PDF(Pubmed)
Abstract：
Falls in older individuals often result from unexpected balance disturbances during walking, necessitating the analysis of recovery strategies for effective falls prevention. This becomes particularly crucial for individuals with cognitive impairment, who face a higher fall risk compared to cognitively healthy adults. Hence, our study aimed to compare the recovery response to standardized walking perturbations on a treadmill between older adults with cognitive impairment and cognitively healthy older adults. 36 individuals with a recent history of a severe fall, leading to an emergency department visit without subsequent admission, were stratified into two groups (with and without probable cognitive impairment) based on scores of the Montreal Cognitive Assessment. Recovery performance was quantified using force plate data from a perturbation treadmill (M-Gait, Motek Medical B.V., Amsterdam, the Netherlands), specifically evaluating the number of steps needed to restore step length and width to pre perturbation baseline across two trials of nine different perturbations. Individuals with cognitive impairment (n = 18, mean age: 74.7) required significantly (p = 0.045, Cohen\'s d = 0.69) more steps to recover total steps after perturbations compared to cognitively healthy individuals (n = 18, mean age: 69.7). While step width recovery was similar between the groups, those with probable cognitive impairment required significantly more steps to recover their step length (p = 0.039, Cohen\'s d = 0.72). Thus, our findings indicate that older adults with probable cognitive impairment manifest inferior gait adaptability, especially in adapting step length, potentially underscoring a critical aspect for effective falls prevention in this population.
摘要：
老年人的跌倒通常是由于步行过程中意外的平衡障碍造成的，需要分析有效预防跌倒的恢复策略。这对有认知障碍的人来说尤其重要，与认知健康的成年人相比，他们面临更高的跌倒风险。因此，我们的研究旨在比较有认知障碍的老年人和认知健康的老年人对跑步机上标准化步行扰动的恢复反应.36个人最近有严重跌倒的历史，导致急诊就诊而没有随后的入院，根据蒙特利尔认知评估的评分，将其分为两组（有和没有可能的认知障碍）。使用来自扰动跑步机的测力板数据对恢复性能进行量化(M-步态，MotekMedicalB.V.,阿姆斯特丹,荷兰),特别评估在9个不同扰动的两个试验中，将步长和宽度恢复到扰动前基线所需的步数。与认知健康个体(n=18,平均年龄:69.7)相比,患有认知障碍的个体(n=18,平均年龄:74.7)需要显著(p=0.045,Cohen\'sd=0.69)更多的步骤来恢复扰动后的总步骤。虽然两组之间的步宽恢复相似，那些可能有认知障碍的人需要更多的步骤来恢复他们的步长(p=0.039,Cohen'sd=0.72).因此，我们的研究结果表明，可能有认知障碍的老年人表现出较差的步态适应性，特别是在调整步长方面，潜在地强调了在这一人群中有效预防跌倒的关键方面。
