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A longitudinal study of gait function in people with Alzheimer disease
S138
Abstracts / Gait & Posture 39S (2014) S1–S141
Fig. 1. The cross-sectional differences between gait speed at single – task names and dual-task animals.
Fig. 2. BTS Smart movement imaging using the Davis modified model.
The kinematic parameters were registered with BTS Smart movement analysis system (Fig. 2). The registration of five muscle groups electrical activity in left and right lower limb (m.vastus medialis oblique, m.rectus femoris, plantar flexor group, hamstrings, lateral dorsal flexor group) was carried out with telemetric EMG measurement system NORAXON TeleMyo 2400 G2. Results: 180 movement cycles were registered for each training device. Discussion and conclusions: The measurements results suggest there is a statistically significant difference between muscle activation (EMG), range of motion and joint angles in the movement cycles performed on two tested training devices. The registered muscle activation patterns give the opportunity to be compared with muscle activation patterns in the same muscle groups during skiing reported in literature [2]. Reference [1] Bober T, Rutkowska-Kucharska A, Pietraszewski B. Cwiczenia plyometryczne – charakterystyka biomechaniczna, wskazniki zastosowania. Sport wyczynowy 2007;7–9:511–3. [2] Panizzolo FA, et al. Comparative analysis of muscle activation patterns between skiing on slopes and on training devices. Proc Eng 2010;2:2537–42.
http://dx.doi.org/10.1016/j.gaitpost.2014.04.197 P82 A longitudinal study of gait function in people with Alzheimer disease Ylva Cedervall 1,∗ , Kjartan Halvorsen 2 , Anna Cristina Åberg 1 1 Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Sweden 2 Department of Information Technology, Uppsala University, Sweden
Introduction and aim: Executive and attention dysfunctions have been suggested to be the main cause of early gait impairments and falls in people with Alzheimer’s disease (AD). Walking in daily life, places high demands on the interplay between cognitive and motor functions. A well-functioning ability to dual-tasking is thus essential for walking safely. Identifying changes in gait function during dual-tasking may guide the design of interventions aimed at fall prevention, and contribute to maintaining physical function and among people with AD. The aims were, to study longitudinal changes in gait parameters during single- and dual-task conditions over a period of two years among people with initially mild AD. Patients/materials and methods: Twenty-one individuals with mild AD (Mini Mental State Examination: 21–30), 10 male/11 female: 55–78 years, were included. The data collection was con-
Fig. 2. The dual task cost percent for naming animals. The horizontal line indicates a reference value (9%) for healthy older adults.
ducted on three occasions, 12 months apart. A Qualisys® motion capture system, a three-dimensional optical gait analysis system, was used. Reflecting markers were applied on anatomical landmarks according to a standardized procedure. The participant walked barefoot a distance of 7 m. A six camera Pro Reflex® system recorded the position of the markers at a sampling frequency of 240 Hz. At each gait occasion, the following gait parameters were computed: gait speed, step width, -length, -height, and double support time. All gait parameters were examined at the participant’s comfortable gait speed during three different conditions; five single-task trials, three dual-task trials naming names, and three dual-task trials naming animals. The mean values of 3–4 steps in the middle part of each trial were analysed. Results: There was a significant decline in gait speed and step length during single- and dual-tasking. In contrast, no significant longitudinal change could be found in dual-task cost (single-task value–dual-task value). However, the cross-sectional differences between single- and dual-tasks gait parameters were significant for 9/10 comparisons at baseline, 8/10 at the one-year follow-up, and 9/10 at the two-year follow-up. The significant differences for all gait parameters were observed between the one- and the two-year follow-ups. Systematic visual examination of the motion capture files revealed that the gait speed slowing in dual-tasking included, e.g. general hesitating, intermittent stops in single- and double stance (Figs. 1 and 2). Discussion and conclusions: Gait function was found to be markedly affected in early years of AD. In addition to a slowed gait speed, an evident impact of dual-tasking was shown. However, the dual-task cost appeared to remain stable over time. This was unexpected and could be hypothesized to reflect a diminishing ability to adjust walking to declining cognitive function. Various gait pattern disturbances were observed during dual-tasking and contributed to the slowed gait speed, and may also increase fall risk. Future research may be focused on identification of people at risk of AD by the use of dual-task methods, and on dual-task walking performances to identify fall risk in AD. http://dx.doi.org/10.1016/j.gaitpost.2014.04.198
Abstracts / Gait & Posture 39S (2014) S1–S141
Fig. 1. The cross-sectional differences between gait speed at single – task names and dual-task animals.
Fig. 2. BTS Smart movement imaging using the Davis modified model.
The kinematic parameters were registered with BTS Smart movement analysis system (Fig. 2). The registration of five muscle groups electrical activity in left and right lower limb (m.vastus medialis oblique, m.rectus femoris, plantar flexor group, hamstrings, lateral dorsal flexor group) was carried out with telemetric EMG measurement system NORAXON TeleMyo 2400 G2. Results: 180 movement cycles were registered for each training device. Discussion and conclusions: The measurements results suggest there is a statistically significant difference between muscle activation (EMG), range of motion and joint angles in the movement cycles performed on two tested training devices. The registered muscle activation patterns give the opportunity to be compared with muscle activation patterns in the same muscle groups during skiing reported in literature [2]. Reference [1] Bober T, Rutkowska-Kucharska A, Pietraszewski B. Cwiczenia plyometryczne – charakterystyka biomechaniczna, wskazniki zastosowania. Sport wyczynowy 2007;7–9:511–3. [2] Panizzolo FA, et al. Comparative analysis of muscle activation patterns between skiing on slopes and on training devices. Proc Eng 2010;2:2537–42.
http://dx.doi.org/10.1016/j.gaitpost.2014.04.197 P82 A longitudinal study of gait function in people with Alzheimer disease Ylva Cedervall 1,∗ , Kjartan Halvorsen 2 , Anna Cristina Åberg 1 1 Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Sweden 2 Department of Information Technology, Uppsala University, Sweden
Introduction and aim: Executive and attention dysfunctions have been suggested to be the main cause of early gait impairments and falls in people with Alzheimer’s disease (AD). Walking in daily life, places high demands on the interplay between cognitive and motor functions. A well-functioning ability to dual-tasking is thus essential for walking safely. Identifying changes in gait function during dual-tasking may guide the design of interventions aimed at fall prevention, and contribute to maintaining physical function and among people with AD. The aims were, to study longitudinal changes in gait parameters during single- and dual-task conditions over a period of two years among people with initially mild AD. Patients/materials and methods: Twenty-one individuals with mild AD (Mini Mental State Examination: 21–30), 10 male/11 female: 55–78 years, were included. The data collection was con-
Fig. 2. The dual task cost percent for naming animals. The horizontal line indicates a reference value (9%) for healthy older adults.
ducted on three occasions, 12 months apart. A Qualisys® motion capture system, a three-dimensional optical gait analysis system, was used. Reflecting markers were applied on anatomical landmarks according to a standardized procedure. The participant walked barefoot a distance of 7 m. A six camera Pro Reflex® system recorded the position of the markers at a sampling frequency of 240 Hz. At each gait occasion, the following gait parameters were computed: gait speed, step width, -length, -height, and double support time. All gait parameters were examined at the participant’s comfortable gait speed during three different conditions; five single-task trials, three dual-task trials naming names, and three dual-task trials naming animals. The mean values of 3–4 steps in the middle part of each trial were analysed. Results: There was a significant decline in gait speed and step length during single- and dual-tasking. In contrast, no significant longitudinal change could be found in dual-task cost (single-task value–dual-task value). However, the cross-sectional differences between single- and dual-tasks gait parameters were significant for 9/10 comparisons at baseline, 8/10 at the one-year follow-up, and 9/10 at the two-year follow-up. The significant differences for all gait parameters were observed between the one- and the two-year follow-ups. Systematic visual examination of the motion capture files revealed that the gait speed slowing in dual-tasking included, e.g. general hesitating, intermittent stops in single- and double stance (Figs. 1 and 2). Discussion and conclusions: Gait function was found to be markedly affected in early years of AD. In addition to a slowed gait speed, an evident impact of dual-tasking was shown. However, the dual-task cost appeared to remain stable over time. This was unexpected and could be hypothesized to reflect a diminishing ability to adjust walking to declining cognitive function. Various gait pattern disturbances were observed during dual-tasking and contributed to the slowed gait speed, and may also increase fall risk. Future research may be focused on identification of people at risk of AD by the use of dual-task methods, and on dual-task walking performances to identify fall risk in AD. http://dx.doi.org/10.1016/j.gaitpost.2014.04.198