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Einfluss von Dual-Tasking auf das Geradeaus- und Kurvengehen älterer Menschen

Influence of dual-tasking on straight ahead and curved walking in older adults

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Zusammenfassung

Hintergrund

Gehen ist kein automatisierter Bewegungsablauf, sondern beansprucht kontinuierlich Aufmerksamkeitsressourcen. Beim Gehen mit zusätzlicher Aufmerksamkeitsanforderung („dual tasking“) treten Gangveränderungen auf, welche bei älteren Menschen mit Stürzen assoziiert sind. Die Beurteilung des Gangbilds unter Dual-task-Bedingungen erfolgt bislang in der Regel während des Geradeausgehens (GG). Der Alltag erfordert jedoch auch komplexere Gangmanöver, wie das Kurvengehen (KG). Möglicherweise werden für solche Gangmanöver höhere Aufmerksamkeitsressourcen benötigt und damit das Gangbild unter Dual-task-Bedingungen stärker beeinträchtigt.

Ziel

Das Ziel war es, das Gangbild während des GG und KG unter Dual-task-Bedingungen zu vergleichen.

Material und Methoden

Bei 30 zu Hause lebenden älteren Menschen (71,6 ± 6,6 Jahre) wurden die Gangparameter Einbeinstandphase, Geschwindigkeit, Kadenz, Schrittlänge und Spurbreite jeweils unter Single- und Dual-task-Bedingung für das GG und KG über elektronische Ganganalyse (GAITRite®, CIR Systems Inc., Franklin, New Jersey, USA) untersucht. Für alle Gangparameter wurden die relativen Veränderungen von der Single- zur Dual-task-Aufgabe als Dual-task-Kosten (DTK) berechnet und über gepaarte t‑Tests verglichen.

Ergebnisse

Für die Einbeinstandphase, Geschwindigkeit, Kadenz und Spurbreite zeigten sich deskriptiv höhere DTK während des KG (2,08–23,74 %) im Vergleich zum GG (1,39–12,90 %). Für Kadenz (DTK: GG: 6,81 ± 12,58 %, KG: 10,54 ± 13,46 %, p = 0,026) und Spurbreite (DTK: GG: −12,90 ± 18,01 %, KG: −23,74 ± 56,37 %, p = 0,004) waren die Unterschiede signifikant.

Diskussion

Unter Dual-task-Bedingungen wird das Gangbild während des KG stärker beeinträchtigt als während des GG. Diese Ergebnisse lassen darauf schließen, dass KG höhere Aufmerksamkeitsressourcen erfordert als GG. Möglicherweise ist dadurch insbesondere beim KG unter Dual-task-Bedingungen das Sturzrisiko erhöht. Die vorliegenden Ergebnisse dienen der Entwicklung neuer, ökologisch valider Assessment- und Trainingsansätze, welche komplexe Gangmanöver miteinbeziehen.

Abstract

Background

Walking is not an automatic movement task but requires continuous attention resources. While walking and undertaking an additional task (dual tasking), gait changes occur which are associated with falls in older adults. To date, the evaluation of gait characteristics under dual task conditions is typically performed during walking straight ahead (SW); however, everyday life also requires more complex walking maneuvers such as walking in a curve (CW). Complex walking maneuvers may require higher attentional resources and thus might have a greater impact on the gait under dual task conditions.

Objective

The aim was to compare the gait characteristics under dual task conditions during SW and CW.

Material and methods

In 30 community-dwelling older adults (mean age: 71.6 ± 6.6 years) gait parameters including single leg support phase, velocity, cadence, step length and width were measured by electronic gait analysis (GAITRite®, CIR Systems Inc., Franklin, New Jersey, USA) during SW and CW under single and dual task conditions. For each gait parameter the relative change from single to dual task condition was calculated as dual task costs (DTC) and compared using paired t‑tests.

Results

For the single leg support phase, velocity, cadence and step width, descriptive results showed increased DTC during CW (2.08–23.74%) as compared to SW (1.39–12.90%). For cadence (DTC: SW 6.81 ± 12.58%, CW 10.54 ± 13.46%, p = 0.026) and step width (DTC: SW −12.90 ± 18.01%, CW −23.74 ± 56.37%, p = 0.004) the differences were statistically significant.

Conclusion

The relative decline in gait performance under dual task conditions is greater during CW than during SW. The results suggest that CW requires greater attentional resources as compared to SW. In turn, the risk of falling might be increased during CW under dual task conditions. The present findings may contribute to the development of new, ecologically valid assessment and training strategies taking complex walking maneuvers into account.

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Danksagung

Diese Studie wurde von der Klaus Tschira Stiftung unterstützt.

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Authors and Affiliations

  1. Netzwerk AlternsfoRschung, Universität Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Deutschland

    Katharina Gordt, Thomas Gerhardy &  Michael Schwenk

  2. Institut für Sport und Sportwissenschaft, Universität Heidelberg, Heidelberg, Deutschland

    Christina Müller &  Michael Schwenk

Authors
  1. Katharina Gordt
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  2. Christina Müller
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  3. Thomas Gerhardy
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  4. Michael Schwenk
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Correspondence to Michael Schwenk.

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Interessenkonflikt

K. Gordt, C. Müller, T. Gerhardy und M. Schwenk geben an, dass kein Interessenkonflikt besteht.

Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Katharina Gordt und Christina Müller teilen sich die Erstautorenschaft.

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Gordt, K., Müller, C., Gerhardy, T. et al. Einfluss von Dual-Tasking auf das Geradeaus- und Kurvengehen älterer Menschen. Z Gerontol Geriat 52, 673–679 (2019). https://doi.org/10.1007/s00391-018-01482-3

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  • DOI: https://doi.org/10.1007/s00391-018-01482-3

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