Article

OBJECTIVE: To determine whether the cognitive function contribution to straight-
and curved-path walking differs for older adults. DESIGN: Cross-sectional
observational study. SETTING: Ambulatory clinical research training center.
PARTICIPANTS: People (N=106) aged 65 to 92 years, able to walk household
distances independently with or without an assistive device, and who scored 24 or
greater on the Mini-Mental State Examination. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Cognitive function was assessed using the Digit Symbol
Substitution Test (DSST) as a measure of psychomotor speed, and Trail Making Test
Parts A and B (TMT-A and TMT-B) and the Trail Making Test difference score
(TMT-B-A) as executive function measures of complex visual scanning and set
shifting. Gait speed recorded over an instrumented walkway was used as the
measure of straight-path walking. Curved-path walking was assessed using the
Figure-of-8 Walk Test (F8W) and recorded as the total time and number of steps
for completion. RESULTS: Both DSST and TMT-A independently contributed to usual
gait speed (P<.001). TMT-A performance contributed to F8W time (P<.001). Neither
TMT-B nor TMT-B-A contributed to usual gait speed or time to complete the F8W.
For the number of steps taken to complete the F8W, TMT-A, TMT-B, and TMT-B-A (all
P<.001) were independent contributors, while DSST performance was not.
CONCLUSIONS: Curved-path walking, as measured by the F8W, involves different
cognitive processes compared with straight-path walking. Cognitive flexibility
and set-shifting processes uniquely contributed to how individuals navigated
curved paths. The measure of curved-path walking provides different and
meaningful information about daily life walking ability than usual gait speed alone.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS