan W.
Divine, Alison
Omana, Humberto
Wittich, Walter
Hill, Keith D.
Johnson, Andrew M.
Holmes, Jeffrey D.
author_sort Hunter, Susan W.
collection PubMed
description 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.
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spelling pubmed-68394642019-11-20 Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker Hunter, Susan W. Divine, Alison Omana, Humberto Wittich, Walter Hill, Keith D. Johnson, Andrew M. Holmes, Jeffrey D. J Alzheimers Dis Research Article 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. IOS Press 2019-09-19 /pmc/articles/PMC6839464/ /pubmed/31127767 http://dx.doi.org/10.3233/JAD-181170 Text en © 2019 – IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hunter, Susan W.
Divine, Alison
Omana, Humberto
Wittich, Walter
Hill, Keith D.
Johnson, Andrew M.
Holmes, Jeffrey D.
Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title_full Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title_fullStr Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title_full_unstemmed Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title_short Effect of Learning to Use a Mobility Aid on Gait and Cognitive Demands in People with Mild to Moderate Alzheimer’s Disease: Part II – 4-Wheeled Walker
title_sort effect of learning to use a mobility aid on gait and cognitive demands in people with mild to moderate alzheimer’s disease: part ii – 4-wheeled walker
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839464/
https://www.ncbi.nlm.nih.gov/pubmed/31127767
http://dx.doi.org/10.3233/JAD-181170
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