M Montero-Odasso1, Y Sarquis-Adamson2, N Kamkar3, F Pieruccini-Faria4, N Bray5, S Cullen6, J Mahon7, J Titus8, R Camicioli9, M J Borrie10, L Bherer11, M Speechley12. 1. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada. Electronic address: mmontero@uwo.ca. 2. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada. Electronic address: ysarquis@uwo.ca. 3. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada. Electronic address: Nellie.Kamkar@sjhc.london.on.ca. 4. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada. Electronic address: Frederico.Faria@sjhc.london.on.ca. 5. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada. Electronic address: nbray2@uwo.ca. 6. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada. Electronic address: scullen8@uwo.ca. 7. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada. Electronic address: jmahon7@uwo.ca. 8. Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON, Canada. Electronic address: jtitus6@uwo.ca. 9. Department of Medicine (Neurology) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: rcamicio@ualberta.ca. 10. Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada. Electronic address: michael.borrie@sjhc.london.on.ca. 11. Department of Medicine, Université de Montréal, Montreal, Quebec, Canada; Montreal Heart Institute, Montreal, Quebec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, Quebec, Canada. Electronic address: louis.bherer@umontreal.ca. 12. Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada. Electronic address: mark.speechley@schulich.uwo.ca.
Abstract
BACKGROUND/ OBJECTIVES: Slow gait speed prospectively predicts elevated risk of adverse events such as falls, morbidity, and mortality. Additionally, gait speed under a cognitively demanding challenge (dual-task gait) predicts further cognitive decline and dementia incidence. This evidence has been mostly collected using electronic walkways; however, not all clinical set ups have an electronic walkway and comparability with simple manual dual-gait speed testing, like a stopwatch, has not yet been examined. Our main objective was to assess concurrent-validity and reliability of gait speed assessments during dual-tasking using a stopwatch and electronic walkway in older adults with mild and subjective cognitive impairment (MCI and SCI). DESIGN: Cross-sectional, reliability study. SETTING: Clinic based laboratory at an academic hospital in London, ON, Canada. PARTICIPANTS: 237 walk tests from 34 community-dwelling participants (mean age 71.84 SD 5.38; 21 female - 62%, 13 male - 38%) with SCI and MCI. were included from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. INTERVENTION: Each participant performed seven walk tests: three single gait walks at their normal pace, three dual-task walks (walking and counting backwards by one, by sevens, and naming animals), and one fast walk. MEASUREMENTS: Gait speed (cm/s) for each walk was measured simultaneously with an electronic walkway (Zeno Mat®) and a handheld stopwatch (Ultrak chronometer®). Dual-task cost (DTC) was calculated for the three individual dual-task walks as [((single gait speed - dual-task gait speed) / single gait speed) ∗ 100]. Level of agreement between the two measurement methods was analyzed using Pearson correlations, paired t-tests, and Bland-Altman plots. RESULTS: Gait speed was consistently lower when measured with the stopwatch than with the electronic walkway (mean speed difference: 10.6 cm/s ± 5.1, p < 0.001). Calculating DTC, however, yielded very similar results with both methods (mean DTC difference: 0.19 ± 1.18, p = 0.872). The higher the DTC, the closer the measurement between methods. CONCLUSION: Assessing and calculating DTC with a stopwatch is simple, accessible and reliable. Its validity and reliability were high in this clinical sample of community older adults with SCI and MCI.
BACKGROUND/ OBJECTIVES: Slow gait speed prospectively predicts elevated risk of adverse events such as falls, morbidity, and mortality. Additionally, gait speed under a cognitively demanding challenge (dual-task gait) predicts further cognitive decline and dementia incidence. This evidence has been mostly collected using electronic walkways; however, not all clinical set ups have an electronic walkway and comparability with simple manual dual-gait speed testing, like a stopwatch, has not yet been examined. Our main objective was to assess concurrent-validity and reliability of gait speed assessments during dual-tasking using a stopwatch and electronic walkway in older adults with mild and subjective cognitive impairment (MCI and SCI). DESIGN: Cross-sectional, reliability study. SETTING: Clinic based laboratory at an academic hospital in London, ON, Canada. PARTICIPANTS: 237 walk tests from 34 community-dwelling participants (mean age 71.84 SD 5.38; 21 female - 62%, 13 male - 38%) with SCI and MCI. were included from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. INTERVENTION: Each participant performed seven walk tests: three single gait walks at their normal pace, three dual-task walks (walking and counting backwards by one, by sevens, and naming animals), and one fast walk. MEASUREMENTS: Gait speed (cm/s) for each walk was measured simultaneously with an electronic walkway (Zeno Mat®) and a handheld stopwatch (Ultrak chronometer®). Dual-task cost (DTC) was calculated for the three individual dual-task walks as [((single gait speed - dual-task gait speed) / single gait speed) ∗ 100]. Level of agreement between the two measurement methods was analyzed using Pearson correlations, paired t-tests, and Bland-Altman plots. RESULTS: Gait speed was consistently lower when measured with the stopwatch than with the electronic walkway (mean speed difference: 10.6 cm/s ± 5.1, p < 0.001). Calculating DTC, however, yielded very similar results with both methods (mean DTC difference: 0.19 ± 1.18, p = 0.872). The higher the DTC, the closer the measurement between methods. CONCLUSION: Assessing and calculating DTC with a stopwatch is simple, accessible and reliable. Its validity and reliability were high in this clinical sample of community older adults with SCI and MCI.
Authors: Yohanna MejiaCruz; Jean Franco; Garret Hainline; Stacy Fritz; Zhaoshuo Jiang; Juan M Caicedo; Benjamin Davis; Victor Hirth Journal: Curr Geriatr Rep Date: 2021-01-20
Authors: Juan Antonio Párraga-Montilla; Diana Patricia Pozuelo-Carrascosa; Juan Manuel Carmona-Torres; José Alberto Laredo-Aguilera; Ana Isabel Cobo-Cuenca; Pedro Ángel Latorre-Román Journal: Int J Environ Res Public Health Date: 2021-03-25 Impact factor: 3.390