Abstract
Abstract AIM This study aimed to identify the effects of aging and Alzheimer’s disease (AD) on gait parameters after a four-month period and to investigate the effects of a four-month program of physical activity, with emphasis on the cognitive components of gait during single and dual task, in people with AD. METHODS Twenty-three people with AD, divided into the Training Group (TG; n=12; aged 79.17±7.62 years) and the Control Group (CG; n=11; aged 77.00±5.57 years), and eleven healthy older adults (Healthy Group - HG; aged 75.82±4.83 years) were included in this study. TG participated in a physical activity program for four months. The CG and HG were instructed not to participate in any kind of regular physical activity in this period. The physical activity program includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week. The kinematic parameters of gait were analyzed under two conditions, before and after a physical activity program: single and dual task. Deltas for all dependent variables between pre and post training were calculated. The deltas were compared using two-way ANOVAs with group (TG x CG and CG x HG) and task (single x dual task) as factors, with repeated measures for task. RESULTS After the training period, the TG improved stride length, duration, velocity and cadence compared to the CG. CONCLUSION Physical activity with emphasis on cognitive components promotes better reallocation of attention while walking in people with AD, improving attentional focus on the gait and thus resulting in a safer locomotive pattern.
Highlights
Changes in gait are associated with normal aging and may be aggravated in the people with Alzheimer’s disease (AD)[1]
The Control Group (CG) and Healthy Group (HG) showed similar anthropometric characteristics, HG presented a higher score in the cognitive functions (MMSE; t20 = -11.29, p
In the following paragraphs, we provide explanations for the maintenance of the gait parameters of people with AD who did not participate in the intervention and for the improvements in the gait parameters of people with AD after a physical activity program with emphasis on cognitive components
Summary
Changes in gait are associated with normal aging and may be aggravated in the people with Alzheimer’s disease (AD)[1]. Gait adjustments in patients with AD have been explained by frontal lobe dysfunctions, especially in the motor cortex[2], and by an intense decrease in executive functions[3]. People with AD have a shorter stride length, reduced cadence and gait speed, and a higher double support phase of gait compared to neurologically healthy older adults[1,4,5]. Deficits in gait are even greater when people with AD perform a task simultaneously with gait (dual task)[5-7], increasing the temporal gait parameters (single and double support phase and stride duration) and reducing the gait speed and cadence, compared to gait without a cognitive task (single task). People with AD are more prone to falls when compared to healthy older adults[8], with a fall rate of 4 to 5 times per year[9]. As a way to prevent the effects of AD on locomotion in this population, the practice of regular physical activity is recommended
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