Article

OBJECTIVE: To test the proposed mechanism of action of a task-specific motor
learning intervention by examining its effect on measures of the motor control of
gait. DESIGN: Single-blinded randomized clinical trial.
SETTING: University
research laboratory. PARTICIPANTS: Adults (N=40) aged >/=65 years with gait speed
>1.0m/s and impaired motor skill (figure-of-8 walk time >8s). INTERVENTIONS: The
2 interventions included a task-oriented motor learning and a standard exercise
program; both interventions included strength training. Both lasted 12 weeks,
with twice-weekly, 1-hour, physical therapist-supervised sessions. MAIN OUTCOME
MEASURES: Two measures of the motor control of gait, gait variability and
smoothness of walking, were assessed pre- and postintervention by assessors
masked to the treatment arm. RESULTS: Of 40 randomized subjects, 38 completed the
trial (mean age +/- SD, 77.1+/-6.0y). The motor learning group improved more than
the standard group in double-support time variability (.13m/s vs .05m/s; adjusted
difference [AD]=.006, P=.03). Smoothness of walking in the anteroposterior
direction improved more in the motor learning than standard group for all
conditions (usual: AD=.53, P=.05; narrow: AD=.56, P=.01; dual task: AD=.57,
P=.04). Smoothness of walking in the vertical direction also improved more in the
motor learning than standard group for the narrow-path (AD=.71, P=.01) and
dual-task (AD=.89, P=.01) conditions. CONCLUSIONS: Among older adults with
subclinical walking difficulty, there is initial evidence that task-oriented
motor learning exercise results in gains in the motor control of walking, while
standard exercise does not. Task-oriented motor learning exercise is a promising
intervention for improving timing and coordination deficits related to mobility
difficulties in older adults, and needs to be evaluated in a definitive larger
trial.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS