Abstract
The common occurrence of age decline in mobility and cognition does cause a decrease in the level of physical activity and an increased falls risk. Consequently, dual -task (DT) assessment that simultaneously addresses both mobility skills and cognitive functions are important because, continued difficulties and fall injuries will have a sizable impact in this population. The first objective of the present study was to assess test-retest reliability of a computerized DT treadmill walking protocol and concurrent outcome measures of gait and visuospatial executive function in a group of healthy older adults. Secondly, discriminative validity was evaluated by examining the effect of DT conditions (single task vs. dual-task) on; (a) spatiotemporal gait measures (average and coefficient of variation) and (b) visuomotor and visuospatial executive performance measures. Twenty-five community-dwelling individuals median age 65 (range 61–67) were recruited from a Fitness Facility. Participants performed a computerized visuomotor tracking task and a visuospatial executive game task in standing and while treadmill walking. Testing was conducted on two occasions, 1 week apart. Moderate to high test-retest reliability (ICC values of 0.65–0.88) were observed for spatiotemporal gait variables. No significant differences between the group means were observed between test periods in any gait variable. Moderate test-retest reliability (ICC values of 0.6–0.65) was observed for measures of visuomotor and visuospatial executive performance during treadmill walking. Significant DT effects were observed for both spatiotemporal gait variables and visuospatial executive performance measures. This study demonstrates the reliability and reproducibility of the computer-based assessment tool for dual task treadmill walking. The high to moderate ICC values and the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable data from community-dwelling older adults. The present computerized dual-task protocols broaden the types of standardized visuomotor and visuospatial executive activities for use with DT treadmill walking that has previously been reported.
Highlights
IntroductionThe frequent occurrence of mobility limitations and falls with age can arise due to singular events (e.g., stroke, peripheral vestibular dysfunction) or can have an insidious onset, with the problem source found in multiple predisposing factors, such as, the gradual decline of musculoskeletal and/or neural fitness (sensory, cognitive, motor; Santos-Eggimann et al, 2008)
The frequent occurrence of mobility limitations and falls with age can arise due to singular events or can have an insidious onset, with the problem source found in multiple predisposing factors, such as, the gradual decline of musculoskeletal and/or neural fitness
Moderate intra-class correlation coefficient (ICC) values were observed for average step length (0.65) during the visuomotor task, and for SL coefficient of variation (COV) (0.65) when performing the executive game task
Summary
The frequent occurrence of mobility limitations and falls with age can arise due to singular events (e.g., stroke, peripheral vestibular dysfunction) or can have an insidious onset, with the problem source found in multiple predisposing factors, such as, the gradual decline of musculoskeletal and/or neural fitness (sensory, cognitive, motor; Santos-Eggimann et al, 2008). In particular outdoors, become evident when compensatory strategies have failed, or where certain tasks and environmental conditions cannot be avoided (Shumway-Cook et al, 2007; Santos-Eggimann et al, 2008). Independent community walking outdoors requires both mobility skills and cognitive flexibility to address threats to balance while attending to a range of environmental demands and concurrent executive tasks.
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